DSM V Changes Will Increase Atypical Antipsychotic Use

The public review period for the proposed DSM V changes has begun, and there is much chatter. One change that I believe is a good one for the reasons discussed here is the creation of the disorder known as Temper Dysregulation Disorder (TDD). This disorder should significantly decrease the diagnosis of bipolar disorder in children. With bipolar seen as a stigmatizing and lifelong disorder, the prospects for children diagnosed with the condition were not good, and the label itself could be self-defeating and self-esteem destroying. To tag a child with such a severe disorder is truly dangerous from a psychological perspective. Nonetheless, psychiatrists must provide diagnoses in order to insure insurance reimbursement for their clients at the least. This new disorder will allow psychiatrists who had been reluctant to label a child as bipolar to have a new more attractive alternative tag to attach that is time-limited to childhood and carries none of the stigma of the bipolar diagnosis.

So, we'll see a decrease in the diagnosis of bipolar disorder, but this will be more than offset by the diagnosis of TDD. I can see the atypical psychotic marketing teams sitting in their conference rooms now correlating the symptoms of TDD and bipolar to see which TDD symptoms they can lawfully market for their product because they also happen to be symptoms of bipolar. It may not even be necessary since atypicals are the clear choice among psychiatric drugs to treat the symptoms of TDD. You might try an anti-depressant, but as soon as the parents complain, the next step will be the atypical.

How long before the first company steps up to bat in a clinical trial to get the first antipsychotic label for TDD? Can anyone say patent extension?