# Advertising pharmceuticals



## cave76 (Jan 23, 2014)

The United States and New Zealand are the only two countries in the world that allow advertising of pharmaceuticals (DTC= Direct to Consumer) on TV or in magazines.I personally think that the rest of the world is more 'advanced'  in that way, in that area. 

But I can see pros and cons for both ways.

I've been to doctors who have given me totally wrong advice.

I've also been on some health forums where one of the more popular threads was the benefits of coffee enemas---- I mean LOTS of them. (A friend dubbed them Reverse Lattes.)

The NHS has been considering relaxing those restrictions---- probably since the Internet's arrival. Does the NHS want people to get their drug/health questions from doctors or from the general public in health forums? That may be one of the undecided points.

What do you think? Anyone?


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## pacanis (Jan 23, 2014)

Coffee enemas?! 
What's next? K-cup suppositories? 

Oh I'm sorry, what was the question?


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## PrincessFiona60 (Jan 23, 2014)

Drug advertising should stop, now.


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## cave76 (Jan 23, 2014)

@Pacanis---- K-cup suppository? *YEE--OW-OW-CH!!!*

I think I'm with you, PF---- even though I waffled a bit.  Truthfully now, everyone----- can you even HEAR those words that are piled on top of each other about the 'dangers'  of drugs on TV?

Or read those teensy tiny words (package insert) in a magazine? Come on now!!!! That's really an insult to me.


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## Andy M. (Jan 23, 2014)

We laugh at them.  Some of the side effects, when compared to the benefit, are comical.

"May cause leprosy, shingles, heart disease and death, but you'll have nice long eyelashes!"


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## PrincessFiona60 (Jan 23, 2014)

The advertising makes it very difficult for doctors to do their jobs.  It was bad enough when patients would not leave with out a new script, now they have the names of specific drugs they most likely do not need and won't leave until they have it.

Big Pharm should get out of advertising and go back to research where they belong.


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## Rocket_J_Dawg (Jan 23, 2014)

PrincessFiona60 said:


> The advertising makes it very difficult for doctors to do their jobs.  It was bad enough when patients would not leave with out a new script, now they have the names of specific drugs they most likely do not need and won't leave until they have it.
> 
> Big Pharm should get out of advertising and go back to research where they belong.


+1 100%  And most of the drugs advertised are drugs that are not normally needed. Other, less dangerous drugs could do the exact same thing. Might take a bit longer to relieve what ever is the symptom, but a lot safer.


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## jabbur (Jan 23, 2014)

I've always hated the drug advertising.  While I fully believe one needs to be informed to be their own health advocate, these ads don't really benefit the consumer.  They don't give enough information and don't address drug interactions.  Your doctor knows about these drugs since most pharmaceutical companies send people out to teach the doctors about the new drugs and give them samples to try.  Trust your doctor and ask questions about why s/he put you on that particular one.  Don't trust the drug company.  They are in business to make money, not take care of you.


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## cave76 (Jan 24, 2014)

PrincessFiona60 said:


> The advertising makes it very difficult for doctors to do their jobs.  *It was bad enough when patients would not leave with out a new script, now they have the names of specific drugs they most likely do not need and won't leave until they have it*.
> 
> Big Pharm should get out of advertising and go back to research where they belong.



Isn't that butterfly in the Lunesta ads just the cutest little darn thing you've ever seen??


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## cave76 (Jan 24, 2014)

Jabbur said:
_"these ads don't really benefit the consumer. They don't give enough information and don't address drug interactions."_

What? You don't have ears capable of picking out the drug interactions in those TV ads that are spoken at twice the speed of sound??? 

Drug Ads Play Up Benefits, Downsize Risks : NPR


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## Steve Kroll (Jan 24, 2014)

PrincessFiona60 said:


> The advertising makes it very difficult for doctors to do their jobs.  It was bad enough when patients would not leave with out a new script, now they have the names of specific drugs they most likely do not need and won't leave until they have it.


It's all because of the phrase "Talk to your doctor about <drug name> to see if <drug name> is right for you.


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## cave76 (Jan 24, 2014)

Steve Kroll said:


> It's all because of the phrase "Talk to your doctor about <drug name> to see if <drug name> is right for you.



Takes the ad men/manufacturers/TV stations off the hook, right?  Sigh.


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## Andy M. (Jan 24, 2014)

cave76 said:


> Isn't that butterfly in the Lunesta ads just the cutest little darn thing you've ever seen??




I'm still trying to figure out why there are two cast iron bathtubs in the Cialis ads.


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## Addie (Jan 24, 2014)

PrincessFiona60 said:


> The advertising makes it very difficult for doctors to do their jobs.  It was bad enough when patients would not leave with out a new script, now they have the names of specific drugs they most likely do not need and won't leave until they have it.
> 
> Big Pharm should get out of advertising and go back to research where they belong.



I have to agree very strongly PF. I worked for three years for Wyeth Pharmaceuticals in the research and trials divisions. You would be surprised at how many drugs were started for field trials and stopped after about a month when patients were dropping as fast as they were signed up. A lot of these drugs they are advertising are actually in their third or fourth round of trials. They have been approved by the FDA for the public consumption with the agreement that more trials are needed. 

Enbrel. A drug for skin condition, mostly Psoriasis. What the doctor doesn't tell you is that it will clear up the skin, but you can only be on it for four months. Then when you stop using it, the disease comes back with a vengeance. Yet it is advertised as the answer to all your problems. Forever! 

I handled the paper work for the trials. I was also eligible for the trials. But because I worked for the company that made the drug, for ethical reasons, I turned down the opportunity. Thank heavens I did. 

Your doctor is only human. Constantly being bombarded for drugs that you don't need begins to wear him down. Do yourself and your doctor a favor. Let him do his job. That is what his eight to ten years of training was for.


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## Zhizara (Jan 24, 2014)

I don't get the 2 bathtubs either.  The required listing of all the possible side effects makes for a very long commercial and is a definite turn off for most prospective users.  Why bother advertising at all?


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## cave76 (Jan 24, 2014)

Addie said:


> I have to agree very strongly PF. I worked for three years for Wyeth Pharmaceuticals in the research and trials divisions. You would be surprised at how many drugs were started for field trials and stopped after about a month when patients were dropping as fast as they were signed up. A lot of these drugs they are advertising are actually in their third or fourth round of trials. They have been approved by the FDA for the public consumption with the agreement that more trials are needed.
> 
> Enbrel. A drug for skin condition, mostly Psoriasis. What the doctor doesn't tell you is that it will clear up the skin, but you can only be on it for four months. Then when you stop using it, the disease comes back with a vengeance. Yet it is advertised as the answer to all your problems. Forever!
> 
> ...



And now more trials are fast-tracked and brought to the public too soon in order to start making money sooner.

That's why I prefer (when there's a choice, and there usually is) an older drug---- one that's already shown where it's weaknesses are.


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## Addie (Jan 24, 2014)

cave76 said:


> And now more trials are fast-tracked and brought to the public too soon in order to start making money sooner.
> 
> That's why I prefer (when there's a choice, and there usually is) an older drug---- one that's already shown where it's weaknesses are.



It is true that it does cost millions of dollars to bring a drug to market. Starting with the salaries of the scientists, all the lab workers, supplies, etc. Then the manufacturing of the trial drug, the doctors who participate in the studies, patients, and the support staff back at the office who take care of the paper trail and read those reports that come back from the trial doctors. Then the cost of preparing the reports for the FDA. I haven't even mentioned all the other costs. So it can be understandable why they are in a rush to get the drug to market.


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## cave76 (Jan 24, 2014)

Yes, I understand there are many $$$$ reasons to get a new drug to market, and especially if that new drug might be the 'breakthrough' drug for a very serious disease for which no available drugs did much good for  the majority.

I'd probably would be the first one to try one, if I had refractory cancer, end-stage kidney problems etc. You bet! I'd probably also try some off-the-wall solutions too. 

But I'm still concerned about fast-tracking. As Fierce Pharma states:

"When the FDA puts drugs on the fast track for approval, they do make it to market sooner. But *they're tested for a shorter period of time *than are drugs reviewed under the agency's standard process, according to a new study in the Journal of the American Medical Association. And that has researchers worried."

""The testing of new drugs has shifted from a situation in which most testing was conducted prior to initial approval to a situation in which* many innovative drugs are more rapidly approved after a small trial in a narrower patient population with extensive additional testing conducted after approval*," 

That makes the general public their lab rats too. 

JAMA: Fast-tracked drugs tested less, with follow-up studies lagging - FiercePharma

The Jama abstract can be found on PubMed:
PMID: 24166236


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## Sir_Loin_of_Beef (Jan 24, 2014)

cave76 said:


> Isn't that butterfly in the Lunesta ads just the cutest little darn thing you've ever seen??


 
My doctor says I am not a good candidate for Lunesta. I live alone, I sleep naked, and I own a convertible.


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## cave76 (Jan 24, 2014)

Sir_Loin_of_Beef said:


> My doctor says I am not a good candidate for Lunesta. I live alone, I sleep naked, and I own a convertible.



You sleep in your convertible???


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## Aunt Bea (Jan 24, 2014)

I'm against drug companies advertising and other forms of medical advertising!

Doctors were lousy business men and they sold the medical profession to corporate America so they could concentrate on practicing medicine, the health care industry was born, a big mistake!

Now it is all about money, market share, treating symptoms and not solving problems or curing diseases.  We are sliding back into the days of the medicine show quacks!  

It ain't right I tell ya, it just ain't right!  

I'm all done ranting, for now!


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## AnthonyJ (Jan 24, 2014)

cave76 said:


> The United States and New Zealand are the only two countries in the world that allow advertising of pharmaceuticals (DTC= Direct to Consumer) on TV or in magazines.I personally think that the rest of the world is more 'advanced'  in that way, in that area.



I apologize in advance for not reading the entire thread, but I couldn't go any further without mentioning the elephant in the room.

Every… Single… Commercial has the SAME warning: Side effects may include […] suicidal thoughts or actions. 

My little brother was on an anti-depressant and on the 14th he ended his life. I'm not trying to make a direct correlation, but, there's really only one way to know this is a side effect: Someone in the test group experienced it. 

The other good example is the RA meds that can cause lymphoma. My sons mother had Hodgkin's lymphoma, twice. I've had neither, but I would rather have RA than lymphoma. 

But the best of the best is the fibromyalgia med: "It is not known how exactly Cymbalta works." That's good… Here, take this, it will work, but we don't know how it works."


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## GotGarlic (Jan 24, 2014)

I'm sorry for your loss, Anthony. 

Every symptom someone experiences while they're in a drug trial has to be reported and included in the patient information packet. 

Regarding RA, I also have a severe auto-immune disease. I would not be alive now if it weren't for drugs that started out being approved for RA. I've been on several because people often develop antibodies and they stop working. I'll take my chances with the side effects.


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## Dawgluver (Jan 24, 2014)

So sorry, Anthony, my deepest sympathies.


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## taxlady (Jan 24, 2014)

Sorry for your loss Anthony. It just seems wrong that suicidal thoughts are a side effect of several anti-depressants.


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## taxlady (Jan 24, 2014)

"Talk to your doctor about Zantac (or Zoloft)." Why? The ad didn't even tell me what these drugs do.


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## Addie (Jan 24, 2014)

taxlady said:


> Sorry for your loss Anthony. It just seems wrong that suicidal thoughts are a side effect of several anti-depressants.



For many years suicide has been known to be a major side effect for teenagers who take these drugs. When prescribed for teenagers, it should be noted to the parents and family of this nasty little secret. They need to be made aware so that everyone can keep their eyes open. I am not sure if it is one of those drugs that you can't get a refill on without going back to the doctor's office. If it isn't, it should be. 

When my daughter was murdered, my granddaughter was having a hard time dealing with it. I was no help as I was dealing with my own grief. I called a mental health center to make an appointment for her. They asked her name. And that is all. After I hung up I got a phone call a couple of minutes later to inform me that there was a prescription for one of these antidepressants for her. The doctor that phoned it in had never seen her, didn't know her weight, age or any other information about her. I didn't bother to get the prescription or have her keep the appointment.


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## Dawgluver (Jan 24, 2014)

Antidepressants have helped many, and right now, it's the best we can do with what we've got.  Are they perfect?  Absolutely not.  But if they're needed, they should be used.  Having worked with adolescents for over 30 years, I find that most depressed kids have had their lives turned around for the better with the antidepressants, including the suicidal kids.


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## Addie (Jan 25, 2014)

Dawgluver said:


> Antidepressants have helped many, and right now, it's the best we can do with what we've got.  Are they perfect?  Absolutely not.  But if they're needed, they should be used.  Having worked with adolescents for over 30 years, I find that most depressed kids have had their lives turned around for the better with the antidepressants, including the suicidal kids.



I am not against them when needed. I just think there needs to be closer follow up for when they are prescribed for teenagers. We know the dangers, yet we choose to hope that a pill will solve all the problems. The easy way for a solution? Hardly.


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## cave76 (Jan 25, 2014)

GotGarlic said:


> I'm sorry for your loss, Anthony.
> 
> Every symptom someone experiences while they're in a drug trial has to be reported and included in the patient information packet.



Yes it is. But who reads it, besides perhaps me and a few others? Even when my eyesight was better I had to use a magnifying glass to read it.

To further complicate things----- if people *did* read all the things that could go wrong, they'd never take that drug. 

Although I'm a big supporter for people reading the patient packet it's also a CYA kinda thing to discourage lawsuits.


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## cave76 (Jan 25, 2014)

@AnthonyJ

I'm sorry for the loss of your brother---- I'm sure you and your family have felt that loss tremendously.


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## AnthonyJ (Jan 25, 2014)

GotGarlic said:


> I'm sorry for your loss, Anthony.
> 
> Every symptom someone experiences while they're in a drug trial has to be reported and included in the patient information packet.
> 
> Regarding RA, I also have a severe auto-immune disease. I would not be alive now if it weren't for drugs that started out being approved for RA. I've been on several because people often develop antibodies and they stop working. I'll take my chances with the side effects.



Don't get me wrong. I'm happy that we've developed the medicines we have to treat the wide variety of ailments people suffer. It's true testament to what we can do when we work towards good. 

Just as with our renewable energy sources, I hold firm that we can make them better through proper R&D. Medicine and energy and everything that we do we can only improve on. Where we are is a good start, but we still have work to do we need to continue studying these things and figuring out what causes the side effects we aren't happy with and work on changing that. Things will only get better with time.



Dawgluver said:


> Antidepressants have helped many, and right now, it's the best we can do with what we've got.  Are they perfect?  Absolutely not.  But if they're needed, they should be used.  Having worked with adolescents for over 30 years, I find that most depressed kids have had their lives turned around for the better with the antidepressants, including the suicidal kids.



I agree completely. My brother was on meds for 8 years or so and was very proud of how they, along with therapy, helped him turn his life around. I wanted to take him out for a drink on his 21st birthday and he turned it down because it would have had complications with his medicine. He said "I'd rather not skip taking my meds. I like being a productive person and I don't want to risk that." 

Like I said whatever he was going through was big, so I don't blame the meds entirely. There was something deeper than that that he needed to get away from. I just try to take solace in knowing that he's no longer dealing with whatever burden pushed him to this limit. 

And I thank all of you from the bottom of my heart for your condolences. The best thing right now is the outpouring of his friends on his Facebook page remembering all the fun times they had with him and how much of a caring person he was that he was always helping out people in the neighborhood.


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## bakechef (Jan 25, 2014)

Dawgluver said:


> Antidepressants have helped many, and right now, it's the best we can do with what we've got.  Are they perfect?  Absolutely not.  But if they're needed, they should be used.  Having worked with adolescents for over 30 years, I find that most depressed kids have had their lives turned around for the better with the antidepressants, including the suicidal kids.



Years ago my dad was hurt on the job and was fired illegally (company didn't even try to meet OSHA standards).

This threw him into a deep depression, we didn't know what was going on.  Finally my mom sent him to the doctor and he was prescribed antidepressants.  With close monitoring and therapy he got so much better.  I think that is the secret, having a doctor closely monitoring and a mental heath professional keeping things on track.

It seems that antidepressants are handed out these days without psychotherapy, that seems a bit dangerous.

I have anxiety issues, and I've been hesitant to talk to my doctor about it, I don't want antidepressants.  There are sure times that I could use a Valium though!


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## GotGarlic (Jan 25, 2014)

cave76 said:


> Yes it is. But who reads it, besides perhaps me and a few others? Even when my eyesight was better I had to use a magnifying glass to read it.
> 
> To further complicate things----- if people did read all the things that could go wrong, they'd never take that drug.
> 
> Although I'm a big supporter for people reading the patient packet it's also a CYA kinda thing to discourage lawsuits.



I'm sorry, I wasn't clear. Every symptom has to be reported whether there is any evidence it's related to taking the drug or not. Most of the time, they're not. Correlation does not equal causation. 

Regarding antidepressants, obviously the people taking them are depressed and the people who join a clinical trial have tried other options already. And it takes some time for most antidepressants to build up to a therapeutic dose in the body, so it shouldn't be surprising that people continue to suffer symptoms of depression, including suicidal thoughts, while they're taking the drug. That doesn't mean the drug caused the suicidal thoughts - just that they happened at the same time. Correlation does not equal causation.


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## cave76 (Jan 27, 2014)

"FDA approves Duavee to treat hot flashes and prevent osteoporosis"
FDA approves Duavee to treat hot flashes and prevent osteoporosis

"Estrogen and drugs like bazedoxifene *can increase the risk of blood clots*."

"Pfizer said that Duavee should not be used by women who: have or have had blood clots "

_[my note---- of those who don't want blood clots, in some cases.]_

"Duavee should be used with caution, and* only for the shortest time possible*," said Dr. Jennifer Wu, an ob/gyn with Lenox Hill Hospital in New York City. "No hormone replacement is intended for the long term."

"Uterine cancer may still be a risk when using the estrogen," Wu added. *"Longer term studies are needed.*"

_[my note: Or just let the guinea pigs out there 'study' it some more.]_

http://www.webmd.com/menopause/news/20131004/fda-oks-drug-to-treat-hot-flashes-in-menopausal-women"

"Common side effects of Duavee include muscle spasms, nausea, diarrhea, upset stomach, abdominal pain, throat pain, dizziness and neck pain, according to Pfizer."
FDA OKs Drug to Treat Hot Flashes in Menopausal Women

There ARE women who have severe hot flashes. However 'severe' is a very subjective word.. Mine were pretty bad (severe? to some?) but I didn't have to  make any life-style changes (except to turn the  heater down, to the great joy of my husband!)

And I guess that a very few women might get hot flashes that are medically dangerous but I haven't found them. Menopause can have some dangerous problems associated with it but the ones listed don't include hot flashes.

*So why the drug for them? Ka-ching!?*


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## tinlizzie (Jan 27, 2014)

In last Sunday's newspaper, one of the full-page ads was about "The Youth Hormone."  At the top of the page, it said "Advertorial," a new word to me.


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## Cooking Goddess (Jan 27, 2014)

AnthonyJ said:


> ...My little brother was on an anti-depressant and on the 14th he ended his life...


Anthony, my heart aches for your loss. Our daughter experienced the death of a friend through suicide when she was in high school and it shook her to her core.  Your brother's pain ended for him when he died, but you and all his loved ones will continue to hurt for the rest of your lives. Good thoughts and prayers for all of you.


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## GotGarlic (Jan 27, 2014)

One important thing I learned from working at a medical school, and from working with a GI doctor who is on the faculty there, is that medical understanding of disease processes is becoming more and more refined, which means that they understand better why different drugs affect different people differently, and so new drugs are developed to address those differences. 

The other important thing I always remember is that I'm not a doctor or a microbiologist. 

It's a cliché that there is always more than one side to a story. In medicine, there are many factors that doctors must take into account when deciding on which medication to prescribe, how much to start, how much and how fast to increase (if necessary) and how long a person should take it. A cost-benefit analysis (risk of side effects against the likelihood of effectiveness and safety)  is part of that.

Here's an example:



> "We used to have this monolithic view that you treat all patients who have Crohn's or ulcerative colitis the same way. With the advent of individual or personalized medicine, we're beginning to appreciate that there is considerable individual variation in response to a particular medication.
> 
> "For example, even with the anti-tumor necrosis factor agents, arguably the most effective class of medications for IBD, only 70 to 80 percent of people, at most, respond initially, and many of those patients lose their response over time. So we need multiple drugs with multiple mechanisms of action."



From http://www.mayoclinic.org/medical-p...ing-pipeline-inflammatory-bowel-disease-drugs


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## DaveSoMD (Jan 27, 2014)

PrincessFiona60 said:


> Drug advertising should stop, now.



I totally agree!


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## PrincessFiona60 (Jan 27, 2014)

And also different patients are willing to take those risks to fight their disease.


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## AnthonyJ (Jan 28, 2014)

GotGarlic said:


> One important thing I learned from working at a medical school, and from working with a GI doctor who is on the faculty there, is that medical understanding of disease processes is becoming more and more refined, which means that they understand better why different drugs affect different people differently, and so new drugs are developed to address those differences.



Exactly. It's a slow process and unfortunately some people are going to experience these unwanted side effects, but without taking this first step to address it in the first place, we would never make any kind of progress at all.



PrincessFiona60 said:


> And also different patients are willing to take those risks to fight their disease.



Usually the risks are low, but the fact that they are risks at all are rather unnerving. 

The flip side is, the last one I heard for anti-social disorder, or being afraid to go out, whatever it is, they listed the side effects as nose bleeds, vomiting and severe diarrhea. I couldn't help but laugh at the thought of the poor sod taking this stuff, making it to the party and then being struck with a bad case of the runs and having to spend the night on the bowl instead of enjoying the party.

But I was listing to Ben Bailey standup the other day and he was talking about it. He said it seems like they, the pharmaceutical industry, are inventing ailments just so they can sell us a pill. I've worked in a hospital/nursing home for ten years and 90% of the doctors I know thing fibromyalgia is, in their own words "bulls**t." But the area I work in is notorious for druggies coming in getting scripts for valium or oxycontin and then later claiming they lost their meds or their script, so that may skew the views of these doctors.


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## Aglio Vestito (Jan 28, 2014)

... Erm... Coffee enemas? Really? Don't know what would make me more nervous: the coffee or the emema?


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## Aglio Vestito (Jan 28, 2014)

Personally I don't like that system, especially for some heavy drugs: they shouldn't be commercialised like if they were candies...


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## Addie (Jan 28, 2014)

PrincessFiona60 said:


> And also different patients are willing to take those risks to fight their disease.



When you have been given a death sentence, and your present drugs are not working, you will gladly sign up for trials for a new drug.


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## Aglio Vestito (Jan 28, 2014)

Yes in those case the more u get to know the better. This also means you do not want to depend on the doctors' decisions and you don't surrender to them. I believe self awareness is a key in that case and I indirectly had experience if it. But in the case of a anti depressive drug or a sleeping pill, you can't simply advertise the product it itself as if if was a bag of crisps.


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## GotGarlic (Jan 28, 2014)

AnthonyJ said:


> Exactly. It's a slow process and unfortunately some people are going to experience these unwanted side effects, but without taking this first step to address it in the first place, we would never make any kind of progress at all.



"Without taking this first step?" You make it sound like they just noticed some people get unwanted side effects. Four phases of clinical (in people) trials follow animal studies which follow laboratory (in vitro) research. 



AnthonyJ said:


> Usually the risks are low, but the fact that they are risks at all are rather unnerving.



I'm sorry, but the fact that you seem to think that medical treatment, especially of serious, chronic disease, should be risk-free is naive. The human body is extremely complex and, as far as medicine has come in the last century, no one claims to understand how everything works.

Did you read the article I linked to? It's for medical professionals, but that's the point. I was hoping to illustrate that however much lay people think they know, even physician-researchers who have studied and treated a set of diseases for decades admit they don't know how the disease process starts. That's no one's fault - it's just a fact of life.


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## cave76 (Jan 28, 2014)

What If Everything Worked Like Health Care?

Checkout - YouTube


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## cave76 (Jan 28, 2014)

"Pharmaceutical companies typically spend substantially more on marketing than they do on research and development."

From:

Ad-proofing tips from The Ad Guy | The Ethical Nag


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## GotGarlic (Jan 28, 2014)

For the record, I oppose marketing pharmaceuticals to patients and have since it started. I have no more to say about this.


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## PrincessFiona60 (Jan 28, 2014)

GotGarlic said:


> For the record, I oppose marketing pharmaceuticals to patients and have since it started. I have no more to say about this.



I am done, too!  Not really appropriate for DC.


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## Oldvine (Jan 28, 2014)

The ads sell the drugs that's for sure.  We have friends that brag "I'm taking that new medicine you see advertised.  My doctor sure fought the insurance company to pay for it".    Some times the warnings are carefully worded to make the side effects sounds like a benefit.   Think of the one that warns if the "benefit" lasts longer than 4 hours, seek medical attention.  
I agree with everyone, stop the ads.  The cost of those commercials is tacked onto the price of the drug.


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