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Antipsychotic Set For Approval For Depression, Anxiety Has Big Problems

Most of you are well aware that AstraZeneca has been trotting out data--not especially impressive data BTW--touting its antipsychotic Seroquel as a treatment for depression and generalized anxiety disorder. The drug is already approved for treating schizophrenia, mania in bipolar disorder and bipolar depression. It is widely used off label for treating sleep problems, agitation, anxiety, depression, public speaking anxiety (bring back Toastmasters!), ADHD and so on. It rings up about $4 billion a year in sales and AZ is determined to wring every nickel possible out of this molecule, especially since it's not a particularly good performer in treating schizophrenia as the 2005 CATIE study showed.

What strikes me as strange is how the media has largely given the drug's many well-known problems a free pass and has instead largely parroted AZ's press spin in announcing the depression and anxiety data the company presented at the APA on Monday. Here's an example from WebMD.com wherein the "reporter" (or would that be copywriter?) details the new data on the drug and ignores its propensity to induce rapid weight gain in patients and cause diabetes and all sorts of fun extra pyramidal symptoms as well as daytime somnolence. Instead, she sticks to the AZ script.

Why does that piss me off? First, a lot of people read WebMD.com. It is the number 34 website in the world, according to quantcast.com, as it's read by an estimated 19 million unique readers a month. Regardless of what one thinks of websites like WebMD (I think it largely blows), it's clear that the public is paying attention to the site's prose. The public certainly deserves more complete information about any drug the site writes about. Second, the Seroquel article on WebMD was allegedly reviewed by a doctor. One has to wonder precisely what kind of doctor would let pass an article that doesn't even offer the most basic set of information about the drug, especially since Seroquel's problems are well documented. Third, you also have to wonder what kind of media ethics and editorial oversight are in use at the company if that's the kind of prose they feel compelled to offer the public.

In short, WebMD is not being fair to the experiences of the many millions of people who have taken this drug and run into problems on it. And, fairness much less objectivity is supposed to be the hallmark of the mainstream media and WebMD clearly flunks that test. You can read my own writing about this drug here. While I don't always acknowledge that some people do derive benefits from the drug, no one really expects me to since blogs are supposed to be the metaphorical equivalent of an old school newspaper column and they are not required to be as fair-seeming.

What blows my little mind is that WebMD makes no mention of the fact that AZ faces a large class action lawsuit in federal court in Florida over its handling of the drug and that the drug is sometimes converted into a drug of abuse by crushing it and snorting it or by melting it down with cocaine and shooting it (a Q-ball). The drug already has some catchy street names such as Susie Q and Quell and is a favorite of prisoners. For WebMD to pretend that such information wouldn't be important to the casual reader looking for information on the drug is galling. This is basic stuff that most any responsible journalist would find a way to slide into an article on the drug, pro or con.

And it's websites like WebMD that have helped drive thousands of journalists out of their jobs. Keep that in mind every time you read its prose. These are the clowns driving hardworking people out of their jobs and they are doing a bad job of replacing them. Personally, I trust WebMD about as much as I'd trust adders fanged, to steal from Shakespeare. The article doesn't even mention that the "studies" it cites are in fact unpublished (meaning the data has technically not passed peer review yet) and that the data it pimped at the APA is little more than averages of each arm of the placebo controlled studies, not a report of what percentage of patients in which arm saw how much benefit from the drug. That's just lame.

The sad fact is that I get dozens of hits to this site each week from readers searching for information on "shooting seroquel," "snorting seroquel," "Susie Q" and the like. Teens have been arrested around the country for dealing the drug.

And that's just really strange for a drug that is on the verge of being approved to treat depression and anxiety. And it's strange that the mainstream media--online and offline--hasn't noticed. Weirder still: I've recently begun to get stray hits from people searching for information about "snorting Abilify." I kid you not.

Or am I wrong to be bothered by any of this?

Posted by Philip Dawdy