Unethical practices - drug industry

Jason Kennerly jkenner at cello.gina.calstate.edu
Fri Sep 1 19:50:32 EST 1995

Sy Fisher <sfisher at utmb.edu> writes:
> That's the name of the game when a company's profits are threatened by 
> published research results:  try to discredit the studies as "flawed" 
> or "bad science" (of course, some studies may indeed be flawed).  That's 
> what Pfizer was trying to do with our Zoloft vs Prozac study (J Clin 
> Psychiatry 1995;56:288-296).  

Are you referring to the "Selective Serotonin Reuptake Inhibitor Dose 
Titration in the Naturalistic Setting" study?

Oops, nevermind that was elsewhere. Damn... wish I had a library.. heh.. 
anyways, 2 of the 4 researchers listed on the author line are affiliated 
with Lilly directly.... I'd be interested in seeing the affiliations of 
your study. 

Zoloft[sertraline], as a drug, is more specific in its actions on the 
serotonin transporter than Prozac [fluoxetine]. While there is indeed a 
very real possibility that Prozac might be slightly more effective in 
aleviating depression due to its effects on the norepinephrine 
transporter, this "observation" doesnt mean Prozac is a better SSRI than 
Zoloft, but rather that Prozac isn't even an SSRI to begin with...

Zoloft has been more effective for "non-depression" problems treated with 
SSRI drugs from what I have learned chatting with psychiatrists and 
cruising the net. Prozac is indeed slightly more effective against 
depression, as I have learned via similar channels. This is not of course 
hard data, nothing but anecdotes actually, but still worthy of note IMHO.

With regards to Prozac's status as an SSRI, make your own decision:
As mentioned in the original article, these drugs typically have active
metabolites which may be significant.  Thus, actual in vivo activity may
be slightly different.
                     Receptor Affinities for SSRI drugs
              (Values normalized to the IC50 for 5-HT reuptake)
     [Data Taken from: Internatn-Clin-Psychopharm, 9 suppl 1: 19-26 (1994)]

Clomiprimine  Fluoxetine   Sertraline    Paroxetine       Fluvoxamine
(Anafranil)   (Prozac)     (Zoloft)      (Paxil)          (Luvox)
SRI:      1   SRI:      1  SRI:       1  SRI:        1  SRI:      1
NARI:    14   NARI:    54  NARI:    840  NARI:     280  NARI:   160
DARI:  2900   DARI:   740  DARI:    250  DARI:   18000  DARI: 11000  
D1:     130   D1:    1500  D1:    33000  D1:     52000  D1:  >26000
D2:     290   D2:    4700  D2:   130000  D2:    180000  D2:   17000
H1:      36   H1:     470  H1:    53000  H1:    66,000  H1:    2900
ACh:     45   ACh:    445  ACh:    5800  ACh:      720  ACh:   8900
S1A:   1900   S1A:  12000  S1A: >530000  S1A:  >340000  S1A: >26000
S2A:     36   S2A:    100  S2A:   45000  S2A:    62000  S2A:   3200
S2C:    n/a   S2C:    235  S2C:     n/a  S2C:    69000  S2C:   1800
Alpha1:  40   Alpha1:2000  Alpha1:15000  Alpha1: 66000  Alpha1:1300
Alpha2:1200   Alpha2: 410  Alpha2: 9500  Alpha2:300000  Alpha2: 500
Beta: 15000   Beta:   264  Beta:  74000  Beta:  120000  Beta: 23000
Radioligands used in binding: 
D1:     SCH23390;    D2:     Spiperone;          5-HT1A: 5-OH-DPAT;  
5-HT2A: Ketanserin;  5-HT2C: Ly278584;           Alpha1: Prazosin; 
Alpha2: Idazoxan;    Beta:   Dihydroalprenolol;  H1:     Mepyramine; 
ACh:    QNB.

     ____   ______  ________ _____
    /    \ |      \|   /\   |     \   jkenner at cello.gina.calstate.edu
   /      \|   _   \   \/   |  _   \  
  /___/\   \___|>   >       |__|>   > BORN TO BE WIRED... 
 /         |       /   /\  |       /  All the sugar and twice the 
 \_________|______/|___\/__|______/   caffeine of regular netusers!
 finger me and make a pgp key come.

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