After the 90s, antipsychotics began to be prescribed carelessly even to non-schizophrenics
In the late 80s and 90s, new SSRIs began to sell widely and rapidly. The newer generation of atypical antipsychotics (Risperdal, Zyprexa, Seroquel), introduced in the mid-1990s, are an even more astounding and frightening marketing triumph. Initially they seemed a big step forward—not in efficacy, but in having a much more favorable side effect profile. A patient on traditional antipsychotics had an absolutely characteristic look, easily spotted from far down the hallway—the fixed stare, rigid posture, tremors, abnormal movements, and drooling were dead giveaways. Switched to an atypical, the patient looked and often felt much more normal. Soon these much easier to give and easier to take drugs were climbing to the top of the charts, beating all sales records.
This couldn’t have been accomplished within the confines of the narrow schizophrenia market. First, the drug companies had to get an indication for bipolar disorder and then they had to advertise a conception of bipolar disorder so broad as to be unrecognizable. Antipsychotics were soon being prescribed promiscuously, even by primary care physicians, to patients with garden-variety generalized anxiety, sleeplessness, and irritability. The paradox is that dangerous drugs capable of causing massive obesity, diabetes, heart disease, and a shortened life span now account for $18 billion a year in sales.
Primary care physicians are prescribing potentially dangerous medications, outside their competence, for people who should not be taking them. Proof again that drugs that are too easy to give and too easy to take will be taken far too often, especially when the lots of money is behind them. In retrospect, the unpleasant side effect profiles of early psychiatric drugs had the value of preventing their overuse and of keeping diagnostic inflation in check.
References
- Frances, Allen. (2013). Saving Normal CHAPTER 3. Diagnostic Inflation (p. 127). New York, NY: HarperCollins.
Metadata
Type:🔴 Tags: Psychiatry Status:☀️