34 ms·

FDA approves a novel drug for schizophrenia

229 points by tintinnabula 2y ago

RobotToaster 2y ago
It's this https://en.wikipedia.org/wiki/Xanomeline/trospium_chloride https://en.wikipedia.org/wiki/Xanomeline/trospium_chloride
- kstrauser 2y ago
  > 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. Whoa. Wonder if that's being evaluated?
  - jmcgough 2y ago
    Yes, it's being tested for autism as well.
    - LoganDark 2y ago
      I wonder what their hopes are for autism. I think the detail-oriented (or at least logic-oriented) thinking at least is an intrinsic part of brain development in autistics, but I wonder if it'll ever be possible to control certain other symptoms of autism through medication.
      - consteval 2y ago
        It could very well become a cost/reward analysis thing since Autism is a spectrum disorder. People who are high-functioning will probably be fine without the drug, but people who are, for example, non-verbal may be more willing to take it. I'm assuming such a drug would have drastic drawbacks in terms of how Autistic people think. Similar to other drugs that address mental state, they might not feel like themselves.
        LoganDark 2y ago
        > I'm assuming such a drug would have drastic drawbacks in terms of how Autistic people think. Similar to other drugs that address mental state, they might not feel like themselves. Knowing how I think, and how I use knowledge, I'm not sure that I'd be better at anything if a drug altered my ability to think in detail. Even if something made me non-autistic like magic, I have a lifetime of autistic knowledge that is structured differently than what a non-autistic brain would need. I could have to learn everything all over again if I were to become unable to comprehend/assemble the logical building blocks that I normally use to do everything. So I have to assume the drug doesn't actually attempt to treat the core defining trait of autism and only attempts to treat some of the side effects. As far as I'm aware, even though autism is a spectrum, every brain that is autistic has a particularly distinctive redistribution of connections, which is what results in basically everything. This redistribution is likely what results in the overly logical/analytical thinking (whether it's bottom-up or top-down), although I don't think anyone's been able to prove or disprove that, it's just a correlation.
        consteval 2y ago
        Right, but we need to consider outcomes. If such a drug could help those who can't take care of themselves, take care of themselves, that's a very good outcome. An outcome for someone like you wouldn't be very good so it doesn't matter much. But for some, this could be the difference between being institutionalized forever versus living a somewhat independent life.
- therein 2y ago
  Co-administration of an agonist and an antagonist for the same pharmacophore seems like an interesting approach.
  - nwienert 2y ago
    Looks like the antagonist is only outside the brain, so it works to counteract the side-effects, pretty cool. I wanted sort of the opposite of this for opioids - work in the body, not the brain. There's been a few attempts but non that passed trials.
    - swores 2y ago
      Would the opposite (work in the brain but not the body) also be a healthier alternative for people addicted to getting high on opiates?
      - johnisgood 2y ago
        Yeah, because it is the high they are after, but not working in the brain would make opioids completely useless for depression and anxiety (for which it really does wonders).
        nwienert 2y ago
        My want is for relieving pain in the body without making me feel high, I actually assumed you want it in the body not brain, as the brain effects are the feel-good effects, but really not sure or familiar with how they work.
        nullindividual 2y ago
        Ibuprofen and acetaminophen may already be that option. https://www.aafp.org/pubs/afp/issues/2018/0301/p348.html https://www.aafp.org/pubs/afp/issues/2018/0301/p348.html I believe there are other studies besides this that points to these two OTC pain relievers as being 'just as good' as opiates.
boingo 2y ago
https://archive.is/BYzWs https://archive.is/BYzWs
KomoD 2y ago
> 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.
- givemeethekeys 2y ago
  Didn't some bro from the pharma industry get mercilessly shat upon for charging so much for a life saving drug?
  - the_sleaze_ 2y ago
    You're being downvoted for using an easily google-able factoid incorrectly because you're pattern matching on "high drug prices" What happened was Martin Shekreli purchased patents for existing life-saving drugs and raised the price for them from $1.50 to $30 to cover the cost of the purchasing the patents themselves. This is an entirely different.
    - givemeethekeys 2y ago
      How people feel about facts is much more important than the facts themselves. The perception of the drug price increase much more than the details, along with other asshole things he did made him an easy target for outrage. What is the cost of mass producing this new drug? How much profit should the company be allowed to make? Where's the outrage?
      - nozzlegear 2y ago
        The company paid $14b for the research to bring this drug to market. Like all Americans — and all citizens of the world, apparently — I agree that drug prices in the US are too high, but shouldn't they be allowed to at least recoup that investment? How can we expect companies like this to continue researching such drugs if not? Especially when, more often than not, the research leads to a dead end or failed trials, and they can't even bring the drug to market?
photochemsyn 2y ago
The FDA is under regulatory capture by the pharmaceutical industry, and their approval or lack thereof is one of the most unreliable measures of the safety and efficacy of psychiatric drugs in particular. Schizophrenia diagnoses are almost entirely subjective in nature (there's no reliable biochemical or biomolecular or biophysical test for the presence or absence of the condition) - really the whole field of psychiatric care for mental health issues is about as useful as tuberculosis experts were in the 1850s, before Koch's demonstration of the infectious microbial nature of the disease.
- olliej 2y ago
  No it’s under pressure from people who go to the press saying “the FDA won’t let me use this drug to help me/my family” who ignore “because there’s no evidence it works” as the reason. The pharmaceutical just has to tell those people that it does work in their particular case and just ignore the studies that say it doesn’t, and the media and politicians uncritically report that as “the FDA is mean, let pharmaceutical companies sell new and expensive snake oil and re-victimise these people”, then in a few years later the same reporters and politicians berate the “ineffectual” FDA for allowing snake oil.
  - dmix 2y ago
    Regulatory capture doesn’t mean the entire of idea of FDA as a safety mechanism is bad… nor does a legitimate reason for their existence mean that capture doesn’t exist It is good to hold federal agencies with large power to a very high standard. But that’s often not the case as any critiques get dismissed with the “well they have good intentions and can you imagine if they didn’t exist?” hand wave tactic.
- 77pt77 2y ago
  > Game changer in treatment of disease we can't even define Doesn't quite have the same ring to it, now does it?
- fnordpiglet 2y ago
  I’m sort of surprised to see someone claiming schizophrenia is subjective. Schizophrenia has extraordinarily pronounced symptoms. It’s like claiming lupus doesn’t exist because there’s no single reliable diagnostic test for it. Schizophrenia has very specific and easily observed symptoms and is specifically affected by medications such as Zyprexa that doesn’t cause similar changes in behavior for people without schizophrenia or psychosis. However that and related medications have horrible side effects leading most patients to avoid taking it. For people who are or have family members ravaged by schizophrenia this is some of the best news you can imagine - a medication with similar beneficial effects on their loved ones but without turning them into zombies. It feels callous to an extraordinary degree to deny the existence of schizophrenia and to not recognize the benefit to a minimal side effect mediation that can give the schizophrenics life back.
rozab 2y ago
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 https://books.google.com/ngrams/graph?content=game+changer&year_start=1800&year_end=2022&corpus=en&smoothing=3 https://books.google.com/ngrams/graph?content=game+changer&y...
- drdaeman 2y ago
  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.
  - olelele 2y ago
    Readers hate this one trick, click to find out why!
- howard941 2y ago
  At $22.5K/yr it'll be more money changer than game changer.
- beautifulfreak 2y ago
  "Double down" has a similar chart, another annoying phrase.
- unsupp0rted 2y ago
  In the early days just before and just after AGI, all of a sudden a lot of games will be changed in a short period of time.
- dang 2y ago
  Ok, we've unchanged the game in the title above.
motohagiography 2y ago
[flagged]
- 3abiton 2y ago
  Mostly fourchan tbh, I didn't notice it that much HN.
- Uptrenda 2y ago
  Quite a low comment. Terry Davis had schizophrenia and could code circles around just about anyone.
- edm0nd 2y ago
  If only we had Terry Davis back...
  - Uptrenda 2y ago
    He really was a genius. I think its inspiring how much high quality work he created all by himself. A true hacker IMO.
ck2 2y ago
The audacity of pedaling a drug pricetag of $22,000 to solve someone being homeless when government safetynets won't even offer a fraction of that. 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-medicine-four-thieves-vinegar-collective/ https://www.vice.com/en/article/how-to-make-your-own-medicin...
- johnisgood 2y ago
  Wait till Europe gets generics, it will cost less than $5 per month. My MS medication would cost me $8k per month in the US, costs me $2 here.
  - devin 2y ago
    What medication?
    - johnisgood 2y ago
      Both dimethyl-fumarate and natalizumab are very expensive, well, MS medications are expensive in general.
      - devin 2y ago
        Thanks. I have a relative who was recently diagnosed and I heard their first treatment was very expensive (an order of magnitude more than 8k). I was curious what medication cost 8k, as finding the true cost for drugs is often quite difficult in the US.
        johnisgood 2y ago
        Most MS medications are very expensive at market price, unfortunately. :/ I would love to move to the US (because of friends), but I am afraid I will not be able to get my MS medication for ~$2 but $8k or more which I would not be able to afford. I want to switch to Tysabri (once a month injection), but it costs $1500 here at market price where I am in Eastern Europe, but I can get it for $2. In the US, it says: "The cost for Tysabri (300 mg/15 mL) intravenous concentrate is around $8,654 for a supply of 15 milliliters" (once a month supply). It does not matter though, even dimethyl-fumarate costs just as much (and is much weaker). So... needless to say, I am lost.
ldjkfkdsjnv 2y ago
[flagged]
- howard941 2y ago
  Other people exhibit psychotic behaviors because they're suffering from dementia. You wouldn't go with physical restraints if a chemical relieves the behavior?
- jenders 2y ago
  As someone with firsthand experience of a sibling with schizophrenia, this comment comes off incredibly callous and ignorant. I encourage you to learn more about this disease because you’re gravely mistaken—it is not a transient condition of early adulthood nor is untreated isolation on anyone’s treatment plan. The disease often presents in early adulthood and is a lifelong affliction thereafter. Left untreated, the condition worsens. Drugs are taken for life because the condition is incurable. Despite the risks, I am extremely grateful for Clozapine because it’s given me time back with my brother from this horrible disease. We’ve been through a gamut of medicines and treatments like Cobenfy are welcome. Like most families, we are jubilant at the prospect of finding better treatment options with fewer risks and side effects.
chiefalchemist 2y ago
If the FDA was truly interested in game changing it would lead. As it is, it's a sock puppet for Big Pharma. https://michaelpollan.com/books/how-to-change-your-mind/ https://michaelpollan.com/books/how-to-change-your-mind/
- EasyMark 2y ago
  As long as the government can’t cut deals with pharmaceutical companies it will continue to be like this. I’m sure the current SCOTUS will somehow make sure that is unconstitutional though if such a law did pass.
pjmorris 2y ago
> a price in line with expected clinical benefits to patients What would a price in line with recouping R&D and production costs and, say, a 20% profit margin be?
- thefounder 2y ago
  It may not be fair math. The company may bet on 10 different things and just one pays off. It needs to pay off for the bad bets as well.
  - gramie 2y ago
    > in line with recouping R&D and production costs That's the "recouping R&D" part.
    - thefounder 2y ago
      And who invests in companies that merely recoup the R&D ?
  - datavirtue 2y ago
    It seems like a previous comment pointing out how investors actually fund new drug development seems to track with the loads of pharma startups working on one thing each. Run some stock screeners on your brokerage account. You have to work to generate a list without a pharma startup on it.
    - s1artibartfast 2y ago
      A big part of this businesses model is because only large Pharma companies are equipped to handle the regulatory barriers and large enough to negotiate with the PBMs
- jdietrich 2y ago
  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%. https://www.sec.gov/ix?doc=/Archives/edgar/data/14272/000001427224000044/bmy-20231231.htm https://www.sec.gov/ix?doc=/Archives/edgar/data/14272/000001...
tomrod 2y ago
Per wikipedia, wholesale for the drug is $1,850/month. I think I echo my prior comments on the US health and pharma system: why? [0] https://en.wikipedia.org/wiki/Xanomeline/trospium_chloride https://en.wikipedia.org/wiki/Xanomeline/trospium_chloride
- deleted 2y ago
  [deleted]
- relativ575 2y ago
  Why not? Software engineer in the US makes 100K or higher. Why? If you have reasons to believe the price is too high, present them?
- slibhb 2y ago
  1. If prices weren't this high then there wouldn't be incentive to develop these drugs in the first place. There's a reason most novel drugs come from the US! 2. The vast majority of drugs do not pan out and most fledging companies formed to study them fail 3. In the US, insurance mostly covers the cost of drugs 4. In 14-20 years, the drug will be turned into a generic and the prices will plummet
  - guerrilla 2y ago
    > then there wouldn't be incentive to develop these drugs in the first place. This isn't true. The incentive is to help people. There are many people who are calable of doing that but can't do it afford to. We can just pay for their cost of living and research directly, cutting out the profit entirely.
    - deleted 2y ago
      [deleted]
    - s1artibartfast 2y ago
      Most doctors, nurses, and even scientists dont work for free. The incentive to help people is insufficient alone.
imperio59 2y ago
Let's remember it was recently proven that there is little to no evidence that serotonin levels are linked to depression: https://www.nature.com/articles/s41380-022-01661-0 https://www.nature.com/articles/s41380-022-01661-0 It's pretty much likely to be the same deal here. Since there is no chemical or biological test one can do to confirm a schizophrenia diagnosis, it's a subjective diagnosis by practitioners, treating such subjective diagnosis with powerful brain-chemistry altering drugs. Worse, we do not yet know whether these new drugs will be easy to get off of. Some of the other anti-psychotic type medication is VERY hard to get off of, such as abilify, where most drug treatment centers will not deal with Abilify withdrawals or take on those patients because those are so severe (extreme violence, self harm, etc during withdrawal). Until Psychiatry can reform itself to become a real science, using the scientific method (repeatable, provable results and not just a "theory of how brain chemistry maybe works sorta but we're not sure"), it will continue to just be a big cash cow for Big Pharma while hooking many patients who do not need these drugs onto them for life, while failing to effect ANY cure on the things they are treating (Have you heard of someone getting "better" after taking anti-depressants and being able to come off them? No. They have to take them for life. That's not a cure.)
- throw18376 2y ago
  i'm curious what is the longest conversation you've ever had with an untreated schizophrenic person? it's so obviously a "real disease" even if we don't fully understand the biological basis. it's subjective but honestly, there are just a ton of completely obvious cases. abuses of the psychiatric system are very bad, but schizophrenia is so so clearly real.
- crooked-v 2y ago
  > Have you heard of someone getting "better" after taking anti-depressants and being able to come off them? No. They have to take them for life. That's not a cure. There is no medicine in the world that you can take for a limited time to fix problems forever. That's not how medicine works. That's not how the world works.
  - catlikesshrimp 2y ago
throw18376 2y ago
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.
- throwup238 2y ago
  > the people who cared enough and took a huge concentrated risk to do this should just get rich, if in fact it pans out. They already did. Bristol Myer Squibb acquired the company behind this drug for $14 billion earlier this year.
- lukan 2y ago
  "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.
  - dgacmu 2y ago
    It's actually quite high. 10%+ in this meta-analysis, and 21% with some form of psychosis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6880407/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6880407/ If I were to guess, I would say that while many people may experience bouts of homelessness, the ones with schizophrenia are more likely to be persistently homeless.
  - throw18376 2y ago
    this is completely true, but they take up a very disproportionate amount of time and energy from social service providers, people who work in shelters, etc, and make all spaces for homeless people much more chaotic. the crisis would look very different if it was just a mix of people dealing with drug addiction (but basically lucid and rational) and with poverty.
throwaway0665 2y ago
> What are "Novel" Drugs? > "Novel" drugs are new drugs never before approved or marketed in the U.S.
rendx 2y ago
The Role of Childhood Trauma in Psychosis and Schizophrenia: A Systematic Review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8858420/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8858420/ "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-connection-between-schizophrenia-and-trauma/ 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."
- rendx 2y ago
  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 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."
hn72774 2y ago
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.
- hilux 2y ago
  Same story here, more or less. Freshman roommate. It's probably a common story.
- 11235813213455 2y ago
  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
  - iaaan 2y ago
    Just out of curiosity (no obligation to respond): how long have you been experiencing these difficulties? Have you always been sensitive to these things?
    - 11235813213455 2y ago
      I'm 39 now, since 22-24 so 15+ years, it started at the end of studies, I started to stop spending money (except appt. rent), OCD things appeared, I manage to keep stable jobs and after years I started eating better, fueling better the brain, most OCD troubles disappeared, but I feel like I changed myself to someone more sensitive, more wild in some way. in the long run I can't handle a "normal life", sit down in a closed air-conditioned place, eat industrial food, tolerate cigarette smokers around, noisy motorbikes, and all forms of pollutions. I started to also try to avoid polluting as much as possible, by respect for nature, which is my real efficient treatment I think
OhioMan2943 2y ago
Does anyone else feel like this is just some sort of population control measure?
- jacobjjacob 2y ago
  No, what’s your rationale?
- nucleardog 2y ago
  The schizophrenics certainly do! https://my.clevelandclinic.org/health/diseases/23348-paranoid-schizophrenia https://my.clevelandclinic.org/health/diseases/23348-paranoi...
- codezero 2y ago
  If you have ever known someone suffering from schizophrenia then you would know they are keen to not suffer from schizophrenia. The disease itself is a form of population control, as few who have this condition live a full natural lifespan. Since 2020 I lost two friends age 50 and 40. Both very high functioning people with college degrees who were never homeless.
- hindsightbias 2y ago
  They already have Chemtrails and TV for that.
  - sqeaky 2y ago
    "Netflix and chill" is surely a different take on "population control".
ndynan 2y ago
https://www.sciencedirect.com/science/article/pii/S0140673623021906?casa_token=1c8ciudcSp8AAAAA:5ICP1F9fDsBqG-AaO6nxyfohx-6_BmzlHxLTwrkTXgXHWonOOlRLWRR1fP8buzngJZOXbpOy https://www.sciencedirect.com/science/article/pii/S014067362... Here is the drug trial results for EMERGENT-2 which was one of the two phase-3 trials that lead to the approval. I think its striking that the trial is only 5-weeks long and this medication gets approval.
- throwup238 2y ago
  From your linked paper: > Results from additional trials, including the identical EMERGENT-3 trial and the 52-week, open-label EMERGENT-4 and EMERGENT-5 trials, will provide additional information on the efficacy and safety of KarXT in people with schizophrenia. EMERGENT-4 and EMERGENT-5 concluded last year [1], which was the reason for the approval. EMERGENT-2 was mostly a milestone Karuna Therapeutics used to get enough funding for the rest of the trials and inform their design. [1] https://news.bms.com/news/details/2024/Bristol-Myers-Squibb-Presents-New-Pooled-Interim-Long-Term-Safety-and-Metabolic-Outcomes-Data-from-the-EMERGENT-Program-Evaluating-KarXT-in-Schizophrenia-at-the-2024-Annual-Congress-of-the-Schizophrenia-International-Research-Society/default.aspx https://news.bms.com/news/details/2024/Bristol-Myers-Squibb-...
  - ndynan 2y ago
    Thanks for the info - curious to look at these trials and see if there are sustained long term positive outcomes on the PANSS or these are just safety /tolerability studies.
deleted 2y ago
[deleted]
bombi 2y ago
Schizophrenia can be cured with niacin (vitamin B3). Search for Adam Hoffer's achievements
- the_gorilla 2y ago
  Every single time someone has told me a disease could be cured with vitamins, it was scurvy or bullshit.
  - FollowingTheDao 2y ago
    Enzymatic cofactors (vitamins) many not a be cure, but maybe a better, cheaper, less harmful, treatment. Take pyridoxine (B6) as an example. Also, did you know vitamin C deficiency not only casues scurvy but mood disorders as well? The neuropsychiatric effects of vitamin C deficiency: a systematic review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7302360/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7302360/ on Pyridoxine: Pyridoxamine: A novel treatment for schizophrenia with enhanced carbonyl stress https://onlinelibrary.wiley.com/doi/full/10.1111/pcn.12613 https://onlinelibrary.wiley.com/doi/full/10.1111/pcn.12613 Vitamin B6 deficiency hyperactivates the noradrenergic system, leading to social deficits and cognitive impairment https://www.nature.com/articles/s41398-021-01381-z https://www.nature.com/articles/s41398-021-01381-z Vitamin B6 as add-on treatment in chronic schizophrenic and schizoaffective patients: a double-blind, placebo-controlled study https://pubmed.ncbi.nlm.nih.gov/11838627/ https://pubmed.ncbi.nlm.nih.gov/11838627/ Decreased serum pyridoxal levels in schizophrenia: meta-analysis and Mendelian randomization analysis https://www.jpn.ca/content/43/3/194.abstract https://www.jpn.ca/content/43/3/194.abstract Treatment of Pyroluric Schizophrenia(Malvaria) With Large Doses of Pyridoxineand a Dietary Supplement of Zinc https://isom.ca/wp-content/uploads/2020/01/JOM_1974_03_4_11_Treatment_of_Pyroluric_Schizophrenia_Malvaria.pdf https://isom.ca/wp-content/uploads/2020/01/JOM_1974_03_4_11_...
  - bombi 2y ago
    [dead]
- smolder 2y ago
  It's weird that you would state that so confidently when, as wikipedia says, "Hoffer's ideas about megavitamin therapy to treat mental illness are not accepted by the medical community." It didn't pan out.
dailykoder 2y ago
RIP in peace Terry Davis. If you only had that :(
- heraldgeezer 2y ago
  May he run over many CIA glowies in heaven <3
pcrh 2y ago
Nice to see! 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-Cobenfy https://wellcome.org/news/new-treatment-for-schizophrenia-Co...
- hackernewds 2y ago
  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.
greenish_shore1 2y ago
Want to buy it cheaper? ALWAYS look for the molecule's CAS number in your search engine of choice. https://www.google.com/search?q=131986-45-3 https://www.google.com/search?q=131986-45-3 (Xanomeline) https://www.google.com/search?q=10405-02-4 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 2y ago
  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.
  - greenish_shore1 2y ago
    If you don't trust people to compound a drug for their own use, why would you trust them to not jump off a bridge, to not kill or injure a passerby, or not to perform other serious antisocial actions? Of course this is a way deeper issue, but I tend to approach it this way. In the Western values, we tend to value freedom, also as freedom of people to self-define, very high, despite the risks it takes. And this, this is a modern part of exactly the same dilemma. People already do exactly that, and with some basic knowledge (which should and probably will be in 20-30 years a common knowledge) it's much safer than one could expect. Of course, it'd be ideal if they wouldn't need to worry about it and could leave this to a person who is guaranteed to be more knowledgeable in doing that, but with all the over-regulation burden, drug patents, drug schedules, it's not happening. Example of that is, precisely, the price of this. It could literally be 2000x smaller if we only get rid of that burden, which was created to give some people profit. And if we subside that with taxes, these taxes go to the pocket of a gatekept and protected-by-the-state manufacturer. That's not how taxes should even work, they should benefit the society instead. TL;DR: This is a much wider issue.
    - glial 2y ago
      I mean, I wouldn't compound drugs for myself for the same reason I don't do maintenance on my car's transmission myself: I don't really know what I'm doing and would probably get myself killed. From what I understand - may be wrong - the 2000x has more to do with IP protections than production safety.
ThinkBeat 2y ago
This reads like a happy clappy advertisement. 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 2y ago
  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.
  - 2close4comfort 2y ago
mik0n 2y ago
New drugs are sorely needed 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).
- rs999gti 2y ago
  Remove the stigma of mental illness and new drugs are not really needs. The current class of drugs are excellent at controlling psychosis. Sure there are side effects, but in this case the side effects are better than the psychotic behavior and breakdown of the patients.
  - mik0n 2y ago
    Wouldn't it be better to have a drug with NO severe side effects, so we can actually get people to eat them? Which is exactly what they are trying to do. So many quit their meds, then wham another psychosis. I just don't understand the negativity in this thread. They are doing gods work as far as I'm concerned.
BiggerComputer 2y ago
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.

229 points by tintinnabula 2y ago

It's this https://en.wikipedia.org/wiki/Xanomeline/trospium_chloride https://en.wikipedia.org/wiki/Xanomeline/trospium_chloride

kstrauser 2y ago
> 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. Whoa. Wonder if that's being evaluated?
- jmcgough 2y ago
  Yes, it's being tested for autism as well.
  - LoganDark 2y ago
    I wonder what their hopes are for autism. I think the detail-oriented (or at least logic-oriented) thinking at least is an intrinsic part of brain development in autistics, but I wonder if it'll ever be possible to control certain other symptoms of autism through medication.
    - consteval 2y ago
      It could very well become a cost/reward analysis thing since Autism is a spectrum disorder. People who are high-functioning will probably be fine without the drug, but people who are, for example, non-verbal may be more willing to take it. I'm assuming such a drug would have drastic drawbacks in terms of how Autistic people think. Similar to other drugs that address mental state, they might not feel like themselves.
      - LoganDark 2y ago
        > I'm assuming such a drug would have drastic drawbacks in terms of how Autistic people think. Similar to other drugs that address mental state, they might not feel like themselves. Knowing how I think, and how I use knowledge, I'm not sure that I'd be better at anything if a drug altered my ability to think in detail. Even if something made me non-autistic like magic, I have a lifetime of autistic knowledge that is structured differently than what a non-autistic brain would need. I could have to learn everything all over again if I were to become unable to comprehend/assemble the logical building blocks that I normally use to do everything. So I have to assume the drug doesn't actually attempt to treat the core defining trait of autism and only attempts to treat some of the side effects. As far as I'm aware, even though autism is a spectrum, every brain that is autistic has a particularly distinctive redistribution of connections, which is what results in basically everything. This redistribution is likely what results in the overly logical/analytical thinking (whether it's bottom-up or top-down), although I don't think anyone's been able to prove or disprove that, it's just a correlation.
        consteval 2y ago
        Right, but we need to consider outcomes. If such a drug could help those who can't take care of themselves, take care of themselves, that's a very good outcome. An outcome for someone like you wouldn't be very good so it doesn't matter much. But for some, this could be the difference between being institutionalized forever versus living a somewhat independent life.
therein 2y ago
Co-administration of an agonist and an antagonist for the same pharmacophore seems like an interesting approach.
- nwienert 2y ago
  Looks like the antagonist is only outside the brain, so it works to counteract the side-effects, pretty cool. I wanted sort of the opposite of this for opioids - work in the body, not the brain. There's been a few attempts but non that passed trials.
  - swores 2y ago
    Would the opposite (work in the brain but not the body) also be a healthier alternative for people addicted to getting high on opiates?
    - johnisgood 2y ago
      Yeah, because it is the high they are after, but not working in the brain would make opioids completely useless for depression and anxiety (for which it really does wonders).
      - nwienert 2y ago
        My want is for relieving pain in the body without making me feel high, I actually assumed you want it in the body not brain, as the brain effects are the feel-good effects, but really not sure or familiar with how they work.
        nullindividual 2y ago
        Ibuprofen and acetaminophen may already be that option. https://www.aafp.org/pubs/afp/issues/2018/0301/p348.html https://www.aafp.org/pubs/afp/issues/2018/0301/p348.html I believe there are other studies besides this that points to these two OTC pain relievers as being 'just as good' as opiates.

boingo 2y ago

https://archive.is/BYzWs https://archive.is/BYzWs

KomoD 2y ago

> 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.

givemeethekeys 2y ago
Didn't some bro from the pharma industry get mercilessly shat upon for charging so much for a life saving drug?
- the_sleaze_ 2y ago
  You're being downvoted for using an easily google-able factoid incorrectly because you're pattern matching on "high drug prices" What happened was Martin Shekreli purchased patents for existing life-saving drugs and raised the price for them from $1.50 to $30 to cover the cost of the purchasing the patents themselves. This is an entirely different.
  - givemeethekeys 2y ago
    How people feel about facts is much more important than the facts themselves. The perception of the drug price increase much more than the details, along with other asshole things he did made him an easy target for outrage. What is the cost of mass producing this new drug? How much profit should the company be allowed to make? Where's the outrage?
    - nozzlegear 2y ago
      The company paid $14b for the research to bring this drug to market. Like all Americans — and all citizens of the world, apparently — I agree that drug prices in the US are too high, but shouldn't they be allowed to at least recoup that investment? How can we expect companies like this to continue researching such drugs if not? Especially when, more often than not, the research leads to a dead end or failed trials, and they can't even bring the drug to market?

photochemsyn 2y ago

The FDA is under regulatory capture by the pharmaceutical industry, and their approval or lack thereof is one of the most unreliable measures of the safety and efficacy of psychiatric drugs in particular. Schizophrenia diagnoses are almost entirely subjective in nature (there's no reliable biochemical or biomolecular or biophysical test for the presence or absence of the condition) - really the whole field of psychiatric care for mental health issues is about as useful as tuberculosis experts were in the 1850s, before Koch's demonstration of the infectious microbial nature of the disease.

olliej 2y ago
No it’s under pressure from people who go to the press saying “the FDA won’t let me use this drug to help me/my family” who ignore “because there’s no evidence it works” as the reason. The pharmaceutical just has to tell those people that it does work in their particular case and just ignore the studies that say it doesn’t, and the media and politicians uncritically report that as “the FDA is mean, let pharmaceutical companies sell new and expensive snake oil and re-victimise these people”, then in a few years later the same reporters and politicians berate the “ineffectual” FDA for allowing snake oil.
- dmix 2y ago
  Regulatory capture doesn’t mean the entire of idea of FDA as a safety mechanism is bad… nor does a legitimate reason for their existence mean that capture doesn’t exist It is good to hold federal agencies with large power to a very high standard. But that’s often not the case as any critiques get dismissed with the “well they have good intentions and can you imagine if they didn’t exist?” hand wave tactic.
77pt77 2y ago
> Game changer in treatment of disease we can't even define Doesn't quite have the same ring to it, now does it?
fnordpiglet 2y ago
I’m sort of surprised to see someone claiming schizophrenia is subjective. Schizophrenia has extraordinarily pronounced symptoms. It’s like claiming lupus doesn’t exist because there’s no single reliable diagnostic test for it. Schizophrenia has very specific and easily observed symptoms and is specifically affected by medications such as Zyprexa that doesn’t cause similar changes in behavior for people without schizophrenia or psychosis. However that and related medications have horrible side effects leading most patients to avoid taking it. For people who are or have family members ravaged by schizophrenia this is some of the best news you can imagine - a medication with similar beneficial effects on their loved ones but without turning them into zombies. It feels callous to an extraordinary degree to deny the existence of schizophrenia and to not recognize the benefit to a minimal side effect mediation that can give the schizophrenics life back.

rozab 2y ago

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 https://books.google.com/ngrams/graph?content=game+changer&year_start=1800&year_end=2022&corpus=en&smoothing=3 https://books.google.com/ngrams/graph?content=game+changer&y...

drdaeman 2y ago
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.
- olelele 2y ago
  Readers hate this one trick, click to find out why!
howard941 2y ago
At $22.5K/yr it'll be more money changer than game changer.
beautifulfreak 2y ago
"Double down" has a similar chart, another annoying phrase.
unsupp0rted 2y ago
In the early days just before and just after AGI, all of a sudden a lot of games will be changed in a short period of time.
dang 2y ago
Ok, we've unchanged the game in the title above.

motohagiography 2y ago

[flagged]

3abiton 2y ago
Mostly fourchan tbh, I didn't notice it that much HN.
Uptrenda 2y ago
Quite a low comment. Terry Davis had schizophrenia and could code circles around just about anyone.
edm0nd 2y ago
If only we had Terry Davis back...
- Uptrenda 2y ago
  He really was a genius. I think its inspiring how much high quality work he created all by himself. A true hacker IMO.

ck2 2y ago

The audacity of pedaling a drug pricetag of $22,000 to solve someone being homeless when government safetynets won't even offer a fraction of that. 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-medicine-four-thieves-vinegar-collective/ https://www.vice.com/en/article/how-to-make-your-own-medicin...

johnisgood 2y ago
Wait till Europe gets generics, it will cost less than $5 per month. My MS medication would cost me $8k per month in the US, costs me $2 here.
- devin 2y ago
  What medication?
  - johnisgood 2y ago
    Both dimethyl-fumarate and natalizumab are very expensive, well, MS medications are expensive in general.
    - devin 2y ago
      Thanks. I have a relative who was recently diagnosed and I heard their first treatment was very expensive (an order of magnitude more than 8k). I was curious what medication cost 8k, as finding the true cost for drugs is often quite difficult in the US.
      - johnisgood 2y ago
        Most MS medications are very expensive at market price, unfortunately. :/ I would love to move to the US (because of friends), but I am afraid I will not be able to get my MS medication for ~$2 but $8k or more which I would not be able to afford. I want to switch to Tysabri (once a month injection), but it costs $1500 here at market price where I am in Eastern Europe, but I can get it for $2. In the US, it says: "The cost for Tysabri (300 mg/15 mL) intravenous concentrate is around $8,654 for a supply of 15 milliliters" (once a month supply). It does not matter though, even dimethyl-fumarate costs just as much (and is much weaker). So... needless to say, I am lost.

ldjkfkdsjnv 2y ago

[flagged]

howard941 2y ago
Other people exhibit psychotic behaviors because they're suffering from dementia. You wouldn't go with physical restraints if a chemical relieves the behavior?
jenders 2y ago
As someone with firsthand experience of a sibling with schizophrenia, this comment comes off incredibly callous and ignorant. I encourage you to learn more about this disease because you’re gravely mistaken—it is not a transient condition of early adulthood nor is untreated isolation on anyone’s treatment plan. The disease often presents in early adulthood and is a lifelong affliction thereafter. Left untreated, the condition worsens. Drugs are taken for life because the condition is incurable. Despite the risks, I am extremely grateful for Clozapine because it’s given me time back with my brother from this horrible disease. We’ve been through a gamut of medicines and treatments like Cobenfy are welcome. Like most families, we are jubilant at the prospect of finding better treatment options with fewer risks and side effects.

chiefalchemist 2y ago

If the FDA was truly interested in game changing it would lead. As it is, it's a sock puppet for Big Pharma. https://michaelpollan.com/books/how-to-change-your-mind/ https://michaelpollan.com/books/how-to-change-your-mind/

EasyMark 2y ago
As long as the government can’t cut deals with pharmaceutical companies it will continue to be like this. I’m sure the current SCOTUS will somehow make sure that is unconstitutional though if such a law did pass.

pjmorris 2y ago

> a price in line with expected clinical benefits to patients What would a price in line with recouping R&D and production costs and, say, a 20% profit margin be?

thefounder 2y ago
It may not be fair math. The company may bet on 10 different things and just one pays off. It needs to pay off for the bad bets as well.
- gramie 2y ago
  > in line with recouping R&D and production costs That's the "recouping R&D" part.
  - thefounder 2y ago
    And who invests in companies that merely recoup the R&D ?
- datavirtue 2y ago
  It seems like a previous comment pointing out how investors actually fund new drug development seems to track with the loads of pharma startups working on one thing each. Run some stock screeners on your brokerage account. You have to work to generate a list without a pharma startup on it.
  - s1artibartfast 2y ago
    A big part of this businesses model is because only large Pharma companies are equipped to handle the regulatory barriers and large enough to negotiate with the PBMs
jdietrich 2y ago
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%. https://www.sec.gov/ix?doc=/Archives/edgar/data/14272/000001427224000044/bmy-20231231.htm https://www.sec.gov/ix?doc=/Archives/edgar/data/14272/000001...

tomrod 2y ago

Per wikipedia, wholesale for the drug is $1,850/month. I think I echo my prior comments on the US health and pharma system: why? [0] https://en.wikipedia.org/wiki/Xanomeline/trospium_chloride https://en.wikipedia.org/wiki/Xanomeline/trospium_chloride

deleted 2y ago
[deleted]
relativ575 2y ago
Why not? Software engineer in the US makes 100K or higher. Why? If you have reasons to believe the price is too high, present them?
slibhb 2y ago
1. If prices weren't this high then there wouldn't be incentive to develop these drugs in the first place. There's a reason most novel drugs come from the US! 2. The vast majority of drugs do not pan out and most fledging companies formed to study them fail 3. In the US, insurance mostly covers the cost of drugs 4. In 14-20 years, the drug will be turned into a generic and the prices will plummet
- guerrilla 2y ago
  > then there wouldn't be incentive to develop these drugs in the first place. This isn't true. The incentive is to help people. There are many people who are calable of doing that but can't do it afford to. We can just pay for their cost of living and research directly, cutting out the profit entirely.
  - deleted 2y ago
    [deleted]
  - s1artibartfast 2y ago
    Most doctors, nurses, and even scientists dont work for free. The incentive to help people is insufficient alone.

imperio59 2y ago

Let's remember it was recently proven that there is little to no evidence that serotonin levels are linked to depression: https://www.nature.com/articles/s41380-022-01661-0 https://www.nature.com/articles/s41380-022-01661-0 It's pretty much likely to be the same deal here. Since there is no chemical or biological test one can do to confirm a schizophrenia diagnosis, it's a subjective diagnosis by practitioners, treating such subjective diagnosis with powerful brain-chemistry altering drugs. Worse, we do not yet know whether these new drugs will be easy to get off of. Some of the other anti-psychotic type medication is VERY hard to get off of, such as abilify, where most drug treatment centers will not deal with Abilify withdrawals or take on those patients because those are so severe (extreme violence, self harm, etc during withdrawal). Until Psychiatry can reform itself to become a real science, using the scientific method (repeatable, provable results and not just a "theory of how brain chemistry maybe works sorta but we're not sure"), it will continue to just be a big cash cow for Big Pharma while hooking many patients who do not need these drugs onto them for life, while failing to effect ANY cure on the things they are treating (Have you heard of someone getting "better" after taking anti-depressants and being able to come off them? No. They have to take them for life. That's not a cure.)

throw18376 2y ago
i'm curious what is the longest conversation you've ever had with an untreated schizophrenic person? it's so obviously a "real disease" even if we don't fully understand the biological basis. it's subjective but honestly, there are just a ton of completely obvious cases. abuses of the psychiatric system are very bad, but schizophrenia is so so clearly real.
crooked-v 2y ago
> Have you heard of someone getting "better" after taking anti-depressants and being able to come off them? No. They have to take them for life. That's not a cure. There is no medicine in the world that you can take for a limited time to fix problems forever. That's not how medicine works. That's not how the world works.
- catlikesshrimp 2y ago

throw18376 2y ago

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.

throwup238 2y ago
> the people who cared enough and took a huge concentrated risk to do this should just get rich, if in fact it pans out. They already did. Bristol Myer Squibb acquired the company behind this drug for $14 billion earlier this year.
lukan 2y ago
"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.
- dgacmu 2y ago
  It's actually quite high. 10%+ in this meta-analysis, and 21% with some form of psychosis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6880407/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6880407/ If I were to guess, I would say that while many people may experience bouts of homelessness, the ones with schizophrenia are more likely to be persistently homeless.
- throw18376 2y ago
  this is completely true, but they take up a very disproportionate amount of time and energy from social service providers, people who work in shelters, etc, and make all spaces for homeless people much more chaotic. the crisis would look very different if it was just a mix of people dealing with drug addiction (but basically lucid and rational) and with poverty.

throwaway0665 2y ago

> What are "Novel" Drugs? > "Novel" drugs are new drugs never before approved or marketed in the U.S.

rendx 2y ago

The Role of Childhood Trauma in Psychosis and Schizophrenia: A Systematic Review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8858420/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8858420/ "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-connection-between-schizophrenia-and-trauma/ 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."

rendx 2y ago
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 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."

hn72774 2y ago

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.

hilux 2y ago
Same story here, more or less. Freshman roommate. It's probably a common story.
11235813213455 2y ago
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
- iaaan 2y ago
  Just out of curiosity (no obligation to respond): how long have you been experiencing these difficulties? Have you always been sensitive to these things?
  - 11235813213455 2y ago
    I'm 39 now, since 22-24 so 15+ years, it started at the end of studies, I started to stop spending money (except appt. rent), OCD things appeared, I manage to keep stable jobs and after years I started eating better, fueling better the brain, most OCD troubles disappeared, but I feel like I changed myself to someone more sensitive, more wild in some way. in the long run I can't handle a "normal life", sit down in a closed air-conditioned place, eat industrial food, tolerate cigarette smokers around, noisy motorbikes, and all forms of pollutions. I started to also try to avoid polluting as much as possible, by respect for nature, which is my real efficient treatment I think

OhioMan2943 2y ago

Does anyone else feel like this is just some sort of population control measure?

jacobjjacob 2y ago
No, what’s your rationale?
nucleardog 2y ago
The schizophrenics certainly do! https://my.clevelandclinic.org/health/diseases/23348-paranoid-schizophrenia https://my.clevelandclinic.org/health/diseases/23348-paranoi...
codezero 2y ago
If you have ever known someone suffering from schizophrenia then you would know they are keen to not suffer from schizophrenia. The disease itself is a form of population control, as few who have this condition live a full natural lifespan. Since 2020 I lost two friends age 50 and 40. Both very high functioning people with college degrees who were never homeless.
hindsightbias 2y ago
They already have Chemtrails and TV for that.
- sqeaky 2y ago
  "Netflix and chill" is surely a different take on "population control".

ndynan 2y ago

https://www.sciencedirect.com/science/article/pii/S0140673623021906?casa_token=1c8ciudcSp8AAAAA:5ICP1F9fDsBqG-AaO6nxyfohx-6_BmzlHxLTwrkTXgXHWonOOlRLWRR1fP8buzngJZOXbpOy https://www.sciencedirect.com/science/article/pii/S014067362... Here is the drug trial results for EMERGENT-2 which was one of the two phase-3 trials that lead to the approval. I think its striking that the trial is only 5-weeks long and this medication gets approval.

throwup238 2y ago
From your linked paper: > Results from additional trials, including the identical EMERGENT-3 trial and the 52-week, open-label EMERGENT-4 and EMERGENT-5 trials, will provide additional information on the efficacy and safety of KarXT in people with schizophrenia. EMERGENT-4 and EMERGENT-5 concluded last year [1], which was the reason for the approval. EMERGENT-2 was mostly a milestone Karuna Therapeutics used to get enough funding for the rest of the trials and inform their design. [1] https://news.bms.com/news/details/2024/Bristol-Myers-Squibb-Presents-New-Pooled-Interim-Long-Term-Safety-and-Metabolic-Outcomes-Data-from-the-EMERGENT-Program-Evaluating-KarXT-in-Schizophrenia-at-the-2024-Annual-Congress-of-the-Schizophrenia-International-Research-Society/default.aspx https://news.bms.com/news/details/2024/Bristol-Myers-Squibb-...
- ndynan 2y ago
  Thanks for the info - curious to look at these trials and see if there are sustained long term positive outcomes on the PANSS or these are just safety /tolerability studies.

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bombi 2y ago

Schizophrenia can be cured with niacin (vitamin B3). Search for Adam Hoffer's achievements

the_gorilla 2y ago
Every single time someone has told me a disease could be cured with vitamins, it was scurvy or bullshit.
- FollowingTheDao 2y ago
  Enzymatic cofactors (vitamins) many not a be cure, but maybe a better, cheaper, less harmful, treatment. Take pyridoxine (B6) as an example. Also, did you know vitamin C deficiency not only casues scurvy but mood disorders as well? The neuropsychiatric effects of vitamin C deficiency: a systematic review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7302360/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7302360/ on Pyridoxine: Pyridoxamine: A novel treatment for schizophrenia with enhanced carbonyl stress https://onlinelibrary.wiley.com/doi/full/10.1111/pcn.12613 https://onlinelibrary.wiley.com/doi/full/10.1111/pcn.12613 Vitamin B6 deficiency hyperactivates the noradrenergic system, leading to social deficits and cognitive impairment https://www.nature.com/articles/s41398-021-01381-z https://www.nature.com/articles/s41398-021-01381-z Vitamin B6 as add-on treatment in chronic schizophrenic and schizoaffective patients: a double-blind, placebo-controlled study https://pubmed.ncbi.nlm.nih.gov/11838627/ https://pubmed.ncbi.nlm.nih.gov/11838627/ Decreased serum pyridoxal levels in schizophrenia: meta-analysis and Mendelian randomization analysis https://www.jpn.ca/content/43/3/194.abstract https://www.jpn.ca/content/43/3/194.abstract Treatment of Pyroluric Schizophrenia(Malvaria) With Large Doses of Pyridoxineand a Dietary Supplement of Zinc https://isom.ca/wp-content/uploads/2020/01/JOM_1974_03_4_11_Treatment_of_Pyroluric_Schizophrenia_Malvaria.pdf https://isom.ca/wp-content/uploads/2020/01/JOM_1974_03_4_11_...
- bombi 2y ago
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smolder 2y ago
It's weird that you would state that so confidently when, as wikipedia says, "Hoffer's ideas about megavitamin therapy to treat mental illness are not accepted by the medical community." It didn't pan out.

dailykoder 2y ago

RIP in peace Terry Davis. If you only had that :(

heraldgeezer 2y ago
May he run over many CIA glowies in heaven <3

pcrh 2y ago

Nice to see! 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-Cobenfy https://wellcome.org/news/new-treatment-for-schizophrenia-Co...

hackernewds 2y ago
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.

greenish_shore1 2y ago

Want to buy it cheaper? ALWAYS look for the molecule's CAS number in your search engine of choice. https://www.google.com/search?q=131986-45-3 https://www.google.com/search?q=131986-45-3 (Xanomeline) https://www.google.com/search?q=10405-02-4 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 2y ago
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.
- greenish_shore1 2y ago
  If you don't trust people to compound a drug for their own use, why would you trust them to not jump off a bridge, to not kill or injure a passerby, or not to perform other serious antisocial actions? Of course this is a way deeper issue, but I tend to approach it this way. In the Western values, we tend to value freedom, also as freedom of people to self-define, very high, despite the risks it takes. And this, this is a modern part of exactly the same dilemma. People already do exactly that, and with some basic knowledge (which should and probably will be in 20-30 years a common knowledge) it's much safer than one could expect. Of course, it'd be ideal if they wouldn't need to worry about it and could leave this to a person who is guaranteed to be more knowledgeable in doing that, but with all the over-regulation burden, drug patents, drug schedules, it's not happening. Example of that is, precisely, the price of this. It could literally be 2000x smaller if we only get rid of that burden, which was created to give some people profit. And if we subside that with taxes, these taxes go to the pocket of a gatekept and protected-by-the-state manufacturer. That's not how taxes should even work, they should benefit the society instead. TL;DR: This is a much wider issue.
  - glial 2y ago
    I mean, I wouldn't compound drugs for myself for the same reason I don't do maintenance on my car's transmission myself: I don't really know what I'm doing and would probably get myself killed. From what I understand - may be wrong - the 2000x has more to do with IP protections than production safety.

ThinkBeat 2y ago

This reads like a happy clappy advertisement. 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 2y ago
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.
- 2close4comfort 2y ago

mik0n 2y ago

New drugs are sorely needed 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).

rs999gti 2y ago
Remove the stigma of mental illness and new drugs are not really needs. The current class of drugs are excellent at controlling psychosis. Sure there are side effects, but in this case the side effects are better than the psychotic behavior and breakdown of the patients.
- mik0n 2y ago
  Wouldn't it be better to have a drug with NO severe side effects, so we can actually get people to eat them? Which is exactly what they are trying to do. So many quit their meds, then wham another psychosis. I just don't understand the negativity in this thread. They are doing gods work as far as I'm concerned.

BiggerComputer 2y ago

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.