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 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?)