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(NPR)   Worried that the expiring patent on Prozac will ruin your profit margins? Just paint it pink, change the name to "Sarafem", and sell it to women for $10 a pill   (npr.org) divider line 48
    More: Scary, Prozac, profit margins, wrecking, PMS, pills, paints, Statistical Manual, severe depression  
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2331 clicks; posted to Business » on 21 Oct 2013 at 10:03 AM (1 year ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



48 Comments   (+0 »)
   
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2013-10-21 10:06:50 AM  
Who cares what they do with their own expired patent as long as the rest of the world gets to produce and purchase the off-brand version?
 
2013-10-21 10:26:13 AM  
Usually the scam is to combine the drug with something relatively useless like Tylenol and patent it as another drug. Then send in the drug sales people to push it on to doctors as a new replacement.
 
2013-10-21 10:26:46 AM  

cefm: Who cares what they do with their own expired patent as long as the rest of the world gets to produce and purchase the off-brand version?


Here's the trick though--PMDD isn't a labelled indication for Prozac, nor is intermittent dosing a recognized regimen. Prozac is indicated for major depression and OCD to be taken daily. Sarafem is indicated for PMDD and to be taken either continuously or intermittently, depending on symptoms. Of course the doctor could choose to use Prozac in the same way as Sarafem, since they're identical medications, but he would be opening himself up to potential liability. There's no law that says you can't use medications for off-label indications, but when you do you're not afforded some of the same protections. This is one of those situations where the drug company actually is being exploitative. I'll stop before calling it "evil," but it crosses my mind.
 
2013-10-21 10:30:52 AM  
A story about emotional women being sold a high profit drug by big pharma.
This Fark thread will be full well-thought, rational discourse on the human condition versus modern technological advance.

/women! pshh...Am I right?
//who are the ad geniuses behind this one?
 
2013-10-21 10:33:30 AM  

Yes please: This is one of those situations where the drug company actually is being exploitative.


I am actually interested as to why you consider this to be exploitative.  Not saying you are wrong mind you, but just interested at what you mean here.
 
2013-10-21 10:34:10 AM  
I'm no doctor, but shouldn't PMDD be a hormonal or gyno disorder, not a mental illness?

PCOS and other disorders can result in mood swings, but no one is going to a shrink to get diagnosed with PCOS.

The mere fact that this is considered a mental illness sounds sexist.
 
2013-10-21 10:37:29 AM  

Teiritzamna: Yes please: This is one of those situations where the drug company actually is being exploitative.

I am actually interested as to why you consider this to be exploitative.  Not saying you are wrong mind you, but just interested at what you mean here.


New use for a known composition of matter simultaneously raises questions about inherency. ;)
 
2013-10-21 10:39:31 AM  
goregirl.files.wordpress.com

Approves.
 
2013-10-21 10:43:20 AM  

Theaetetus: New use for a known composition of matter simultaneously raises questions about inherency. ;)


Ahem, i know why i or another IP attorney would find the new patent to be problematic - especially since determining why pharma patents (especially follow-on pharma patents) are bad is kinda my job these days.  I wanted to know why he thought it was exploitative.

Also my concern would be less inherency, as that is often an easier bar to jump (or razzle-dazzle a judge on), and more good ol' fashioned 103.
 
2013-10-21 10:54:23 AM  
Side effects may include a burning sensation and visions of six-winged, reptilian angels.
 
2013-10-21 10:56:37 AM  

Teiritzamna: Theaetetus: New use for a known composition of matter simultaneously raises questions about inherency. ;)

Ahem, i know why i or another IP attorney would find the new patent to be problematic - especially since determining why pharma patents (especially follow-on pharma patents) are bad is kinda my job these days.  I wanted to know why he thought it was exploitative.

Also my concern would be less inherency, as that is often an easier bar to jump (or razzle-dazzle a judge on), and more good ol' fashioned 103.


That's what I was saying. If it's actually a new use, then the process wouldn't be anticipated by the drug, but if the prior art drug inherently affects the disease, then the only remaining steps are the prescribing ones and combined with other art about prescribing drugs, you'd have an easy 103.

But as a philosophical argument, I think it seems "unfair" in that it feels like illegal patent extension: during the existence of the Prozac patent, but prior to issuance of the Sarafem patent, you know that if you used Prozac on PMDD, they'd sue for infringement. By getting a separate patent on Sarafem and getting an additional 6 or so years of term, it feels like they ended up with 26 years of monopoly rather than 20.
Now, there are arguments why this is false and why, legally, it's not really patent extension. But that doesn't mean it doesn't feel unfair.
 
2013-10-21 11:03:42 AM  
Is this like how benedryl can be sold as an antihistimine or a sleep aid and be sold next to itself, at sometimes dramatically different prices?
 
2013-10-21 11:18:28 AM  

error 303: Is this like how benedryl can be sold as an antihistimine or a sleep aid and be sold next to itself, at sometimes dramatically different prices?


I like seeing customers' reactions to this.
"I want liquid Benadryl."
"Okay, then you need to either buy Children's Benadryl, ZZZQuil, or our store brand."
"But that's a sleep medicine."
"It's the same ingredient, same dose, just a different flavor/color and labeled for sleep."
"But it's for sleep."
"And allergies. Look here, they're both diphenhydramine hydrochloride."
"Big words frighten me. I'm getting Children's Benadryl and following the adult directions."
"That whole bottle is six adult doses. The purple one is cheaper and more doses."
"But it's for sleep."
 
2013-10-21 11:24:16 AM  

kittyhas1000legs: error 303: Is this like how benedryl can be sold as an antihistimine or a sleep aid and be sold next to itself, at sometimes dramatically different prices?

I like seeing customers' reactions to this.
"I want liquid Benadryl."
"Okay, then you need to either buy Children's Benadryl, ZZZQuil, or our store brand."
"But that's a sleep medicine."
"It's the same ingredient, same dose, just a different flavor/color and labeled for sleep."
"But it's for sleep."
"And allergies. Look here, they're both diphenhydramine hydrochloride."
"Big words frighten me. I'm getting Children's Benadryl and following the adult directions."
"That whole bottle is six adult doses. The purple one is cheaper and more doses."
"But it's for sleep."


Are they even formulated/released differently, or is it like the exact same thing?
 
2013-10-21 11:35:37 AM  

error 303: Are they even formulated/released differently, or is it like the exact same thing?


From what I've seen, they're the same. No extended release/etc. They're even both 25mg per dose (though I think another brand is 50mg/dose). From what I've seen:

Benadryl/generic: pink tablets, pink and white capsules, or dye-free liquigels 25mg
Children's: pink liquid, bubble gum or cherry flavor (also available dye free) 12.5mg
ZzzQuil/generic: purple liquigels or purple/red liquid depending on flavor, 25mg

I'll take another look while going through my aisles tonight.

/must escape retail pharmacy
//why do I know this off the top of my head?
 
2013-10-21 11:36:42 AM  
Didn't I see this on an episode of House a few years ago?  Seriously if your company is so bankrupt of ideas you need to steal your dirty tricks from a fictional TV show then you need new marketing people.
 
2013-10-21 12:01:53 PM  
The drug I've been taking for the last decade which used to cost $10/pill and was prescription only now only costs $1/pill and comes in grape flavoring to differentiate it from all the generic versions on the shelf.
 
2013-10-21 12:25:33 PM  
upload.wikimedia.org

Allowing Big Pharma to profit from the pain and suffering of others since 1906.
 
2013-10-21 12:59:10 PM  

offmymeds: Allowing Big Pharma to profit from the pain and suffering of others since 1906.


Truly, the FDA is the worst of all American agencies.
 
2013-10-21 01:16:19 PM  

Teiritzamna: Yes please: This is one of those situations where the drug company actually is being exploitative.

I am actually interested as to why you consider this to be exploitative.  Not saying you are wrong mind you, but just interested at what you mean here.


Because they're taking a drug that's already on the market and changing the labeling to pretend that it's a new drug in order to gain market share at the expense of customers. And doctors have been using antidepressants for PMDD for years as an off-label treatment, but now that there's a labeled drug for that purpose the off-label use of the exact same drug now potentially carries an increased risk of liability.

Imagine you own a poultry plant, and you need a truck to get your poultry to market. So a company offers you a refrigerated truck that they promise will keep your product at the proper temperature and is safe to drive. They say it's good for chicken, duck, turkey, Cornish game hen, pheasant, quail, and goose. So November comes around and you get a call... "Are you shipping Thanksgiving turkeys this year? Not in that truck, I hope. It's not approved for Thanksgiving turkeys. We can't guarantee food safety or even road safety if used for Thanksgiving turkeys. You need to buy our seasonal Thanksgiving turkey truck." And it's the exact same truck with a different paint job. But if something happens and there's a salmonella outbreak, or a driver hits a pedestrian, or a customers complain that the turkey wasn't as moist as they had hoped, then you have a lawsuit. And the first thing the lawyer is going to say is, "So I don't understand--you knew there was a specific truck for Thanksgiving turkeys, but you chose to use your regular truck to deliver these Thanksgiving turkeys, is that correct?"
 
2013-10-21 02:00:49 PM  

Yes please: And doctors have been using antidepressants for PMDD for years as an off-label treatment, but now that there's a labeled drug for that purpose the off-label use of the exact same drug now potentially carries an increased risk of liability.


That's not true - there was always an increased risk of liability for an off-label treatment, regardless of whether there's an FDA approved version. Nothing changes about that liability, just because the FDA approved Sarafem.
 
2013-10-21 02:02:56 PM  

shortymac: I'm no doctor, but shouldn't PMDD be a hormonal or gyno disorder, not a mental illness?

PCOS and other disorders can result in mood swings, but no one is going to a shrink to get diagnosed with PCOS.

The mere fact that this is considered a mental illness sounds sexist.


This. This. A thousand times this.
 
2013-10-21 02:09:48 PM  
The same active ingredients are in Excedrin Extra Strength as in Excedrin Migraine, the only thing I can think of that is different is the buffers.

/Best headache medicine
 
2013-10-21 02:24:05 PM  

Theaetetus: That's not true - there was always an increased risk of liability for an off-label treatment, regardless of whether there's an FDA approved version. Nothing changes about that liability, just because the FDA approved Sarafem.


Also, in cases such as this involving the follow-on drug, liability through off-label prescribing is pretty much nil. There are generally two avenues of liability for a doctor of off label prescription: malpractice (i.e. negligence) and failure to obtain informed consent.  In this instance the doctor can quickly dispose of the second potential for liability by telling her patient what she is doing.  i.e. "YesPlease, i can either prescribe you this med at $10 a pill, or the generic at $0.5 a pill, you will also end up paying a far lower co-pay on the generic.  The trick is, although the two drug are identical, due to the way the law works, the cheaper generic is only FDA approved for general depression, not PMDD.  I believe that there is no difference in prescribing these two compounds, except for the price, so i am going to write a script for the generic unless you have an objection."

As to the second - merely prescribing an off-label drug is not grounds for malpractice.  Instead you need to show that the doctor did something else wrong, such as failing to know that the off-label use has higher risks.  Given that this particular drug has been off-labeled for a long time, and the branded drug has been FDA approved for the purpose we are discussing as an off label use, the doctor would be in pretty good shape in avoiding liability.

The real reason Ely Lilly and Warner Chilcott are doing this is they know they can get many doctors to go along with prescribing the new labeled drug instead of the generic - i.e. they know many physicians aren't price sensitive to the cost of meds and many that are can be swayed by junkets and hotties with swag.  Also, there is the fairly consistent American disdain for generics of all sorts, be it medicine or cereal.  Just look at the OTC market and the fact that although the patents on pretty much any formulation of OTC you can think of expired years ago and the Wallgreens/CVS/Longs/etc generic is still usually far cheaper than the branded - people still by branded drugs.
 
2013-10-21 02:24:07 PM  

shortymac: I'm no doctor, but shouldn't PMDD be a hormonal or gyno disorder, not a mental illness?

PCOS and other disorders can result in mood swings, but no one is going to a shrink to get diagnosed with PCOS.

The mere fact that this is considered a mental illness sounds sexist.


I thought that being a woman was a mental illness? Or maybe that is just the married ones...and the unmarried ones too.

/ducks
 
2013-10-21 02:39:03 PM  

Teiritzamna: Just look at the OTC market and the fact that although the patents on pretty much any formulation of OTC you can think of expired years ago and the Wallgreens/CVS/Longs/etc generic is still usually far cheaper than the branded - people still by branded drugs.


Guilty, but then NyQuil is about 3x cheaper than a co-pay, where they recommend you take a Pharmaceutical version of NyQuil, which costs 10x what NyQuil costs, so I stopped going to the doctor and started keeping Nyquil on hand. Nyquil.

/nyquil-nyquil.
/generic allergy pills though, because lol no not paying 24$ for that.
 
2013-10-21 02:58:28 PM  

Kristoph57: /generic allergy pills though, because lol no not paying 24$ for that.


Seriously ... Costco sells 24 generic Zyrtec-D for $16 instead of $24, and they sell 400 Benadryl for the price of one box of the name brand stuff.
 
2013-10-21 03:00:26 PM  

Teiritzamna: Also, there is the fairly consistent American disdain for generics of all sorts, be it medicine or cereal.  Just look at the OTC market and the fact that although the patents on pretty much any formulation of OTC you can think of expired years ago and the Wallgreens/CVS/Longs/etc generic is still usually far cheaper than the branded - people still by branded drugs.


It's not just Americans.

I worked at a Boots Pharmacy in the UK for a while (it's a bit like CVS). Whenever people asked for Nurofen (brand name Ibuprofen) I asked if they would like the Boots brand version at about a quarter the price. Maybe 10% of customers went with the Boots brand, the rest all would say "nope, only Nurofen works for me". The odd bit - Ibuprofen was invented by Boots. Technically all other brands are off-brand knockoffs that rose up after their patents expired a long time ago.
 
2013-10-21 03:19:49 PM  

Theaetetus: Yes please: And doctors have been using antidepressants for PMDD for years as an off-label treatment, but now that there's a labeled drug for that purpose the off-label use of the exact same drug now potentially carries an increased risk of liability.

That's not true - there was always an increased risk of liability for an off-label treatment, regardless of whether there's an FDA approved version. Nothing changes about that liability, just because the FDA approved Sarafem.


In theory, you're correct. But in front of a jury there's a world of difference. When there is drug with that labeled indication, off-label alternatives can easily be portrayed as being inferior. The fact that it's the exact same medication only partially mitigates that.
 
2013-10-21 03:36:00 PM  

Teiritzamna: Theaetetus: 

The real reason Ely Lilly and Warner Chilcott are doing this is they know they can get many doctors to go along with prescribing the new labeled drug instead of the generic - i.e. they know many physicians aren't price sensitive to the cost of meds


I heard on the news today that doctors get 6% of the cost of any prescriptions that they provide to Medicare patients.  ie Medicare pays 106% of any prescription cost.  I'm not sure how that works since the patient probably has to pay 20% also.  Anyway, I think that doctors are price sensitive.  They'd rather have 6% of $10 instead of 6% of $0.50.
 
2013-10-21 04:17:45 PM  

Gig103: Kristoph57: /generic allergy pills though, because lol no not paying 24$ for that.

Seriously ... Costco sells 24 generic Zyrtec-D for $16 instead of $24, and they sell 400 Benadryl for the price of one box of the name brand stuff.



I get 365 pills for $16 (non-D formula). Awesomeness. Especially since I have to take two at a time.
 
2013-10-21 04:56:10 PM  

ski9600: Teiritzamna: Theaetetus: 

The real reason Ely Lilly and Warner Chilcott are doing this is they know they can get many doctors to go along with prescribing the new labeled drug instead of the generic - i.e. they know many physicians aren't price sensitive to the cost of meds

I heard on the news today that doctors get 6% of the cost of any prescriptions that they provide to Medicare patients.  ie Medicare pays 106% of any prescription cost.  I'm not sure how that works since the patient probably has to pay 20% also.  Anyway, I think that doctors are price sensitive.  They'd rather have 6% of $10 instead of 6% of $0.50.


Even if that's true, I doubt there are any medicare PMDD patients...
 
2013-10-21 05:05:20 PM  

ski9600: Teiritzamna: Theaetetus: 

The real reason Ely Lilly and Warner Chilcott are doing this is they know they can get many doctors to go along with prescribing the new labeled drug instead of the generic - i.e. they know many physicians aren't price sensitive to the cost of meds

I heard on the news today that doctors get 6% of the cost of any prescriptions that they provide to Medicare patients.  ie Medicare pays 106% of any prescription cost.  I'm not sure how that works since the patient probably has to pay 20% also.  Anyway, I think that doctors are price sensitive.  They'd rather have 6% of $10 instead of 6% of $0.50.


The doctor only gets that if he provides the drug, not if he prescribes it. There are very few instances where this comes into play. When it does it's usually injectable meds like flu shots or things like that that have to be given in the office, and they do that mostly as a courtesy. Most doctors don't stock oral meds to fill a month's supply. If they did, the 6% wouldn't cover the cost of storing and distributing them.
 
2013-10-21 05:24:39 PM  

shortymac: I'm no doctor, but shouldn't PMDD be a hormonal or gyno disorder, not a mental illness?

PCOS and other disorders can result in mood swings, but no one is going to a shrink to get diagnosed with PCOS.

The mere fact that this is considered a mental illness sounds sexist.


Also not a doctor and I am reading a bit into your comment but you seem to be implying that other mental illness don't have originating causes outside what we call psychiatry, but many of them are better classified as neurological issues.

PMDD does meet the medical definition of mental illness, having symptoms that are predominantly mood or thought based. It is important to remember that there is no difference between the mind and the body.  I hate the term mental illness and its separation from other forms of medicine because it does propagate the belief that the mind and body are different, and also propagates the stigma associated with it.  I don't know what the better alternative is though...
 
2013-10-21 06:29:03 PM  
www.wcrx.com

This is really Old News. FDA approved Sarafem back in 2000.
 
2013-10-21 06:47:54 PM  

bambi121899: Gig103: Kristoph57: /generic allergy pills though, because lol no not paying 24$ for that.

Seriously ... Costco sells 24 generic Zyrtec-D for $16 instead of $24, and they sell 400 Benadryl for the price of one box of the name brand stuff.


I get 365 pills for $16 (non-D formula). Awesomeness. Especially since I have to take two at a time.


How do you manage that? I found Simply Right Cetirizine HCl 10mg at amazon for $22 for 400 tablets, so that's not too bad and it seems to work just as well as actual Zyrtec. (not Zyrtec-D, just Zyrtec) I also get generic Benadryl on the cheap.
 
2013-10-21 07:43:30 PM  
SAM's club has the genric cetirazine in 360 pill bottles, probably what he's talking about..

But to the article. Yep, drug companies can patent old drugs for new symptoms in certain cases...

Boner pills are one case of this. A low dose version of Viagra is sold generic for high blood pressure, but take it as a boner pill, still patented for the next 5 years...
 
2013-10-21 09:38:39 PM  

Rihlsul: shortymac: I'm no doctor, but shouldn't PMDD be a hormonal or gyno disorder, not a mental illness?

PCOS and other disorders can result in mood swings, but no one is going to a shrink to get diagnosed with PCOS.

The mere fact that this is considered a mental illness sounds sexist.

This. This. A thousand times this.


I have worked in mental health and am of a firm belief that only psychiatrists and mental health professionals should be prescribing psychoactive medications. Some of the psychoactive treatments and dosage regimens (particularly "off-label" ones) that GP's put their patients on are scary as shiat. If PMDD treatment requires anti-depressants (and PCOS doesnt typically require psychoactive treatments), I'd be more comfy getting a psychiatrist to manage my medication. Then again I wouldnt ask a psychiatrist to prescribe me birth control.

I know it sucks and can be more costly to go to specialists, but which is more important--safety or convenience?
 
2013-10-21 09:50:52 PM  
My favorite is Propecia, which is the same as Proscar -- but in lower dosages. And it costs about six times as much.
 
2013-10-21 09:54:41 PM  

Rihlsul: shortymac: I'm no doctor, but shouldn't PMDD be a hormonal or gyno disorder, not a mental illness?

PCOS and other disorders can result in mood swings, but no one is going to a shrink to get diagnosed with PCOS.

The mere fact that this is considered a mental illness sounds sexist.

This. This. A thousand times this.


Being female is a pre-existing condition.
 
2013-10-21 11:10:01 PM  

ski9600: I heard on the news today that doctors get 6% of the cost of any prescriptions that they provide to Medicare patients.


This is wrong. Doctors get zero dollars for any drug they prescribe. There are no kickbacks, these are illegal.
 
2013-10-22 02:41:36 AM  

Occam's Disposable Razor: ski9600: I heard on the news today that doctors get 6% of the cost of any prescriptions that they provide to Medicare patients.

This is wrong. Doctors get zero dollars for any drug they prescribe. There are no kickbacks, these are illegal.


They just get lavish gifts and golf weekends...er...conferences hosted by young nubile sales associates.
 
2013-10-22 02:44:09 AM  
They did the same thing with Nexium vs Prilosec.

The do the same thing. One went off patent so they changed a single inert portion of the molecule to reestablish the patent so they could charge more.

My MD just prescribed the generic.

Big Pharma is driven by patents not by innovation.
 
2013-10-22 07:15:37 AM  
Interesting article. I've suffered w/ PMDD since my teens. It took years of GYN and GP visits w/ some counseling before GP prescribed Prozac. (we tried Zoloft & a couple of others before hitting the jackpot w/ Prozac)

Most weeks of the month, I'm 'normal', but for a few days to a week prior to my period I have dibillitating depression. Horrid depression. Want-to-die-almost-kill-myself-depression. In the back of my mind I knew it was hormones, but it took all my effort to fight it w/out meds.

As soon as I saw the same symptoms in our daughter, I took her to the doctor. No way would I let her suffer for years as I did.

The added benefit of Prozac is it deals w/ my mild-to-raging-during-that-time OCD. I don't understand folks who pridefully label any sense of order as OCD. It's a disorder, basically meaning that your need for particular order or orders disrupts your life. It's nothing to be 'proud' of. During the PMDD cycle, my OCD was so intense I could barely manage to sleep, let alone function. Even on meds, I 'sense' germs everywhere and must have things in a certain order to function. On meds, functioning is feasible with a little extra work/caution in my part. Without meds and especially during PMDD, functioning was difficult to not even possible at times.

Enyhoo, I know this thread is about the patent yada yada, but I thought y'all should know this PMDD shiat is real. If you or someone you love goes psycho beyond 'normal' PMS, maybe meds are the answer. And quit saying you're OCD just because you're cleanly or orderly. Neither are a disorder.

/no shame
 
2013-10-22 08:13:55 AM  
lohphat:

Big Pharma is driven by patents not by innovation.

See i would disagree with such reductionism.  The Pharmaceutical industry, like pretty much all industries is driven by money. This means that sometimes if they have to innovate to make money, they do.  See, e.g., when they invented omeprazole, which is the chemical in Prilosec.  However, just like most folks, the people running companies are, at bottom, pretty lazy.  So if they have the option, they are going to forgo the hard work and just stick with making the money.

In other words, you ask most people if they would rather a) work really hard, invest a bunch of money and effort, to make a given amount of money or b) make the same amount of money doing something simple that wont hurt anyone but is based on quirks of human nature, my guess is they are going to pick b.  In my mind, its really often doctors that piss me off in these follow on drug scenarios.  In the case of omeprazole vs esomeprazole (i.e. nexium) all AZ did was remove the inactive enantiomer form of the drug (long story short, the original was made up of ~50/50 mirror images of a given molecule and only one image actually did anything).  Thus, nexium and prilosec are generally considered identical, and in the words of the director of the Center for Medicare & Medicaid Services "You should be embarrassed if you prescribe Nexium because it increases costs with no medical benefits.... The fact is Nexium is Prilosec ...it is the same drug. It is a mirror compound."

TL;DR the issue here is not innovation vs monopolies - it is doctors who can be swayed into prescribing the new more expensive follow-on even though it does nothing and patients who will irrationally* prefer branded drugs.

/* preferring branded drugs is not always irrational, but it bugs me when it is.
 
2013-10-22 09:47:14 AM  

GBmanNC: shortymac: I'm no doctor, but shouldn't PMDD be a hormonal or gyno disorder, not a mental illness?

PCOS and other disorders can result in mood swings, but no one is going to a shrink to get diagnosed with PCOS.

The mere fact that this is considered a mental illness sounds sexist.

Also not a doctor and I am reading a bit into your comment but you seem to be implying that other mental illness don't have originating causes outside what we call psychiatry, but many of them are better classified as neurological issues.

PMDD does meet the medical definition of mental illness, having symptoms that are predominantly mood or thought based. It is important to remember that there is no difference between the mind and the body.  I hate the term mental illness and its separation from other forms of medicine because it does propagate the belief that the mind and body are different, and also propagates the stigma associated with it.  I don't know what the better alternative is though...


Okay, but it's the result of hormonal functions of the menstrual cycle, not a imbalance in the brain itself (like say with depression).

For example, hypoglycemia can be misdiagnosed as bipolar disorder due to blood sugar's effect on mood, however no one claims hypoglycemia is a mental illness.

Also, would something like Roid Rage be considered a mental illness or a hormonal disease?
 
2013-10-22 12:00:49 PM  

shortymac: GBmanNC: PMDD does meet the medical definition of mental illness, having symptoms that are predominantly mood or thought based. It is important to remember that there is no difference between the mind and the body.  I hate the term mental illness and its separation from other forms of medicine because it does propagate the belief that the mind and body are different, and also propagates the stigma associated with it.  I don't know what the better alternative is though...

Okay, but it's the result of hormonal functions of the menstrual cycle, not a imbalance in the brain itself (like say with depression).

For example, hypoglycemia can be misdiagnosed as bipolar disorder due to blood sugar's effect on mood, however no one claims hypoglycemia is a mental illness.

Also, would something like Roid Rage be considered a mental illness or a hormonal disease?


The body is all connected (meaning "hormone" fluctuations can affect the brain/mood or they can affect the cardiovascular system). The disease epidemiology, treatment and way it presents in patients guide what field of specialty diagnoses and treats the illness.

You dont treat hypoglycemia with psychoactive drugs and most of its symptoms/diagnostic criteria are physical (like physical weakness and nausea, so any doctor diagnosing a hypoglycemic as bipolar should either close shop or just freakin stop diagnosing bipolar).

Steroid use is essentially substance abuse and it can become addiction. I'm sure a psychiatrist and endocrinologist would both give a steroid user the same recommendation--discontinue steroid use. Of course I somehow doubt mood change is usually the problem that brings most steroid users to seek medical help...blood in urine, man boobs, jaundice, total lack of energy...that sort of thing seems like it would motivate a vain person to seek help.

My point is that any doctor you would see for a particular issue (gyno or psych for mood swings--I suppose u might see the gyno if youre just sure your vag is making you depressed, endocrinologist or psych for "roid rage", etc)..they'll all generally treat you. The designation of illness type just specifies who probably should be treating you. Specialization allows docs to become really good at what they do and really familiar with classes of medication. If you see a specialist, you're less likely to be a hypoglycemic dx'ed as bipolar *facepalm*
 
2013-10-22 03:28:34 PM  

Little Nikke: ski9600: Teiritzamna: Theaetetus: 

The real reason Ely Lilly and Warner Chilcott are doing this is they know they can get many doctors to go along with prescribing the new labeled drug instead of the generic - i.e. they know many physicians aren't price sensitive to the cost of meds

I heard on the news today that doctors get 6% of the cost of any prescriptions that they provide to Medicare patients.  ie Medicare pays 106% of any prescription cost.  I'm not sure how that works since the patient probably has to pay 20% also.  Anyway, I think that doctors are price sensitive.  They'd rather have 6% of $10 instead of 6% of $0.50.

Even if that's true, I doubt there are any medicare PMDD patients...


If you are on SSDI for 2 years then you are eligible for Medicare for health insurance. Live long enough and you age into Medicare but others qualify as well.
 
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