Sunday, March 13, 2005

men's health magazine ranks 101 'most depressed.' philly, pull out your hankies...

The April issue of Men's Health Magazine will name the city of brotherly love as the most depressed place in the USA. Keeping company with us at the bottom of the list are Detroit, St. Louis, St. Petersburg, & Tampa, according to a news release.

The rankings were based on antidepressant sales & suicide rates, among other facts from the CDC. Interestingly, this all comes on the heels of Michael Blanding's recent Boston Magazine article. In "Bad Medicine," Blanding described pharmaceutical companies' common practice of bribing doctors to prescribe their version of a medication over another.

Blanding pointed to the recent flap over Vioxx, noting the contributions of Dr. Jerry Avorn. Avorn studies the safety & cost-effectiveness of drugs, & authored Powerful Medicines: The Benefits, Risks, and Costs of Prescription Drugs. He was one of the first to question Vioxx.

Here's the part where I buried the real lead... During the FDA approval process for Vioxx, Avorn & Dr. Dan Solomon did research on their own. They found that despite Vioxx's high cost, it was no better than aspirin or ibuprofen. Its benefit was to patients who experienced side effects with OTC pain relievers.

So what, you can just hear the drug companies whispering... There's such a thing as placebo effect. Yeah, right. Merck shelled out more money to market Vioxx than Anheuser-Busch to sell Budweiser, in the year 2000.

We've heard about doctors' tendencies to medicate society's every ill. And with the abundance of pharmaceutical companies in Philly, should we be shocked at our drug intake levels?

Blanding's article also pointed to AstraZeneca. An ongoing court case involves plantiffs in California and Massachusetts who claim the company swindled the American public by marketing a copycat of its own drug! AstraZeneca allegedly stopped making its heartburn medication Prilosec- "the purple pill"- just as the patent was running out (& the price was about to plummet). Instead, it began pushing the nearly identical medication Nexium- "the healing purple pill." AstraZeneca claims Nexium is more effective than Prilosec. In clinical studies, however, the necessary dosages were 2x as high.

Onto GSK... GlaxoSmithKline has U.S. headquarters in Philly. Recently, they've undergone a series of troubles. Quarter after quarter, Wall Street confidence levels have dropped. GSK just announced more job cuts last month and admitted they were under investigation by DOJ for 'nominal pricing arrangements' (defrauding Medicaid). More recently, federal regulators seized two of its drugs (antidepressant Paxil & diabetes med Avandamet) for what the FDA called "poor production standards."

Here a drug, there a drug, everywhere a (sub-par) drug The January 2005 issue of the Journal of Psychiatric Practice showcased two new studies that say patients' medication combinations vary widely, making it incredibly difficult to foresee interactions (of great comfort, no doubt, to the family of Villanova professor Mine Ener).

At the end of the day, it comes down to numbers. 20 million Americans suffer with depression. A Consumer Reports survey showed that in the past 10 years, patients taking pills as their main treatment for mental illness rose from 40 percent to nearly 70 percent. Some types of depression can be treated as chemical imbalances. Some types are "chronic" emotional conditions that could be helped by much touted 'talk therapies.' The problem is, insurance companies cover pills, not yada yada yada...

Cognitive talk therapy began in Philly, where founder Dr. Aaron Beck still practices. Cognitive-behavior therapy, a version of Beck's original work, focuses people on recognizing negative thought patterns that contribute to their moods.

The New England Journal of Medicine published a study in 2000 that showed patients undergoing cognitive-behavioral therapy while taking an antidepressant did better on a depression rating scale after 12 weeks of treatment than either the drug-only or psychotherapy-only groups. A companion study showed a lesser relapse rate.

*Men's Health, on newsstands March 15.

Thanks to Abby & Mark for this.