Michael F. Shaughnessy
Senior Columnist EducationNews.org
Eastern New Mexico University
1) Dr. Bonkers, you have this online gallery at the Bonkers Institute which lampoons the current "state" of psychiatry. What is your latest addition?
The Institute's "Marvelous Mental Medicine Show" is an online museum where visitors may stroll through the galleries, viewing outlandish examples of psychiatric drug advertising.Some of the exhibits, such as Bayer Heroin and Eli Lilly Cannabis, are dated from the 19th century, while others feature more familiar products like Ritalin from the 1950s.
This month we opened our newest gallery, "A-typical Scam," highlighting atypical antipsychotics, so-called "new generation" drugs with brand names like Abilify, Risperdal and Zyprexa.Everything in "A-typical Scam" is from the modern era, and some of the ads are less than a year old.
2) It seems that these "atypical" antipsychotic medications are no more useful than the old standbys of 20 or 30 years ago... in fact the research seems to indicate they have MORE side effects and are even MORE dangerous to patients. What is going on?
When atypical antipsychotics were first introduced in the 1990s, they were widely claimed to be far superior to older drugs, and less likely to cause movement disorders like tardive dyskinesia and dystonia.In fact the manufacturers relied on rigged clinical trials lasting only a few weeks, biased studies, and other unethical practices to deceive doctors and the public.
Now after more than a decade on the market, and after earning billions of dollars in profits, the truth is finally being told that by almost every standard the new drugs are no improvement over the old.In some ways, such as their tendency to cause weight gain and diabetes, the new drugs are actually much worse.
Perhaps the most significant difference between the old drugs and the new is their price.Because their patents haven't yet expired, the new drugs cost 20 or 30 times more.That's the real reason the atypicals have been promoted so heavily.They're not any better clinically, they're just a lot more profitable commercially.
3) It seems that marketing and promotion are helping the drug companies to push these "a-typical" medications. Is the current state of advertising overcoming good common sense?
The current state of medical advertising, and modern medicine in general, has nothing to do with healing and everything to do with business.It's a colossal money-making industry.But a system based on maximizing quarterly corporate profits may not be the best way to promote the health and well-being of our citizenry.
Modern-day pharmaceutical advertising is harmful in two distinct ways.
First, ordinary citizens are bombarded with advertisements promoting the view that any conceivable discomfort or imperfection is a medical condition, disease or disorder requiring drug treatment, and they're exhorted to "ask your doctor if the purple pill is right for you."
Second, beginning the moment they enter medical school and continuing non-stop after that, doctors are bombarded with an onslaught of pharmaceutical industry propaganda and insidious forms of industry pressure that strongly shape the way medicine is practiced.This two-pronged strategy aimed at consumers on one hand and medical providers on the other has reaped enormous benefits for drug manufacturers but untold harm for everyone else.
4) What are some of the medications out there that give you concern?
I'm concerned about the widespread over-prescribing of all psychiatric drugs, including stimulants like Daytrana and Adderall given to children diagnosed with ADHD... antidepressants like Paxil and Zoloft given to young mothers diagnosed with postpartum depression...tranquilizers like Klonopin and Xanax given to veterans diagnosed with post-traumatic stress... and the list goes on.
Increasingly, these drugs are prescribed in combination with one another, mixed-and-matched in "drug cocktails" with unpredictable consequences for patients.
Antipsychotics (whether an old standby like Haldol or a new bestseller like Zyprexa) belong to the most potent class of psychotropic medications, yet many doctors think nothing of prescribing them to almost any patient for almost any reason.
Abilify, for example, is heavily advertised for depression, and Risperdal is often prescribed to children with autism and other behavioral problems.Giving Risperdal to children is especially troubling, because Risperdal may be even worse than Haldol in causing movement disorders like akathisia, dyskinesia and parkinsonism.
5) Has anyone ever found a germ, virus, bacteria, or any other infection that could be causing psychosis, bi-polar or schizophrenia?
No, I think it's safe to say mental illness is not a contagious disease like influenza or chicken pox, and I'll add there's no evidence of genes causing any mental illness either.Nowadays, mental illness is commonly believed to be an organic, physical, biological and/or genetic ailment, but I believe these so-called mental disorders are nothing more than pseudo-scientific labels attached to unwanted behavior and unpleasant emotions.Simply calling something a disease doesn't make it a disease!
For example, obesity was once understood to be a condition resulting from any variety of factors, but today obesity itself is considered a disease.Consider this: if your only exercise is walking from the sofa to the refrigerator, and you consume 5,000 calories per day without gaining any weight, then maybe you have some kind of disease -- but if you DO gain weight, would that be a surprise?Where's the disease here?It's the same with mental disorders.Recently I heard a news report about the high number of prison inmates who suffer from depression.So, when individuals are deprived of their liberty they feel depressed -- is this a surprise to anyone?Yes indeed, there may really be an epidemic of mental illness: our society has gone crazy!
6) What is the current state of the art of psychiatric drug advertising?
In one sense, I don't think the advertising has changed much from a hundred years ago, except that now it's more sophisticated technically.On the other hand, I think the extent to which drug promotion has infiltrated every level of medical science, academic research, and even government regulation, has surpassed anything ever seen before.Also, any distinction between drug promotion and disease promotion has now virtually disappeared.
7) I have seen a lot of advertising for ADD medications. In these ads, the kids all seem to be studying, and enjoying their homework. Is this all glitter and gloss or bells and whistles?
Ads for ADHD drugs are aimed not at the patient, but at the patient's parents, because ultimately it's the parents who decide to put their kids on drugs.So I guess it's natural for ad agencies to use idealized images of happy, well-adjusted children.They're selling an idealized image that every parent hopes for their child.This is no different than the images of perfect, flawless models seen in all pharmaceutical advertising.In the ads promoting Abilify for depression, we see good-looking, energetic, and successful adults -- none of whom exhibit the typical side effects associated with antipsychotics like Abilify: tremors, weight gain, lethargy, etc.
8) I looked at the Geodon advertisement and was astounded at the number of side effects. They are all listed quite clearly. Yet, some doctors use these pills in spite of all these possible side effects. Do they not read these adverts clearly?
While the claims of safety and efficacy are splashed in bright bold headlines, the side effects are listed in tiny print, so in a patently obvious way the side effects are minimized.I don't know how else to explain why so many doctors seem so unconcerned about possible adverse reactions.Don't forget that advertising is only one way the drugs are promoted to doctors.There are daily visits from drug reps, industry-sponsored continuing medical education courses, industry booths at medical conventions, industry-funded medical seminars and symposiums, etc.
By the way, symposium is a Greek word meaning "drinking party."All this may explain why so many doctors have become such enthusiastic pill pushers, dispensing prescription drugs like they're handing out jelly beans!
9) Now, what is the web site for your Bonkers Institute?
Bonkersinstitute.org is the official web site of the Institute for Nearly Genuine Research.In addition to hosting the Marvelous Mental Medicine Show, our web site publishes the latest studies released by the Institute, and promotes our ongoing mission to explain the origin and etiology of mental illness in ways that sound more scientific than ever before.
10) How would our readers navigate to the exact place where you have your latest expose?
It's quite easy to arrive at the Marvelous Mental Medicine Show simply by following the link that's prominently displayed on our home page at www.bonkersinstitute.org . Entering the Medicine Show is like entering a museum: simply scroll down the page as if strolling down a museum hallway, and select the gallery you wish to visit.If that particular gallery fails to interest you, there are plenty more to choose from!
11) What question have I neglected to ask?
You didn't ask how we obtain the ads that are featured in the Marvelous Mental Medicine Show.We have three main sources:
1. We scour the internet, searching web sites of medical journals and pharmaceutical ad agencies, occasionally stumbling across an item of interest; 2. We browse used bookstores and keep an eye on Ebay for old magazines that might contain drug ads; 3. We receive submissions from our web site visitors, who scan ad images and send them to us by email.In this way we've obtained ads from all over the world, including England, Australia, Sweden and Japan.
If any EdNews readers know of any ads that ought to be included in the Medicine Show, please contact the Institute!There's one ad in particular we'd love to obtain.It's a 2-page spread for Ritalin, originally published in the American Journal of Psychiatry in 1971 with the headline, "MBD... Medical Myth or Diagnosable Disease Entity?"We know this ad exists because we've seen it referenced in more than one academic paper, but so far we've been unable to track down a copy.If anyone out there can help locate this ad, we'll be thrilled to include it in the Medicine Show!
Psychiatry is to medicine what astrology is to astronomy. ~ Leonard Roy Frank
Bonkers Institute for Nearly Genuine Research www.bonkersinstitute.org
Published February 12, 2009
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