Posted by ttee on May 20, 2006, at 12:06:44
In reply to Re: Emsam: aabag » ttee, posted by Iansf on May 19, 2006, at 16:52:06
First, BMS makes NO other competing anti-depressants to worry about. BMS is not going to give a crap about dipping into Lexapro sales; in fact they would like that to happen. Paxil, Zoloft, and Celexa are already off patent. Effexor will follow the end of the year.
Emsam still has the same drug/drug interactions that are the main reason most PCP's and pdocs were scared to prescribe Nardil or Parnate in the first place. Nardil and Parnate combined only represented 0.01% of all anti-depressants prescribed. In that over 80% of all anti-depressants are prescribed by PCP, not psychiatrists, for a drug to become a blockbuster it needs to have full support from the majority of the PCP's. PCP's are scared to death of the liability to prescribe any MAOI's. That will not change until Emsam has been out for over 7 years and there have been no deaths from drug or dietary problems. Even BMS in the financial statements estimates peak Emsam sales to be around $200 million per year. Compare that to Effexor that makes over 3 Billion per year. Since the average new drug takes $800 million to get FDA approval, it is going to take many years of only making $200 million per year for BMS to breakeven on Emsam. If they can get EMSAM approved for other indications like ADHD, Anxiety, Dementia, etc. then it might become more then a minor footnote in the annual financial statements for the drug company.
As far as knowing how well Emsam works, I doubt the 5 or 8 people on the site represent a scientific study as to efficiency. In addition, I think it is about even as to those that are finding it helpful and those that are discontinuing Emsam early because they were going out of the mind.
Amphetamines have a similar fast response and low side effect profile as Emsam. But I don't think amphetamines are the long term answer for many.
I would be worried about a doctor that treats a first time depressed patient with Emsam before seeing if and SSRI (generic) or SNRI might do the trick without the fuss of potentially fatal drug/drug interactions with something as simple as getting Novocain at the dentist's office.
Time will tell and I think Emsam is a great alternative to the older MAOI's for a certain subtype of depressed patients. The more different treatments there are, the better the chances people have to get a response.
Good luck all your Emsam'ers!!
poster:ttee
thread:642628
URL: http://www.dr-bob.org/babble/20060520/msgs/646241.html