it is interesting how we keep getting more and more antipsychotics being prescribed more and more broadly. Meanwhile my friend who has schizophrenia is frustrated because nothing has really ever been better for him than zyprexa and he still hears voices and has delusional beliefs. Meanwhile he struggles with weight gain, experiences sedation, has constant thirst, and some impairment in cognition. He has an extremely high IQ and is connected to a very strong supportive network so is able to reason this stuff out fairly well compared to the majority of the patients I have known with schizophrenia. One thing he said to me was that the medication is like a shotgun targeting things throughout his brain and what he really needs is someone to develop a medication that is more like a sniper rifle that targets the part of his brain that malfunctions. Pretty insightful for someone who doesn't know any neurobiology. He might even try this Rexulti and probably be disappointed yet again because the marketing is way ahead of the science.[/QUOTE
It's more than just marketing though. It's not like the Rexulti reps are doing anything clever or unique. It's simply a function of the system being broken.....namely, why should medicaid/medicare EVER pay for a drug like Rexulti? That is so absurd on so many levels.
The question we should all be asking is- how many of my patients that have a longstanding dx of a psychotic d/o are being helped by their meds? And how could we work on better identifying those patients? And even amongst those patients, how long should we treat for? Yes, I know there is a bunch of work towards those questions now(at least one of them), but there really is no concensus standard of care.
