How the World of the Atypical Passed Me By–and How I Could Use Your Help

Posted on September 16, 2012 by


I blithely wrote a post for my blogging day job on the atypical antipsychotics, cleverly (or so I thought at the time, at least) entitling it “The Atypical History of Atypical Antipsychotics,” and I covered what I considered the big guns among the atypicals: Clorazil, Zyprexa, Risperdal, Seroquel, Geodon, and Abilify.

Little did I know that I was years behind the times.

For though these drugs still hold the lion’s share of the atypical market, drug makers have been working doggedly to make atypical antipsychotics with better side effect profiles, and have been coming out with new ones–behind my back it seems–for years now.

Three in particular caught my eye–and if anyone is on them or has experience with them, I’d love to hear your input about these meds, that feel so foreign to me, after my years of being used to the Big 6, as I call them. In other words, I’d love to actually know what I’m talking about.

Let me start with the three that jumped out and bit me just the other week.

Invega was FDA approved in 2007 for schizophrenia, so it would be perfectly shameful that I know so little about it, except that it’s one of those ‘change a little thing and get a whole new patent’ evergreening jobbies, so it’s not like I missed a major shift in the pharmaceutical industry.

Put out by Janssen right as its Risperdal was losing patent, Invega contains the active compound of Risperdal, but allows for once a day dosing, vs the twice a day dosing of the older drug. Of course that’s connected to Janssen’s Consta, which is, again Risperdal, but can be given intramuscularly (and thus needed a whole new patent).

So perhaps for something a little more novel.

Saphris, made by a company I’ve surely never heard of called Catalent UK Swindon Zydis Ltd,  is marketed and distributed by one I have heard of–Schering Corporation–and was FDA approved in 2009 for both schizphrenia and bipolar disorder, the very first psychotropic drug ever to receive initial approval for both indications at the same time.

Saphris is the only antipsychotic delivered sublingually–and you can even get it in black cherry-flavor, which is a big sell in my book.

Clinical trials were not stellar, particularly, and were a bit hard to interpret since the data was released quite light, but there seems to be less weight gain associated with it than with Zyprexa, one of the drugs it went head to head with in the trials–although there still is weight gain, and dizziness and akathisia are also apparently common.

It is clearly a good choice for people with swallowing difficulties, as it’s the only atypical with sublingual distribution.

I’m quite interested in people’s experiences, and if anyone found it, indeed, more effective than one of the older atypicals.

Finally there’s Latuda, approved for schizophrenia in 2011.

Put out by Sunovian Pharmaceuticals, by the time Latuda made its arrival in drugstores, it had more than its fair share of competition, including a leading generic (Risperdal had already lost patent and morphed into risperidone, at a fraction of the original price), plus promises of more generics speedily on their way.

Well, as the strippers in ‘Gypsy’ knew, ‘you gotta have a gimmick,’ and Latuda’s got one that could make it a contender yet: It purportedly doesn’t have the weight gain associated with the atypicals, although the numbers supporting this assertion are small.

Fierce Pharma made a good point about that issue, which I update in brackets: “The company has priced Latuda at $14 per pill [it's $18.41 at the local CVS], or about $5,000 per year. In addition, Eli Lilly’s Zyprexa goes off [done deal--it went off] patent later this year, and AstraZeneca’s Seroquel loses exclusivity in early 2012 d. Both have been linked to weight gain, but will patients and payers be willing to pay the price for a new brand, on the promise that it won’t?”

Would you?

Have you?

Well, that’s enough for me for one day, of addressing drugs that just pop up with no warning.

But, you might say, what of the other atypicals you apparently never mentioned in your original post. What of Fanapt, what of Solian, what of Remoxipride, and more?

Well, I’m worn out for the moment by finding out about all these drugs sneaking onto the market without my knowledge. But I’d sure love to come back tomorrow and find a comment telling me I’d better get at it and check out one of them, since it’s the best thing since sliced bread.

Failing that–I’ll get around to it.