http://www.alternet.org/health/151513/big_pharma%27s_latest_shady_ploy_to_sell_depression_drugs_that_people_may_not_need_/?page=entire
To imply that depression is not a real and serious mental health issue for some of us is a mistake. To imply that antidepressant medication doesn't work or only works through "the placebo effect" or is a "quick fix" for a bad mood comes off as ignorant and insulting to those of us who have had to fight for years with this wretched disorder and HAVE been helped by medication.
That being said, are prescription drugs (particularly drugs related to the treatment of disorders such as depression and ADHD) overprescribed? I would say yes. Are there people who have been described antidepressants who perhaps don't need them? Sure there are. Are there harmful and dangerous drugs on the market that are being prescribed to people who are ignorant of the side effects and repercussions of such medication? I'll be the first one to agree with that.
But some drugs do work. And some people need medication. Major depressive disorder is caused by an imbalance of chemicals in the brain such as serotonin and norepinephrine and the way the brain processes these chemicals. Sometimes antidepressants can help balance things out, enabling the person to be able to live some semblance of a normal life.
There are good drugs and bad drugs. Drug companies are out to make a profit and for the most part they don't really care what happens in the long term. They peddle new medications (which are often just reformulations of existing medications) to physicians promising incentives if they'll prescribe them.
Take for example the fraternal twins of antidepressants Pristiq and Effexor, drugs of which I've had personal experience. Effexor (venlafaxine) was formulated by Wyeth (part of Pfizer) as an SNRI (serotonin norepinephrine reuptake inhibitor). It is available in doses from 25mg up to 150mg.
About the time the patent on Effexor was due to expire (thus allowing generic versions to enter the market), Wyeth formulated a new drug they called Pristiq or desvenlafaxine. Essentially Pristiq is a reformulation of Effexor or venlafaxine, the main difference being the way the body metabolizes the drug. Pristiq is essentially the active metabolite of Effexor and basically Effexor is metabolized by the body into desvenlafaxine anyway after it's taken, so all Pristiq does is just eliminate a step in that process. Pristiq is available in 50mg and 100mg tablets. There is no equivalency in dosage between Effexor and Pristiq, meaning that 50mg of Pristiq does not equal 50mg of Effexor.
So why two drugs that basically do the same thing? Because Wyeth/Pfizer wanted to recoup the money they would lose when their overpriced antidepressant went generic. It's that simple.
It was around the time that Pristiq entered the market that I visited a psychiatrist to re-evaluate my depression treatment. I had been taking Effexor for awhile but felt that it wasn't really helping enough and I was also concerned about the heinous withdrawal side effects*. My psychiatrist's answer was to transition me over to Pristiq- this brand new drug that would be better for me than Effexor because my body would metabolize it differently. Now, I'm in my early twenties at this time and know nothing about pharmacology. I grew up believing that doctor had your best interests at heart and that when it came to medication you could trust their judgment so I figured that if this was what she was recommending, it was the way to go.
So, leaving the office with about 5 sample packs (I didn't have insurance) of this promising new drug, I switched over to Pristiq after having taken 150mg of Effexor daily for I don't even remember how long. Given that there's no dosage equivalency between the two medications (very clever, Wyeth), the changeover was rocky and I experienced some symptoms of withdrawal which I slugged through. Now I did think the Pristiq helped at the time, but knowing what I know now (given that Pristiq is essentially the same drug as Effexor), it may have been coincidence or it may have been the proverbial "placebo effect". However, I still had symptoms, so a few months later I was prescribed Wellbutrin (buproprion) in addition to the Pristiq. That actually did help- after a couple of weeks of physical and mental hell adjusting to the drug.
I tell you all this, because I look back and think that I was essentially sold a bill of goods. Not that I think my doctor did it malevolently, but did she have some kind of incentive to change my medication to this brand new drug? Probably. And hey, it was practically the same med anyway, so victimless crime, right?
I wish I had known better.
It's probably been about two or three years since the Great AD Switchover and I'm still on 100mg of Pristiq a day. However, as of about 2 weeks ago, spurred partially by the fact that I was losing my Rx coverage and partially by the fact that the more I thought about this drug I was taking (side effects, discontinuation, etc), the more I began to distrust that Pristiq was effective or safe. After all, I had improved far more with Wellbutrin than I ever did with the venlafaxine twins.
So... I decided to wean myself off of Pristiq. I am doing this slowly and without my psychiatrist's supervision or knowledge. I don't really want to try to justify myself to the people who hocked Pristiq at me in the first place and I don't really want to be on any other pills. My method of weaning simply consists of cutting my pills. Every night when I take my pill, I cut a little sliver off with a knife, over time I'll cut off progressively larger and larger slivers until I'm able to function without the medication altogether. Now, a lot of the information I've read discourages cutting your pills since they're supposedly covered with a time release coating, but I've been doing this for a little over a week thus far and I'm down to 2/3 of a 100mg Pristiq nightly with no noticeable side effects. So far so good, and every night when I cut my pill I get excited thinking about the day when I won't be dependent on this god-awful drug anymore.
I'm not really worried about what I'm doing because I figure if the withdrawal gets to be too much or I stop the meds and realize I mentally felt better with them, I can always begin taking them again, considering that the doctor will keep prescribing them as long as I pretend to be taking them. I'm prepared for some discomfort and don't expect not to feel any withdrawal, but cannabis has always proven effective in quelling the side effects such as nausea, headache, severe mood swings, etc. I plan to stay on the Wellbutrin at least for awhile, since I'm pretty happy with what it does and don't have the worries about side effects and discontinuation that I do with desvenlafaxine.
Moral of the story? Don't ever take a medication without researching it first. Even if you trust your physician. Or maybe the real moral of the story is that you can't always trust medical professionals to have your best interests at heart, even if you are paying them to do so.
Drug dependence comes in many forms. The drug companies have realized they can profit off this. Internetland is filled with accounts of other people who are facing the same struggles with des/venlafaxine as me. I don't believe that drug companies and physicians aren't aware of the hellish side effects of this drug, but as long as there is money to be made they can't be trusted to give a shit.
*Heinous withdrawal side effects for me specifically have been nausea, headache, dizzyness, weakness, tremor, dry mouth, extreme lethargy and sleepiness, intestinal upset (to put it nicely), INTENSE mood swings, and this lovely little thing we venlafaxine dependents call "brain shivers". These effects usually begin at approx the 5 hour mark, intensify quickly, and they usually occur simultaneously, although the brain shivers alone are enough to send me running back to that little orangey-brown tablet.
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