Frightening report on the ABC about dangers of anti-psychotic drug Seroquel

Concerns grow over top-selling drug's side effects. 7.30.
Australian Broadcasting Corporation
Broadcast: 27/11/2013
Reporter: Louise Milligan
http://www.abc.net.au/7.30/content/2013/s3900419.htm

http://www.abc.net.au/news/2013-11-27/growing-concerns-over-side-effects-of-seroquel/5120554

"....doctors are warning the drug is being massively overprescribed and the potentially dangerous side-effects are being ignored."

This is a shocking and important report. Nice work Louise. 

The drug Quetiapine (brand name Seroquel) stands out among other anti-psychotic drugs for two reasons: the astronomical increase in the rate of prescription of this drug in the last ten years in Australia far outstrips the rates of prescription of other anti-psychotic drugs, and the measured rate of cases of serious harm to patients from side-effects of the drug also far outstrip those of other anti-psychotic drugs. As if that is crazy enough, consider the fact that that this drug is also prescribed for depression even though it comes with an increased risk of suicide compared to other anti-psychotic drugs. Something must be seriously wrong with medicine in Australia when increased potential for harm sit alongside spectacular prescriber popularity. 

Grave concerns about side effects are by no means the only reason why this drug has been hitting the headlines in the last few years. Readers of this blog might recall that the celebrity psychiatrist Prof. Patrick McGorry tried to trial this drug on patients thought to be at risk of developing psychosis in 2011 in a trial that was known as the NEURAPRO-Q study, but that study was closed down following objections from McGorry’s international peers. The drug has also been the subject of a deluge of litigation in the United States, which should surprise no one. So why does this drug continue to elicit such huge popularity with Australian doctors, and is even sought after by some as a drug of abuse? I think there’s no over-estimating the power of marketing and there’s no under-estimating the common sense of my fellow Australians. 

Nice work, Tony.

My amazement has grown over the way that journalists at the ABC's current affairs TV program Lateline have firmly challenged the inappropriate use of anti-psychotic drugs by Australian doctors and psychiatrists. In fact a very good argument could be made that there is no appropriate application of these dangerous and harmful drugs, but I think it would be too much to expect that this argument should be found on Australian TV.

In 2011 Tony Jones interviewed the powerful Irish-Australian psychiatrist Professor Patrick McGorry. At the time I thought this interview was informed but too soft, and the findings of research that has been done since this interview has shown that much of what McGorry claimed about the effectiveness and evidence-base of the interventions he has been advocating for many years was wrong. In 2012 Tony Jones appeared to be quite personally inflamed when he reported about elderly dementia patients having their lives shortened in Australian nursing homes because of the widespread over-prescription of anti-psychotic drugs.

The last couple of editions of Lateline have examined the issue of a 600 per cent increase in the use of the anti-psychotic drug Seroquel in just five years by Australia's Department of Defence, presumably for the treatment of post-traumatic stress disorder (PTSD) in soldiers. Allegations have been made that this drug is being used instead of proper and expensive psychological interventions, is being prescribed in dangerous high doses and is being prescribed inappropriately to treat insomnia symptoms of PTSD. Last night Tony Jones was steadfast in asking questions, recounting evidence and seeking answers in an interview with a clearly very irritated senior person in the Australian Defense Force, our Commander Joint Health and the ADF Surgeon General. The interview was a pleasure to watch. I am sure that there are heaps of journalists who would not have had the confidence to question the practices and administration of a qualified doctor and senior bureaucrat on an issue about the rights or wrongs of medical/psychiatric clinical practice. I am sure that many journalists would simply defer to authority, or be too intimidated to be seen questioning that great sacred cow of Australian popular culture; the "mental health" industry. Not Tony Jones. A good journalist should be hot on the inside, cool on the outside, filled to the brim with all the relevant facts, and able to recognize the truth beyond personal agendas. I think Mr Jones approaches that ideal. Nice work Tony.

Prof McGorry's pet theory loses battle with reality

I've only just found out about the online publication in late November of last year of a study by former Australian of the Year and influential psychiatrist Prof. Patrick McGorry and his research team, which tested the prof's pet theory that elevated risk for developing psychosis can be identified in young people and treated in an early intervention to prevent a conversion to mental illness.The subjects of the trial were 115 young clients of a PACE clinic in Melbourne. Two supposedly effective forms of intervention were tested: the neuroleptic antipsychotic drug risperidone and cognitive therapy. McGorry's team had planned a couple of years ago to trial a different antipsychotic drug, but that trial was abandoned after complaints from other mental health experts. In this trial only a low dose of the drug risperidone was trialed. Three different combinations of drug or placebo and talking interventions were trialed (check the details for yourself), one being only placebo with "supportive therapy". No significant difference in results was found between the three groups. The supposedly effective interventions apparently weren't found to be any more effective than placebo and a nice chat, and as any true expert in the field of trying to predict risk for developing psychosis could have predicted, a large majority of the youths that had been labelled as being at "ultra-high risk for psychosis" did not become psychotic within the year that the trial was run. Call that ultra-high risk? I certainly don't! The sky isn't falling Henny Penny, and your interventions don't work!

Patrick D. McGorry, MD, PhD; Barnaby Nelson, PhD; Lisa J. Phillips, PhD; Hok Pan Yuen, MSc; Shona M. Francey, PhD; Annette Thampi, MRCPsych; Gregor E. Berger, MD; G. Paul Amminger, MD; Magenta B. Simmons, BA; Daniel Kelly, Grad Dip (Psych); Andrew D. Thompson, MD; and Alison R. Yung, MD (2012) Randomized Controlled Trial of Interventions for Young People at Ultra-High Risk of Psychosis: Twelve-Month Outcome. Journal of Clinical Psychiatry. Submitted: March 16, 2012; accepted September 13, 2012. Online ahead of print: November 27, 2012 (doi:10.4088/JCP.12m07785).
http://article.psychiatrist.com/dao_1-login.asp?ID=10008115&RSID=3876442436586

Thank you Neuroskeptic for the interesting blog post about the trial:

Neuroskeptic (2012) Neither Drugs Nor Therapy Prevent Psychosis. Neuroskeptic. December 15th 2012.
http://neuroskeptic.blogspot.co.uk/2012/12/neither-drugs-nor-therapy-prevent.html