My official position on pharmaceutical companies and psychotropic meds

In previous posts, perhaps I’ve come off a little bit as “I hate Big Pharma.” I did. For a while.

I’m not in love with pharmaceutical companies either. I’ve quoted it before but “to whom much is given, much is required.” As a result of accumulating knowledge through reading and research, I know a whole lot more about pharmaceutical companies, the treatment options they put out there, and what lengths they go to get those treatments out there. Most of the things I read are negative. Much of what I’ve said is negative. Perhaps “ignorance is bliss.” My husband said this recently:

“The Internet is the great bitching ground. No one’s going to talk about how great medication is. Everyone’s going to go on and just bitch about side effects and bad experiences.”

I agree. “Effexor really helped me feel better today” doesn’t make for an interesting blog post. No one pays attention to medication when it’s working, however, everyone will complain if something is going wrong. The most “positive” drug comments I’ve seen are on my seemingly “negative” posts from people who are being helped by a drug.

Take, for instance, the following comment from Suffering:

All I see in this post is hatred of the drug companies. I hate em too, but I’m stuck needing their drugs. I don’t care what it’s called, or how they market it, as long as it helps me out of my pit of despair. truly. If you don’t feel this way, you probably don’t have depression.

Ouch. That did kinda sting. Suffering wasn’t the only one to point out how harsh I was on Wyeth. I quoted BJ Harroun in a recent post who wrote:

I cannot take Effexor because it increases my appetite. Pristiq has really helped me. … Don’t dismiss this drug because it is an Effexor metabolite.

I wonder if other bloggers, i.e. CLPsych or Dr. Carlat, have had similar comments left on their blogs.

Therefore, I need to make my official position on the way I feel about pharmaceutical companies clear.

I feel the same way about pharmaceutical companies as I do about politicians — they’re necessary evils.

Are there people who work in the pharma industry who are well intentioned? Sure, there are. Such as there are politicians who are well intentioned. A lot of it, however (as we all know is the case with politics), much of it is corrupt. But electing politicians to positions of government is necessary. While we piss and moan about how nothing gets done, a whole lot more would be left undone without our elected officials. (Btw – thank you Congress and President Bush [gag] for my stimulus check!)

I feel the same about Big Pharma. I don’t trust much of what they do. But you won’t see me putting up a fight to pop an ibuprofen on naproxen pill when I’m in pain. Perhaps the problem is that we, as patients, are so used to sitting back and having doctors shoving prescriptions in our hands and going to blindly fill them and ingest them that it’s wrong to question anything pharma does? I certainly am not the most educated patient on medication by any means and often suffer from a bit of laziness myself but I don’t think it’s wrong for me to question (albeit with cynicism) what the motives are behind Big Pharma’s actions.

To answer “Suffering,” I’m pretty sure that all of us who suffer from psychiatric disorders of some kind are desperate for help to manage our conditions. With many of these medications, management comes at a price — sometimes, too steep of a cost. What point is there for a person suffering from depression to take an antidepressant that may just aggravate the symptoms? Why should a patient who suffers from bipolar disorder subject himself to an antipsychotic that will likely contribute to hyperglycemia and diabetes — more medical problems than he’s already dealing with right now?

Psychiatric patients (this includes me) need to weigh the potential risks and benefits before taking a psychotropic drug. If my bipolar disorder symptoms are so bad that I need to subject myself to the possibilities of weight gain and hyperglycemia on Zyprexa, then so be it. That is a choice to be made between a patient and a doctor. But the fact of the matter is that the side effects of Zypexa are ugly and Eli Lilly’s attempt to sweep some of them under the rug and promote the drug for off-label usage should be called out.

Big PharmaBig Pharma only cares about one thing: the bottom line. If they can show enough benefits to get FDA approval and make money without causing excessive deaths (see Merck’s Vioxx), they’re on it. Granted, the better the drug, the better the profits. It’s not in pharma’s best interest to create mediocre drugs (unless the patent is expiring). I’m optimistic that Big Pharma tries to make sure the drug is as effective as it possibly can be — falling just short of curing anything. Because, as ex-pharma rep Gwen Olsen so eloquently said:

“Because, in fact, what the pharmaceutical industry is in the business of doing is disease maintenance and symptoms management. They are not in the business to cure cancer, to cure Alzheimer’s, to cure heart disease. Because if they were, they would be in the business of putting themselves out of business. And that, in fact, doesn’t make sense. I don’t want people thinking that I am a conspiracy theorist because, in fact, there is no theory behind what I’m telling you. It’s all provable. And what I’m saying is provable is that the pharmaceutical industry doesn’t want to cure people.”

Is it fair for me to dismiss Pristiq because it’s an Effexor metabolite? Perhaps not.
Can I pose questions on whether its efficacy will be any better than that of its predecessor? Yes.
Is it fair of me to point out the fact that Pristiq is set to cover Wyeth’s butt for Effexor going generic soon? You bet.

If you haven’t clicked on it yet, “Pristiq’s FDA Chances: Depression – Yea; Menopause – Nay” is the post in question. Feel free to traipse on over and comment on whether I was too harsh. I am curious to get some feedback.

(Photo from Where Did It All Go Right?)

9 Comments

  1. May 19, 2008 at 9:29 pm

    I totally agree that meds are a “necessary evil.” This is incredibly well-versed, Marissa! You explained everything that has been running through my head. 🙂

  2. Gianna said,

    May 19, 2008 at 11:07 pm

    I don’t believe they are a necessary evil I believe they may be completely unnecessary. I think we suffer from a terrible lack of imagination and refuse to look at successful alternatives that have indeed worked because big pharma is controlling the scene by aggressive marketing…
    so I don’t agree with you at all and I think we are poisoning an entire population—but you wrote a wicked argument…you’re in good form.
    I’m very ill as a result of meds and I see people everywhere sick because of meds and often times they don’t even realize it.
    I was interviewed for two hours by Robert Whitaker the other day…he is writing a book on meds being the cause of chronicity and disability among the mentally ill…he has a lot of evidence to support that thesis—I was thrilled to give him additional ammunition to make his argument. We need this book out yesterday. I’ve seen it play out with hundreds of mentally ill clients over the years.
    because of the lack of imagination and lack of professional direction for alternatives, yes, right now many people appropriately feel they have no alternatives and so take medications.

  3. May 19, 2008 at 11:14 pm

    Michelle – We’re on the same page today. 🙂
    Gianna – I see what you’re saying. From your post, I finally realized why I’ve been hesitant with alternative therapy. I’m quite reliant on the FDA’s stamp of approval for safety. Indeed, we know that the FDA’s approval doesn’t mean anything but it’s regulatory oversight that I feel is missing from alterna-therapy. I was on 5-HTP for depression after my rollercoaster ride on Paxil and Lexapro and that didn’t do a thing. It might help someone with depression but for someone with bp like me, I’m not sure what else is out there. I’ve learned that alternative or natural therapy doesn’t necessarily mean safe.
    But I’m strictly thinking of St. John’s Wort and the like. Is there another kind of alterna-therapy that I’m missing?

  4. Gianna said,

    May 19, 2008 at 11:30 pm

    Marissa,
    it’s all over my blog…and i’ve taken more than a year to share it…if you want to find it you can find it there…it points you in all sorts of directions and resources to groups, books on withdrawal and diet and nutrition, to articles written by the few experts there are to personal stories of recovery through alternatives. it’s there if you want to open you mind to it…
    I can’t do it here in a hundred words or less.

  5. May 19, 2008 at 11:59 pm

    You’re right; it is all over your blog! So much so that it’s actually quite overwhelming because there is so much information to cull. I’m assuming I should start here?

  6. Gianna said,

    May 20, 2008 at 12:05 am

    yes..that’s a good place to start and also the recovery stories tab…
    I should update the about page too because I’ve added more relevant stuff since then…
    the thing is it’s not just one thing that helps people it’s an arsenal of things…
    and the stories can show some of that…

  7. Gianna said,

    May 20, 2008 at 12:07 am

    also as far as FDA oversight goes…over 100,000 people die a year of taking their meds as prescribed…not just psych meds all sorts of meds…
    there are no such stats for nutrients…they simply virtually never kill…with the exception of something like ephedra which I strongly suggest no one with mental health issue even consider taking.

  8. Heather said,

    May 31, 2008 at 2:39 am

    I have to strongly disagree with the quote form Gwen Olsen. First of all, I am a pharmacist, and she was a drug rep. reps just relay information, they dont actually have to understand it. In my experience, they do not understand medical terminology at all. They are very good at handing out pens and notepads with whatever drug they are selling’s name on it. Reps are NOT a source of information for me. They simply point out when a new drug is available and I accept their free gift of pens, post-its, or popcorn, etc. Then I go look up the information myself, simply becuase reps are untrustable sources of information. With that said, there are millions of sick people in this country. Whether its from cholesterol, diabetes, epilepsy, alzheimers, schizophrenia, bipolar, hypertension, the list goes on. There is no way for the big pharma as you put it to come up with cures for dieases that are either inborn or created from years and years of bad health habits. There are no miracle drugs, and from that quote, it makes it sound that there could be if the pharmaceutical industry would “take a hit.” If it were possible to cure diseases, the pharamceutical industry would take advantage of that. These drugs would be wildly popular and therefore make a lot of money. So, if making money were the only main objective, we would have a cure for at least some diseases.

  9. December 27, 2008 at 6:10 pm

    The FDA are law unto themselves….why are they soooooo strict?


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