VA spent $717 million on a drug deemed as effective as a placebo

[James48]

Source: Nextgov.com

VA spent $717 million on a drug deemed as effective as a placebo
By Bob Brewin 08/22/2011


Over the past decade, the Veterans Affairs Department spent $717 million for an anti-psychotic drug to treat post-traumatic stress disorder that a recent study shows is no more effective than a placebo.

Data provided by the department in response to a Nextgov query showed that VA doctors wrote more than 5 million prescriptions for risperidone from October 2000, the beginning of fiscal 2001, through June 2010. Risperidone is the generic name for Risperdal, a second-generation anti-psychotic drug originally developed by the Janssen Pharmaceuticals division of Johnson & Johnson to treat severe mental conditions such as schizophrenia and bipolar disorder.

But a paper by VA researchers published Aug. 2 in the Journal of the American Medical Association concluded, "treatment with risperidone compared with placebo did not reduce PTSD symptoms."



Read more: http://www.nextgov.com/nextgov/ng_20110822_6423.php?oref=topstory

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Disappointing that we spend so much on treatments that can't help soldiers.

The best treatment for PTSD, is prevention in the first place.

End war- bring our soliders home.

[Lasher]

1. Good on the VA for checking this out.

The FDA must have dropped the ball when they initially approved the drug.

[MadLinguist]

2. Its pretty clear that neither the VA or anybody else knows much about PTSD treatment effectiveness

The research is still just so murky. At least the VA isn't sweeping it under the rug.
The Institute of Medicine put out a report detailing just how murky.

http://www.iom.edu/Reports/2007/Treatment-of-PTSD-An-Assessment-of-The-Evidence.aspx

[madokie]

5. For me and many like me

it was booze and pot. With a little help from an occasional psychedelic.

[HereSince1628]

11. PTSD vets often self-medicate and have additional addiction problems

The VA actually has a PTSD treatment program targeted at dealing with that.

[Capitalocracy]

13. What little research has been done into the effects of psychedelics

on ptsd is very, very promising. Go light on the booze, it's bad for you (I'm one to talk!) but the pot and the psychedelics are likely to be helping. Just don't get caught, we live in a fascist country.

[madokie]

20. I've quite the drinking

only have a bowl from time to time. Having a grand daughter was what done it for me to quite the etoh. Last thing I want is for my grandy to know me as a drunk like her dad did, I won't let it happen to her. Lungs are the reason for the stopping, for the most part, my toking.

[McCamy Taylor]

21. Not true. Long term behavioral and cognitive therapy work. They just require a lot of $$$

in time spent with therapists. And the patient can not be sent back to combat.

[customerserviceguy]

3. Someday, we're going to look back

on the psychopharamaceutical drug set of today, and conclude that we were no better off than in the days of electroshock therapy.

[RobinA]

6. As Someone Who Works

in a psychiatric hospital, I'm going to have to disagree with this. I am not anti-ECT, and in fact believe that it is probably under utilized, however, I have seen the difference the right medication can make in some people. The drugs are far from perfect and they don't work for everyone, but this is not so say they have no merit at all. There IS a long way to go. Part is better drugs and part is better understanding the nuances of the underlying illnesses.

[hunter]

16. I've got an unfortunate family history of mental illness.

I'm a lot better off than my grandparent's generation (and all the other semi- or dysfunctional lunatics in my family tree) because I've got "psychopharamaceutical" meds that work.

Clearly there are some evolutionary advantages to the autistic-depressed-crazy-crazy gene set in small doses, in much the same way that genes for sickle cell anemia protect against malaria, but the full expression of these genes often have symptoms that are devastating.

A lot of people, myself included, would be entirely dysfunctional without modern meds.

That doesn't mean theses meds are not carelessly, inappropriately, or over-prescribed, but a lot of us are much better off than we would have been in the bad old days of electroshock therapy.

[aquart]

4. Not to mention it has a few swell side effects.

[valerief]

7. Ah, but rich people got richer and that's all that matters in this world. nt

[HereSince1628]

8. The lack of evidence of this drug's effectiveness for PTSD has been known

by the VA for years. Which raises the question--Why would VA psychiatrists continue to prescribe the drug not specifically approved for PTSD?
Only a study of prescibers' decision making could reveal an answer to that question.

However, VA psychiatrists function mainly as prescibers of medication. When a patient is referred to them by psychological staff, there is an expectation that an Rx will be made. It usually is.

In the context of that expectation, with few medications available, it seems quite possible that VA psychiatrists continue to make the choice to prescribe because the class of drugs is reported to reduce strong emotional responses--which at least partly describes the distress of those afflicted by PTSD.

[bertman]

9. Kinda makes me wish I had bought a lot of J & J stock. I'll bet someone at VA and FDA did that.

Signed,

an old vet


REC.

[Spider Jerusalem]

10. I'd honestly think risperidone wasn't a good choice anyway

especially because of the side-effect risks of tardive dyskinesia (permanent and irreversible damage to motor nerves that results in stereotyped jerking movements and so on).

[Recursion]

12. I read something the other day about how the placebo effect is getting stronger

At least as regards psychotropics. It's an open area of research.

[CanSocDem]

14. Back in the day....

...you could get your friend righteously 'stoned' on oregano as long as you observed the prescribed ritual of preparation.

Later on, simplified marketing techniques took over the ruse.....


.

[Recursion]

15. The guy who ran the lab I worked at thought it was that too

Though his point was, rather than keeping the placebo effect as this unwanted black box, physicians need to learn more about it to harness its fairly impressive capabilities.

[truthisfreedom]

17. Placebos are used more often than you'd think.

It's a powerful effect. Even Valium will not reduce anxiety unless administered by an authority figure telling a patient that it will. When given by IV in double-blind studies (with saline solution being used as a control) to volunteers who are anxious, it works only as well as the saline alone. Valium does something, but it does not reduce anxiety per se (any better than water) unless suggestion is included. The following link does not have a complete description of the study done to prove this, but does mention it.

http://disgruntledphd.blogspot.com/2010/07/placebo-response-without-placebos.html

[CanSocDem]

18. Indeed.

Buyers and sellers alike, don't want to be told they're dealing in make-believe.


.

[lonestarnot]

19. k & r!