5 Major Classes of Psych Drugs
Question #1
Most Common Disease (point prevalence)
Question #1
Most Common Disease
Somatic vs.
Psychiatric
Lifetime Prevalence - USA
Question #2
Top Selling Drug Class in the U.S.A.
Question #2
Top Selling Drug Class in the U.S.A.
U.S. Drug Sales 2009
[IMS Health]
# of U.S. Prescriptions -
2009
[IMS Health]
U.S. = 4.5 % of world population
U.S.A.: Psychiatric Drugs 2009
[Source: Express Scripts 2009 Drug Trend Report]
Question #3
Leading Cause of Death in the U.S.A.
Question #3
Leading Cause of Death in the U.S.A.
Institute of Medicine
(1999)
44,000 to 98,000 dead from errors
Reality Check: # of deaths (2006)
Public MH patients = 5.9 million per year
High Rate of Health
Disorders
SMI Compared to Non-SMI Groups
Maine Medicaid – 2004
Burden of Medical
Illness:
Maine Medicaid 2004
Psychiatric Drugs á the Odds of Disease
≥ 65 years of
age
12% to 18% to 21%
U.S. Drug Sales – 2009 ($ billions)
Dept. of Veterans
Affairs
Kales et al (2007)
"12,821 avoided psychiatric drugs"
"Other folks started to notice..."
Black Box
Warnings
“not for dementia-related psychosis”
U.K. - DART-AD
Dementia AP Reduction Trial
Outcomes Based Upon
Continuing
Use of Drugs vs. Placebo
Antipsychotic drugs are
deadly for
dementia patients…
How Do Doctors Diagnose Alzheimer’s Disease?
Do Antipsychotic Drugs Cause Alzheimer’s Disease ?
"2002 Bozikas – 18 schizophrenia..."
apoD is marker of neuropathology
Thomas et al (2001)
autopsy study of brain levels of apoD (ug/mg)
Other Postmortem Studies
rabbits, rats, monkeys, guinea pigs
University of Pittsburgh
(2005, 2007, 2008)
Old and new
antipsychotics
all increase Alzheimer’s proteins…
NIMH / UCLA study
child onset schizophrenia
Multiple brain scans > age 13.5 to 18
Reduced Exposure to
APs
no gray matter deficit in temporal lobe