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September 23, 2004 |
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In This Issue...
THE POWER OF SUGGESTION Did you know that the fastest-growing group of men who take drugs for erectile dysfunction (ED) is between the ages of 18 and 45? It is not because this group is suddenly impotent. Rather, drug manufacturers are pumping millions of dollars into advertising their products directly to consumers. In the case of ED drugs that were once directed toward Bob Dole and his contemporaries, however, a much broader and younger male audience is now the primary target for what many suspect is primarily recreational use. The advertising efforts are working. DIRECT-TO-CONSUMER ADVERTISING: A GOOD IDEA? The big question with such direct-to-consumer advertising is whether it is educating consumers or, rather, encouraging consumers to use pills and other prescription medications instead of other more healthful techniques to solve their problems. Pharmaceutical companies say that these ED drug ads have motivated men who were undertreated for conditions, such as diabetes, to see their physicians, and that's a good thing. Diabetes inhibits circulation, which can lead to ED. Of course, you need to consider that the pharmaceutical company stands to profit handsomely from the explanation of "undertreatment." Critics counter that direct-to-consumer ads are designed simply to sell more pills. They are concerned that when drugs are developed for a particular condition, manufacturers market the condition rather than the medication. Using traditional marketing strategies of sex and fear, opponents say that pharmaceutical firms are creating illness where it didn't exist and leading consumers to think that there is a magic pill for every ailment (real or imaginary). Down in the dumps? How about a Zoloft? Did you sneeze? Have a Claritin. Overindulge at the dinner table this evening? If you don't take this little purple pill, you'll get heartburn. Recently, Bottom Line teamed up with the Web site Vote.com to pose the question Should Congress ban drug advertising? Most voters agreed with critics that direct-to-consumer advertising was not a good idea. Of the 29,323 people who voted...
MORE INSIDIOUS: DRUG ADVERTISING TO DOCTORS Charles B. Inlander, consumer advocate and president of People's Medical Society, weighs in with the "no" camp. He believes that banning direct-to-consumer advertising means withholding valuable information from the public. In fact, Inlander notes that many doctors originally opposed direct-to-consumer advertising because it put patients on an equal footing with them in terms of drug awareness. On the downside, he acknowledges that pharmaceutical companies tend to advertise more expensive products, and he'd like to see broader advertising of a wider selection of medications at all price levels. Inlander is much more concerned about pharmaceutical companies marketing directly to doctors. He notes that drug manufacturers spend three times more money on advertising to physicians than to the public, and that this practice can result in serious conflicts of interest. For example, this past May, Pfizer paid a $430 million fine because drug representatives illegally promoted Neurontin to doctors for nonapproved uses to boost sales. The seizure medication was illegally promoted for off-label uses such as pain syndromes and diabetic neuropathy. Kickbacks to physicians come in all shapes and sizes, from golf outings to free tickets to ball-games to lavish dinners. In one of the more extreme examples of what might be considered direct-to-doctor advertising, Schering-Plough sent unsolicited $10,000 stipends to physicians to encourage them to prescribe its hepatitis C drug and participate in clinical trials that turned out to be thinly veiled marketing initiatives. This dubious tactic triggered the scrutiny of federal prosecutors. CHANGE IS IN THE AIR The good news is that several states are cracking down on how pharmaceutical giants advertise their medicines (not just pills) to doctors and the public. In recent years, federal prosecutors and state attorneys general have taken a number of major drug companies to court, accusing them of illicit marketing programs that cost the government billions of dollars in drug benefit payments. AstraZeneca and TAP Pharmaceuticals have both pleaded guilty to criminal charges of fraud for encouraging doctors to bill the government for drugs that the companies provided for free, and paid millions of dollars in fines. Other drug companies are setting aside funds to cover present or anticipated legal problems. Consumer groups also are taking pharmaceutical companies to task. When heart disease experts made an announcement this July urging more people to take cholesterol-lowering statin drugs, the Center for Science in the Public Interest harshly criticized them for failing to reveal potential conflicts of interest. Six of the nine experts who composed the new cholesterol guidelines -- which would add seven million more Americans to the 36 million who are presently encouraged to take cholesterol-lowering drugs -- have financial ties to the makers of statins, whose profits will soar as a result of their recommendation. WHAT YOU CAN DO NOW In the meantime, between biased ads and doctors who themselves may be influenced by pharmaceutical companies, what's a consumer to do? Stay informed, says Inlander. Educate yourself at the National Institutes of Health Web site, www.medlineplus.gov (click on Drug Information), and the US Food and Drug Administration (www.fda.gov). These will help you keep up on the latest research on your medical condition and the drugs you can take for it. Speak up at the doctor's office... feel free to get second opinions... ask your pharmacist questions... and keep in mind that you know your body best and are the best advocate for your own health. Sometimes, believe it or not, you may not even need a pill to fix your illness. As we've discussed numerous times in Daily Health News, sometimes drugs for one condition create or exacerbate other conditions, and some conditions are the direct result of diet and lifestyle choices. Look at the entire situation. Make the appropriate lifestyle changes that you know are simply unhealthy (e.g., smoking, not eating enough fresh fruits and vegetables). Then, as Dr. Inlander said, make informed decisions along with your health-care team. MAKE YOURSELF MUCH LESS LIKELY TO DIE OF A HEART ATTACK... Heart disease is America's number-one killer today. But what if you can make yourself virtually immune to death by heart attack -- just by knowing what to do in the first golden hour after a heart attack? Believe it or not, the secret isn't diet, workouts or supplements. According to the latest research from the nation's leading health professionals... CHROMIUM EASES CARB CRAVINGS There is an interesting and often undiscussed phenomenon among depressed people -- they eat a lot of carbohydrates. The theory is that it's the endorphins released by the consumption of carbohydrates that help people who are struggling with depression feel better. However, eating carbohydrates sets up a different cycle of problems related to blood sugar swings. The answer might lie in chromium. This mineral helps insulin work efficiently in the body. Now, a new study suggests that the mineral, in the form of chromium picolinate, helps control carbohydrate cravings in certain people who suffer from depression. The research was sponsored by Nutrition 21, Inc., marketer of Chromax, a chromium picolinate product, but the learning can apply to all chromium picolinate products. Findings were presented at the National Institute of Mental Health's annual new clinical drug evaluation unit conference in June. ABOUT THE STUDY According to lead researcher John P. Docherty, MD, president and CEO of Comprehensive NeuroScience, Inc., in White Plains, New York, and adjunct professor of psychiatry at Weill Medical College of Cornell University, researchers in the small double-blind, placebo-controlled clinical trial found that daily supplementation with Chromax brought about significant improvement in people who were both depressed and had carbohydrate cravings as compared with a placebo. Two-thirds of the participants were given chromium picolinate supplements for eight weeks, and one-third received a placebo. Those with the highest levels of carbohydrate cravings experienced the greatest benefit from chromium supplementation. Carb cravings diminished, as did rejection sensitivity (an emotional vulnerability common in this type of depression). No side effects were reported. THE INSULIN CONNECTION Many studies note that chromium supplementation can improve diabetes and the function of insulin and blood sugar. Dr. Docherty observes that there is a strong connection between depression and diabetes. He reported to me that diabetes predicts the onset of depression, and depression predicts the onset of diabetes. Depression is twice as common in diabetics than in the general population. Chromium's role in insulin regulation may be the biological link between diabetes, carbohydrate cravings and atypical depression. Atypical depression is a common but frequently undiagnosed disorder that affects as many as one-third of depressed patients. It is characterized by carbohydrate cravings, weight gain and unexplained fatigue. If a person consumes excessive carbohydrates, more pressure is brought to bear on insulin regulation, and he/she faces a greater risk of diabetes. In theory, speculates Dr. Docherty, giving chromium to people who suffer from depression and related carbohydrate cravings may prevent them from developing diabetes. It is important to note that while this study used Chromax, there are many forms of supplemental chromium picolinate that could provide similar results. Further study is necessary to see whether this proves to be the case. For more on chromium's health impact, see Daily Health News (March 2, 2004). People who take prescription medication, such as antidepressants, should consult their physicians about any and all dietary supplements. Be well,
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Chromium Eases Carb Cravings
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