Did US Drug Ads Increase the Number of Depression Sufferers?
Did US Drug Ads Increase the Number of Depression Sufferers?
A man makes his way home from work on a bus as darkness falls in Glasgow, Scotland, on Oct. 10, 2005. Seasonal affective disorder (SAD), or winter depression, is a mood disorder related to the change in the seasons and the resulting reduction of exposure to daylight. (Christopher Furlong/Getty Images)

A man makes his way home from work on a bus as darkness falls in Glasgow, Scotland, on Oct. 10, 2005. Seasonal affective disorder (SAD), or winter depression, is a mood disorder related to the change in the seasons and the resulting reduction of exposure to daylight. (Christopher Furlong/Getty Images)

Bottles of antidepressant pills (L–R) Wellbutrin, Paxil, Lexapro, Effexor, Zoloft, and Fluoxetine in Miami, Fla., on March 23, 2004. The Food and Drug Administration (FDA) asked makers of popular antidepressants to add or strengthen suicide-related warnings on their labels as well as the possibility of worsening depression especially at the beginning of treatment or when the doses are increased or decreased. (Joe Raedle/Getty Images)

Bottles of antidepressant pills (L–R) Wellbutrin, Paxil, Lexapro, Effexor, Zoloft, and Fluoxetine in Miami, Fla., on March 23, 2004. The Food and Drug Administration (FDA) asked makers of popular antidepressants to add or strengthen suicide-related warnings on their labels as well as the possibility of worsening depression especially at the beginning of treatment or when the doses are increased or decreased. (Joe Raedle/Getty Images)

A man makes his way home at the Preston bus station in Preston, England, on Jan. 23, 2005. Scientists from Cardiff University have worked out a formula to calculate that Jan. 23 is the most depressing day of the year. The formula 1/8W+(D-d) 3/8xTQ MxNA where W is weather, D is debt, money (d) due on January's pay day and T is the time since Christmas, Q is the period since the failure to quit a bad habit, M for motivational levels, and NA is the need to take action and do something about it. (Christopher Furlong/Getty Images)

A man makes his way home at the Preston bus station in Preston, England, on Jan. 23, 2005. Scientists from Cardiff University have worked out a formula to calculate that Jan. 23 is the most depressing day of the year. The formula 1/8W+(D-d) 3/8xTQ MxNA where W is weather, D is debt, money (d) due on January's pay day and T is the time since Christmas, Q is the period since the failure to quit a bad habit, M for motivational levels, and NA is the need to take action and do something about it. (Christopher Furlong/Getty Images)

A bottle of antidepressant pills Effexor in Miami, Fla., on March 23, 2004. (Joe Raedle/Getty Images)

A bottle of antidepressant pills Effexor in Miami, Fla., on March 23, 2004. (Joe Raedle/Getty Images)

Bottles of antidepressant pills Prozac on a pharmacy shelf in New York City on Jan. 4, 2005. The British Medical Journal (BMJ) sent the U.S. Food and Drug Administration documents submitted by an anonymous source that seem to show a link between Eli Lilly and Co.'s Prozac (fluoxetine) and suicide attempts and violence. (Stephen Chernin/Getty Images)

Bottles of antidepressant pills Prozac on a pharmacy shelf in New York City on Jan. 4, 2005. The British Medical Journal (BMJ) sent the U.S. Food and Drug Administration documents submitted by an anonymous source that seem to show a link between Eli Lilly and Co.'s Prozac (fluoxetine) and suicide attempts and violence. (Stephen Chernin/Getty Images)

A single-dose pill of Valium is displayed on March 2, 1979. Also known by its pharmacuetical name Diazepam, this prescription drug is used for its anti-anxiety properties. Leo Sternbach was the inventor of a new class of tranquilizers that included Valium, one of the first blockbuster

A single-dose pill of Valium is displayed on March 2, 1979. Also known by its pharmacuetical name Diazepam, this prescription drug is used for its anti-anxiety properties. Leo Sternbach was the inventor of a new class of tranquilizers that included Valium, one of the first blockbuster "lifestyle" drugs. Sternbach died Sept. 28, 2005. He was 97. (AP Photo/Marty Reichenthal)

From the debut of Prozac in 1988, 10 years before direct-to-consumer (DTC) drug advertising, one of the top-performing drug categories in the United States was depression drugs. Because depression has no drug or lab test and pop culture has convinced many that life should be one big “buzz” of extreme happiness, “depression” sailed Pharma through the 1990s and 2000s—even sometimes when people really didn’t probably have it. Certainly, if you had money, job, and career problems, family and relationship problems, or many kinds of health problems, you could be “unhappy” but not necessarily “depressed.”

Whereas drugs like Valium and Librium were once prescribed for “anxiety,” anxiety was redefined as “really” depression during the blockbuster antidepressant years and was treated with the new drug class. In fact, 10 years after DTC advertising began, the number of Americans on antidepressants had doubled to 27 million, or 10 percent of the population! Nor was it probably a marketing coincidence that unlike anxiety drugs, antidepressants were not taken as needed but taken every day, for years. Ka-ching.

Ten years after direct-to-consumer drug advertising began, the number of Americans on antidepressants had doubled to 27 million, or 10 percent of the population!
Bottles of antidepressant pills Prozac on a pharmacy shelf in New York City on Jan. 4, 2005. The British Medical Journal (BMJ) sent the U.S. Food and Drug Administration documents submitted by an anonymous source that seem to show a link between Eli Lilly and Co.'s Prozac (fluoxetine) and suicide attempts and violence. (Stephen Chernin/Getty Images)
Bottles of antidepressant pills Prozac on a pharmacy shelf in New York City on Jan. 4, 2005. (Stephen Chernin/Getty Images)

During the same time period that antidepressant use grew, the number of doctor visits where individuals were prescribed antidepressants even though they had no psychiatric diagnoses increased from 59.5 percent to 72.7 and accounted for four out of five antidepressant prescriptions according to published sources. A growing number of people were also prescribed antipsychotics—though they were not diagnosed as psychotic—and the number of people undergoing psychotherapy shrank. Both insurers and patients preferred pills to psychotherapy because they were quicker and easier and sometimes even “fun.” What was to not like about popping a pill?

Whereas depression had been considered self-limiting (it would go away after a while), depression was now sometimes cast as a lifelong condition requiring lifelong drugs. Worse, drug companies now said the condition was “progressive”—it would get worse if you did not treat it. The claim added new urgency to the “sell” but evidence was weak to nonexistent.

Once the big money makers like Prozac, Paxil, and Zoloft went off patent, though, they did not always seem the miracle drugs they had been cast. Some, notably Paxil, were linked to higher suicide rates—especially in adolescents and young adults. The new antidepressants were sometimes reported to quit working after a honeymoon period, sometimes called “Prozac poop-out.” (“Prozac wears off within a year for about one-third of those who take it,” said Harvard magazine.) And a 2010 article in the Journal of the American Medical Association (JAMA) suggested that the pills were not even effective in milder forms of depression. Their popularity could have been the “placebo” effect.

Once the big money makers like Prozac, Paxil, and Zoloft went off patent, though, they did not always seem the miracle drugs they had been cast.

Human nature might have been a contributor to poop-out, too, said psychiatrist Phillip Sinaikin. “An antidepressant not working anymore is no different from getting used to anything that used to thrill us,” said Sinaikin in an interview about his book “Psychiatryland.” “We buy our dream house with two bedrooms and a garage, and after a while it doesn’t make us happy anymore, and we are eyeing the house with three bedrooms and a pool. Another example, of course, is falling in and out of love.”

An antidepressant not working anymore is no different from getting used to anything that used to thrill us.
— Dr. Phillip Sinaikin, author of 'Psychiatryland'
A single dose pill of Valium is displayed on March 2, 1979. Also known by its pharmacuetical name Diazepam, this prescription drug is used for its antianxiety properties. Leo Sternbach was the inventor of a new class of tranquilizers that included Valium, one of the first blockbuster "lifestyle" drugs. Sternbach died Sept. 28, 2005. He was 97. (AP Photo/Marty Reichenthal)
A single-dose pill of Valium is displayed on March 2, 1979. (AP Photo/Marty Reichenthal)

When the bloom began falling off antidepressant sales, drug companies began to market “add-on” drugs to boost the original drug that seemed to have stopped working. The add-on drug could cost several hundred dollars a month, but no one seemed to mind since people were not paying for the drugs out of their pockets. (No one seemed to consider the effect on insurance premiums and taxes.)

Still, the U.S. antidepressant market finally peaked in 2008 and has been declining by 4 percent every year since according to industry sources. While certainly depression exists—as does bipolar disorder, ADHD, and other mood and behavior conditions—it is likely that it was over-diagnosed and over-treated when the expensive pills were covered by patents. It was also over-screened—there were even quizzes to find out if you “were depressed.” (Who would not know if they were depressed?) Once the aggressive marketing stopped, some sufferers clearly got “better.”

Martha Rosenberg is author of the award-cited food exposé “Born With a Junk Food Deficiency,” distributed by Random House. A nationally known muckraker, she has lectured at the university and medical school level and appeared on radio and television.

Views expressed in this article are the opinions of the author(s) and do not necessarily reflect the views of Epoch Times.

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