The PharmacoScientific Creation of Well-Being

Neuroskeptic offers an elegant unpeeling of a study seeming specifically designed to find a marketing-friendly distinction for a drug -- Abilify -- otherwise undistinguished.

Suppose you were a drug company, and you've invented a new drug. It's OK, but it's no better than the competition. How do you convince people to buy it?

You need a selling point - something that sets your product apart. Fortunately, with drugs, you have plenty of options. You could look into the pharmacology - the chemistry of how your drug works in the body - and find something unique there. Then, all you need to do is to spin a nice story to explain how the pharmacological properties of your drug make it brilliant.

On an entirely unrelated note, aripiprazole (Abilify) is an antipsychotic marketed in the US by Bristol Meyers-Squibb. A Cochrane meta-analysis finds that it's about as good as any other antipsychotic in terms of efficacy and side effects. As good, but no better. However, uniquely, aripiprazole is a D2 receptor partial agonist. Other antipsychotics work by blocking D2 receptors in the brain, switching them off (full antagonism). Aripiprazole also blocks D2 receptors, but it activates them slightly in the process (partial agonism).

Is that a good thing? A paper just published says yes - The relationship between subjective well-being and dopamine D2 receptors in patients treated with a dopamine partial agonist and full antagonist antipsychotics. The research in question was funded, by the way, by Bristol Meyers-Squibb. Let's see if it holds up.

Some clean and clear-eyed writing follows, in which Neuroskeptic educates us about dopamine receptors even while exposing a cleverness of study design -- the study manages , absurdly but "not unreasonably," to find a possible lift in well-being without any measured correlations -- that comes close to provoking wonder.

"I leave it to the reader to evaluate this claim," Neuroskeptic concludes, "and to consider how likely we are to progress in our understanding of the brain when so much of the research is funded by organisations with a direct financial interest in certain theories."

More like this

The Teh finally hit the conservative pages of Scrip World Pharmaceutical News. Wyeth's new antipsychotic receives FDA non-approvable letter after fatality August 13, 2007 Scrip The US FDA has issued a non-approvable letter for Wyeth/Solvay's new-generation atypical antipsychotic bifeprunox, which…
In the 1950's, a new class of antipsychotic drugs was discovered: the antipsychotics.   href="http://en.wikipedia.org/wiki/Chlorpromazine" rel="tag">Chlorpromazine (Thorazine®) was the first. By the 1970's, several related compounds had been discovered.  In 1976, it was learned that there is a…
href="http://en.wikipedia.org/wiki/Agomelatine" rel="tag">Agomelatine is a new chemical entity that is nearing approval for treatment of depression.  It was developed by href="http://www.servier.co.uk/aboutus/history.asp" rel="tag">Servier Laboratories; they have entered into an agreement…
The new drug is called iloperidone; the brand name in the USA will be Fanapt.  It is yet another antipsychotic that blocks D2 and 5HT2 receptors.  Although there is no universally accepted way of classifying drugs into families, it will be referred to as an atypical or second-generation…

Cheers for the link -

When I said the result was "not unreasonable", what I meant was that it's theoretically plausible. Although the data are rubbish and don't by any means prove it. This is all too common - dubious data gets published because "the conclusion is plausible"...