Sorry, pharma, but when it comes to drugs, newer doesn't always mean better. So why are new drugs prescribed so often? Especially in a disease where an old treatment is actually the so-called "gold standard?" That's what a psychiatrist asks in a New York Times article today. He's wondering why lithium--proven safe and effective over decades of use--is sometimes left out of bipolar patients' drug regiments.
The culprit appears to be "new kid in town" syndrome. You know, when the new kid seems so much better-looking, so much funnier, so nice and kind and fun to be around. The author of the article, Dr. Richard Friedman, says scores of his own patients show up in the examining room, asking for the latest psychotropic meds. Sometimes, these patients are responding to ads they've seen on TV. And sometimes, the best drug for them turns out to be an older med rather than one that's brand new.
Friedman ends up advocating more comparative effectiveness research. What he wants to know is whether new mood stabilizers really show treatment advantages over lithium in head-to-head trials. Or whether older, cast-aside antidepressants such as the tricyclics and MAOI meds are really outclassed by new drug cocktails for "treatment-resistant" depression. Well, these particular trials may not be first on the list for President Obama's comparative efforts, but head-to-head studies are definitely on their way. Let's see how the new drug vs. old drug question plays out then.
- read the NYT story