"Your blog posting suggesting I was unenthusiastic about Pristiq mischaracterized my views. It is very useful for clinicians to have another serotonin-norepinephrine reuptake inhibitor (SNRI) available to treat depression. This class of antidepressants is very useful for treating an often disabling and sometimes life threatening condition, and the more tools we as clinicians have available, the better we can serve our patients. In addition, Pristiq's very tolerable starting dose of 50 mg per day may also turn out to be its usual therapeutic dose, avoiding the need for dose escalation. If so, this would differentiate it from Effexor XR and Cymbalta, the two previously marketed SNRI's.
With regard to my remark that if Pristiq was useful, it would make money for Wyeth, this was in response to your question about whether the company was marketing it for altruistic or commercial reasons. The intent of my comment was twofold. First, I believe that it was not an either-or proposition. Rather, if the drug turned out to be highly useful, it would also be highly profitable, so a company can be motivated both by wanting to advance science and health care and make a profit. Secondly, how widely a given drug will be used is not always something one can usually predict until a drug is marketed and clinicians have a chance to test it out in daily clinical situations. For example, who would have predicted that Celexa or Lexapro, marketed for depression after numerous other SSRI's, would turn out to be very useful, popular and widely used drugs.
Michael Liebowitz M.D.
Professor of Clinical Psychiatry
Tuesday, March 11, 2008
Liebowitz Sets the Record Straight on Pristiq Views
I recently posted this critique of Wyeth's newly approved antidepressant Pristiq, and in that article I quoted Dr. Michael Liebowitz, who was the lead investigator on some of the Pristiq clinical trials. Dr. Liebowitz contacted me because he felt I had mischaracterized his opinions. I invited him to send me a clarification, which I offered to print in full. In reviewing this issue, I plead guilty to having taken some of his comments out of context, and I apologize to Dr. Liebowitz for having done so. These are his views on Pristiq, in his own words: