Wednesday, December 19, 2012

Fanapt: The Drug Prescribed For The Shooter

The December 18, 2012 Business Insider says that he was prescribed a controversial anti-psychotic medicine named Fanapt.  Yet a search shows no obvious matches to Asperger's Syndrome, but it is prescribed for schizophrenia.  Let me emphasize that I am not saying that Fanap caused the attack (although there are concerns about it provoking aggression), but that it is increasingly appearing that he was schizophrenic, not Asperger's.

UPDATE: A reader tells me that Fanapt is ALSO prescribed for autism spectrum disorders. I found this reference to it, but the manufacturer's web site doesn't mention it.  Is this perhaps an off-label use?

UPDATE 2: This note from Regence Blue Shield concerning Fanapt and autism says:

AUTISTIC DISORDER
There is limited evidence for the efficacy of pharmacotherapy in autistic disorder;
however, SSRIs and atypical antipsychotics are used to alleviate some of the associated
symptoms.
UPDATE 3: The "uncle" turns out to be unrelated, and a well-known criminal.

3 comments:

Flight-ER-Doc said...

Not to pick nits, but thats Fanapt (iloperiodne).

And it has a whole raft of bad side effects, IMHO

Clayton said...

Thanks for the catch on the typo. And one of the links points to some of those problems.

hga said...

They all have a "whole raft of bad side effects", those are just considered to be worth paying to keep sane. Although of course those results in grave compliance problems, outside of institutions many just won't take the meds that make them feel so nasty. That was a problem with the woman who suffered from postpartum psychosis and killed her children; when I heard she was on an old "typical" antipsychotic I knew she was getting depot injections (that stay in the body and work for a while), and indeed, she was flushing her Zyprea down the toilet.

I speak from experience: after a doctor screwed up and prescribed a drug that made me hypomanic (mania without hallucinations, and fortunately I realized I was impaired and didn't do anything too stupid), and took too long to recognize it, I was prescribed full strength Zyprea for a while.
Not fun. At all. But it brought me down quickly and smoothly, so I tolerated it. Barely.

Anyway, a drug like Fanapt which hits that range of receptors is not going to be nice, so the suspicion that he had worse problems than we've been told about so far is warranted. Although these drugs are used off label, and some are used on label to control bipolar disorder as well as schizophrenia.

(Lithium may be the gold standard but it's therapeutic index is narrow, frequent blood tests are required to make sure the patient stays in that narrow window, and it's not too pleasant according to an acquaintance who was taking it. Anticonvulsants are also used, but a lot of people have intolerable side effects (e.g. skin rash) and they are the only class of drugs I've heard of where generics frequently don't work, so atypical antipsychotics are a legit alternative. Doesn't sound like the shooter had bipolar disorder, though, not even close.)