Mental Health Project is the Seattle Times Initiative, which focuses on dealing with mental and behavioral health problems. The company supports funds by BallMer Group, a national organization that focuses on economic mobility for children and families. The Seattle Times maintains editing control of the team’s work.
During the few months after a 24 -year -old DJ was diagnosed with schizophrenia, he searched online to answer questions that gave an urgent and existential feeling.
Is it really bad over time? Can I live an ordinary life?
He read statistics. He saw a news article. He said, “It is quite fatal,” he said in the University of Washington.
He was nervous about his career outlook and Reddit and YouTube are edible for people who have experienced scary symptoms like him. I’m looking at a confusing species with no eye. I feel the invisible insects that bite his skin. Before you leave the house, you will be trapped in a “forking ring” as if you lose 20 times.
One day, online DJs watched an advertisement for new drugs. Local researchers conducted clinical trials on drugs that work differently from drugs with recently prescribed weak side effects.
“I tried to find out if I could make 60-70%of my symptoms,” DJs said, “It’s close to zero,” DJ uses his nickname to protect the future employment opportunities.
The DJ tried a new anti -psychosis drug called Cobenfy, a drug that potential lives to one of the most difficult mental illnesses of psychiatrists, but long -term side effects have become one of the first lines that are still unknown.
Coven About 3.7 million American adults. The drug is now in the hands of the Washington people. Psychiatrists report that pharmaceutical sales officers are dropping brochures in the office, patients have begun to ask the drug slowly, and in certain situations, they have begun to write cobenfy scripts.
Dr. SWAPNA VAIDYA, a psychiatrist of personal practice and behavioral health care officers in Seattle, said, “I was interested.”
Psychiatrists have chosen a limited drug to treat flat effects related to serious hallucinations, cold emotions and schizophrenia for decades. At least some of the symptoms of schizophrenia are associated with excessive dopamine activity. All previous anti -psychosis drugs depended on blocking the receptors of chemical messengers.
How is cobenfy different from other anti -psychotic drugs?
Unlike the previous generation of anti -psychotic drugs, cobenfy does not directly interact with dopamine or serotonin receptors.
Although relatively effective in darkening hallucinations, anti -psychosis is having a hard time managing so -called “negative symptoms.” Social withdrawal, memory problems and lack of motivation are so powerful that many people do not keep their jobs or keep their daily lives. Some circulate several anti -psychotic drugs without finding any mitigation of symptoms. Others avoid it from the beginning because they stop taking drugs or believe that they are not worn from the beginning. Common symptoms known as Anosognosia.
The drug is also extreme fatigue, permanent exercise disorders, weight gain and fatal cardiovascular disease, and people can often abandon drugs periodically or entirely.
Cobenfy has many aspects of the drug, such as whether it works better than the previous generation of anti -psychotic drugs, but can provide a more hopeful promise. The drug, manufactured by Bristol Myers Squibb, has been tested in a small number of short -term tests and one -year subsequent measures so far. However, it has not yet been measured for the effects of head-to-head tests for major anti-psychotic drugs such as Aripiprazole, Lisperidone or Closapin. There are self -side effects such as nausea, vomiting, high blood pressure and risk of liver disease. The monthly list price starts at $ 1,850.
But it can have at least some big advantages. It does not cause significant weight gain, metabolic change or fatigue that can be found in other anti -psychotic drugs.
“The patient’s tolerance is excellent,” said Dr. AriF Khan, a medical officer at Northwest Clinical Research Center, a research facility at Bellevue.
Local doctors, such as Vaidya, say they are carefully optimistic for patients who do not respond to other options, especially.
Vaidya, who has not yet prescribed the drug, said, “I am not a person who wants to start a person for this drug until there is enough data to start this drug, but she said,“ It is definitely promising. At least it comes from a scientific point of view. ”
“Helpless”
Dr. Peter Loeffler has exhausted his choice.
Anti -psychosis drugs, including clozapine. Electricized therapy. Combine multiple drugs at once. When Cobenfy was launched in the market, he had considered the last sedative, such as Benzodiazepines for patients in his 60s, and he was hospitalized several times over the past three years.
As a “helpless” Loeffler wrote Cobenfy Prescription to her.
LOEFFLER, a four -year psychiatrist in Spokane’s Providence Sacred Heart Medical Center, said, “Yesterday, her symptoms were actually the first time.” Now he’s wet, but he’s imagining a promising future as it shows.
Psychiatrists and their patients can be considered a special inflection point at the moment when five to ten years have passed.
Since the introduction of the first anti -psychosis medicine, there was no significant improvement in treating schizophrenia. Chloro Pro Margin in the 1950s. The drug caused a psychological pharmacological revolution when researchers began to understand the root cause of mental illness in the 1950s, and more and more drugs about psychosis, depression and anxiety came to the market. In particular, anti -psychosis drugs provided some people with the ability to manage serious symptoms and played a central role in emptying the government’s psychiatric and institutions.
The new repetition of anti -psychotic drugs has shown that it has less side effects, but this drug is not perfect. Some people with uncontrolled symptoms will be hospitalized in hospitalization, prison or streets. Drug therapy is often part of living a stable life with diagnosis such as schizophrenia, which is generally diagnosed as schizophrenia.
Unlike other anti -psychotic drugs, cobenfy does not directly block dopamine or serotonin.
Dr. Steve Paul, a professor of psychiatric and neurological professor of St. Lewis, and Steve Paul, a former CEO of Karuna Therapeutics, who developed drugs, said that the coven -blooded characteristics were “Serendy Observation.” It was found.
Paul was eventually in the early 1990s when he first became interested in the compound that would become a cofent. Paul, a scientific director of the National Institute of Mental Health, was working on drugs for Alzheimer’s disease for Eli Lilly. However, the stomach side effects were so serious that it never released it on the market.
But researchers knew that this drug was good for something else.
Some patients who attempted compounds had symptoms related to schizophrenia (suspicion, stirring, hallucinations) and significant improvements. The researchers decided to combine the drugs with the drug to prevent unpleasant side effects of the initial compound, and eventually began testing in patients with schizophrenia.
Paul said that the result of placebo control clinical trials and 52 weeks follow -up is encouraging. But he added, “There are many things to learn in the real world.”
In Spokane, the group home employee tells LOEFFLER that he is working with a community expert who helps the patient spend more time outside the room and connects to volunteer opportunities.
But he is still waiting to hear that her hallucinations are less powerful. While visiting, she knows she is a doctor.
“I want to feel that she is getting better,” he said. “She hasn’t said that yet.”
“Lost chance”
Researchers, doctors and patients face questions without answers. If history tells us what it is, we will not answer for years or decades.
For example, it is not clear whether the drug can cause involuntary and repeated face ticks and limbs. Often developed, it takes several years to develop, permanent symptoms of previous anti -psychosis drugs or other infected people or rare symptoms.
Cobenfy does not contain a black box warning. But about one -third of the drug According to a 2017 study, safety issues after the FDA approval occurred, which stimulates the institution to add such warnings, remove drugs from the market, or give new side effects. Mental drugs were more likely than other types of drugs that would cause new safety warnings after approval.
Whether the drug surpasses existing drugs or significantly scratches the voice and cognitive symptoms of schizophrenia is often unstable for those with this disease. And whether the patient can join the insurance is that many insurers are demanding preliminary approval documents for this drug. The list price of this drug is more than $ 22,000 per year compared to about $ 600- $ 3,200 for one-year supply of annual closed clozapine pills.
“Boys, I thought they had a chance to go when I saw this medicine. that The first (optional) psychosis medicine, ‘and they did not set the price like that. ” Analyze clinical evidence and cost efficiency Prescription and other treatment.
“I think that’s a lost opportunity.”
Patients who prescribed drugs that require prior approval are sometimes insignificant through bureaucratic red tape every year, and are stressed by pause or delayed treatment, according to Dr. Claire Brutocao, who supervises Loefler’s research. “At least at this point, it would be a difficult sales to choose a line earlier than other things you can easily get.
For DJs, at least now drug treatment is free. For the next few months he will continue to receive the drug as a clinical trial.
He has more energy, has not been forgotten, and the hallucinations are quiet, but it is difficult to see if improvement is due to medication or changes in life, he said.
“What I and many others are worried about … the possibility of an irreversible damage we don’t know.” But he said: “I have a good feeling for the first time. I am really working on this disease.”
