Big Pharma - Medicalisation being brought to a problem you might have

Big Pharma is getting worried, there are no Block Buster drugs coming down the pipeline. So they are desperately looking to find new reasons for doctors to prescribe drugs that have been cleared for human consumption. This branch of medecine (or marketing) is called medicalisation - in which health or behavior problems are defined and treated as medical conditions and thus require - and (it is often claimed) respond to chemical intervention - the research costs are low as well ..

The attraction of this expansion of the role of the doctor / confidant of the patient is that (especially in the USA) , consumer-directed advertisements instruct, suggest, advise patients to ask for a named drug. This creates both consumer confidence in the product and eases the function of the doctor in satisfying the patient / customer's perceived problems.

Increasingly the patients role has changed - once passive recipients of prodding, poking and eventually pills, patients can now occupy active positions as advocates, consumers, or even agents of change.

Increasingly the marketing departments of drug companies identify their target as the consumer not the clinician.

Cymbalta (duloxetine) is an Eli Lilly drug (annual sales US$1.3Bn.) which is a serotonin and norepinephrine reuptake inhibitor (SNRI), it currently approved in the US for adults with major depressive disorder, and diabetic peripheral neuropathic pain, and was approved in February 2007 for use in generalised anxiety disorder (GAD) a condition which the National Institute of Mental Health (NIMH) says,"affects more than 6.5 million American adults in a given year." The NIMH represents people who make their living out of dealing with (we'll hesistate to say cure) people who they determine have mental health problems - so they are not in the game to reduce the enormity or complexity of the problem.

It is believed (but not known or provable so far) that Cymbalta, as an SRNI acts on depression and anxiety symptoms, as well as its effect on pain perception by increasing the activity of serotonin and norepinephrine in the central nervous system.

Lilly have filed for FDA approval for the use of Cymbalta in the management of fibromyalgia and presented study data presented at the Congress of the International MYOPAIN Society (IMS) in Washington.D.C. on Tuesday which spent the whole day on considering the "Fibromyalgia Syndrome" - luckily a lunchtime Symposium was supported by an Educational Grant from Eli Lilly & Co.

As a result of a study for six month on 874 patients with fibromyalgia with or without depression who took Cymbalta experienced a greater reduction in pain, compared with patients who received placebo.

At 3 months, patients who received the drug had a significantly greater reduction in pain, compared to patients in the control group. The study was one of f5 submitted by Lilly as part of the expanded fibromyalgia application.

"Cymbalta seems to be a gatekeeper for how much pain message gets to the brain," explained Madelaine Wohlreich, a psychiatrist and medical adviser in neuroscience at Eli Lilly. "Nobody absolutely knows the mechanism of action, but the belief is that the two brain chemicals involved in depression are also involved in tamping down the signals of pain." Lilly is currently investigating Cymbalta as a treatment for lower back pain and arthritis.

Madelaine Wohlreich will also be presenting at the Academy of Psychosomatic Medicine 54th Annual Meeting, November 14-18 Amelia Island, Florida .

The Safety and Efficacy of Duloxetine Hydrochloride for the Treatment of Fibromyalgia: Results from a Six-Month Randomized, Double-Blind, Placebo-Controlled, Fixed-Dosed Trial

Principal Author: Madelaine Wohlreich, MD Co-Authors: I. Jon Russell, MD, Phillip Mease, MD, Timohy Smith, MD, Daniel Kajdasz, PhD, Daniel Walker, PhD, Amy Chappell, MD

Fibromyalgia is one of those rather indeterminate conditions of the human flesh - hence the description "Fybromyalgia Syndrome" this is how the world famous Mayo Clinic introduces it ..

You hurt all over, and you frequently feel exhausted. Even after numerous tests, your doctor can't find anything specifically wrong with you. If this sounds familiar, you may have fibromyalgia.

Fibromyalgia is a chronic condition characterized by widespread pain in your muscles, ligaments and tendons, as well as fatigue and multiple tender points — places on your body where slight pressure causes pain. Fibromyalgia is more common in women than in men. Previously, fibromyalgia was known by other names such as fibrositis, chronic muscle pain syndrome, psychogenic rheumatism and tension myalgias.



or ....

Life's just much too hard today
I hear ev'ry mother say
The pursuit of happiness just seems a bore
And if you take more of those
you will get an overdose
No more running for the shelter
of a mother's little helper

(c) Jagger / Richards december 1965