Doctors Say New Mental-Health Drugs Face Patients' Resistance
Bloomberg News
November 10, 1998, 1:16 p.m. ET
Paris, Nov. 10 (Bloomberg) -- Doctors departed from Europe's
biggest psychiatric conference, armed with the latest research
that may help persuade patients to use new drugs for depression,
schizophrenia and other diseases -- though they acknowledge that
resistance from patients can be high.
In recent years, Pfizer Inc., Eli Lilly & Co., Novartis AG
and other top drugmakers have spent hundreds of millions of
dollars to develop new drugs for mental disorders, one of the
most challenging areas of research. The effort has yielded an
impressive array of new drugs, doctors said, like Prozac, the
biggest-selling antidepressant, and Risperdal for schizophrenia.
However, experts at the 11th European Congress on
Neuropsychopharmacology said patient distrust of new mental-
health drugs remains high -- partly because of serious side-
effects caused by previous drugs once similarly hailed, such as
Roche Holding AG's Valium. Once the Swiss drugmaker's biggest-
seller, Valium was found later to cause dependence and withdrawal
problems. Older schizophrenia drugs like Johnson & Johnson's
Haldol also brought an array of side-effects.
''A problem of distrust of drugs has built up over the
years,'' acknowledged Stuart Montgomery, professor of psychiatry
at London's Imperial College and an organizer of the conference.
Lack of Funding
Montgomery estimated that only 10 percent of all depression
patients have any treatment, a ''scandal'' that he says is due to
a lack of government recognition and funding -- and also a lack
of knowledge that newer drugs can be more effective, with fewer
side-effects than older ones.
Furthermore, patients are treating themselves at
unprecedented levels, as in Germany, where St. John's Wort, a
herbal treatment, is the biggest-selling antidepressant. ''There
is serious confusion in the public mind,'' Montgomery said.
For drug companies, the challenge is persuading doctors that
their drugs work better, faster, have fewer side-effects or are
cheaper than their rivals'.
Close competitors include Johnson & Johnson, which released
a study showing that patients using its Risperdal psychosis
treatment improved their conditions with fewer side-effects than
Eli Lilly & Co.'s Zyprexa, a fast-growing rival drug threatening
to supplant Risperdal as the leading drug for the disease. The
latest analysis is the second head-to-head study of the two
drugs, with the first -- sponsored by Eli Lilly -- suggesting
Zyprexa is superior.
Also presenting data was American Home Products Corp., which
released a study showing that Effexor, its new antidepressant,
can have ''significant'' beneficial effects in a week after the
start of therapy.
Effexor, part of a class of drugs called SNRIs, is aiming to
be a second-generation drug in competition to Eli Lilly's Prozac
and similar drugs called SSRIs, which can take four to six weeks
to act. Doctors said the finding that the drug acts faster than
Prozac could boost its sales, which were $430 million in 1997,
dwarfed by Prozac sales of $2.56 billion.
'Very Valuable'
Effexor and a similar drug called Ixel, made by Pierre Fabre
Medicament, ''could be a very valuable option for the treatment
of depression,'' said Pierre Blier, a professor of psychiatry at
McGill University in Montreal.
The Effexor study was one of dozens presented to the 6,000
or so doctors at the meeting, many sponsored by drug companies
who are aiming to differentiate their drugs in the face of what
is expected to be major competition in the $8.4 billion
antidepressant market starting in 2001.
That's when Prozac begins to lose patent protection, opening
the way to what is likely to be a flood of cheaper generic copies
onto the market.
The market for antidepressants is currently dominated by
Prozac, Pfizer's Zoloft and SmithKline Beecham Plc's Paxil, all
SSRIs. In addition to Effexor and Ixel, at least five new
competitors have reached the market in recent years, including
Pharmacia & Upjohn Inc.'s Edronax, Akzo Nobel NV's Remeron and
Bristol-Myers Squibb Co.'s Serzone.
''Lilly opened the door to a huge market by helping
demystify depression,'' said John Van Den Berg, product manager
for Akzo Nobel's Organon drug division. ''There's room for other
people in that market and we want to take advantage of that.''
--Dane Hamilton in Paris, through the London newsroom (44-171)
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