Posted by: drrozkaplan | March 24, 2011

Take this Drug and Call Your TV in the Morning

I am thoroughly dismayed by the number of television commercials that I am seeing for prescription drugs.  I am certainly in favor of free speech, and happy for my patients to be educated about the medications they take, but direct-to-consumer advertising for medications that must be prescribed by a doctor seems entirely counterproductive to me, especially since the commercials are anything but educational.

In the past couple of evenings, I have watched television for a total of 2 1/2 hours, and in the time, saw commercials for powerful immunosuppressant agents for rheumatoid arthritis and psoriasis, hypnotics (sleep medication), antidepressants, atypical psychiatric drugs, antiinflammatory agents, cholesterol-lowering agents,  and potent gastrointestinal acid suppressors.  None of these medications are first-line treatments for the problems they address; they are all the kind of drugs that should be prescribed only  after careful consideration with a doctor- one’s primary care doctor in some cases, and in others, way down the road after consultation with a specialist, when more benign options, including life-style changes,  have been exhausted.

I won’t mention any of these medications by name, but I bet, if you watch any TV at all, you’ll recognize these scenarios:

1.  Someone with insomnia now sleeping soundly, with fluorescent butterfly wings.  Butterflies waft effortlessly across the bedroom.

2. A stick person with a ball and chain to represent depression not in full remission.  When the figure moves, the heavy ball drags him (or her?) into a deep hole.

3. A wind-up wooden doll, which the ‘patient’ uses to demonstrate how she feels she has to ‘wind herself up’ just to function with her depression.

4. A good-looking, physically fit older man in jeans walking and playing Frisbee on the beach with his dog, meeting up with other dog-owners and yukking it up.  Presumably without his arthritis medicine, he wouldn’t be outside, he would have no social life, and his dog would be neglected and unwalked.

5. A woman with psoriasis going to a school reunion.  Apparently,  because she takes her immunosuppressant, her otherwise unsightly psoriasis is well-controlled, so she is not nervous about seeing people from decades ago.  And her lovely skin gets her a man:  she goes to the reunion alone, but leaves with a handsome guy.

I don’t doubt that the medications in question help some people.  But the implication is that if you have the condition the medication addresses, but are not taking the medication, your life is not as good as it should be.  The commercials instruct viewers to ‘ask your doctor.’  Well, fine, you can ask your doctor, that’s a good idea.  But a certain proportion of people have now been brainwashed to believe that this is the drug they need and nothing else will do.  Hopefully, their doctors will take the time and have the patience to explain why they are not on this treatment, if it is inappropriate, and those patients will understand.

Then there is the other component of these commercials:  the disclaimers and listing of complications and side effects. Things like ‘adverse effects include seizures, worsening of depression, and increased risk of suicide’  and ‘tell your doctor if you have high fevers and rigidity as this may be a life-threatening complication.’  ‘Side effects may include gastrointestinal bleeding which may be serious and lead to death.’   ‘ Eating, walking and driving while unconscious have been reported.’  After hearing these sorts of things, there are people who are so terrified of medications that they refuse to take them.  Even if they really do need them.

One more thing.  How much do these TV ads cost?  I really don’t have the vaguest idea, but I know it’s a lot.  Medications, especially brand-name medications in the U.S. already cost way too much.  Drug companies are cutting back on all kinds of marketing for both legal and financial reasons:  no pens with drug names for doctors, no more trips and fancy meals to try to lure physicians to prescribe specific medications.  And I wholeheartedly agree with those restrictions.  Why, then, is it okay to try to sell the drugs directly to the consumers, when the cost of advertising pushes the cost of the medications up considerably?

Education is good.   Patients should know their options and they should know the potential side effects of their medications.  There are risks and benefits to just about everything out there.  But I think it is our job, the physicians’ job, to give proper education, tailored to a given patient’s conditions and needs, not the job of the pharmaceutical industry to market to the masses.

What do you think?



  1. My husband and I were discussing this topic the other night, especially the listing of side effects, which although are at a normal sound level, really are “hidden” by the visual of such a wonderful life that one can have if they take the advertised medication. With so many drug pushing commercials on nightly, it can be difficult for one’s primary care physician to treat patients most appropriately as they are brainwashed into believing what they see on TV.
    Of course, if I can go to my reunion and find a RICH handsome man to leave with, I may have to try some of the medications being advertised. Oh wait….I’m already married……..guess I got lost in the fantasy world the advertising people at the pharmaceutical companies have developed for us.

    • and what a fantasy world it is!


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