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Commentary


New drugs: The whole story

Vol. 3, No. 7 / July 2004

Dr John Battaglia’s article about intramuscular (IM) olanzapine (Out of the Pipeline, Current Psychiatry, May 2004) appears biased because of his pharmaceutical company connection. He mentions four studies supporting its use in treating schizophrenia, bipolar type I mania, and dementia.

As a resident eager to learn what constitutes good clinical care, I feel the article does an injustice by mentioning no negative studies or those that recorded no significant change.

Getting all the facts is key to establishing how to best use a treatment. Debate or unbiased commentary should accompany articles on new medications/treatments.

Matthew Sager, MD
Chief resident
Brown University Psychiatry Program
Providence, RI

Dr. Battaglia responds

I appreciate the passion with which Dr. Sager is approaching his education; he might want to learn more about drug development.

For decades, the overwhelming majority of FDA approvals for psychiatric medications have resulted from industry-supported studies. Very few researchers are doing substantial psychopharmacology clinical trials without industry support. It is extremely difficult to publish “negative” studies or those that show “no significant change.” I am not aware of any such published studies with IM olanzapine.

The best “unbiased” commentary on IM olanzapine will occur when it is used widely in clinical practice. For now, we are limited to published studies.

John Battaglia, MD
Medical director, Meriter Hospital adult psychiatry program
Associate professor, department of psychiatry
University of Wisconsin Medical School
Madison

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