Saturday, February 13, 2010


Once again antidepressants are in the news.

There was a January Newsweek story ( about how little affect antidepressants really have on depression. I really encourage people to read the Newsweek article.

There continues to be more research showing that placebos (sugar pills) are as effective as antidepressants. So, with all of this data why are antidepressants becoming more and more popular? And with no true data to support the effectiveness of antidepressants, why are pharmaceutical companies continuing to create more antidepressants?

Well, let's look at it this way...

If you were running a pharmaceutical company and could choose one of the following areas to pursue, which would you? Here is a very simple analysis:

Area 1 - Serious psychological illnesses like schizophrenia.

Characteristics: easy to diagnose when someone suffers from it - easy to tell when someone improves from treatment.
Market size: very small percentage of the population, but the patient must take the medication the remainder of his/her life. Good long term sales but low volume.

Area 2 - Bacterial infections.

Characteristics: easy to diagnose the condition - also easy to tell when someone improves.
Market size: Potentially large, anyone can get an infection. One big downside, you only take the medication until the infection is healed. All sales are short term. Sales are great when there is a major outbreak of infections though.

Area 3 - Depression

Characteristics: not easy to diagnose clearly - a very wide range of levels of depression. Although there are outward symptoms a great deal of the diagnosis is based on patient self report...much like pain.
Market size: The entire population, virtually everyone displays some of the symptoms of depression at some time (as the Zoloft commercial says we all feel a little down at times.) Plus, the patient, once on antidepressants must take them the rest of his/her life. Excellent potential volume and long term sales.

So, strictly from a profit standpoint, which drug makes the most sense to pursue? Ones that have clear symptoms and limited markets or a drug for a condition that is hard to determine with a huge market...with a lifetime of use?

Hmmmm. So, you make the choice...

Of course, one would hope that someone at a pharmaceutical company might be more concerned about ethics and health, than just profits...but then maybe I am just a dreamer.

How does the saying go, "Just follow the money..."

Monday, February 8, 2010

Being a Professor

I was sitting in my office at the university, trying to prepare for my new semester of classes. In reality, I was looking out the window and watching the snowflakes drift to the ground. It is amazing the patterns they make as they fall. It is especially fulfilling since my office is on the third floor and the wind currents are much more interesting. Its a good thing that I have a window by my allows me to be more easily distracted. I rationalize this by telling people that the window allows me to ponder the great truths of life.

In actuality I was wondering why it is that every year I revise my courses rather than take the easy way out and just teach the same thing. I am sure that must say something about me, but I am not sure what. Perhaps I should go ask a psychologist...heavens no, I can't do that. You know what I always tell my therapy students? Going to see a therapist is at one extreme like receiving a warm hug and at the other extreme like hiking up a steep mountain trail with someone poking you in the back with a stick every few steps! And usually it is more like the stick in the back...but for some reason we know we need to get up the mountain, so in some strange way we are thankful for the poke in the keeps us motivated. And that stick in the back sort of like that itch we can't stop scratching.

As I pondered this question of the ages my email made the little "ping" sound that I had received a message. A little window popped up and I did not recognize the sender. It used to be that the phone would ring and I would have to answer it. But now hardly anyone calls anymore and that is probably good. Email allows me to see who is trying to reach me and then I can decide if I want to respond now, later or not at all. The problem with the phone is that, at best, you may know who is calling, but you don't know what they are calling about. It could be something interesting, or it could be your which case you always let the call go to voice mail. Email gives us many more options and ways to avoid responding to people...avoiding and procrastinating...isn't technology great!

Since I did not recognize the person who sent me the message I was curious enough to open it gave me another excuse to not do my work preparing my courses. The note said something about how they were referred to me by a friend of a friend who has a relative who works with me. I hate it when people do that and they don't even say who these people are. I am sure that one day a stock broker from New York call bank will send me an email with that same excuse for writing.

Of course this person just wanted to know if she could talk to me on the phone since she was told that I was "the only one who could help her." She also said that her situation was urgent and somehow involving a legal matter of some sort. The legal thing got my attention since I have been involved with a number of cases involving law and counseling over the years. I waited a few more minutes and decided that that calling her would at the very least allow me to procrastinate even further and there really were no down I called.

When I called I got voice mail...of course. Even diversions from work have voice mail now! I left a message saying that I was responding to her message.

Within minutes I received a call back. And boy did she have a story to tell...definitely worth my time and efforts...and a little ego boost too. It was a very involved tale and I may be able to help...boy the life of a college professor is a never ending adventure...

Being a professor also allows me at times to help people who cannot afford to pay for help...and that is a very fulfilling part of my life. This one was an issue that always gets my attention