This expensive drug basically offers the same anti-depressant activity as the generic forms of Prozac, Zoloft, Paxil or Celexa but at a much greater price. For some unknown reason nausea remains a common, long lasting side effect. Nowhere in the barrage of televised advertising is there mention that the daily cost of the drug exceeds $10 versus $3-10 for one month of the generic versions of selective serotonin reuptake inhibitors.
You you hello i’m dr. ken landau thanks for joining us let’s talk about paroxetine paroxetine commonly known as trent elects is a drug that’s used to treat major depressive disorder on the press so you’re going to take pill it was initially approved in 2013 by the food and drug administration costs a lot of money costs about $10 or more a pill compared to
A generic drug that you could take for three to ten dollars a month now a major depressive disorder is extremely common start if you look at people in family doctors offices somewhere between five and ten percent are suffering from major depressive disorder that will simply cause depression if we look at people who are hospitalized the number increases to ten
To fifteen percent and it’s even higher among the elderly now depression isn’t the disease that’s commonly bandied about when someone says i’m depressed no depression is a specific medical condition that requires specificall criteria the criteria include low mood and sadness loss of interest maybe lack of energy you’re tired but you can’t sleep and you have a
Change in your appetite your weight goes down your sleep patterns are completely different difficulty concentrating your feelings that you’re guilty of things or worthless some people have suicidal ideas they want to kill themselves and in rare cases they can suffer from delusions and hallucinations now it’s important to realize that bipolar disorder combines
Depression and mania it is not for people who suffer from bipolar disorder it can actually make mania worse now to the general public the drug was launched in mid-2016 with a barrage of ads first just to make you aware of depression there were ads that didn’t mention the pills the ads were for a lighter blue calm you go to a website and learn about depression
Subsequently they started advertising by name company after they got the approval for treating major depressive one of the change in the label they said it gave your brain a boost in its power and it’s abilities that helped you think it helped you pay attention to help you make decisions the fda said now it doesn’t so as a result it’s only for treatment of major
Depressive disorder it was actually originally known as brittle x but there is another pill on the market known as belinda and valenta helps make your blood not clot sort of like kundun one of those blood thinners so they have to change the name so there wouldn’t be any confusion for pharmacy so now it’s known as trench alexi takes a drug once a day take a look
Without food take ten milligrams a day as a starting dose if necessary you can increase it to 20 milligrams or if it seems like it’s working very well you can try going down to 5 milligrams fortunately this is one of the drugs that you can discontinue with roughly if you would like on the other hand if you’re taking the higher though it’s probably better to cut
It in half and then take that for a while and then discontinue it otherwise you might have rebound headache or some dizziness some muscle disorders and a burst of anger now it’s a treatment for major depressive disorder but it doesn’t work right away takes about two weeks to start working and then reaches its maximum after about six to eight weeks or even several
More months and you probably have to take it forever in order to prevent depression from recurring because depression is a recurrence condition have some side effects somewhere between ten and twenty percent of the people who take the drug initially are going to suffer from nausea even after taking it for several weeks still about one in ten people suffer from
Nausea then there’s vomiting and constipation and flatulence and sexual dysfunction in men and because the drug works on a chemical known as serotonin you could have too much serotonin in the system and then that might cause the serotonin syndrome where you have nausea vomiting fever you can have sweating your heart rate can go up you can be severely agitated
Have a change in your mental state even have hallucinations or go into coma something that’s obviously quite important there are some people who especially when they take aspirin suffer from some bleeding episodes and we know that the drug isn’t for those people who have manic episodes from the breakfast bipolar disorder combines with mania but sometimes you
Just suffer from depression and ended originally when you see the doctor doesn’t know that it really is associated with this bipolar disorder so you take the bill then you might have an increase in energy trouble sleeping racing thoughts you might have some behavioral disorders behave recklessly and you talk faster than normal in some people taking the drug the
Sodium goes down and that can lead to headache and difficulty concentrating and memory loss and confusion and some people with the drug can suffer from vision problems vision problems from reddening of the eyes dilated pupil to pain in the eye and even suffer from attacks of glaucoma you have to be very careful if you’re taking the drug and taking certain other
Kinds of drugs not to be combined with fentanyl or try cyclic antidepressants the older kinds of antidepressants not for people who are taking the lithium or st. john’s wort people who are taking buspar and it’s not for people who have migraine headaches and are taking the trip tens it’s not for women who are pregnant not for women who are nursing and the drug
Carries with it a black box warning saying that suicidal thoughts and actions might occur especially in children or teens or young adults who are taking the drug or in people who have recently had a change in the dose of the drug and as a result it’s not for people who are under the age of 18 now the trials have mostly been done in people with moderate depression
Not severe depression and while it’s statistically significant the benefits people get it’s very difficult to realize whether it’s a clinically significant provement how does it work at boost of serotonin in the brain and it works just like other drugs in the same family drugs that are much cheaper drugs that are generically available drugs like zoloft and
Prozac and paxil or lexapro their variety of other drugs that can be used to treat depressive disorders matter of fact in june of 2015 the drug was brought before the british regulatory authorities and they said that you know the drug really doesn’t provide any special benefit it’s no better than the worse than lots of the other drugs that we have on the market
But as a result of lobbying by the company they change their mind in november of 2015 but said you have to go and take at least two other antidepressants first and have them not be effective before you could take this drug and in the united states most of the insurance companies require other antidepressants often in the same family before you can take print
Elects because it’s just so expensive the price for 30 tablets either 10 million or 20 milligram cash price is $400 you can get some of the other similar drugs same family for three to ten dollars a month so with relatively little added benefit significant risk since it’s no better than other cheaper medicines well how do we rate it well for cost it’s ridiculous
The price is absolutely out of the ballpark on the other hand how do we write it for effectiveness it’s okay it’s nothing special so anyway thanks for joining us i’m your host dr. ken landau
Transcribed from video
Trintellix By wellnowdoctor
