Posted by Dr. Bob on January 27, 2004, at 21:20:56
In reply to Long rant: drug profits, regulation, patients, posted by omegon on January 27, 2004, at 20:59:37
> > [efexor, prozac, SSRI's in general]
> > http://www.prozactruth.com/weight.htm
> >
> > The fact is you can run 5 miles a day for a month straight and not lose a lb. I'm proof of that. This is because these drugs lower our metabolism, this is why we gain weight.
>
> Some people gain. Others lose it. Prozac has destroyed my appetite completely in the last few weeks.
>
> Before anyone gets any ideas about weight loss, this is not necessarily a good thing, especially as the main reason for the change is that I feel too sick to eat most of the time. I am well underweight for my height already: male, 23, 178cm, under 60kg before I started it.
>
> (Other SSRIs I've tried didn't make me gain weight either - though they certainly destroyed any fitness I had, due to the absolute apathy and inertia they produced.)
>
> > Shame of the drug companies for denying it! All they want is $$$.
>
> Well, yes. That's why they are called companies, and why they have managed to develop the few drugs they have at costs of hundreds of $million each. It's what they do and it's why their staff work for them. A non-profit company might have an outside chance of discovering a useful drug, but getting it through the (necessary) regulatory systems, and then actually marketing it enough so that it reaches patients? no chance.
>
> The current systems work for the most part - it's just that they need a bit of (necessarily forcible) adjustment of the profit<->people balance, to sort out the side-effects that profitability doesn't notice, like making the people you're "helping" feel suicidal when you stop "helping" them.
>
> Despite this, I see lots of posts on here slating "the drug companies" for releasing drugs that help some people but not others / not giving the side effects and withdrawal symptoms enough emphasis / not giving out free medicine to everyone / making any money at all. (For the record, I am a victim [perhaps only partially an unwitting victim] of paxil, effexor, and (increasingly) prozac - see earlier posts - so I'm not entirely biased towards those drug companies.) Again, who would develop these drugs in the absence of vast profits, especially given the current culture of litigation? The regulatory process (which is entirely necessary for new drugs) is inevitably very expensive to get through.
>
> Obviously if you look at the whole system, and the devastating damage that these drugs can inflict on an individual human level when they are not used carefully enough, it it looks shaky under any moral scrutiny. Unfortunately, big companies don't work like that, for much the same reason as why one country can go to war against another and sanction the killing of people they've never seen: self-interest, tribe instinct. People in those companies will settle for helping some people, some of the time, and getting paid. The people who are hurt are someone else's problem.
>
> If anyone is to blame, I think it is precisely those various governmental regulatory systems (much the same in any country, from what I've read): surely their primary purpose is to rationalise (humanise?) and keep this kind of thing in check while maintaining the advantages of opening the drug development sector up as a commercial market? Those agencies should be placing far more emphasis than they are effectively managing to do on sparing patients/victims the adverse effects of these drugs, which in many cases could be easily avoided or at least greatly reduced. Clearly the human cost of this is vast, and should be enough for those supposedly human-focussed governmental thingums to sort things out.
>
> Of course, this is rarely enough unless the mainstream press happen to jump on the bandwagon. Taking the cynical point of view, the economic cost is huge as well, inevitably greater than the drug company profits! And it's likely that, even if you don't offset the economic losses directly against those profits, the latter will get zapped eventually when the aforementioned litigation gets going and produces multi-billion class-action lawsuits. They need to encourage cautious dosage changes, warn about withdrawal symptoms, potential for mood changes if misdiagnosed, and so on into hell for the patient. This information is widely available, seems to be well supported by studies as well as anecdotal evidence (admittedly I have not formally researched this, and my viewpoint may be biased) and is readily found if you research on the web, whether focussed on research or on patient experiences. Yet despite this, it is emphatically NOT getting to many of the doctors who prescribe these drugs, until their better-informed patients go through it and report back to them!
>
> So what can we do?
>
> Well, since most of us "victims" only have access to the doctors who put us through this, and to peers who might have to go through this later, the most useful thing is just to tell those people.
>
> And of course if it might help you feel better, or satisfy your moral sense to some extent without actually having to engage in any conflict with those who might disagree, you could do worse than to post a long, unnecessarily detailed rant to an internet board where most people won't even read it.
poster:Dr. Bob
thread:306241
URL: http://www.dr-bob.org/babble/social/20040120/msgs/306241.html