Wednesday, November 5, 2008

Antidepressant Advertising a Major Source of Depression

I do not think it is a good idea for the pharmaceutical industry to advertise directly to the public. Would you trust the advice of the big pharmaceutical companies in regard to medications they manufacture? As an analogy, would you continue to see a doctor who only orders the drugs advertised on the pen with which he writes the prescription? How many times have we heard a patient ask for Viagra or Cialis after seeing an ad on television. We reply, "Oh, do you have erectile dysfunction?" The patient answers, "Gosh no doc. I can get it up OK. I just want an erection like I used to have when I was 16." Or, there is the patient too stupid to even understand the message in the television ads. The mother looks me in the eye and asks, "Do you think my child should get that there vaccination called Gardasil?" I think for a moment and decide to give a simple answer. I say, "No." She goes on, "Well on TV they say it prevents many types of cancer. I don't want my child to get cancer." I take off my glasses and look the mother in the eye and say, "Until your son grows a uterus, his chances of cervical cancer are quite low and I really don't think he needs Gardasil." Missing my humor (alright, frank sarcasm) she says, "Thank goodness. That is one less thing to worry about." I sigh and wish I had gotten a business degree instead.

One of the biggest issues I have, at present, is the advertising for antidepressants. Hell, the advertisements depress me and I am usually as happy as a clam. Last night I saw an ad for Cymbalta. The ad was dark and the music sad. The people were virtually catatonic. Before I knew it I was in the kitchen looking at knives and trying to determine which was sharpest and would be the least painful when I cut my own wrists. Later, I saw an ad for Abilify. It was equally depressing. What is most disconcerting is the fact that I have never heard of Abilify. Thus, the patients may be more informed than me. But, I am just an emergency doc and don't prescribe antidepressants and rarely diagnose depression.

Is it me or is depression the diagnosis de jour? Feel bad, here, take a pill. I think the problem of depression is related to modern television. Today the people watch too much television and the programs on television are as depressing as the antidepressant ads (except House and Boston Legal). When I was a kid I watched the Three StoogesTom and JerryFelix the Cat and similar epics. We never got depressed (besides, we rode our bikes so much we slept like rocks). I think the major reason we have so much depression is because of the 24 hour media and the fact that too few children now grow up seeing the exploits of Curly Howard. Instead of writing a prescription for some SSRI, just tell the patient to go to Wal-Mart and buy Three Stooges DVDs and watch them for one hour before retiring for the night. That is a much safer, less expensive, greener, and more appropriate treatment. To quote the great philosopher Curly, "I'm a victim of circumstance!"

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