Friday, February 13, 2009

Do you think the pharmaceutical companies have something to do with it?

I came across an article entitled “Drugmakers draw criticism for pushing fibromyalgia” in Newsday, distributed by the Associated Press. While the article was about fibromyalgia, I couldn’t help but think otherwise.
WASHINGTON - Two drugmakers spent hundreds of millions of dollars last year to raise awareness of a murky illness, helping boost sales of pills recently approved as treatments and drowning out unresolved questions . . . . 

Key components of the industry-funded buzz over the pain-and-fatigue ailment fibromyalgia are grants, more than $6 million donated by drugmakers Eli Lilly and Pfizer in the first three quarters of 2008, to nonprofit groups for medical conferences and educational campaigns, an Associated Press analysis found. 

 . . . Fibromyalgia draws skepticism for several reasons. The cause is unknown. There are no tests to confirm a diagnosis. Many patients also fit the criteria for chronic fatigue syndrome and other pain ailments. 

Experts don't doubt the patients are in pain. They differ on what to call it and how to treat it. 

Many doctors and patients say the drugmakers are educating the medical establishment about a misunderstood illness. But critics say the companies are hyping fibromyalgia along with their treatments, and that the grant-making is a textbook example of how drugmakers unduly influence doctors and patients. 

"I think the purpose of most pharmaceutical company efforts is to do a little disease-mongering and to have people use their drugs," said Dr. Frederick Wolfe.
Couldn’t you just sub in any number of so-called childhood psychiatric disorders wherever it says “fibromyalgia”? I mean, there is no denying that the pharmaceutical companies “spent hundreds of millions of dollars” to “raise awareness” of these disorders. Just look at their full page ads in magazines, full length, prime time commercials, and the videos, CDs and mailings that are sent directly to consumers about these “disorders.” Equally true is the fact that such direct to consumer advertising helps increase sales of the pharmaceutical companies’ products.
There is also no denying that drug companies have contributed lots of monies to “nonprofit groups” to “educate” people about these disorders. CHADD (a national nonprofit group that deals with attention deficit disorder) immediately comes to mind. That organization alone had has received hundreds and hundreds of thousands of dollars from the makers of Ritalin.
Similarly, the cause of childhood psychiatric disorders is unknown; there are no biological tests to confirm a diagnosis – only observation and questionnaires; many patients diagnosed with a particular disorder also fit the criteria for other disorders or other conditions. Experts don’t doubt that the patients are experiencing difficulties, but many experts disagree on what exactly is wrong and how best to treat it.
We are talking about a billion dollar industry, after all.
It just makes you wonder . . .

Monday, February 9, 2009

Drugs for Everyone

Okay, so now we’re going to start medicating “healthy” people because "’[t]his takes prevention to a whole new level, . . . appl[ying] to patients who we now wouldn't have any evidence to treat,’ said Dr. W. Douglas Weaver, a Detroit cardiologist and president of the American College of Cardiology.”

Yes, you read that correctly. In an article entitled Cholesterol drug Crestor cuts deaths, heart attacks in healthy people; could see wider use, by Marilynn Marchione, and reported in Newsday, it is suggested that we medicate otherwise healthy people with Crestor (manufactured by AstraZeneca) in order to prevent possible heart attacks when the risk for such attacks is nearly non-existent.

Of course, I’m all for taking care of people, and certainly do not want anyone to suffer from a heart attack, however . . .
“[S]ome doctors urged caution. Crestor gave clear benefit in the study, but so few heart attacks and deaths occurred among these low-risk people that treating everyone like them in the United States could cost up to $9 billion a year — ‘a difficult sell,’ one expert said. About 120 people would have to take Crestor for two years to prevent a single heart attack, stroke or death, said Stanford University cardiologist Dr. Mark Hlatky.” (Emphasis added.)

Also, consider that:
1. AstraZeneca paid for the study, and the study’s authors have consulted for the company and other statin makers.
2. More people in the Crestor group saw blood-sugar levels rise or were newly diagnosed with diabetes.
3. Crestor also has the highest rate among statins of a rare but serious muscle problem.

Where does something like this stop? Should we start giving Vioxx to healthy people to prevent arthritis? (Oh wait, Vioxx isn’t on the market anymore . . .) Or let’s give Diethylstilbestrol (DES) to pregnant women to prevent miscarriages and avoid other pregnancy problems. (Oh wait, doctors did that and it turned out to be a really, really bad idea . . .) I know, let’s all take Aricept to prevent Alzheimer’s. (what could possibly go wrong?)

Call me crazy, but wouldn’t eating right, getting enough sleep, and exercising get the same, or even better, results at a cost substantially less than nine (9) billion dollars and without the dangerous side-effects?

But, it gets better.

In an article entitled, Feed brain with pills, published in Newsday, so-called experts stated that “’[w]e should welcome” the idea of allowing otherwise healthy people to take powerful, psychotropic, Class II narcotics in the hopes of “improving our brain function.” This sentiment appears in an opinion article published in the journal Nature (note the irony).

Perhaps even more disturbing is the comment that using such drugs is “no more morally objectionable than eating right or getting a good night’s sleep.”

I kid you not!

OUTRAGEOUS. There is simply no other word for this.

When did exposing otherwise healthy people to dangerous, mind-altering drugs become “okay?” In fact, according to the "experts," it is not only “okay” but it should be equated to eating right, getting a good night’s sleep and, one must presume, exercising. Wow.

Let’s see. Eating right, getting enough sleep and exercising are healthy, free, non-addictive (although, sometimes exercising can be addicting – in a good way), and have no side-effects other than improving brain function, improving mood, slowing aging, preventing heart disease, fighting obesity and improving the immune system.

Drugs like Ritalin help people sustain attention. They also carry with them the risks of, among other things, heightened anxiety, radical mood swings, growth inhibition, sleep problems, addiction, strokes, sudden death, and possible chromosomal changes. On the other hand, prescribing these drugs for otherwise healthy people opens up a brand new, multi-billion dollar market for the pharmaceutical companies and most likely extra fees for the doctors who get to write so many more prescriptions for such medications.

Yeah, the two approaches can obviously be equated.

Note that two of the authors of the Nature article consult for pharmaceutical companies.

Saturday, February 7, 2009

On the subject of MEDICATIONS

I wrote this piece a little while back. While the information is a bit dated, based on my recent conversations with parents at the center, it is important information that is still applicable today. (Also, it serves as a good introduction for forthcoming blogs.)

Anyone who has had experience with any of the medications typically prescribed for ADD/ADHD is well aware of the fact that these medications have side-effects. In fact, at two separate SEPTA meetings at which I was fortunate enough to speak, ONE HUNDRED (100!) PERCENT of all parents whose children who had tried medications indicated that their child had some sort of side-effect.

So much for the “rare” occurrence of such issues.

Some of the more common side-effects are weight loss, sleep disturbance, tics, mood swings, and “rebound.”

However, far greater problems are being discovered in connection with the use of many of these drugs. Adderall XR, Concerta, Ritalin, Strattera and almost all antidepressants, drugs commonly prescribed for children and adults diagnosed with ADD/ADHD, have come under new fire. Researchers have warned that each of these drugs may carry additional, and very serious, side-effects ranging from depression and suicidal thoughts to stroke, cancer and death.

Adderall XR was pulled off the market in Canada after reports linked the use of the drug to a dozen strokes and twenty sudden deaths. Fourteen of the sudden deaths and two of the strokes were suffered by children.

Researchers at the University of Texas and the M.D. Anderson Cancer Center have found chromosome damage in twelve children that used Ritalin for three months. The chromosome damage was similar to that caused by known cancer-causing drugs.

After reviewing recent relevant studies and psychiatric reports, the Food and Drug Administration warns of suicidal thinking and behavior in children who have taken Strattera and antidepressants. The same concerns, as well as hallucinations and violent behavior, were expressed in connection with Concerta,

Similarly, after reviewing relevant scientific studies, Britain’s Medicines and Healthcare Products Regulatory Agency concluded that there was “no solid evidence that the benefits outweigh the possible side effects” of antidepressant use by individuals under the age of 18. (American researchers were quick to fire back with a study of their own that concluded the risks associated with depression outweighed any potential harm caused by antidepressants.)

Also, on a personal note, I have to wonder just how “effective” these medications truly are. If one defines “effective” as having an effect, well, yeah, the meds are very effective. However, if one defines “effective” as having the expected and, more importantly, DESIRED, effect, then, I gotta tell you, I'm not so sure the meds are all they're cracked up to be.

Again, at the SEPTA meeting where I spoke, even though 100% of the parents noted side-effects, LESS THAN ONE IN THREE felt the meds were producing desirable results! (And, in general, I rarely meet any parent who doesn't complain about the meds – maybe it's the business I'm in.)

Maybe that's why there is so much experimenting with different meds and amounts and combinations on our kids. Maybe it's also why these “effective, safe and tested” meds are constantly being replaced by “new and improved” drugs developed to replace the old.

Now, I understand why parents resort to medication. We tried them, too. If there is nothing else, and your child is suffering, and the teachers and doctors are all telling you that this is the right thing to do, with all the requisite assurances, what choice do you feel you have?

Just know, that there are alternatives. Like anything else, there is a chance that these alternatives won't work completely, but hey, I can almost guarantee a better than one in three chance that they will – and all without side-effects!


The Associated Press

New York Times