Posted by med_empowered on October 2, 2005, at 12:54:31
In reply to Re: Perphenazine, Trilafon for Antipsychotic, posted by Phillipa on October 1, 2005, at 22:52:07
yup. Apparently, they chose this drug as the "conventional" comparison med...interestingly enough, in an interview I read, one of the study researchers said initially they weren't even going to include an old drug; they just assumed that it would come up very substandard, and the side-effects would throw off the double-blind set up. Wow...scary stuff; since when has it become OK to just "assume" stuff like that in modern medicine? (Remember the old saying about assuming: makes an *SS out of U and ME). Anyway, somebody got the brilliant idea to use perphenazine/Trilafon as the comparator drug b/c it's medium potency (fewer obvious EPS than, say, Haldol, but much less sedation than Thorazine) and it apparently has a rep. for being milder than some of the other old drugs (which runs against the current line that "all the old drugs are the same"). From what I understand, perphenazine used to be pretty popular as an augmenting agent for antidepressants in Triavil/Etrafon, where it was mixed with Elavil (that was in the early 60s; interesting how almost 40years later, symbyax comes out and is "the first drug of its kind"). Low-dose Triavil was considered good for "agitated depression" (probably a bipolar mixed-state), psychotic depression, and depression with high-grade anxiety...it was also used in depression in schizophrenia (which has been historically under-recognized; also, lots of people DX'd as schizophrenic back then would be considered bipolar under today's diagnostic criteria, so it really was the Symbyax of yesteryear). Anyway, I'm discouraged that today's new, fancy, heavily-advertised and incredibly expensive drugs can't even outperform perphenazine, which has been around since 1958 or 1959...its a sad statement on the pharmaceutical industry that they'd milk desperate patients and families for $$$ while delivering drugs that aren't any better than the old ones. I think it's also a damning indictment of the psychiatric profession that they'd buy into all the hooplah and take over a decade to demand some solid, substantial evidence of the superiority of these new drugs. **sigh** Oh well. BTW- I haven't actually seen the study; I've only read about it...did they analyse the rates of tardive dyskinesia? I'd be really interested to know how perphenazine did in that area compared with the new drugs.
poster:med_empowered
thread:561772
URL: http://www.dr-bob.org/babble/20050927/msgs/561937.html