I lost a good friend to this. Hope it helps other people.
The meds helped him but he didn't like the side effects so he stopped taking them. Went in and out of homelessness. In the end he thought he had superpowers and could fly. He could fly, but he could not land. It eventually took him.
Oh man, I'm probably half schizophrenic, tried some antipsychotics at some point and had same reaction, and recently started to spend most my time outside (sleeping too), I found a nice spot. Fortunately I still have my remote developer job, and try to remain stable but I'm over sensitive and in the long run I can't sleep in my apartment (noise, smells - cigarette, here in France, it's horrible, maybe WIFI waves too). But isolation tends to makes me a bit more tolerant to people, I love birds and any really natural living being though
> The meds helped him but he didn't like the side effects so he stopped taking them.
This is frustrating to me as a long time psych med user. If the meds have intolerable side effects then the meds do not help. Period. I do better off my meds than anything they ever tried to give me.
The system failed your friend. Not his ability to tolerate these horrible side effects.
IF we actually cared about human life we would have done much more to help your friend, but we did not. We care about human life up to the point it starts diminishing our comfort, and I am afraid we are valuing our comfort more and more than we care about others who are suffering in the last thirty years.
It is often not the common side effects: "gain weight, fall asleep and experience involuntary muscle jerking" that cause people to stop taking meds.
It is that their brain feels different, not like how it should be.
Now involuntary muscle jerking has a high stigma.
It can, in the worst cases be highly visible.
The new drugs seem to stop this drawback and instead
introduces vomiting.
That would be even worse.
The worst part of the article though is the frequent reference to homeless people.
and that seems to be written by someone who has no idea of the realities.
A majority of homeless people do not have access to even basic healthcare.
There are different reasons for this, but it is true of the majority.
You dont have a look that closely to see open wounds, some infected, esp on
feet and legs. These are basic healthcare concerns.
Probably they have several other conditions that require treatment,
and deficiencies due to a lack of food period, and certain lack of food that
is nutritious and healthy.
Are the doctors just going to walk up and down the lines of homeless giving
out bottles of pills and hope the world will change?
These types of drugs should always be closely monitored by a psychiatrist.
Which is made nearly impossible with homeless people.
(not to mention the cost. It could have high co-pays but I hope there are programs
that can mitigate this.
The only way to do this is to give the person a place to live.
Ensure the person has healthy and decent food.
This will require time and treatment so build up a new sense of
safety.
Once achieved treatment for schizophrenia could start with the drug and be
closely monitored by professionals.
None of the drugs to treat mental health issues will work on all,
And some people will have strong side effects.
My read on the one reference to homelessness in the article was that a life-changing medication that can help with a disease like schizophrenia can prevent homelessness in the first place.
I have a close family member that had a psychotic episode during the pandemic. They were hospitalized but were eventually able to get effective treatment and medication and now live a mostly normal life.
Had they not had the support to get proper medication, I have a hard time seeing how they wouldn’t end up homeless.
"The only way to do this is to give the person a place to live."
The people who are homeless are homeless because they, due to drugs, alcohol, or mental illness aren't safe to have around others of extreme poverty.
My friend operate several halfway houses. Almost weekly he has to kick someone out because they are a danger to staff or other clients. Generally this is at 2am, and the police are involved.
Our society has decided that institutionalizing people is inhumane. Well, if someone isn't safe enough to be in a halfway house and institutions are inhumane, the only place for them to go is the street, and, eventually, if they are lucky, prison.
> The only way to do this is to give the person a place to live. Ensure the person has healthy and decent food. This will require time and treatment so build up a new sense of safety.
> Once achieved treatment for schizophrenia could start with the drug and be closely monitored by professionals.
At least for mental illness, the US state run mental hospitals should be reopened to put the mentally ill under care, monitoring, and to get them back on medicine.
Modern psychiatric medicine could reverse the issues that used to stigmatize the mentally ill.
Improperly supervised psychiatric patients are a nightmare, if for no other reason than they often don’t take the drugs that make them not a nightmare.
That means stand-alone housing just won’t work properly.
Now you see, they're selling it with a huuuuge markup, just for that FDA's "stamp" on the box. But inside the packaging, it's just... this. But to everyone their own, I guess.
You're suggesting to people that they should buy research use only chemicals and attempt to compound them at home? That is incredibly irresponsible and dangerous.
> M4 and M1 receptor stimulation indirectly rebalances dopaminergic and glutamatergic circuits involved in the symptoms associated with neurological and neuropsychiatric diseases such as schizophrenia and Alzheimer's disease.
That's quite a handsome return. Which BMS feels empowered to do to since they can charge exorbitant amounts for it
I often am against the narrative that every pill should be priced at the cost of manufacturing + healthy margin, since by that logic the first pill should cost billions to cover for the R&D. In this case, it doesn't quite translate.
"Childhood Trauma is probably the most important environmental factor associated with Schizophrenia. There is evidence of multiple paths between traumatic experiences and psychosis. Mental disorders are systems of interacting symptoms through a framework of networks. Psychotic symptoms in patients with a history of child abuse are more severe, persistent, and refractory to treatment. In developmental years, exposure to neglect and abuse reveals severe adverse effects on the average neurobiological growth, leading to vulnerable neurobiology preceding disadvantageous psychiatric outcomes."
"The guiding principles of trauma-specific care can give you the space to uncover the root of your schizophrenia and trauma. Thus, understanding how your early traumas have impacted you opens the door to dismantling maladaptive coping mechanisms. As you deepen your self-understanding, it encourages you to lean into adaptive coping strategies to process your experiences and life stressors. Furthermore, with support, you can find a path to recovery from schizophrenia and trauma that considers you and your specific experiences."
i'm getting very argumentative on the internet today (under a pseudonymous account because as you might guess from my incessant posting, this issue is personal for me)
trauma (at any time), drug use, other experiences -- all can make schizophrenia more likely in those susceptible. absolutely true.
but it is a biological disease, and healing trauma won't stop its progression. as your source notes, the trauma causes differences in brain development, and once that's done its done.
i don't think coming up with a new drug, the main advantage of which is it doesn't numb you the horrible way existing antipychotics do, is a bad thing.
this is basically a drug that was only created to improve the QoL of people with schizophrenia. if society just wanted to numb them, we already have drugs for that and could just be much more aggressive in violently coercing treatment.
investing in these drugs isn't "looking away", it's putting in a huge investment of many billions of dollars to help the victims live better lives.
Schlesselmann, A. J., Huntjens, R. J., Renard, S. B., McNally, R. J., Albers, C. J., De Vries, V. E., & Pijnenborg, G. H. (2022).
A Network Approach to Trauma, Dissociative Symptoms, and Psychosis Symptoms in Schizophrenia Spectrum Disorders.
Schizophrenia Bulletin
https://doi.org/10.1093/schbul/sbac122
"Ccongruent with the idea of an association between stressful life events and dissociative experiences, research has established a link between the presence and severity of dissociation and reported interpersonal traumas such as sexual, physical, and emotional abuse, with multiple traumas being linked to more severe symptoms.
In SSD populations up to 60% of individuals report a history of interpersonal trauma. The core explanation for the mechanism linking trauma and symptoms of SSD states that trauma leads to a vulnerability rendering the individual susceptible to the experience of perceptual and sensory intrusions. In line with the idea of trauma as a vulnerability factor for psychotic as well as for dissociative symptoms, studies have shown that more frequent dissociative and more severe psychotic symptoms in SSD are linked to reported trauma in a dose-response relationship."
> with support, you can find a path to recovery from schizophrenia
They misspelled "medication". There are narrow situations where very skilled psychiatrists have successfully treated schizophrenics using non-pharma (read: traditional) psychotherapy, but they are truly exceptional cases.
Being schizophrenic is not a lack of "deepening your self-understanding" that blocks them from "uncovering the root of " their illness! That is absolutely horse shit and belongs in a new age Homeopathy boutique.
Schizophrenics firmly believe their delusions and paranoia. In fact, one of the worst things you can say to them is "it's all in your head! The voices aren't real!". Commonly, they split the world into allies and suspects, so the moment you try to invalidate them, they add you to the list of agents/spirits/whatever is after them.
This disease requires a psychiatrist and medication, full stop, and is fully orthogonal to child abuse.
look, if someone has actually have a new drug that works like antipsychotics but doesn't have the nightmare side effects, i am very happy for that person to get filthy rich.
if this pans out the way they hope, by all means give the lead guy a couple yachts or whatever he wants. space tourism, gold statue of himself, whatever. big bonuses all the way down the org chart.
there's the potential to reduce an absolutely staggering amount of human misery here. frankly (again if this pans out) our homelessness crisis would look very different if this drug had existed 20 years ago, when the mechanism of action was discovered.
the people who cared enough and took a huge concentrated risk to do this should just get rich, if in fact it pans out.
"frankly (again if this pans out) our homelessness crisis would look very different if this drug had existed 20 years ago"
Are there numbers, for how many homeless people, are suffering from schizophrenia?
I would assume only a very small number of homeless people has the clinical condition, but those who have it, are just very visible. Most homeless people are hidden usually and avoid attention.
Bristol Myers Squibb acquired Karuna Therapeutics, the company behind Cobenfy (formerly KarXT), for $14 billion earlier this year so that’s their break even for the drug and presumably what their investors thought was fair. I don’t think Karuna had anything else interesting in trials so they have to recoup all of that from Cobenfy before they’re in the black on the acquisition.
Pharmaceutical companies offload most of the risk onto institutional investors and the public (most biotechs IPO pre-revenue to fund clinical trials) but the flipside is that they have to pay eye-watering sums to acquire promising drugs.
In their last 10-K, Bristol Myers Squibb reported an operating income of $8.4bn on sales of $43.7bn, giving them a gross profit margin of just over 19%.
You shouldn't look at R&D on one product, since lots fail. Would be like saying a record label that funds 100 artists with 1 being profitable should have a strict 20% profit cap on the profitable one. That wouldn't allow ongoing funding of the broader pool of bets.
After things got weird I got taken out by an obese guy and other nurses. Woke up in a hospital, which turned out to be a very strange week, surrounded by clues that I was going to get killed. I was let go by agreeing to an injected medication administered every month. Years later I changed to Zyprexa pills. I don't even have a doctor yet I'm taking schizophrenia pills by intertia since my mom is programmed to continue that. When I cut the dosage in half I start feeling like exercising, moving more, right now I don't feel like moving. My brain feels like it's rotting, akin to the covid mind-fog reports. I don't feel pleasure or happiness. I'm in a constant state of anxiety and self-hatred. This thing is killing me and I part of me doesn't care since it's suicidal, enjoying the punishment. My guess is that eventually I get out of this since nothing is permanent and evil is a caricature.
The current crop can best be described as chemical lobotomy. Impossible to focus on anything for more than 30 seconds. And it's not even a pleasant stupidity.
There's Abilify, but unfortunately doctors don't like it (due to it being perceived as less effective).
> Cobenfy, set to launch in October, will have a list price that would cost about $22,500 a year. The influential Institute for Clinical and Economic Review this year estimated that a price in line with expected clinical benefits to patients should be in the range of $16,000 to $20,000 a year. Bristol Myers Squibb executives say most eligible patients are covered by Medicare or Medicaid and wouldn’t pay the list price.
I can't stand this term 'game changer', I started noticing it being used a lot during early covid and then the Ukraine war, all for things which did not turn out to be 'game changers'.
You can see its explosive rise on Google Ngrams. Looks like we're still not quite at the peak
An unfortunate requirement of modern attention/engagement economy. Readers hate this one trick, but for the media outlets, if you don't crank up hype clickbait engine to 11, you're out, or running some very niche business.
[+] [-] boingo|1 year ago|reply
[+] [-] hn72774|1 year ago|reply
The meds helped him but he didn't like the side effects so he stopped taking them. Went in and out of homelessness. In the end he thought he had superpowers and could fly. He could fly, but he could not land. It eventually took him.
[+] [-] 11235813213455|1 year ago|reply
[+] [-] FollowingTheDao|1 year ago|reply
This is frustrating to me as a long time psych med user. If the meds have intolerable side effects then the meds do not help. Period. I do better off my meds than anything they ever tried to give me.
The system failed your friend. Not his ability to tolerate these horrible side effects.
IF we actually cared about human life we would have done much more to help your friend, but we did not. We care about human life up to the point it starts diminishing our comfort, and I am afraid we are valuing our comfort more and more than we care about others who are suffering in the last thirty years.
[+] [-] hilux|1 year ago|reply
It's probably a common story.
[+] [-] ThinkBeat|1 year ago|reply
It is often not the common side effects: "gain weight, fall asleep and experience involuntary muscle jerking" that cause people to stop taking meds. It is that their brain feels different, not like how it should be.
Now involuntary muscle jerking has a high stigma. It can, in the worst cases be highly visible. The new drugs seem to stop this drawback and instead introduces vomiting. That would be even worse.
The worst part of the article though is the frequent reference to homeless people. and that seems to be written by someone who has no idea of the realities.
A majority of homeless people do not have access to even basic healthcare. There are different reasons for this, but it is true of the majority. You dont have a look that closely to see open wounds, some infected, esp on feet and legs. These are basic healthcare concerns. Probably they have several other conditions that require treatment, and deficiencies due to a lack of food period, and certain lack of food that is nutritious and healthy.
Are the doctors just going to walk up and down the lines of homeless giving out bottles of pills and hope the world will change?
These types of drugs should always be closely monitored by a psychiatrist. Which is made nearly impossible with homeless people. (not to mention the cost. It could have high co-pays but I hope there are programs that can mitigate this.
The only way to do this is to give the person a place to live. Ensure the person has healthy and decent food. This will require time and treatment so build up a new sense of safety.
Once achieved treatment for schizophrenia could start with the drug and be closely monitored by professionals.
None of the drugs to treat mental health issues will work on all, And some people will have strong side effects.
[+] [-] smugma|1 year ago|reply
I have a close family member that had a psychotic episode during the pandemic. They were hospitalized but were eventually able to get effective treatment and medication and now live a mostly normal life.
Had they not had the support to get proper medication, I have a hard time seeing how they wouldn’t end up homeless.
[+] [-] debacle|1 year ago|reply
The people who are homeless are homeless because they, due to drugs, alcohol, or mental illness aren't safe to have around others of extreme poverty.
My friend operate several halfway houses. Almost weekly he has to kick someone out because they are a danger to staff or other clients. Generally this is at 2am, and the police are involved.
Our society has decided that institutionalizing people is inhumane. Well, if someone isn't safe enough to be in a halfway house and institutions are inhumane, the only place for them to go is the street, and, eventually, if they are lucky, prison.
[+] [-] rs999gti|1 year ago|reply
> Once achieved treatment for schizophrenia could start with the drug and be closely monitored by professionals.
At least for mental illness, the US state run mental hospitals should be reopened to put the mentally ill under care, monitoring, and to get them back on medicine.
Modern psychiatric medicine could reverse the issues that used to stigmatize the mentally ill.
[+] [-] lazide|1 year ago|reply
That means stand-alone housing just won’t work properly.
[+] [-] omegaworks|1 year ago|reply
> The only way to do this is to give the person a place to live. Ensure the person has healthy and decent food.
> This will require time and treatment so build up a new sense of safety.
In many ways, just meeting people's basic needs would go farther to address mental health than any miracle drug.
[+] [-] greenish_shore1|1 year ago|reply
https://www.google.com/search?q=131986-45-3 (Xanomeline) https://www.google.com/search?q=10405-02-4 (Trospium chloride)
Now you see, they're selling it with a huuuuge markup, just for that FDA's "stamp" on the box. But inside the packaging, it's just... this. But to everyone their own, I guess.
[+] [-] notQuiteEither|1 year ago|reply
[+] [-] RobotToaster|1 year ago|reply
[+] [-] kstrauser|1 year ago|reply
Whoa. Wonder if that's being evaluated?
[+] [-] therein|1 year ago|reply
[+] [-] pcrh|1 year ago|reply
This was developed in the UK for £11million and sold to Bristol Myers Squib for USD 14billion...
https://wellcome.org/news/new-treatment-for-schizophrenia-Co...
[+] [-] hackernewds|1 year ago|reply
I often am against the narrative that every pill should be priced at the cost of manufacturing + healthy margin, since by that logic the first pill should cost billions to cover for the R&D. In this case, it doesn't quite translate.
[+] [-] rendx|1 year ago|reply
"Childhood Trauma is probably the most important environmental factor associated with Schizophrenia. There is evidence of multiple paths between traumatic experiences and psychosis. Mental disorders are systems of interacting symptoms through a framework of networks. Psychotic symptoms in patients with a history of child abuse are more severe, persistent, and refractory to treatment. In developmental years, exposure to neglect and abuse reveals severe adverse effects on the average neurobiological growth, leading to vulnerable neurobiology preceding disadvantageous psychiatric outcomes."
https://www.theguesthouseocala.com/understanding-the-connect...
"The guiding principles of trauma-specific care can give you the space to uncover the root of your schizophrenia and trauma. Thus, understanding how your early traumas have impacted you opens the door to dismantling maladaptive coping mechanisms. As you deepen your self-understanding, it encourages you to lean into adaptive coping strategies to process your experiences and life stressors. Furthermore, with support, you can find a path to recovery from schizophrenia and trauma that considers you and your specific experiences."
[+] [-] throw18376|1 year ago|reply
trauma (at any time), drug use, other experiences -- all can make schizophrenia more likely in those susceptible. absolutely true.
but it is a biological disease, and healing trauma won't stop its progression. as your source notes, the trauma causes differences in brain development, and once that's done its done.
i don't think coming up with a new drug, the main advantage of which is it doesn't numb you the horrible way existing antipychotics do, is a bad thing.
this is basically a drug that was only created to improve the QoL of people with schizophrenia. if society just wanted to numb them, we already have drugs for that and could just be much more aggressive in violently coercing treatment.
investing in these drugs isn't "looking away", it's putting in a huge investment of many billions of dollars to help the victims live better lives.
[+] [-] rendx|1 year ago|reply
"Ccongruent with the idea of an association between stressful life events and dissociative experiences, research has established a link between the presence and severity of dissociation and reported interpersonal traumas such as sexual, physical, and emotional abuse, with multiple traumas being linked to more severe symptoms.
In SSD populations up to 60% of individuals report a history of interpersonal trauma. The core explanation for the mechanism linking trauma and symptoms of SSD states that trauma leads to a vulnerability rendering the individual susceptible to the experience of perceptual and sensory intrusions. In line with the idea of trauma as a vulnerability factor for psychotic as well as for dissociative symptoms, studies have shown that more frequent dissociative and more severe psychotic symptoms in SSD are linked to reported trauma in a dose-response relationship."
[+] [-] gosub100|1 year ago|reply
They misspelled "medication". There are narrow situations where very skilled psychiatrists have successfully treated schizophrenics using non-pharma (read: traditional) psychotherapy, but they are truly exceptional cases.
Being schizophrenic is not a lack of "deepening your self-understanding" that blocks them from "uncovering the root of " their illness! That is absolutely horse shit and belongs in a new age Homeopathy boutique.
Schizophrenics firmly believe their delusions and paranoia. In fact, one of the worst things you can say to them is "it's all in your head! The voices aren't real!". Commonly, they split the world into allies and suspects, so the moment you try to invalidate them, they add you to the list of agents/spirits/whatever is after them.
This disease requires a psychiatrist and medication, full stop, and is fully orthogonal to child abuse.
[+] [-] throw18376|1 year ago|reply
if this pans out the way they hope, by all means give the lead guy a couple yachts or whatever he wants. space tourism, gold statue of himself, whatever. big bonuses all the way down the org chart.
there's the potential to reduce an absolutely staggering amount of human misery here. frankly (again if this pans out) our homelessness crisis would look very different if this drug had existed 20 years ago, when the mechanism of action was discovered.
the people who cared enough and took a huge concentrated risk to do this should just get rich, if in fact it pans out.
[+] [-] throwup238|1 year ago|reply
They already did. Bristol Myer Squibb acquired the company behind this drug for $14 billion earlier this year.
[+] [-] codedokode|1 year ago|reply
[+] [-] lukan|1 year ago|reply
Are there numbers, for how many homeless people, are suffering from schizophrenia?
I would assume only a very small number of homeless people has the clinical condition, but those who have it, are just very visible. Most homeless people are hidden usually and avoid attention.
[+] [-] pjmorris|1 year ago|reply
What would a price in line with recouping R&D and production costs and, say, a 20% profit margin be?
[+] [-] throwup238|1 year ago|reply
Pharmaceutical companies offload most of the risk onto institutional investors and the public (most biotechs IPO pre-revenue to fund clinical trials) but the flipside is that they have to pay eye-watering sums to acquire promising drugs.
[+] [-] jdietrich|1 year ago|reply
https://www.sec.gov/ix?doc=/Archives/edgar/data/14272/000001...
[+] [-] thefounder|1 year ago|reply
[+] [-] cma|1 year ago|reply
[+] [-] BiggerComputer|1 year ago|reply
[+] [-] throwaway0665|1 year ago|reply
> "Novel" drugs are new drugs never before approved or marketed in the U.S.
[+] [-] mik0n|1 year ago|reply
The current crop can best be described as chemical lobotomy. Impossible to focus on anything for more than 30 seconds. And it's not even a pleasant stupidity.
There's Abilify, but unfortunately doctors don't like it (due to it being perceived as less effective).
[+] [-] dailykoder|1 year ago|reply
[+] [-] heraldgeezer|1 year ago|reply
[+] [-] unknown|1 year ago|reply
[deleted]
[+] [-] ck2|1 year ago|reply
It will probably be sold for $220 in other countries.
But hopefully the compounding pharmacies and anti-pharma hacking collectives will solve the pricetag problem here.
https://www.vice.com/en/article/how-to-make-your-own-medicin...
[+] [-] tomrod|1 year ago|reply
I think I echo my prior comments on the US health and pharma system: why?
[0] https://en.wikipedia.org/wiki/Xanomeline/trospium_chloride
[+] [-] KomoD|1 year ago|reply
[+] [-] rozab|1 year ago|reply
You can see its explosive rise on Google Ngrams. Looks like we're still not quite at the peak
https://books.google.com/ngrams/graph?content=game+changer&y...
[+] [-] dang|1 year ago|reply
[+] [-] drdaeman|1 year ago|reply
[+] [-] howard941|1 year ago|reply
[+] [-] unsupp0rted|1 year ago|reply
[+] [-] beautifulfreak|1 year ago|reply
[+] [-] motohagiography|1 year ago|reply
[deleted]
[+] [-] 3abiton|1 year ago|reply
[+] [-] edm0nd|1 year ago|reply
[+] [-] chiefalchemist|1 year ago|reply
https://michaelpollan.com/books/how-to-change-your-mind/