![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 83 to 107 of 164. Go back in thread:
Posted by River1924 on February 6, 2003, at 22:29:14
In reply to Re: Abilify ......., posted by 1313 on February 6, 2003, at 21:53:29
I just wanted to say I admire your struggle. Although I think it is unlikely people are talking about you...cynically, most people are too busy thinking about themselves (and that includes myself.) I wish you luck. It is tiresome to comb one's thoughts, trying to be reasonable and sensible. You sound like a winner to me.
Posted by 1313 on February 7, 2003, at 3:18:53
In reply to Re: Abilify » 1313, posted by River1924 on February 6, 2003, at 22:29:14
River, thank you for your kind words. deb
PS. You sound like a winner to me too!..best of luck...
Posted by 1313 on February 9, 2003, at 2:19:39
In reply to Re: Abilify, posted by 1313 on February 7, 2003, at 3:18:53
RIVER, I NEVER HURT ANYONE....AND I HAVE NO PLANS TO EVER!!! THERE IS ALOT OF CONFUSION IN MY MIND I NEED TO WORK OUT, LIKE THE DIFFERENCE BETWEEN A SERIOUS VERBAL MISTAKE AND BLANTENT LIE. EITHER WAY IT WAS SOMETHING I SAID NOT DID THAT GOT ME IN THIS SITUATION..... I DONT THINK CHANGEING BACK TO ZYPREXA IS GOING TO MAKE ANY DIFFERENCE ( DO YOU THINK!!!???)ASSUME FOR A MOMENT THAT I WAS WRONG IN YOUR ESTIMATION....WHAT WOULD YOU (RIVER) WANT FROM ME..............BESIDES DEATH!!!!!!!!!!!!!
Posted by utopizen on February 9, 2003, at 12:23:19
In reply to Re: AbilifyRIVER, posted by 1313 on February 9, 2003, at 2:19:39
You need more than an atypical at this point- try Haldol or Thorazine. Preferably within the safe confines of an institution, no offense, just advice.
Posted by xjs7 on February 9, 2003, at 14:56:47
In reply to Re: AbilifyRIVER, posted by utopizen on February 9, 2003, at 12:23:19
> You need more than an atypical at this point- try Haldol or Thorazine. Preferably within the safe confines of an institution, no offense, just advice.
Just saying "no offense" does not automatically make what you say non-offensive. Is this supposed to be funny? It's not. Is this supposed to be clever? It definitely is not.
This board is for "mutual support and education." Is this statement supportive? No. Is it educational? Not in my opinion.
By the way, psychiatrists use atypicals even for the most severe cases of schizophrenia. They are not less powerful drugs.
xjs7
Posted by utopizen on February 9, 2003, at 21:21:26
In reply to Re: AbilifyRIVER » utopizen, posted by xjs7 on February 9, 2003, at 14:56:47
Um, there's nothing wrong with going to an institution. Frankly, I find it offensive that you would suggest there's something offensive about institutions, especially since many of us here have had to enter them!!
Posted by Dr. Bob on February 10, 2003, at 9:02:45
In reply to Re: AbilifyRIVER, posted by utopizen on February 9, 2003, at 21:21:26
Posted by gregg on February 10, 2003, at 10:06:00
In reply to Re: AbilifyRIVER, posted by 1313 on February 9, 2003, at 2:19:39
Deb,
How are you doing? In your last post you mentioned switching back to Zyprexa. Is that what you are doing now?
Please let us know how things work out.greg
Posted by nectar otg on March 8, 2003, at 21:46:04
In reply to Re: AbilifyRIVER » utopizen, posted by xjs7 on February 9, 2003, at 14:56:47
Is Abilify an MAOI inhibitor? Could not find info on abilify.com... thanks.
Posted by kd3qc on March 21, 2003, at 18:09:55
In reply to Re: Abilify, posted by 1313 on January 26, 2003, at 8:10:42
I've been on Abilify for 3 months and my heart is acting wierd on it, especially at night. So, I'm taking some Verapimil for the palipitations. Just started it. Saw a cardiologist about it.
> My doctor asked me to give abilify 6 weeks. I am on week four and two days most of the side effects have gone away. I do not have akathesia. My main concern is my HEART! I feel a tenderness and soreness on the skin above it and at night I can feel my heart beat.This makes it hard to fall asleep. I think my nights and and gym workouts would be better if I could prove to myself I was not at risk! To this end I am going to see my regular doctor and ask if it is necessary to see a cardiologist. I hope he will understand. I had an ekg recently and it came back with good results. Maybe I am carrying my stress in a new place! did anyone else feel this way?!
Posted by frisco on April 3, 2003, at 17:19:12
In reply to MAOI inhibitor, posted by nectar otg on March 8, 2003, at 21:46:04
> Is Abilify an MAOI inhibitor? Could not find info on abilify.com... thanks.
Abilify is not a MAOI Inhibitor - MAOI Inhibitors are rarely used anymore. MAOI stands for Mono Amine Oxidase Inhibitor - basically its another way to increase neurotransmitter (particularly serotonin) levels in the brain - This type of drug acts to keep serotonin from being broken down - so basically the serotonin can be used to stimulate more receptors. Abilify is a dopamine-serotonin partial-agonist (basically a thermostat for dopamine and serotonin to an extent). What this means is if someone has high levels of dopamine or a serotonin, Abilify will bring the levels down. High levels of dopamine in certain areas of the brain can cause hallucinations and delusions. In other areas of the brain this new drug could potentially increase dopamine levels if someone needs a little more in those areas - what this does theoretically is minimize side effects like breast tenderness and long term extrapyramidal symptoms. Its a pretty smart drug or at least a smart concept. The concept of Dopamine/Serotonin stabilization was first postulated by a man named Carlsson - dont know actual spelling? - he won the Nobel prize for this concept in my understanding. Hope that helps.
Posted by Max Basil on April 9, 2003, at 21:46:53
In reply to Re:sleep and physical anxiety, posted by Vanidosa on January 20, 2003, at 9:47:01
I'm also having sleep problems from Abilify. Sometimes I sleep too much, sometimes I can't get to sleep at all. And I shake most of the time. I've been on Abilify for three weeks now - are these symptoms normal?(By the way, I pay $334 for a month supply of 15 mgs.)
Posted by 1313 on May 3, 2003, at 23:45:15
In reply to Re: 1313, posted by gregg on February 10, 2003, at 10:06:00
Hi! Greg,
I know its been a long time since I posted but I wanted to wait and see how things would work out first! I no longer take Abilify. I had a very serious adverse effect from it and had to stop.
I had to go to the hospital because I did not feel safe. While I was there I went back to Zyprexa and Lamictal only at higher doses!
So far I have not gained back most of the weight I lost....but that is not important. What is important is the therapy I received in the hospital. I learned that for the first time in my life I can tell people how I feel and stay in the present and concentrate on wellness. I no longer feel the strange need to talk to myself to work through my feelings although it takes a while for me to understand them. The person who walked into the hospital is not the one who left.
I am struggeling to maintain at home the disciplined atmosphere that the hospital had
I pray that I have not branded myself as being dishonest or a hurtful person. I plan to make ammends with people I have wronged especially my family and "extended family "! It is not my way,style,or MO to maintain myself in a negative way. Because I have always lived in my hometown I have had several peaceful interactions with the police and have learned since childhood to respect them as allies and role models. I pray that they still see me in a positive light. My biggest mistake was the stress of 9/11 and the loss of two wonderful friends in the months that followed. Because of this stress my inner voice was dulled and I started to tell groups of people my innermost feelings and fears. When I did this I had no idea what the consequences of my actions would be. I thought I was seeking help in going public with my story. Instead my honesty backlashed at me. I began to think that magic could happen and I tried to force it into happening!!!!!! This is the second time in my life that (with all my might) I wish I could turn back time.The first time was 16 years ago but that is another story. My biggest most ferverant wish is to be considered a good and upstanding daughter, sister,aunt,cousin,co-worker,friend and citizen of the best town ,in the best county, in the best state which is all part of the most outstanding country in the *world*!!!!!!!!!!!!
**G-D BLESS THE USA**
With much love, respect,discipline, and patroitism I am deb1313PS. If I ****ever**** need to go back to the hospital ****I will**** even if I only ****think**** something bad I will run not walk to the hospital!!!!!
****I willnever cry wolf!!!!!!!!****
deb1313
Posted by cuddle on May 15, 2003, at 23:43:14
In reply to Re:sleep and physical anxiety, posted by Max Basil on April 9, 2003, at 21:46:53
wow! i just read all the previous posts and i gotta say that i don't know what to do. my dr. wants me to start taking it instead of zyprexa because of the weight issue. about 6 months ago i stopped zyprexa and i have lost 95 pounds. i can't afford to put any weight back on. so when he suggested abilify, i was excited. he is supposed to start me on it in a couple weeks if i am not doing any better. i have bipolar and i take lithobid and lamictal. i've recently been taken off all antidepressants and tranquilizers. i am a complete mess but i don't know if it will be worth it to try abilify. i am confused and scared.
Posted by canwetalk on May 17, 2003, at 20:14:48
In reply to Re:abilify fear, posted by cuddle on May 15, 2003, at 23:43:14
Cuddle do not be afraid to try Abilify it just might work for you. My daughter has been on it now since January. Her psdoc recently increased her up to 30mg now. She is a heck of a lot calmer and we are so grateful for that.
So I am praying that all goes well for you with Abilify. Increased weight is something you do not have to be concerned about with Abilify. It is only one of the many great things about this medication.
However there are side effects with it among the leading one being insomonia, which after awhile lessens, restlessness/anxiety but in time as your body adjusts to it these should go away.
Posted by cuddle on May 22, 2003, at 11:32:39
In reply to Re:abilify fear, posted by canwetalk on May 17, 2003, at 20:14:48
Thanks for the encouragement canwetalk. I have decided to go ahead and try it. I am gonna give it time for the side effects to go away cause I don't want to give up too quickly. So wish me luck, I'll let you know how it goes.
Posted by Abilify101 on May 24, 2003, at 14:12:36
In reply to Re:abilify, posted by 1313 on January 24, 2003, at 22:23:30
I have been taking Abilify (15 mg) for four days for depression and disorientation, with amnesia. I slept ok the first night but I have not slept (maybey two or three hours night before last and not at all last night). Friends and family say I am doing better. I have nausia and with no sleep I am tired. I have been seeing color bursts of purple. Could this be a side effect? Other meds include Efexor, Glucopage, Diovan, Ogen, Provera, Levoxyl, etc. I am going to skip my dose tonight and begin taking it in the morning. Maybe this will help me sleep some.I am concerned about side effects and I am also afraid not to try something.
Posted by Rhiannonpa on May 29, 2003, at 10:19:10
In reply to Re: Abilify (aripiprazole) cost is PROHIBITIVE!, posted by ItsHowdyDudyTime on November 28, 2002, at 23:19:09
Ok, let me see if I can explain this. I worked for Bristol-Myers Squibb (BMS) prior to this drug being approved. I watched the information going around the company to find out when it would be available. You see amoung other things I am a manic depressive already taking one of BMS's drugs, Serzone, along with Depakote. So I was very interested in this. I left the company before it was approved and went to a differnet Rx company.
Let me see if I can explain some of the cost issues you will not hear Peter Jennings discuss on World News Tonight as to why Rx cost what they do.
In some cases, yes, the NIH "discovers" the compound. HOwever they have little ability to fully develop or research the compound to meet the government standards before approving the drug for human use. Nor does the government have a sales and marketing staff to educate the M.D.'s who will write the Rx.
That is where private industry comes in. Currently I am working in Clinical Oncology for a major Rx company. I am learning a great deal about how the process works.
Did you know that the government regulates what the Rx companys do? Did you know that the gov't has to approve every study on a drug that is done? That the government requires the Rx company to pay all expenses to the Dr.'s and patients including drug during studies? That the gov't REQUIRES Rx companys to hold in person meeting with all dr's and their study teams prior to the study starting? Which means the Rx co. has to pay for transportation, along with hotels, meals etc. for all study investigators involved.
Did you also know that even if the NIH develops the compound it is up to the Rx compnay to do the work...read: shell out the bucks, to prove the drug actually WORKS and is safe for humans? The Rx company is also the ones that have to write the study platform (a.k.a. Protocol), track and analize the data from the studies, and submit to the FDA (food and drug administration) for approval. Which the FDA and approve, reject for more data, or simply reject.It is also the Rx companys responsiblity to have highly qualified Drs, and other scientists on staff to monitor the drug through every step from writing the protocol to writing the Final Study Report for the FDA. who as I said, can do anything they want with the data.
Now after spending anywhere between 100 million and 300 million dollars of manpower hours, travel expenses, expert meetings to bring top people in the field from all over the world together to discuss the merits of the drug and how to proceed with studies, etc. And in many cases, taking YEARS to do all of this, the Rx company is LIMITED to how many years they have the right to sell the drug before it goes generic. That's it! If they do not make their money back and make enough to continue to fund other drugs research as well....too bad, the drug is going generic and the gov't gets to decide who will make and market the generic version.
If it patent ends after 7 years the Rx compnay only has 7 years to get its money back. Meanwhile it continues to study the drug to see if it can be used for other disorders, if the current compound can be improved for current disorders, etc.
All of this is federally mandated. MOnitored by the FDA, etc. So while everyone thinks the government is doing so much actually they are the ones, in the name of patient safety, that slows the process down, increases the cost with the safeguards it requires and the mass amount of people that must be involved in each set of the process to get approval.
The world wants the cure for the common cold, cancer and every other thing that plagues mankind, however they seem to think it should be free. Well at least cheap. Not to mention they are looking for someone to blame for what things cost. "oh look at the profits the drug companies make!"
Do you think that EVERY thing you use, wear, drive, or live in someone does not make money on it? Did you know that Rx companies GIVE away large amounts of both money and drug in times of need and to charities? ARe you aware that many of the studies you read about taking place in private colleges and universities are funded by Rx companies.
Why is it in this country it is so very easy to find someone to blame instead of looking at what is really going on? I am sure many of the people on this board see or have seen a therapist. Mine was very determined to break me out of playing the "blame game". You know if something is wrong find someone to blame, they you can feel better cause you can point a finger at someone else. Much easier to do that then to step back and look at what is really going on.
The Government that everyone is waiting for to fix the situation is basicly the one who put all the expensive safeguards in place. They are the ones that require tons of research and study prior to approval and continue to require it for every new indication. Requires more research to keep the patent on the drug.
So the next time you want to rag on the Rx companies for how much something costs or someone close to you is very sick and you want to know why there is no cure, remember ... you don't what to help pay for the research.
Rhiannon
Wiccan High Priestess, Manic Depressive, & Rx Company Sr. Administrative Assistant, Cancer Drug Studies.> Hmmmmmm I wonder why Abilify costs so darn much? Its not because the drug companies "invented" Abilify...they didnt invent it. See, all the core medical and pharmaceutical research in the USA usually starts out at a taxpayer funded place called NIH. National Institute of Health does the majority of basic research on new potential drugs and treatments. The pharmaceutical companies then come in, take the good stuff and capitalize on it. They then run clinical trials, perfect it, etc. and then market and sell it. But it shouldnt cost $13 a pill, because the company that makes Abilify didnt actually invent it. Taxpayer funded government research labs invented it.
>
> Gee, that makes a lot of sense. You pay all these taxes to our government for basic, core level science research. Then elitist greedy pharmaceutical companies come along and say "hey, that compound looks like it has promise lets pick it up and develop it further." So they do and end up charging YOU, the American taxpayer an arm and a leg for a drug that YOU helped pay for the basic core level research on. How unAmerican.
>
> Damn, maybe we need to get rid of our present government and replace it with one that has balls and a backbone for a change.
>
> Howdy Dudy.
Posted by sisterfriend on June 2, 2003, at 13:23:34
In reply to Re:abilify, posted by Abilify101 on May 24, 2003, at 14:12:36
My husband suffers from Delusional Affective Disorder (Jealous/Persecutory). He was off/on meds for 2 years, mostly off... his illness was becoming severe enough that I took the kids out of the home, and his family and I then were able to encourage him to receive treatment. He started on Abilify 10 days ago, and it seems to be helping. He is a little hyper, and he actually likes this, after the sluggishness of Zyprexa and his horrible experience with Risperdal (Risperdal seemed to exacerbate the symptoms of his illness and threw him into suicidal depression).
He says the delusions are still there, but he's better able to realize it's not reality and push the thoughts to the back of his mind. In order to return home and feel safe, I need him to KNOW the difference between his delusions and what is reality, as his delusions involve our children and myself. Is anyone else taking Abilify for paranoia or delusions, and is it helping? If so, could you describe what it does for you?Thanks-- sisterfriend
Posted by marepax on June 3, 2003, at 20:52:29
In reply to Re:abilify for delusions/paranoia, posted by sisterfriend on June 2, 2003, at 13:23:34
My 28 year old son was diagnosed with schizotypal disorder a month ago & was hospitalized for a couple of weeks. They put him on Risperdal for 2 days, which made him dizzy & nauseous, then Zyprexa, which gave him such jitters that he couldn't drive, therefore get to work. For a week a new doc took him off the Zyprexa & put him on Paxil, but his delusional thinking came back, so now he's on Abilify. He's REALLY tired from it, but it's only been a day. What I want to know is, is this a drug that can make you sleep a lot at first & then have insomnia later? Will his jitters come back? And if they do, should he muddle through for a few weeks & then the side effects will go away? My last problem is, I'm the only person he's confiding in--talking to almost every night be phone (he's 1000 miles away). As his mother, I want to be there for him, but how can I 'make' him find other supports where he lives? And how can I handle this myself? Any help, about the drug, the side effects, and the mothering issue, would be much appreciated.
Thanks.
marepax
Posted by JLM on June 12, 2003, at 3:56:27
In reply to Re: Abilify (aripiprazole) cost is PROHIBITIVE!, posted by Rhiannonpa on May 29, 2003, at 10:19:10
> Ok, let me see if I can explain this. I worked for Bristol-Myers Squibb (BMS) prior to this drug being approved. I watched the information going around the company to find out when it would be available. You see amoung other things I am a manic depressive already taking one of BMS's drugs, Serzone, along with Depakote. So I was very interested in this. I left the company before it was approved and went to a differnet Rx company.
>
> Let me see if I can explain some of the cost issues you will not hear Peter Jennings discuss on World News Tonight as to why Rx cost what they do.
>
> In some cases, yes, the NIH "discovers" the compound. HOwever they have little ability to fully develop or research the compound to meet the government standards before approving the drug for human use. Nor does the government have a sales and marketing staff to educate the M.D.'s who will write the Rx.
>
> That is where private industry comes in. Currently I am working in Clinical Oncology for a major Rx company. I am learning a great deal about how the process works.
>
> Did you know that the government regulates what the Rx companys do? Did you know that the gov't has to approve every study on a drug that is done? That the government requires the Rx company to pay all expenses to the Dr.'s and patients including drug during studies? That the gov't REQUIRES Rx companys to hold in person meeting with all dr's and their study teams prior to the study starting? Which means the Rx co. has to pay for transportation, along with hotels, meals etc. for all study investigators involved.
> Did you also know that even if the NIH develops the compound it is up to the Rx compnay to do the work...read: shell out the bucks, to prove the drug actually WORKS and is safe for humans? The Rx company is also the ones that have to write the study platform (a.k.a. Protocol), track and analize the data from the studies, and submit to the FDA (food and drug administration) for approval. Which the FDA and approve, reject for more data, or simply reject.
>
> It is also the Rx companys responsiblity to have highly qualified Drs, and other scientists on staff to monitor the drug through every step from writing the protocol to writing the Final Study Report for the FDA. who as I said, can do anything they want with the data.
>
> Now after spending anywhere between 100 million and 300 million dollars of manpower hours, travel expenses, expert meetings to bring top people in the field from all over the world together to discuss the merits of the drug and how to proceed with studies, etc. And in many cases, taking YEARS to do all of this, the Rx company is LIMITED to how many years they have the right to sell the drug before it goes generic. That's it! If they do not make their money back and make enough to continue to fund other drugs research as well....too bad, the drug is going generic and the gov't gets to decide who will make and market the generic version.
>
> If it patent ends after 7 years the Rx compnay only has 7 years to get its money back. Meanwhile it continues to study the drug to see if it can be used for other disorders, if the current compound can be improved for current disorders, etc.
>
> All of this is federally mandated. MOnitored by the FDA, etc. So while everyone thinks the government is doing so much actually they are the ones, in the name of patient safety, that slows the process down, increases the cost with the safeguards it requires and the mass amount of people that must be involved in each set of the process to get approval.
>
> The world wants the cure for the common cold, cancer and every other thing that plagues mankind, however they seem to think it should be free. Well at least cheap. Not to mention they are looking for someone to blame for what things cost. "oh look at the profits the drug companies make!"
>
> Do you think that EVERY thing you use, wear, drive, or live in someone does not make money on it? Did you know that Rx companies GIVE away large amounts of both money and drug in times of need and to charities? ARe you aware that many of the studies you read about taking place in private colleges and universities are funded by Rx companies.
>
> Why is it in this country it is so very easy to find someone to blame instead of looking at what is really going on? I am sure many of the people on this board see or have seen a therapist. Mine was very determined to break me out of playing the "blame game". You know if something is wrong find someone to blame, they you can feel better cause you can point a finger at someone else. Much easier to do that then to step back and look at what is really going on.
>
> The Government that everyone is waiting for to fix the situation is basicly the one who put all the expensive safeguards in place. They are the ones that require tons of research and study prior to approval and continue to require it for every new indication. Requires more research to keep the patent on the drug.
>
> So the next time you want to rag on the Rx companies for how much something costs or someone close to you is very sick and you want to know why there is no cure, remember ... you don't what to help pay for the research.
>
> Rhiannon
> Wiccan High Priestess, Manic Depressive, & Rx Company Sr. Administrative Assistant, Cancer Drug Studies.
>
>
>
>
>
>
>
> > Hmmmmmm I wonder why Abilify costs so darn much? Its not because the drug companies "invented" Abilify...they didnt invent it. See, all the core medical and pharmaceutical research in the USA usually starts out at a taxpayer funded place called NIH. National Institute of Health does the majority of basic research on new potential drugs and treatments. The pharmaceutical companies then come in, take the good stuff and capitalize on it. They then run clinical trials, perfect it, etc. and then market and sell it. But it shouldnt cost $13 a pill, because the company that makes Abilify didnt actually invent it. Taxpayer funded government research labs invented it.
> >
> > Gee, that makes a lot of sense. You pay all these taxes to our government for basic, core level science research. Then elitist greedy pharmaceutical companies come along and say "hey, that compound looks like it has promise lets pick it up and develop it further." So they do and end up charging YOU, the American taxpayer an arm and a leg for a drug that YOU helped pay for the basic core level research on. How unAmerican.
> >
> > Damn, maybe we need to get rid of our present government and replace it with one that has balls and a backbone for a change.
> >
> > Howdy Dudy.
>
>Why is it then that the breast cancer drug, Tamoxifen, costs 10 TIMES as much in the USA as it does in Canada? Why is that big drug companies are threatening Canadian pharmacies that sells drugs to Americans with pulling their product lines of their shelves? Perhaps to ensure that they continue to have the 'captive audience' that they have here in America?
I don't know about anyone else, but when I read this following article by the TWO former EDITORS IN CHIEF of the New England Journal of Medicine, it really woke me up:
http://www.commercialalert.org/relmanangell.pdf
I'll give you a few choice excerpts. Keep in mind who wrote this GRIN :)
"The rhetoric is stirring, but the
arguments simply do not hold up.
First, research and development
(R&D) constitutes a relatively small part of
the budgets of the large drug companies.
Their marketing and advertising expenditures
are much greater than their investment
in R&D. Furthermore, they make
more in profits than they spend on R&D.
In fact, their profits are consistently much
higher than those of any other American
industry. Prices (which bear little relation
to the costs of developing and manufacturing
a drug) could be lowered substantially
without coming close to threatening the
R&D budgets of drug companies, much
less their economic survival."So much for just 'making their money back' before
the patent expires."Second, the pharmaceutical industry is
not particularly innovative, and it is growing
less so each year. The great majority of
new drugs coming to market these days,
although patented, are not new at all.
They are variations on older drugs already
on the market. These are called ?me-too?
drugs, and they represent attempts to
capitalize on the success of ?blockbuster?
drugs. (Blockbusters are defined here as
drugs with over $500 million in annual
sales.) The few drugs that are truly innovative
have usually been based on taxpayersupported
research done in nonprofit academic
medical centers or at the National
Institutes of Health. In fact, many drugs
now sold by drug companies were licensed
to them by academic medical centers or
small biotechnology companies."Can anyone here say "Nexium" or "Lexapro" ;)
"Far from being a ?research-based industry,?
as it likes to call itself, the pharmaceutical
industry now devotes most of its
resources to functioning as a vast marketing
and advertising enterprise whose
best products were discovered and often
partially developed elsewhere?usually at
public expense. And this industry is hardly
a model of free enterprise. It may be free to
decide which drugs to develop and to set
its own prices, but its lifeblood is government-
granted monopolies?in the form
of patents and FDA-approved exclusive
marketing rights. Drug companies apparently
see no contradiction in manipulating
existing laws and regulations to stave
off competition from generic and foreign
manufacturers and lobbying for even
more governmental protections while at
the same time using free-market rhetoric
to demand less government involvement
in the pricing and the marketing of drugs."Ahhh, can you SMELL the irony? ;) Go ahead, take
a whiff."The suspicion that average R&D costs
per drug are not nearly as high as claimed
is further supported by other data provided
by Public Citizen. If one divides the
industry-supplied estimates of total R&D
expenses by the total number of drugs
entering the market, making appropriate
allowances for the lag time between expenditures
and the date of entrance into
the market, the resulting net out-ofpocket,
after-tax costs would probably be
less than $100 million for each drug that
was approved between 1994 and 2000.
That, admittedly, is only a rough approximation,
but the general conclusion seems
inescapable: that the $802 million estimate
now being promoted by the industry
and its partisans is much too high.""The pharmaceutical industry
justifies its extraordinary profits
largely by the claim that they are
necessary as an incentive to continue its
vital research. The implication is that if
the public wants new cures for diseases, it
should give the industry free rein. It is
important, then, to ask just how innovative
the pharmaceutical industry really
is. We think the answer is not very. Drug
companies greatly exaggerate their role in
the scientific work leading to the discovery
of new drugs. As we have already noted,
the development of important new drugs
is usually the culmination of many discoveries
in basic science laboratories outside
the pharmaceutical industry. This work
increases the understanding of the molecular
basis of disease and thereby identifies
promising targets and models for the design
of new drugs. Most of this groundbreaking
research, done with support
from the National Institutes of Health
(NIH) or other institutions, appears in
scientific journals before the big companies
become involved. The industry is certainly
not the major engine of discovery
and medical progress that it would have
the public believe. Public investment in
research has been primarily responsible
for the great medical advances society is
enjoying, and this is likely to be so in the
future as well.A general idea of the relative contribution
of the pharmaceutical industry to the
underlying medical research that leads
to the development of new drugs can be
gained from a recent study published
in the journal Health Affairs. The study
reported that in 1998 only about 15 percent
of the scientific articles cited in patent
applications for clinical medicine came
from industry research, while 54 percent
came from academic centers, 13 percent
from government, and the rest from various
various
other public and nonprofit institutions.Remember that these are patent
applications for all new drugs and medical
innovations, not simply for those ultimately
judged to be clinically important.
Had the data been limited to only major
breakthrough drugs, the industry?s role
would undoubtedly have looked even
smaller.The relatively small contribution of
industry is also clear from an unpublished
internal document produced by the NIH
in February 2000, which was obtained by
Public Citizen through the Freedom of
Information Act. The NIH had selected
the five top-selling drugs in 1995 (Zantac,
Zovirax, Capoten, Vasotec, and Prozac)
and found that 16 of the 17 key scientific
papers leading to the discovery and development
of these drugs came from outside
the industry. Looking at all the relevant
published research, not just at the key
studies, 85 percent came from American
taxpayer-supported laboratories or foreign
academic laboratories. While it is
true that academic scientists may have
more incentive to publish their research
results than do their colleagues in industry,
these data are persuasive: publicly
funded medical research is by far the
major source of pharmaceutical innovation?
not the industry itself.""That me-too?s have come to dominate
the new drug market is documented very
clearly by the FDA, which classifies drugs
under review by their likely therapeutic
value and by whether they are NMEs or
simply re-formulations and combinations
of old drugs. Over the twelve-year period
beginning in 1990, 1,035 drugs were
approved, and of these only 23 percent
were classified as likely to be a ?significant
improvement? on products already on the
market. (In our own judgment as physicians,
physicians,
even many of these drugs would be
more accurately described as modest, incremental
improvements.) All the others
were classified as appearing to have ?therapeutic
qualities similar to those of one or
more already marketed drugs.? Moreover,
just 15 percent of the approved drugs were
classified as both a significant improvement
and an NME. Last year, the FDA
approved 66 drugs for the entire drug
industry. The agency classified only ten as
a significant improvement, and only seven
of these were NMEs. So the already small
percentage of newly marketed drug products
that are really novel and important
seems to be dropping still further, with
me-too?s becoming the rule. This trend
has continued during the current year."Can anyone here say "Lexapro" or "Nexium" C'mon
say it, I know you want to. Just say it ONE time with me ;) So much for the hype from big pharma about the 'costs of developing life saving new medicines'NME=new molecular entity. IE, something
that is really NEW, ie NOT like Nexium ;)"Industry spokespeople sometimes
justify the growing profusion of
brand-name me-too drugs by arguing
that they increase market competition and
keep prices down. For this reason, they
object to the term ?monopoly? as applied
to the exclusive marketing rights conferred
by patents or FDA approval. But
me-too drugs are not promoted on the
basis of price. Instead, they are marketed
as being especially effective?usually in
total disregard of the facts."Say "Lexapro" yet again. And don't forget to consult Micromedex ;)
"The major difficulty in
launching a me-too blockbuster, however,
is in persuading doctors and patients that
it is better than the others, since the evidence
is at best marginal. Unfortunately,
the FDA will approve a me-too drug on
the basis of clinical trials comparing it not
with an older drug of the same type, but
with a placebo or a drug of another type."So much for the FDA being the 'big meanie' and driving up the costs of drugs. New drugs should
have to go up against older proven drugs, and not just placebo. However, big Pharma almost allways typically avoids comparisons to older products in their published clinical trials. Hrm, I wonder why that is? ;)"Until the past decade, around 80 percent
of clinical trials were conducted on
patients at academic medical centers and
teaching hospitals under the direction of
medical faculty, who usually initiated the
application for support of the trial. Most
of these trials were supported by grants
from a pharmaceutical company to the
academic institution, although some were
funded by the NIH. The design and execution
of the studies and the collection,
interpretation, and reporting of the data
were all the primary responsibility of the
academic team, made up of experts in
the field. They had no financial ties to the
company or to the drug being tested"Can anyone here say 'conflict of interest'? You can? Good, I knew you could.
"If the industry argues that drug prices
necessarily reflect its high costs for R&D,
then what can it say about its much higher
costs for sales promotion? Those who pay
for prescription drugs are paying for marketing,
too. But if the current crop of new
drugs were as valuable as the industry
would like us to believe, and if there were
not so many me-too drugs, surely it would
not be necessary to spend so much money
pushing them. A genuinely important
new drug, such as Gleevec, does not have
to be marketed widely. Cancer doctors
treating patients with CML will know
about this drug and use it. No sales pitch
is needed."That makes total sense. If its something that's really that good, isn't your doctor allready going to know about it? I wonder why it is that the United States is the only major industrialized nation that allows direct to consumer advertising of drugs? Frankly, I'm tired of paying for that Zoloft commerical with the dancing rock ;)
"The largest single piece of the
known drug-marketing budget is
spent on the direct promotion of
drugs to doctors by representatives of drug
firms. (This is called ?detailing.?) There
are some 88,000 sales representatives
throughout the country, who are paid more
than $7 billion per year by the drug companies
to visit doctors in hospitals and offices
to pitch their employers? products. The
number and the ubiquity of these salespeople
have increased greatly over the past few
years. They roam the halls of almost every
sizable hospital in the country seeking
opportunities to talk with the medical staff
and offering gifts (such as books, golf
balls, and tickets to sporting events), drug
samples, and free meals. In many teaching
hospitals, drug representatives regularly
provide lunches for the resident staff in
order to gain their ear. They attend conferences,
they are invited into operating and
procedure rooms, and sometimes they are
even present when physicians examine
patients in clinics or at the bedside."If I ever see a detail man in MY hospital room, he better hope he's wearing a jockstrap that day ;)
"Sales representatives also regularly visit
doctors in their offices, often armed with
information about the doctor?s prescribing
habits obtained from local drugstores.
(There are firms that buy this information
from pharmacies and sell it to drug companies.)"I bet you didn't know that did you? I wonder
how many doctors even know that."Free samples
of drugs for physicians to give to their
patients are a major gift item provided by
representatives of large drug companies.
Industry sources say they spend about $8
billion per year on free samples. These
samples are an effective way to get doctors
and patients committed to the continued
use of the sampled product?usually an
expensive, newly approved drug, with a
long period of exclusivity ahead of it."8 billion eh? I bet they do that out of altruism ;) After all, they couldn't possibly be deriving
any type of financial benefit from it could they? I wonder who pays for that 8 BILLION DOLLARS worth of 'free samples'. Do you think it comes out of any CEO's compensation or stock options? Last year, the CEO for Pfizer got 75 million in compensation and another 75 million in options. Just think of all the new 'me-too drugs' like Nexium that could have been developed with that cash? ;)"About the only organized sector of the
medical profession that seems genuinely
concerned about this issue is the national
organization of medical students, the
American Medical Student Association.
Last spring, this group voted for a total
ban on the acceptance of all drugindustry
gifts and favors to medical students.
It was a brave and laudable gesture,
but its impact on practicing physicians
and their organizations is doubtful.
Recently we attended the annual meeting
of the state medical society of Massachusetts,
where student delegates urged
their elders to pass a similar resolution
that would apply to physicians. It was
decisively defeated in favor of a resolution
that recommended further study of
the issue."At least the youngsters appear to have a pair. There may be hope yet.
"Hatch-waxman has been a
bonanza for the big drug companies.
While it was meant to
stimulate generic competition, it has often
had exactly the opposite effect. Since the
act was passed, brand-name drug companies
routinely file not just one patent on
their drugs, but a series of them spread
throughout the life of the first patent.
These secondary patents are on every
conceivable attribute?never mind usefulness,
novelty, or non-obviousness. The
result is that generic companies are routinely
charged with patent infringement,
which immediately triggers 30 months
of additional exclusivity. When a generic
company challenges a secondary patent,
the brand-name company sometimes
strikes a deal with it that defers entry of the
generic product into the market. Owing to
the six-month exclusivity given to the first
generic company that challenges a patent,
other generic companies are also stopped.
Through such shenanigans, exclusivity can
be prolonged for years.This sort of gaming of the system is not
supposed to be possible. Under the law,
only challenges to certain patents may
trigger the 30-month stay on generic
entry into the market. These are the
patents on approved drugs that companies
list with the FDA in a publication
known as the Orange Book, available on
the FDA website. To be listed in the
Orange Book, patents are supposed to
apply only to the drug itself and the use
for which it was approved. Other patents
related to the drug?such as those for
new dosage forms or uses?are not supposed
to be listed in the Orange Book.But the FDA does not even attempt to
hold drug companies to that restriction.
Instead, drug companies list any patents
they choose, no matter how remote from
the originally approved drug and no
matter how frivolous its use. Sometimes
they list virtually the same patent twice.
And the secondary patents can be listed
at any time, even years after the original
approval. This means that there is
nearly always some patent in effect that
can be used as an excuse for suing
generic companies, thus triggering the
30-month additional exclusivity. By filing
new patents even after the first lawsuit
and then suing for infringement of
them, it is even possible to obtain successive
30-month stays. In the case
of GlaxoSmithKline?s anti-depressant
drug Paxil, five lawsuits against the
same generic company resulted in five
30-month stays, staggered so that, altogether,
GlaxoSmithKline extended its
exclusivity by over five years."So much for the 'evil' FDA. They don't even enforce the Orange Book rules. It makes
me so depressed, that I might need a Paxil CR ;)"In a damning report issued in July
2002, the Federal Trade Commission
(FTC) documented the widespread
anti-competitive activities within the
pharmaceutical industry. And it implicitly
took the FDA to task for failing to
enforce legal restrictions on the listing
of secondary patents in the Orange
Book. The FTC found evidence that
Hatch-Waxman is regularly exploited to
prevent generic competition, and it has
taken antitrust action against several
brand-name and generic drug companies
that colluded to keep generic drugs
off the market."Very capitalist don't you think? ;)
"The companies extend
their exclusivity by using every possible
stratagem simultaneously, so that if one
fails another might work. First, the big
drug companies change their top-selling
drugs in ways that will add three years?
exclusivity, in accord with Hatch-
Waxman. Second, they stagger multiple
secondary patents, which serve as the pretext
for routine lawsuits to trigger a 30-
month extension. Third, nearly every
blockbuster is tested on children to get the
extra six months of patent protection.
That is true whether the drugs are likely to
be used by children or not. Fourth, brandname
companies sometimes collude with
generic companies to delay their entry
into the market. And fifth, when all else
has failed, they can get a new patent on a
trivial variation of their blockbuster and
promote it as an ?improved? version of
the original."Sure, why not test your Alzheimers drugs in children, especially if you get a 6 month extension?
Anyway, I suggest everyone read the article for themselves. It requires the FREE Adobe Acrobat reader from www.adobe.com.
Boy, I sure am GLAD that we have big Pharma out there developing life saving new drugs like Clarinex for us don't you? ;)
Posted by JLM on June 12, 2003, at 4:51:34
In reply to Re: Abilify (aripiprazole) cost is PROHIBITIVE! » Rhiannonpa, posted by JLM on June 12, 2003, at 3:56:27
By the way, don't forget to visit:
http://pharmawatch.blogspot.com
Run by a doctor from Austrailia. One big pharma horrowshow after another. I'll give ya tidbit, cuz I know you'll like it ;)
"Monday, May 19, 2003 :::
What do doctors think of drug reps these days?
?The vast majority of physicians perceive today's sales reps to be younger, less experienced, more aggressive, less collegial, and more focused on sales as opposed to science. Reps are perceived as mostly interested in "pitching" their products and dropping off samples to promote physician use, while physicians are really looking for timely information they can trust and find credible.
Accel's findings include the fact that sixty-three percent (63%) of MDs would rarely meet with pharmaceutical sales representatives if they stopped distributing samples during their visits, and that nearly 70% of MDs perceive information provided by sales representatives to be "very unbalanced." The report confirms that the field force build-up of the last few years has added significant stress to the dynamic of the physician-sales representative relationship.
Remarks from the survey participants crystallize their current perceptions of sales representatives. They include:
· "There are not as many career or seasoned reps as before; many are now young kids who are marketers-not pharmacists, researchers, nurses, or dieticians like I used to see."
· "We see more "pressure sales tactics," more competitive, younger, and less experienced reps - and frequent turnover."
· "Reps are becoming "walking sample delivery devices."
I wonder what doctors think of drug reps using pressure sales tactics on to deliver political messages? Pfizer is using its reps as political lobbyists, getting them to ask doctors to send misleading letters to their senator about drug pricing reform:
"Pfizer has been working against a bill in Olympia by using its force of more than 160 in-state sales representatives who visit doctors' offices. The reps have been given company "talking points" to sway physicians, and have been handing out a "sample letter" for physicians to sign and send directly to their state senators.
The letter starts out, "Dear Senator, I am a licensed practicing physician and I oppose (the bill)." It says legislation would interfere with physicians' freedom to prescribe what is best for a patient, and it leaves room for a signature at the bottom. Nowhere does it say it is written by a lobbyist.
Dr. Michael Stephens, a family physician in Spokane, said he refused to sign the letter because he studied the issue and considered the letter misleading.
"It just strikes me as another example of how the pharmaceutical companies will do anything they can to protect their interests," Stephens said.
Pfizer lobbyist Kristina Hermach, who wrote the letter, said the tactics are legal. She added that drug companies need to use their sales forces as "grass-roots networks" to counteract notions that would make drug companies "the scapegoats for all the world's problems."
They're certainly a problem in this part of the world. Australia is under political pressure from US trade negotiators to cough up an extra $22 per prescription, because US drug companies think we?re not paying enough:
"US drug companies claim that Australia's world-leading PBS is costing them around $1 billion a year," Dr Hamilton said.
Prices could rise by 90 per cent for non-concession card holders and 104 per cent for concession card holders, he said.
They obviously need that extra $1billion dollars to sponsor more football and baseball stars to promote their lifesaving drugs for impotent men:
In the rush for the U.S. market, drug companies have determined sports properties are one of the best promotional vehicles. Viagra already has NASCAR and Major League Baseball locked up, and now GlaxoSmithKline plc and Bayer AG have inked a multi-year, multimillion-dollar deal with the National Football League to help launch their erectile-dysfunction drug, Levitra.
The NFL just two months ago announced it was lifting a ban on sponsorships by pharmaceutical companies; it was the last of the four major professional U.S. sports leagues to allow such alliances. The rush was on immediately for the NFL's strong male demographics, sports marketers said.
"The NFL is a marketing monster," said Milton Thompson, president of Grand Slam Cos., a local sports-marketing firm.
"If a product like [Levitra] can get the endorsement of a testosterone-driven league like the NFL or a coach or athlete involved in the league, that would really hit home with this drug's target market,"
Though officials for London-based GlaxoSmithKline and Germany-based Bayer are saying little, sources familiar with the deal said it involves more than $5 million a year in rights fees, with media spending on league broadcasts to be in the tens of millions of dollars.
They also need our billions to pay the lawyers who are defending them against a tidal wave of litigation. I don't think this is because the drug companies sell shonky drugs, probably more to do with the way they aggressively and prematurely market new drugs before there is a chance to see what the side effects really are:
"In addition to the 8,700 people who have sued Pfizer, the world's largest drug company, over Rezulin, an additional 32,000 people have said that they may sue, giving notice to avoid missing the opportunity to eventually file such claims.
Wyeth, another big drug company, has already set aside $14 billion since 1997 for claims by people who say they were injured by its diet drugs, and the company has been informed by an additional 90,000 people that they may sue. Johnson & Johnson and Bayer have also been been named in thousands of suits. Drugs from Bristol-Myers Squibb, Eli Lilly and Merck have also been named in lawsuits. A spokesman for the Pharmaceutical Research and Manufacturers of America, the industry's trade group, declined to comment on the wave of lawsuits.
With hundreds of thousands of people claiming that they have been injured by dangerous medicines and deserve compensation, the drug makers say that they are now spending several billion dollars each year to defend themselves from lawsuits and settle claims.
Stop Press: Here's what you could buy with the GlaxoSmithKline's $50 million retirement payout for Jean Paul Garnier:
5,890 primary or 4,531 secondary school places
1,375 extra newly qualified nurses for a year
1,022 additional teachers in inner London, or 1,215 elsewhere in England and Wales, for a year
2 years' training with the Metropolitan Police for 314 officers
1 taxi from London to the Sun (traffic permitting)
Why do drug companies pay so much for these idiots? What do they do to earn it? Stuff like this:
"When Mr. Dolan was named chief executive in February 2001, he promised that he would double the company's sales and earnings within five years. But sales in 2002, his first full year in charge, were $18.1 billion, down 1 percent from 2000, the year before he was appointed. Under his direction, the company's shares have plunged 57 percent, to $25.82. Many of its once top-selling drugs, like Taxol for cancer, Glucophage for diabetes and BuSpar for anxiety, are suffering cutthroat competition from less expensive generic versions. Its laboratories have not discovered a breakthrough since tie-dyed shirts and bell-bottom pants were fashionable. Its big sellers ? Pravachol and the stroke medicine Plavix ? are licensed from other companies.
Almost every major strategic decision Mr. Dolan has made has backfired: he negotiated a $2 billion deal in 2001 with ImClone Systems that became part of a scandal and led to a write-down of nearly all of Bristol-Myers's investment in that company. He bought DuPont's aging drug business in 2001 for $2 billion more than the nearest competitor, according to people involved in the bidding. He broke off a marketing agreement with Novartis of Switzerland to jointly sell an irritable-bowel-syndrome drug when it appeared that the drug would not be approved. But the drug, Zelnorm, is now on the market, with modest and growing sales. And he revised his company's earnings estimates at least five times last year. And now federal law enforcement authorities are investigating him.
Many analysts say they do not understand why Mr. Dolan still has his job. Numerous employees and former employees, including some of the most senior people in the company, are asking the same question."All with links to articles in major publications like Reuters, the New York Times, the British Medical Journal, ad nauseum.
Posted by JLM on June 12, 2003, at 5:06:34
In reply to Re: Abilify (aripiprazole) cost is PROHIBITIVE! » JLM, posted by JLM on June 12, 2003, at 4:51:34
I guess I better toss this in for good measure too:
https://www.family.org/physmag/issues/a0024894.html
Drug Rep Evangelism
By Paul C. Reisser, M.D.
A little humility goes a long way.--------------------------------------------------------------------------------
On Dec. 17, 2002, a study in the following day?s edition of JAMA became a prominent story on all three national network evening news broadcasts. The massive Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial, otherwise known as ALLHAT, had demonstrated (among other things) that the lowly thiazide diuretic chlorthalidone outperformed an ACE inhibitor (lisinopril), a calcium channel blocker (amlodipine) and an alpha-blocker (doxazocin). Why all the news coverage? Because, as Lawrence J. Appel, M.D., of Johns Hopkins noted in JAMA, ?The most effective therapy was also the least expensive. . . . The ALLHAT results provide compelling evidence that thiazide diuretics should be the initial drug of choice for patients with hypertension, especially compared with those agents that were directly tested in this trial.?That is precisely what we were told to do 25 years ago. So why did most of us depart from this standard operating procedure? For one thing, the diuretic doses we once used were too high, leading to brisk sales of potassium supplements. Also, some patients didn?t care for the increased urine output, and more than a few experienced changes in insulin resistance and glucose levels. But no doubt we were also affected by learning about the latest ?hot? anti-hypertensive?and receiving those all-important samples?from our friendly pharmaceutical representatives.
Recently, a number of observers have raised concerns about who actually sets the prescribing agendas for the average physician. In the United States, in 2000?the last year for which statistics are available?the pharmaceutical industry spent some $15.7 billion (up 43 percent from 1997) promoting their products to physicians, not to mention another $2.5 billion advertising them directly to the public. We see their ubiquitous ads in both prestigious journals and throwaways, wade through dozens of advertisements arriving in the mail every week, and sometimes marvel at the creative ways in which products are paraded before us. The pens, Post-its, clocks, calculators and clipboards, while useful, can easily make an office resemble a stockcar bedecked with ads from its sponsors.
Equally (if not more) influential are the 80,000 representatives deployed to our offices and clinics. Along with their detail pieces,
presentations and samples, they offer good cheer, appreciation and invitations to pleasant experiences. In bygone days their offers included sports events, live theater, a round of golf, even a weekend at a plush resort. More recently, under tighter guidelines promoted by the AMA and others, these have been toned down to more modest educational lunches or dinners (minus spouses), though usually presented at upscale restaurants and occasionally accompanied by consulting fees offered in exchange for feedback about the company?s current advertising campaigns.A growing body of research confirms that interactions with drug reps, especially those that involve gifts and other pleasantries, affect the prescribing habits of residents and seasoned physicians alike, and some observers worry that this can compromise objective decision-making. After all, how can anyone on the receiving end of such favors not feel obliged, or at least be influenced, to recommend the medications that have been highlighted? Are patients helped or hindered when we reach for samples of the new product we just heard about, especially if the next issue of the Medical Letter dispassionately points out that it shows no superiority to far less expensive predecessors? Are some of us in danger of inhabiting a parallel universe of CME provided by speakers hired by pharmaceutical companies who are informative, but whose presentations may filter the current literature through a grid favorable to those who are picking up the tab?
A few critics insist that the best response to these issues is for physicians to detach themselves completely and abstain from any interaction with drug companies and their representatives.
While everyone must draw his or her own boundaries on this issue, I find this approach a bit extreme. Instead, a little discernment, skepticism and common sense can go a long way in weighing drug company overtures. I generally take a drug representative?s claims of product superiority with a grain or two of salt, knowing that a competitor?s rep will show up with an equally compelling claim. I also periodically reassess my interactions with the pharmaceutical industry, including a reality check on my own motives and potential blind spots. Are my treatment strategies driven by objectivity and an overriding concern for a patient?s clinical and financial welfare?or by the samples currently on my shelves? When a representative pays a visit, however, I do gain some insight into another arena of my life that is far more important: the way I represent my faith to others. I realize that a decision to prescribe a particular medication and a decision to follow Christ are light-years apart in significance. But in a very real sense we are ?reps? for our God (see 2 Corinthians 5:20), entrusted with presenting the most important message on the planet in the most attractive way possible. We need to be prepared, to take the initiative, to ?know our stuff? without flaunting it, to avoid talking too long (or too loud), to listen, and to present His case (not ours) without being pushy.
Several months ago I attended a dinner presentation on lipid-lowering therapy during which the speaker demonstrated a formidable command of hundreds of statistics from the current literature on this subject. His was also the most slanted medical presentation I had ever heard, insinuating that the sponsor?s product was the only rational choice in its class, based on current evidence. I left the meeting feeling insulted and humiliated.
Since I use a number of products in this class of drugs, I obviously must be one of those dumb slugs in the trenches who doesn?t have the time to master this particular topic. I retaliated by refusing to prescribe the sponsor?s product for several weeks, and when I finally ventilated to the rep who had organized the meeting he was mortified to hear that I had been alienated rather than won over by the presentation.
One thing I gained from this experience was a reminder that no one wins any converts by overpowering them intellectually (or any other way) and that the primary fruits of such effort are resistance and resentment. ?Always be prepared to give an answer to everyone who asks you to give the reason for the hope that you have,? exhorted the apostle Peter. ?But do this with gentleness and respect? (1 Peter 3:15). The gospel is not a sales pitch or an argument to be won; rather, it is good news, first and last, spread by one grateful beggar telling another where he has found food, clothing and shelter.
Posted by Dr. Bob on June 12, 2003, at 18:10:58
In reply to Re: Abilify (aripiprazole) cost is PROHIBITIVE! » JLM, posted by JLM on June 12, 2003, at 5:06:34
> Drug Rep Evangelism...
I'd like discussion of the pharmaceutical industry to be redirected to Psycho-Social-Babble, thanks.
Bob
PS: And discussion of posting policies to be redirected to Psycho-Babble Administration.
Posted by nsaw on June 14, 2003, at 10:22:18
In reply to Re:sleep and physical anxiety, posted by Vanidosa on January 20, 2003, at 9:47:01
My brother was on Abilify for a 6-week trial, and he had trouble falling asleep also. He would stay up very late and get maybe 3 hours of sleep a night. He is back on Abilify, as of yesterday, and we're again experiencing the same problems. His sleep has been fine on all his other medications: including Risperadone and Olanzapine.
I was thinking yesterday that maybe Abilify has something that keeps you awake? Should he not be taking it at night? Does anyone know anything about taking Abilify at night? Please help.
> I've had a very hard time staying asleep. I wake up sometimes at three or four, no matter when I've gone to bed, and I feel like I have to go running or something like that to calm the physical anxiety and sleeplessness. I've been on abilify for a little over four weeks now. There is really no information out there except for PR from the pharmaceutical companies. Does anyone have any other research or medical journals to recommend?
Go forward in thread:
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