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CoffeeBean

Seroquel looks like best bet for AP monotherapy for Bipolar

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So while I wasn't able to find anything explaining just how exactly APs are supposed to help with mood, I did find this:

http://www.medscape.org/viewarticle/554128

And from this it looks like only Seroquel has been shown to be able to improve both mania symptoms and depression symptoms in trials. 

So another vote for trying Seroquel for me, since my pdoc is adamant about doing AP monotherapy. 

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14 minutes ago, toast said:

Remember, just because it's approved for an indication does not mean it necessarily correlates to efficacy.

Yes I understand, but it looks like the best bet so far. Latuda made me feel mixed, and Risperdal made me feel depressed/suicidal. Although it could also be more correct to say that Latuda simply did not help with mixed states, and Risperdal simply could not help with depression, as opposed to that they caused it. Basically like they covered one end of the stick but not the other, so it was like my brain just switched gears to the uncovered end.

Since my pdoc is against mood stabilizers and insists on AP monotherapy, I've got to find an AP that can cover both, and so far Seroquel seems to be the only one that showed anything of any significance in that regard.

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 I don't see how you came to your conclusion based on the article. It was a weird article for me because most of the studies were short term and were looking at how good the AAPs are for acute mania,yet in the conclusion it states that depression was a worse problem than mania in treating BP. There were a couple of studies on the depression side, but not much.

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3 minutes ago, dilemma said:

I don't see how you came to your conclusion based on the article.

Yeah I made a few leaps of faith, focusing mostly on what the FDA had approved them for, and assuming that there were at least some studies that swayed the FDA.

It's also entirely possible that FDA corruption allowed such approvals without any solid evidence, but that would get a little bit into conspiracy theory type territory, which tends to be frowned upon in mental health peer support communities.

So if I start with the assumption that the FDA approved the use of these meds for the checked-off mood states listed, due to at least some significant evidence in studies, then Seroquel would still look like the best bet to try next. 

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4 minutes ago, uncomfortable thoughts said:

Theory, right.

FDA are made by humans, they make mistake and are corrupted, to push a new drug up for MI disorder would take a bunch of cash.

Just do a quick research about generic drug scandal, tobacco regulation, buyers club...

Yes I understand, but different communities have different cultures, some are okay with discussing things like that, some will shout you down and call you anti-psychiatry. Takes me a little while to figure out a new community.

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Why are you talking about "FDA corruption" like it's a fact? Do you have some evidence that the rest of us don't have?

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17 minutes ago, uncomfortable thoughts said:

Besides what's already out there I don't have any new evidence, just basing my arguments into human behavior and the pattern of the agency tough history.

I'm sorry, that was directed towards the OP, CoffeeBean since he was the first to introduce the idea of FDA corruption.

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1 hour ago, jt07 said:

Why are you talking about "FDA corruption" like it's a fact?

 

3 hours ago, CoffeeBean said:

It's also entirely possible that FDA corruption allowed such approvals

 

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Hate  to tell you but those images of early meds were pre-FDA The FDA was founded to do something about them. They were called patient medications.

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Monotherapy for bipolar is an unicorn at best. You have also made broad assumptions and made a mess of a logical argument 

Edited by notloki

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I wrote a somewhat lengthy reply, but for some reason my phone ate it.  I'll summarize some thoughts, which given the condensed version might not be as coherent.

-I'd think that the possibility that a few individuals at the FDA were potentially incompetent (approved something based on bad evidence, didn't question the data they received appropriately, etc.) is a lot more likely than that there is vast corruption.  Maybe I have too much faith in humanity, but I'd like to think that at least a majority of people can't be bought.  If that's true--I couldn't imagine a pharmaceutical company risking its entire livelihood on a hope that every single person involved in the approval chain can be bought.  Because I would tend to think that were it discovered, it wouldn't necessarily only impact the drug they were applying for but potentially others.  Even if it didn't--it's not like one person reviews an application and then it's approved, or at least that seems highly, highly unlikely.  I can't see a sane reason to believe that the manufacturer would bank on each person being bribe-able. 

-I'm not suggesting that all government people are angels or that there wouldn't be someone who could be bought if the price was right or blackmailed if the stakes were too high.  I just think that given the likelihood that it's multiple people, the chances are much more slim.  Although I have not worked for FDA, FBI, or CIA, I would think that the intelligence positions would be slightly easier because of their relative degree of independence and autonomy.  Not that everyone there is a spy against the US or what have you...but it seems like it might be easier to have happen.

I will agree and won't argue with you that what's above relies on a lot of guesswork and assumptions...but so do the conspiracy theories against the FDA, unless you have proof that it's happening and a reason for not turning that info over (to people who could do something, not to CB).

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At least pharmacticals have to test drugs and demonstrate they have some efficacy. Thank God we live in a world that has resperidal and Prozac. Supplements on the other hand are not tested and don't have to prove effectiveness. Yes yes pharmacticals do bad things like suppressing evidence that zyprexa could cause diabetes but they have given me meds that have given me back my life. I'll take clozapine over crackpot science anyday.

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