Forbes magazine published a list of the hottest patented drugs in America, 2005, topped by:

1. Vytorin
2. Cymbalta
3. Avastin
4. Mobic
5. Omnicef
6. Humira
7. Herceptin
8. Lidoderm
9. Abilify
10. Aranesp

Number one, Vytorin, is an anticholesterol drug. But coming in second is the antidepressant Cymbalta. Cymbalta (duloxetine) was only approved in 2004 but it’s surged ahead with a 627% increase in sales, earning $667 million for Eli Lilly.

It’s a selective serotonin and norepinephrine reuptake inhibitor (SSNRI), as opposed to other massively popular antidepressants like Prozac, in the selective serotonin reuptake inhibitor (SSRI) family. They are considered an advance because while many antidepressants target either serotonin or norepinephrine, SSNRIs (also includes Wellbutrin, Remeron) do both. Research is favourable but does it warrant this kind of sales growth? Trends point to an increase in depression rates while we acknowledge its recurrent, persistent nature, rather than a truly effective chemical treatment available now.

Also on the list is the antipsychotic Abilify (aripiprazole) with sales of $1.5 billion in a 40% increase. Forbes notes:

Schizophrenia medicines are another big ($11 billion) and hotly contested area. These drugs are increasingly used for bipolar disease and also for other mental illnesses, including some for which they have not been approved by the Food and Drug Administration. A major shift: Seroquel, from AstraZeneca, has passed Zyprexa from Eli Lilly and Risperdal form Johnson & Johnson as the top-selling schizophrenia drug. One possible reason: controversy over Zyprexa’s potential to cause weight gain in some patients. Abilify, a schizophrenia medicine from Bristol-Myers Squibb and Japan’s Otsuka, is also gaining ground fast.

Neither Cymbalta nor Abilify, adopted so readily after FDA approval, are approved in Canada yet.

The use of antipsychotics for bipolar disorders is now common, with mildly encouraging results.

A cure for depression remains to be found. When it does, no doubt that pill will be number one on many Forbes lists.

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    Last reviewed: By John M. Grohol, Psy.D. on 28 Feb 2006
    Published on PsychCentral.com. All rights reserved.