Try a Psychiatric Medication New to the Market? Think Twice

Every year brings several new medications approved for treating mental illness to the market. With the medications come marketing efforts aimed to recruit physicians to prescribe these new medications. This appears to be a hopeful development!

Sadly, there are reasons to pause before trying new to the market medication. One reason is that most “new” medications are new twists on old medications. These twists generally don’t make the medications better, but they do give the medications protection from competition with generic versions. This protection from competition allows pharmaceutical companies to charge high prices for the “new” medication – 10 times as expensive or even more.  You or your insurance company pay a lot more for a medication that offers at best marginal improvements. This is not a good deal.

Secondly, these medication are marketed to physicians as “better” than old medications, but there is rarely scientific data to justify those claims. I recently met with a salesperson who told me how a recently released medication is better than the older medication (now available as a generic so no longer generating big profit margins) from his company he was comparing it to. Better? I asked for data backing up that claim. He laughed and acknowledged there was no head to head study that demonstrated that the new medication worked better than any of the old medications in its class. He pointed out subtle differences in receptor activity that theoretically make it better. He also indicated some animal studies suggest it is better. I do not see either of these as proof or even good evidence of improvement.

Third, we don’t know the long term safety of a new medication. I do not want to be a test subject for long term side effects unless there is a good reason for it. I don’t want my patients to be unnecessary test subjects either.

So, until a medication has been on the market a few years OR there is scientific (not anecdotal or theoretical) evidence to support it as more effective, it may be better to use older medications instead. They are likely less expensive, as effective, and quite possibly safer.