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.

 

Prebiotics…

There is an increasing level of attention on the relationship between the health of our digestive system and our emotional health. There have been studies looking at the impact of prebiotics on the emotions of people as well as mice. Prebiotics have been associated with a reduction in anxious behavior. This is a long way from showing prebiotics are a proven treatment to decrease anxiety in humans, but the possibility is intriguing.

What are prebiotics? These are components in food which are hard for our intestines to digest, but are broken down by bacteria in the lower intestine. Prebiotics include fructo-oligosaccharides (FOS) and galacto-oligosaccharides (GOS). When they are present in the diet, the intestines tend to have a healthier spectrum of bacteria present.

What foods contain prebiotics? Many fruits and vegetables. Bananas, garlic, onion, asparagus, artichokes, and beans are rich in prebiotics. Because prebiotics are broken down in the lower intestine, some people tolerate them better than others. If adding these foods to your diet causes abdominal distress, cramping, or diarrhea, be sure to consult your physician.

While there is not a clear causal connection between prebiotics and mood in humans, we know fruit, vegetables, and legumes are important cornerstones of a healthy diet. Perhaps with time we will learn exactly how prebiotics may have a role in maintaining our emotional health as well.

Blog Returns

It has been a very busy 12 months here at C2 Your Health. For those of you who see us, we have moved to a new building. This has been a big adventure and source of stress for Christine and I. Things are finally starting to calm down… the building is open, we have new sod, and I am back to blog.