Here’s a scenario concerning the ever expanding market for neuroleptic medication. Perhaps some of you have ideas to contribute to this scenario.
Abilify originally was approved by the U.S. Food and Drug Administration as an antipsychotic, and rather quickly gained approval as a treatment for depression and autism. I am now thinking of Chris, if I have to use a label for him at all, as “depressed,” and no longer “schizophrenic” thanks to Bristo-Myers-Squibb’s (BMS) amazing Abilify trick, aided and abetted by its good friend, the FDA.
BMS has now freed us to pick and choose our label based on the many diagnoses its product is treating. Technically, since Chris is on Abilify only, he is not clinically depressed, because to meet this standard he would have to be also on an antidepressant, as Abilify is only approved for unipolar depression if used in conjunction in conjunction with an antidepressant. I could begin thinking of Chris as bipolar, since bipolar doesn’t seem to carry the same stigma as “schizophrenia.” I sincerely doubt Chris is autistic, so autism is a non-starter. I like the idea of “depressed” because anyone can start off on both Abilify and an antidepressant and then drop the antidepressant. Can Chris now go to his doctor and get his original diagnosis changed, given that he was once on an antidepressant and weaned himself off it? I think, judging from the Abilify, that this is a valid conclusion to draw. On what basis could a doctor refuse to change his original diagnosis?
But what does this mean for the BMS pipeline? The company is going to have to reposition schizophrenia, once again, as horrible, devastating, and, most importantly, “unique.” Will it begin to trash Abilify as no longer useful for schizophrenia while simultaneously introducing a new improved drug, e.g. “Rehabilify” marketed only for schizophrenia? What new “diseases” will replace schizophrenia market for Abilify?
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Aripiprazole (pronounced /ˌɛərɨˈpɪprəzoʊl/ AIR-i-PIP-rə-zohl; brand names: Abilify, Aripiprex) is an atypical antipsychotic and antidepressant used in the treatment of schizophrenia, bipolar disorder, and clinical depression. It was approved by the US Food and Drug Administration (FDA) for schizophrenia on November 15, 2002, for acute manic and mixed episodes associated with bipolar disorder on October 1, 2004, as an adjunct for major depressive disorder on November 20, 2007 and to treat irritability in children with autism on 20 November 2009. Aripiprazole was developed by Otsuka in Japan, and in the United States, Otsuka America markets it jointly with Bristol-Myers Squibb. (Wikipedia)