REAL WORLD EVENT DISCUSSIONS

Pharmageddon

POSTED BY: NIKI2
UPDATED: Friday, May 25, 2012 05:36
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Thursday, March 29, 2012 8:59 AM

NIKI2

Gettin' old, but still a hippie at heart...


Quote:

Dr. David Healy has spent decades delving into the dark corners of the pharmaceutical industry, where, for instance, drug companies have tried to hide the worrisome connection between antidepressant drugs and suicide. In the psychiatrist’s best-known previous books, The Antidepressant Era and Let Them Eat Prozac, Healy explored the often vexing history of the mental health field and its troubled relationship with Big Pharma. In his latest book, Pharmageddon, he presents an even bleaker picture of the way industry has co-opted medicine in general — not just mental health. Healthland spoke with Healy about his findings.

What do you mean by ‘pharmageddon’?

At the moment, treatment-induced death is the fourth leading cause of death [overall], and within the mental health field, it’s probably the leading cause of death.

It’s a little bit like climate change. It may feel great to have a car, the convenience you get is a thing we appreciate each time we hop in the car and drive down to the market. But the use of cars is contributing to the bigger picture of climate change. In the same way, quite a few medications we take produce good outcomes. But we’ve [had a] climate change in medicine, which runs the risk of completely destroying medicine as we’ve known it.

And the key tool in all of this is how companies use the scientific evidence. They construct trials to get the outcomes they want; they only publish positive trials. The study often shows the opposite of what the data actually shows.

In the book, you look at how drug companies sell us on reducing risks — like say, high cholesterol — that may not actually do much to keep us healthy because high cholesterol itself is just a marker for cardiovascular disease risk, not an illness itself.

If you [look at] statins to lower cholesterol or drugs for osteoporosis, there’s no obvious benefit like there is from wearing a parachute when you jump out of a plane. You often just don’t feel good and you may feel a good deal worse. There isn’t even a proven benefit at the end. What you’ve got is proof in the sense of demonstrating that over a six-week period, you can show a marginal change that we have agreed to call a change for the ‘better.’ [The point is that the measure doesn’t necessarily mean your health will improve, but rather is just a marker linked with a reduction in risk.]

Trials get used as tool to persuade doctors to persuade you to have treatment. [And making drugs] available on prescription only is a means to persuade you to take things that if you were more naturally cautious, you’d be less inclined to take.

But don’t we need clinical trials to eliminate quack remedies and look systematically at the best treatments?

There’s two [situations] where trials are useful. There’s an area were you don’t need trials at all, where the treatment really works, such as antibiotics for serious infections. And they’re also really useful when they show that something doesn’t work.

What we’ve got is what’s in between, where in actual fact [some] people would say, for example, if you take all the trials of antidepressants, they actually show that the drugs didn’t work.


Yet many people say they experience profound changes after taking the antidepressant drugs like Prozac — some positive and some negative.

That’s not saying that they don’t work — a bunch of people swear that they’re working. The problem is that if we had all the data available [including the data that the drug companies hid], we ought to have said, ‘We’re not impressed by these drugs. We need to go to back to the drawing board and find the people who really benefit.’ There’s a bunch of people on [antidepressants] who clearly do well. But the companies have made whatever billions of dollars [selling them to a lot of people who don’t].

What do you think about the link between antidepressants and suicide? You’ve found some pretty damning evidence that healthy people may become suicidal or aggressive when they take these drugs.

There’s a group of people for whom antidepressants in general work awfully well, but there’s also a group for whom they don’t work well and they can become either violent or suicidal. The problem again comes back to the role of the doctor. If doctors can’t see that drugs may be good and may be bad, that they can be useful and problematic — if they aren’t experts and can’t handle a bit of complexity — they’re going to go out of business. The problem with doctors and antidepressants making people commit suicide is when it first came out about some children being suicidal, the American Psychiatric Association said that it believed that antidepressants save lives.

I’ve been trying to say to doctors, this is a professional suicide note. What they should say is, Psychiatry can save lives. We know that these pills are good for some and not others and it takes expertise to manage this. If don’t take that [perspective], well, there are cheaper people like nurses, and if pills have no risk and work well, there are cheaper people going to be prescribing.

Why do you emphasize the issue of prescribing privileges so much?

When you come to me for treatment, in sense you’re my hostage. If I ask you if something is wrong [in terms of side effects, you say], ‘No, things are fine.’ You may be having strange thoughts, you may be getting aches and pains you didn’t have before, but the problem is that you either want to keep me happy and so you don’t mention it, [or you say nothing] because I’ve told you that you have to be on these pills because otherwise you will have a heart attack or stroke. You may not even know that the problem is caused by the pill. As a doctor, I’m not trained to pick up that these things may be going on.

The other I’m thing not trained in is that when things are available by prescription only, it’s me, the doctor that ‘consumes’ the pill. I’m the consumer in the sense that companies market these drugs [to me] — in the case of pharma, they’re spending more on marketing than Apple spends or Microsoft or GM. [While those companies] market to all of us, the amount of dollars per head is small. But pharma markets to doctors. Direct-to-consumer ads are only a small part of budget and they’re designed not [just] to get you to believe in the pill, but get you to bring pressure to bear on doctors.

Wouldn’t a big part of the problem be solved simply by requiring drug companies to release all their data?

There should be a law requiring them to reveal all the data. I think that’s a key thing: there should be access to all of the data from the clinical trials. We take risks with new pills on an understanding that the data is going to be made available to experts to sift through and let us all know what the true profiles of these pills are.

If people entering into trials were asked to sign form saying, ‘Do you agree to have pharmaceutical companies sequester the data from this trial?’ they wouldn’t have signed it. Most assumed that because it appears to be science, that the scientific community will get to scrutinize the trials.

You’re personally working on a project to help bring more of the risks to light.

What we’re trying to do with our colleagues is to open up patient adverse event reporting. It’s called rxrisk.org, which will be a website where both people on pills and their doctors can go to report adverse events that may be happening. The idea is to give you a tool so that if things are going wrong, you can get an expert report from us about what is known about the links between the problem and the pills you’re on and by asking a few questions, try to pinpoint whether the pill actually causing the problem. That will give you a report to take to your doctor to make it easier to overcome the kind of hostage problem most people have when they go to the doctor and want to keep him or her happy. The idea is ultimately to create teamwork between doctors and patients and let them know in real time how many other people have reported this problem also.

We’re trying to put patients and doctors in the kind of position where, if they know that thousands of others have had this problem and then the pharmaceutical company says there’s no linkage, people won’t believe it and will say, This isn’t right. It’s in beta at moment.

So what else can be done?

There are ways to play with the system to get the outcomes we want. At the moment, we have a system that works well for the health of pharmaceutical companies but not so well for our health. I’m just trying to raise these issues. How best we solve them is a different matter, but we can’t begin to try to solve them if we don’t raise them. I’m not hugely hopeful but not entirely pessimistic either. http://healthland.time.com/2012/03/28/mind-reading-psychiatrist-dr-dav
id-healy-defines-pharmageddon/

Me, I'm pretty pessimistic. Profit and power usually win in the end, and they've got both. This guy really says it like it is, but i don't expect that to change anything. As we've discussed before, if you actually listen to the ads for pharmaceutical products, you have to shake your head at why ANYONE would take them. I just heard a slew of "potential side effects" for a "medicine" to LENGTHEN EYELASHES!! Insanity at its worst, and they go on pushing this shit and people go on falling for it.

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Thursday, March 29, 2012 1:05 PM

RIONAEIRE

Beir bua agus beannacht


It would be nice if we could know more about who things will work well for and who they won't be good for, that way people can get what they need and not be given something that will be a problem. My mother's depression is nearly in remission thanks to the medicine she takes. I've had some positive experiences with antidepressants myself, but not the the degree she has. I'm taking 5 htp right now instead and it does a little something, but not to the degree I would like, but its still new so we'll see. Wouldn't it be great if we could advance medicine to the point where they could just test your blood and figure out exactly what is going on with your brain, or any other part, and know just what will suit you, be it from the earth or from the pharmacy. That's where science needs to take us.

I assume you're my pal until you let me know otherwise. "A completely coherant River means writers don't deliver" KatTaya

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Friday, March 30, 2012 6:42 PM

OONJERAH



*Raises hand* Yeah, my Sis died that way.

Sometimes, dying of Natural Causes is really awful, too.

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Saturday, March 31, 2012 3:16 AM

WISHIMAY

"Well, so long Earth...Thanks for the air... and what-not" -Philip J. Fry


I'm thoroughly grateful for prozac. I probably wouldn't be still married if not for it...

At our old house there is knuckle marks in a door, a hole in a ceiling, and he BENT A STEERING WHEEL... (no, he never hit a person)

If he misses a dose or two I can see a vast difference. It's like living with a bull in a china shop. I think it helps regulate more extreme emotions, so he can feel the normal ones. He hates to take it, and hates that he needs it, but when he gets like that there is no dealing with him and even he can see that...
Thank you Prozac...


On another note, we messed around with other ones before returning to prozac and I don't remember what they were, but when he went off one it made him psychotic for about a week, and it was really nice of the doc to NOT EVEN MENTION THAT

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Saturday, March 31, 2012 7:53 AM

NIKI2

Gettin' old, but still a hippie at heart...


Wish, I had a similar experience. Our first twenty years were pretty bad, with Jim going into "black moods" (just isolating, he never hit anyone) and getting angry beyond proportion at things, then letting that anger roll over into everything. He also never seemed to enjoy much of anything--now, as a bipolar, I kind of "over" enjoyed stuff, but still, he put SO much emphasis on things that went wrong and was so little pleased by things that went RIGHT, and I could never figure out why.

After I was dx'd bipolar, I began researching mental illness. I bumped across "dysthymia",
Quote:

a mood disorder consisting of chronic depression, with less severe but longer lasting symptoms than major depressive disorder. Dysthymia has a number of typical characteristics: low drive, low self-esteem, and a low capacity for pleasure. Mild degrees of dysthymia may result in people withdrawing from stress and avoiding opportunities for failure. In more severe cases of dysthymia people may even withdraw from daily activities.[4] They will usually find little pleasure in usual activities and pastimes. wiki
Boy, that sounded like Jim!

I was at a point where I was ready to leave him, and told him that unless we got counseling and he got therapy, I would. He agreed, and damned if he wasn't dx'd dysthymic. He got on meds, and the change was dramatic. He went off them two or three times, and it was immediately apparent even when he didn't tell me he'd gone off.

Now in our case, something else happened. Therapy actually helped him, he appreciated a place where he could just say what he felt "safely", and he became more self-aware. He got books on anger management and became quite "buddhist", reading, meditating, etc. Eventually he got off the meds, and now he's the neatest guy I know...still doesn't get a much pleasure out of stuff as others, but doesn't "grind" over bad stuff or stuff that pisses him off, talks to me more about stuff that bothers him, has VERY few "black moods", his anger passes quickly, and he's FAR more loving than I ever thought possible.

Which goes again to my belief that diagnosis and meds are only the FIRST step; therapy, self-awareness, support, there are so many other things that, if we utuilize them, cause medication to become less necessary or actually UNnecessary. I see meds, when they work and work right, as a tool to become aware of our problems and work to mitigate them, rather than just getting on meds and that's that. That's how it worked for me; tho' I still take my meds, I put in practice a ton of other stuff, from therapy to being aware of my triggers to "symptom management", self-education, meditation, and a whole bunch more. The result is I'm an absolute "bear" to newbies about self-education and using every tool we can find to achieve the highest quality of life possible.



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Wednesday, May 23, 2012 7:07 PM

WISHIMAY

"Well, so long Earth...Thanks for the air... and what-not" -Philip J. Fry


Quote:

Originally posted by Niki2:

He agreed, and damned if he wasn't dx'd dysthymic. He got on meds, and the change was dramatic.



Was reading old threads when I found this one that I apparently missed. Sounds a lot like hubbs, that fear of failure thing is a biggie here. Do you know what meds he was on??

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Thursday, May 24, 2012 5:20 AM

WISHIMAY

"Well, so long Earth...Thanks for the air... and what-not" -Philip J. Fry


bump^

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Thursday, May 24, 2012 7:16 AM

NIKI2

Gettin' old, but still a hippie at heart...


Sorry Wish, I missed this one before. I can't remember what it was (if I ever even knew) and I called him and HE doesn't remember either. Not surprising, it was ten years ago! Even if we could remember, it might not be pertinent, as they keep finding/creating new meds for stuff, as well as finding which meds are more effective among the ones they already have. It would have been one of the SSRI anti-depressants then, I know, and he said it was something really common (we learned a lot about meds at the time). I doubt it was prozac, as I'm pretty negative about that, but definitely would have been one of the SSRIs--they were very big at the time.

You have, believe me, my DEEPEST sympathies! That was a damned rough 20-or-so years, and actually if I'D been dx'd earlier and had thereapy earlier, I'd have left him long before. I'm glad I didn't, if for no other reason than that, once he saw the difference meds made and got therapy, I've had over a decade of the sweetest, most wonderful man I could ever have found! For me, it was worth it; that's all in the past and the present and future are lovely. Nonetheless...

Personally, it seemed to me the only thing good about the med was that it showed him the vast difference between who he was and who he could be; it was the psychotherapy which helped the most in that he had a safe place to talk about stuff AND get some feedback as to how he could deal with it. Jim did a TON of reading while he was in psychotherapy on anger management, dysthymia itself, and self-help books on family dynamics...previous to therapy, he wouldn't have TOUCHED any of those, and considered a lot of it "psychobabble". He told me afterwards that the individual therapy meant a lot to him (we tried couples therapy, but that didn't work out real well...), and I think that was the most important help he got, above and beyond medication. Like I said, the meds were most important in showing him that he COULD feel better and not be locked into that negativity and anger...he pretty much took it from there himself.

And that fear-of-failure thing was HUGE with him before. He stopped playing chess with me because I won slightly more often than he did. I took up tennis just to play with him; when I missed a shot or played badly, he got angry, but when HE missed shots or played badly, he went into a real black mood! I finally realized we couldn't do ANYTHING together that was competitive, unless it was something he did tons better than me. Eventually I took up running (he'd been jogging all his life and left me in the dust) and bicycling (where he REALLY left me in the dust) and learned to let him lead when we went motorcycling. He always drove when we went anywhere--now I drive almost exclusively and he's remarked how nice it is to actually look around and enjoy not having to drive! He dabbled in woodwork before I met him; despite my urgings he would never take it up again, kept saying he was lousey at it. I saw it over and over again; if it wasn't something he could reeely excel at, he wouldn't even touch it. So sad!

Sorry to ramble; my heart really goes out to you if you're dealing with the same kind of stuff I was, and I wish to hell I could help--mostly that I could wave a magic wand and fix it (!); nobody should go through that! If there's any way he can "discover" his potential, the change might be astonishing...it sure was for us!


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Thursday, May 24, 2012 5:39 PM

WISHIMAY

"Well, so long Earth...Thanks for the air... and what-not" -Philip J. Fry


Yeah, It's not easy being a human anti-depressant
Especially lately. He doesn't even bother to try most things because "If I don't try then I can't fail..." and I says "Well, in NOT trying, you have already failed."
Don't matter. And there's not much hope of a self-therapy kick. He says psych. is a bunk science. Can't help someone who doesn't believe he can be helped....

I'd REALLY like him to try psilocybin, but it'll never be approved, and he has drug tests about every three months...

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Friday, May 25, 2012 5:36 AM

NIKI2

Gettin' old, but still a hippie at heart...


Yup, that was Jim all the way, especially the "psychobabble". I was lucky in a backwards way; I was dx'd because I had a major crash, and seeing it scared the living shit out of Jim, which made him a bit more open to the idea of meds. I don't recommend it, however. ;o)

WHY psilocybin?! That and mescaline were my two favorite drugs of choice--the color trips--but how would it help someone with dysthymia? Please explain, because now I'm dying of curiosity! Personally, I'd have liked to have had mesc and psyl MYSELF all those years...would have made things much more easy... Yeah, it's got some SSRI properties, but those are far outweighed by its hallucinogenic effects!


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