As a mental health clinician for almost 20 years, not a day goes by where I don’t engage in a conversation with a client, colleague, friend, or family member about the various therapeutic modalities and related efficacy rates pertaining to stress, depression, anxiety, and other mental health disorders. As you might expect, psycho-pharmaceutical medications are often the focus of these conversations, as pharmaceutical companies have done an outstanding job peddling their meds through massive advertising efforts. Regardless of how much we hear about the latest drug to cure ______, how much do we really know about how well these drugs actually work? It used to be in the old days we could always go back to reputable peer-reviewed scientific studies published in scholarly journals to determine the efficacy of various drugs, as well as the specific variables examined in the study, the threats to validity, and the extraneous variables that might have impacted the results. Of course, no single research study should ever be viewed as the absolute truth, per se, but scholars, academics, researchers, and clinicians would likely agree that published scientific studies were by far the most objective, fair, balanced, and complete way to better understand how well a drug worked. Sadly, it appears as though we are now seeing scientific studies being compromised as discussed in this New England Journal of Medicine article, further illustrating how deep and wide-reaching pharmaceutical companies are financially investing in their efforts to persuade medical experts to “find” what they want them to find when studying their drugs.
So what’s the big deal?
At first glance, you might think what’s the big deal? Who really cares about the dry and sterile scientific articles published in journals — I don’t read those anyway! While it might be true that you don’t usually take in the NEJM over coffee each morning, you should know that many of the people making decisions and influencing your medical choices do, and it is in your best interest that these professionals operate with the highest level of integrity in mind at all times (so that you can get better, and do so in healthy and safe ways). The last thing you want is for the advice you are receiving from your doctor to have been tainted because he or she was paid handsomely by a pharmaceutical company, or that your doctor feels indebted to a pharmaceutical company because of all the snazzy “perks” he or she has received from the company over the years.
While most patients might like to think their doctor could never be influenced, the reality is that the money being thrown around by pharmaceutical companies today is so big that even the most noble and respected doctors are tempted to find ways in which they can justify prescribing and/or minimizing risks associated with side effects. In some cases, doctors today make more money from their relations with pharmaceutical companies than they do in the daily role of physician! Please know I am not in any way suggesting that doctors are corrupt or easily persuaded, but I am saying that when the stakes become this big, anything can happen — including the “doctoring” of the results of research studies published in journals as prestigious as the New England Journal of Medicine.
What it all Means for YOU
So what does all this mean to patients today? The short answer is that you can no longer simply passively accept what your doctor tells you to do. For example, if you have felt “a little down” the last couple days, it’s probably not in your best interest to allow your doctor to persuade you to go on an anti-depressant medication (especially before considering safer options first – like counseling). A few more things you might want to consider doing:
- Talk to your doctor and ask about his or her professional relations with pharmaceutical companies – is he or she being compensated and possibly being influenced to write prescriptions for that drug at a more frequent rate as a result? You have a right to know this information.
- Discuss the various side, interaction, and withdrawal effects of the drugs being prescribed to you. All drugs have these concerns, so if your doctor tells you something is 100% safe you should definitely be concerned.
- Talk about the simplest, least intrusive options first before going on mental health medications. How much would diet and exercise changes impact your wellness? What about professional counseling?
- If you are on a prescription medication, don’t get caught in the trap where all you do is ask for your meds to be called in monthly without having regular, in-depth conversations with your doctor about your current mental health status, recent changes, and any other information that could impact treatment.
- Do your homework! Perhaps the best thing you can do is your own research on the various medications being discussed to treat your condition. Go beyond simply reading what is promoted on various pharmaceutical websites and seek objective information whenever possible.
These are very changing times when it comes to mental health and related treatments – the money drug companies make when they convince doctors to regularly write their drugs is astronomical, and we are seeing evidence every day that reveals how good people and reputable journals can be compromised when being paid handsomely by these companies.
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