Notes from the Prozac Nation, Vol. I, No. 3
- Celebrity Depression News: While Cruise's zealous attack of drug therapy is inexcusable and inhumane, particularly his attack on Brooke Shields' book on Post-partum depression, he has unwittingly been helpful in educating the public about the devastation of this illness.
- Gender and Depression: Researchers at the University of Vienna are starting to study the different symptomology of depression between men and women. Men are more likely to be angry and irritable, while women slow down and sleep excessively. (This is one of those studies where I think: duh!)
- Cross-Cultural Depression: Hu Hai-kuo, head of the Psychiatry department at the National Taiwan University Hospital, recommends a yearly mental-health check. On mainland China, a survey reveals that 600,000 Beijingers suffer from depression (what the article refers to as "secret troubles"). "Most of the people suffering depression are from groups who experience unhappy marriage life and domestic violence, have a lowlevel of education and low income and are jobless, according to the survey."
- A Drug for Melancholy: Stanford researchers are testing a new drug, Cymbalta, for low-level depression (the blahs, dysthymia). According to San Jose Mercury reporter, Lisa M Krieger,[t]he popular drug Prozac, used for the treatment of major depression, is not approved for use against dysthymia. While other antidepressant drugs have been used "off-label" to treat dysthymia, they have not been tested in a rigorous way and are not approved for this use by the U.S. Food and Drug Administration.
This is misinformation, since David Healy shows in Let Them Eat Prozac, that fluoxetine was not effective in treating major depression in clinical trials; it was more effective in treating dysthymia. In fact, Peter Kramer's Listening to Prozac foregrounds the ethical question: is it ethically permissible to give Prozac to patients not suffering from depression, but who want to feel better than well? Dr. Elias Aboujaoude of Stanford University School of Medicine asserts:"This is not a personality disorder. It is a real condition that has a name -- and is potentially treatable, helping people who have suffered for years . . ."
This sounds to me like another way for the pharmaceutical industry to profit off of routine human misery, rather than actually identify a real and treatable mental disorder. The very question of what constitutes a mental disorder is hardly settled by studying human response to drugs, as Kramer and co. argue. - Get 'em while they're young and impressionable: Another "duh" news release. The pharmaceutical industry aggressively tries to buy the love and loyalty of medical students, by giving them weekly gifts.
Frederick S. Sierles, M.D., of the Rosalind Franklin University of Medicine and Science, North Chicago, Ill., and colleagues measured the frequency of medical students’ exposure to drug company gifts, students’ attitudes about gifts, and correlates of these frequencies and attitudes. In 2003 the researchers distributed a 64-item anonymous survey to 1,143 third-year students at 8 U.S. medical schools, exploring their exposure and response to drug company interactions. The schools’ characteristics included a wide spectrum of ownership types, National Institutes of Health funding, and geographic locations. In 2005, the researchers conducted a national survey of student affairs deans to measure the prevalence of school-wide policies on drug company–medical student interactions.
The overall response rate of the surveys was 72.3 percent (826/1,143). The researchers found that average exposure for each student was 1 gift or sponsored activity per week. Of respondents, 93.2 percent were asked or required by a physician to attend at least 1 sponsored lunch. Regarding attitudes, 68.8 percent believed gifts would not influence their practices and 57.7 percent believed gifts would not affect colleagues’ practices. Of the students, 80.3 percent (553/604) believed that they were entitled to gifts. Of 183 students who thought a gift valued at less than $50 was inappropriate, 86.3 percent had accepted one.
Nearly 60 percent (59.6 percent) of the students simultaneously believed that sponsored grand rounds are educationally helpful and are likely to be biased. Students at one school who had attended a seminar about drug company–physician relationships were no more likely than the non-attending classmates to show skepticism. Of the respondents, 85.6 percent did not know if their school had a policy on these relationships. In a national survey of student affairs deans, among the 99 who knew their policy status, only 10.1 percent reported having school-wide policies about these interactions.
The overall response rate of the surveys was 72.3 percent (826/1,143). The researchers found that average exposure for each student was 1 gift or sponsored activity per week. Of respondents, 93.2 percent were asked or required by a physician to attend at least 1 sponsored lunch. Regarding attitudes, 68.8 percent believed gifts would not influence their practices and 57.7 percent believed gifts would not affect colleagues’ practices. Of the students, 80.3 percent (553/604) believed that they were entitled to gifts. Of 183 students who thought a gift valued at less than $50 was inappropriate, 86.3 percent had accepted one.
Nearly 60 percent (59.6 percent) of the students simultaneously believed that sponsored grand rounds are educationally helpful and are likely to be biased. Students at one school who had attended a seminar about drug company–physician relationships were no more likely than the non-attending classmates to show skepticism. Of the respondents, 85.6 percent did not know if their school had a policy on these relationships. In a national survey of student affairs deans, among the 99 who knew their policy status, only 10.1 percent reported having school-wide policies about these interactions.
More about this here and here.
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