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Re: AD's vs. Bzds for Anxiety disorders » pharmrep

Posted by Alan on October 9, 2002, at 21:53:18

In reply to Re: marijuana..tough one » Satori, posted by pharmrep on October 9, 2002, at 17:18:02

> Q:
> It seems to me (from this bulletin board and several others)that the preferred option of people suffering from anxiety for a long period seems to be to either take Xanax or another benzo daily, or on an as needed basis. Why is it then that most doctors seem to recommend ADs as the first (and many times only) choice for anxiety? It can't just be marketing by the pharmaceutical companies can it?
>
>
> A:
> Well, it isn't JUST marketing. The makers also performed unprecedented numbers of clinical trials (mostly outside the US) in order to get a handful that were complimentary. They couldn't afford to be satisfied with the first overwhelmingly negative results, as there was too much money already invested. So they persevered and persevered, gradually learning how to design studies with more favorable outcomes. They also changed some data and hid other studies away in company vaults where they weren't "found" until a decade later, and then only under court order.
>
> But yes, antidepressants do seem, according to the little independent research that exists, to be useful against anxiety in maybe 30-50% of cases. Still, it's no coincidence that most manufacturers don't provide data on SSRIs in anxiety that would allow actual percentage calculations to be made. They just say their med was so-and-so % much better than placebo.
>
> Meanwhile, benzodiazapines have proven for 40+ years to be at least 75% - 85% effective by conservative estimates with little side effect comparatively speaking. Plus they are usually added to take with an AD in the end anyway since AD's are most often overstimulating or do not provide adequate releif of symptoms as the anxiolytics do.
>
> You have to understand that the FDA has incestually high employment overlap, among its movers and shakers, with the industries that it regulates. In the pharmaceutical arena, it is common for someone who pushes through an approval at the FDA to then go work for the company that developed the approved product. The financial temptations are nearly irresistible.
>
> There's a rule of thumb in law enforcement that the more highly educated a person is, the more gullible he becomes. You get more Ph.D.s falling for street scams than people whose daily life is closer to the street. Doctors are no exception. They seldom imagine that a drug company would lie and cheat about the information shown to doctors, or that so many of the articles written about SSRIs have been ghost-written by pharmaceutical company hacks who then paid an "independent" MD to put his name on it, or that the respected MD who writes or speaks about a medication neglects to mention that he is earning not only some but the majority of his income from the drug company that makes the medication. They are amazed and outraged when individual cases get exposed, but they don't get it that this is business as usual in the pharmaceutical industry today.
>
>
> Pharmrep:
>
> Besides the "what's your source" company line, any comments? If you dispute it, what are YOUR sources?
>
============================================

I guess that pharmrep is choosing not to answer some very important questions about AD's vis-a-vis their use in treatment of symptoms for anxiety disorders.

One would think that a pharmecutical representative would be more than willing to answer these fundamental questions for a very large population of us anxiety sufferers that tried ssri's for many years only to end up on the basic anxiolytic anyway - the lowly benzodiazapine. Or had to augment an ssri with a bzd in the end ....

Is that because there are really no legitimate medical answers as to why AD's are presently being promoted as the first line of treatment for the disorder - and not on equal footing with the Benzodiazapines???

Why is all of the evidence that the most effective and safe anxiolytic known to medicine - the bzd - brushed aside by the promoting of new AD's in their place rather than along side with the benzodiazapine to give the doctor and patient alike the freedom to choose? Otherwise, isn't freedom being taken away?

Would it have anything to do with putting profit before medicine to regain R & D and marketshare?

Not meant as just rhetorical questions. Sincerely and honestly wondering...

Alan


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poster:Alan thread:109458
URL: http://www.dr-bob.org/babble/20021006/msgs/122998.html