Trampy,
Your posts always elicit thoughts for further discourse and raise important questions. I appreciate that as well as your knowledge and critical thinking on this one.

Having seen patients through both generations of anti-psychotic meds, the picture has changed dramatically. As you indicated, those on the thorazine, haldol, etc. seemed to become "treated psychotics" rather than experiencing a better quality of life. The tardive dyskenesia (even with med to counteract it) seemed to lower their stature in society and appeared like treated psychotics/schizophrenics(without the florid symptoms) and no longer dangerous.

The most frustrating problem in working with patients on the second generation anti-psychotics is the weight gain which ends up leading to non-compliance. Could you please clarify if the reason for the weight gain is that the meds over-stimulate the appetite center? Some articles on the topic suggested that these patients be given a low dose of topomax, the anti-seizure medication, because it suppresses appetite. If this were sound phamacologically, it might keep more people on their medication regimens to allow them to live functional lifes or get through periods of traumatic stress.
Lastly, thanks for the description of the Phases of FDA-monitored drug trials. I have seen some private-sector trials that were so poorly designed that it was impossible to ascertain with validity whether the experimental protocol made a difference or whether it was due to chance.

If diabetes does run in families, do you think it would be possible to rule out those with a genetic propensity? This would not of course eliminate those subjects who develop the diabetes secondary to obesity. Thanks for any more light you can shed on this. It's too late to get into the issue of diet meds to counteract the weight gain because of the complex metabolic problems created...however, this seems to come up often.
anna22