Best Pills-Worst Pills
The following letter was written by Dr. Michael A. Ingall and reprinted with permission from the “Letters to the Editor” section of the August I6, 1996 issue of Psychiatric News.
Many years ago, my father, a pediatrician, used the term "ethical pharmaceutical." As best I understood it, the term differentiated prescription drugs from over-the-counter preparations. The implication was that companies that made prescription drugs held themselves to a standard higher than that of those who pandered snake-oil remedies with outrageous claims.
Today the term is no longer used. Ethics within the pharmaceutical industry, along with those of medicine, law, and journalism, have been redefined.
A new series of advertisements for Zoloft (sertraline) has appeared in psychiatric and other medical journals. They are outrageous not in terms of explicit claims, but rather through the implicit messages that they send out with photographs and captions. A woman's hand guides the small hand of a child holding a crayon; the caption: "The Zoloft Touch." Young parents laugh and play with their child on a swing; the caption: "The Zoloft Saturday." A smiling face: "The Zoloft Smile." The boring scientific stuff is in fine print on the reverse side of the page.
Are we selling medication for depression or are we selling happiness, togetherness, and caring? As psychiatrists, we promote the use of antidepressant medication as a safe and effective treatment for a serious medical illness. We reject the claim that these are "designer" drugs, which healthy people request to get "a leg up" on the competition, popularity in dating, better grades at school, better performance at work. We resist the notion of managed care companies that psychiatry is for "the worried well."
This new series of ads may well work its way into the popular media, so that someone leafing through the pages of Newsweek may encounter a man in his sailboat, hair blowing in the wind, with the caption: "The Zoloft Weekend---Ask Your Doctor." We have no control over that kind of advertising, but we do have a say in what goes into the pages of our own professional journals.
I realize that we fear censorship and that
we depend on pharmaceutical revenues. Nevertheless, I think that you should
consider the implications of this series of ads. They are certainly eye-catching,
but they may end up giving all of us a black eye.