Thursday, 18 December 2014

Treatment of depression with antidepressants, efficiency and disadvantages

 Treatment of depression with antidepressants

Antidepressants have a peculiar place in the public mind. Almost every family in the UK will have someone taking these drugs ; yet , the media are often very hostile to them with disparaging te rms such as “happy pills” (ANTIDEPRESSANTS)used to cast aspersions on their efficacy and utility ( Nutt 2003a ) . Mor eover , claims that they may cause suicidal ideation particularly in young people have lead to warning labels in the USA. Yet , despite the repeated media criticism , the use of antidepressants continues to be wid espread. S o what are the reasons for this? The first is that they are effective and the disorders they are used to treat are very common.

Depression is predicted to be largest cause of d isability in the world by 2020 ( Murray and Lopez 1997) and is now exceeding that of cardiovascular disease in many western countries (ma king it number one there already) . Moreover , several of the anxiety disorders are also in the top ten causes of disability , and these also respond very well to antidepressant treatment. In their primary target of depression , the antidepressants are effective treatments of the acute phase with a number needed to treat (NNT) of about 6 , which compares favourably with treatments in other branches of medicin e. However , when used in the long term to prevent recurrence of depression , they become even more effective with an NNT of 3 (Geddes et al 2003).
This makes them one of the most effective of any medicine: for comparison the NNT of statins to prevent the re currence of a myocardial infarction is about 20. Similar efficacy is seen in their secondary indications of the treatment of anxiety disorders. Moreover , the desire of many countries to reduce the prescribing of benzodiazepines has lead to a switch to the new antidepressants , particularly the selective serotonin reuptake inhibitors (SSRIs) that have greater efficacy and are much freer from problems such as abuse and withdrawal ( Nutt 2003b ) . Although the SSRIs take several weeks to work and can even worsen anxiety at the start of treatment after a few weeks , they become very effective anxiolytic treatments with efficacy exceedi ng that of the benzodiazepines . The SSRIs also have uses in other indications such as pain, some sleep disorders and some sexual problems (particularly SSRIs for premature ejaculation).
There are other factors underlying this increase in use. The most important one is that the newer an tidepressants are extremely safe drugs. Before their invention , the most commonly used antidepressants were those of tricyclic structure such a s amitriptyline and duselepin.
However , these are very toxic in overdose due to their combination of noradrenaline reuptake blocking properties and marked anticholinergic actions on the heart. At the peak of their use , they were the most common cause of drug overdose death in the UK, and still today kill hundr eds of people a year (Nutt 2005) . Patients with depression are at very high risk of suicide , and before the onset of the SSRIs , many used their antidepressants to kill themselves.
Details here
David Nutt
Imperial College London

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Sunday, 14 December 2014

Taking anti-depressants

Taking anti-depressants.Why am I telling you this? Apart from my constant desire to make everything about me?
Well I think it's important to say. Don't worry, I'm not going down the "spokesman for mental health" route. I just thought I'd share some information and my experience so far to help lessen the stigma attached to it.

And that's the thing. I've always been very open when talking about mental health issues. I talk about it on stage, to my friends and family, I even organised an Edinburgh Fringe show on the subject. It was only when I started taking anti-depressants about five weeks ago that the stigma became real for me. And it was a self-imposed stigma. I only told my very closest friends that I had started taking them, the ones I thought would be the most understanding. Thankfully they were, even the ones who said "I presumed you were on them anyway".
On Saturday I was at a conference and went to take my meds after lunch. I caught myself surreptitiously taking my daily tablet so that no one would see or notice. I did it without really thinking why and realised afterward that I was worried someone would ask what I was taking. I was worried that someone would see and would think "Look at yer man, he's on pills for his nerves". That somehow it would mark me out as being abnormal in some way which is just ridiculous. So in order to mitigate that, I thought I'd put it out in the open if it means others will be more willing to tackle it.
So why anti-depressants? 
Well, just over a month ago, I was made redundant. This in itself wasn't a reason to fall into a depression. In fact I was delighted to be made redundant. As my friends or those who follow my Facebook feed will know, I didn't like my job. I hated it. Over the past five years it had slowly eroded my self-confidence and sense of self-worth down to the point where I dreaded every day I had to go into the office. It's partly for this reason that I started doing stand-up comedy.
What leaving my job did for me was give me time to think and to start making some changes in my life. I realised that I hadn't been myself in quite a while. A good number of years. I needed to do something about that in order to get my life back and be the person I used to be.
Having depression is hard to explain to people who have never experienced it. By that I mean people who haven't been effected by it on a daily basis. Having one bad day now and then where you "can't even" doesn't count. For me, I'd have good days and bad days. The bad overwhelmingly outnumbering the good ones. The thing is, I'd try and rationalise it and tell myself that the bad days were normal days. I was always anxious about something from the moment I woke up to the moment I fell asleep. I'd be anxious about going to work, anxious about what mood my boss would be in with me, anxious about meeting people, anxious about driving to a gig, anxious about doing the gig etc etc (you get the idea). When one hurdle was jumped, I'd immediately move on to the next one and start worrying about that. It was like having a constant weight on my shoulders while trying to keep 100 plates spinning on sticks.
It was also very easy for me to fall into a black mood over the most insignificant thing. Things that most people would take in their stride could ruin a day for me. Someone being rude to me at work, some perceived slight or a snarky comment on Facebook could leave me fed up for a day. That's not to say the people involved weren't pricks, it's just that I didn't handle it very well and I let it effect me way more than it should. It also had the effect of making me want to isolate myself from people. I wouldn't want to leave the house to do anything other than go to gigs. Even a trip to the cinema would be an ordeal as even before I'd leave the house, I'd already be fixating on which person in the cinema would ruin the film for me by talking or kicking my seat. I wasn't much fun to be around a lot of the time.
So about six weeks ago I went to the doctor and explained how things had been for me. They were really great. Very understanding. They listened to what I said, nodded in recognition and said that all I had told them was typical of someone who was depressed and could benefit from the use of anti-depressants. I was very wary at first, worried that the pills would in some way change me. Make me someone who wasn't the "real" me. That I'd be zombified in some way. My biggest worry was that if I was numb to everything, I wouldn't be funny anymore and I'd struggle to write anything for stand-up again (You were never funny Christian).
I gave it some thought for a week, reading up on the anti-depressants that the doctor suggested and finally made the decision to give them a go. And I'm glad I did. It's probably the best decision I've made in years. Within a few weeks I was feeling much much better.

Again it's hard to explain but that feeling of anxiousness has eased significantly. It's not there as a constant. I'm a lot more positive about things. Don't get me wrong, I still get irritated when someone's a prick, I just doesn't ruin my day anymore. Or even my minute. I still angry get about things except it's about the right things.
Others have noticed a change too, saying I'm more like my old self. More confident, positive and a lot more pleasant to be around (I hope). I feel happier. Not happy. But happier. And that's a good start.
Watch video documentary antidepressants
So what was my point? My point is this. If you're feeling depressed (and I know there's a few of you reading this), don't put off doing something about it. It doesn't make you weak. It makes you stronger. Go and see someone about it. A doctor, a therapist or a counsellor. But do go and see someone. It's made a huge difference to me so far, all I can do is encourage you to do the same.

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Friday, 12 December 2014

Antidepressants Pills Names

 Antidepressants Pills Names

Antidepressants are drugs used for the treatment of major depressive disorder and other conditions, including dysthymia, anxiety disorders, obsessive compulsive disorder, eating disorders, chronic pain, neuropathic pain and, in some cases, dysmenorrhoea, snoring, migraines, attention-deficit hyperactivity disorder (ADHD), substance abuse and sleep disorders. They can be used alone or in combination with other medications.
The most important classes of antidepressants are the selective serotonin reuptake inhibitors (SSRIs), serotonin–norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs). Other drugs used or proposed for the treatment of depression include buprenorphine, low-dose antipsychotics, and St John's wort

List of antidepressants

This is a complete list of clinically-approved antidepressants, as well as drugs used to augment antidepressants, by pharmacological and/or structural classification. Chemical/generic names are listed first with brand names in parentheses.

Selective serotonin reuptake inhibitors (SSRIs)

Zimelidine (Normud, Zelmid) and indalpine (Upstene) were also formerly used as antidepressants, but were withdrawn from the market.

Serotonin-norepinephrine reuptake inhibitors (SNRIs)

Serotonin modulators and stimulators (SMSs)

These drugs act as serotonin reuptake inhibitors and agonize/antagonize various serotonin receptors.

Serotonin antagonists and reuptake inhibitors (SARIs)

These drugs act as antagonists of various serotonin receptors and as weak serotonin reuptake inhibitors.
Nefazodone (Nefadar, Serzone) was also formerly used as an antidepressant, but was withdrawn from the market.

Norepinephrine reuptake inhibitors (NRIs)

Atomoxetine (Strattera) is also sometimes used as an antidepressant, but is not specifically approved for this purpose.

Tricyclic antidepressants (TCAs)

Butriptyline (Evadyne), demexiptiline (Deparon, Tinoran), imipraminoxide (Imiprex, Elepsin), iprindole (Prondol, Galatur, Tetran), metapramine (Timaxel), propizepine (Depressin, Vagran), and quinupramine (Kinupril, Kevopril) were also formerly markted, but have since been discontinued.
The following are also TCAs, but are atypical pharmacologically:
Amineptine (Survector, Maneon) is another atypical TCA, acting as a norepinephrine-dopamine reuptake inhibitor (NDRI), but was withdrawn from the market.
Tiazesim (Altinil) is not a TCA, but is a bicyclic antidepressant that is closely related structurally and pharmacologically. Similarly to many TCAs, it is no longer marketed.

Tetracyclic antidepressants (TeCAs)

Mianserin, mirtazapine, and setiptiline are also sometimes described as noradrenergic and specific serotonergic antidepressants (NaSSAs).

Monoamine oxidase inhibitors (MAOIs)

Irreversible

Non-selective

Many others, including benmoxin (Neuralex), iproclozide (Sursum), iproniazid (Marsilid), mebanazine (Actomol), nialamide (Niamid), octamoxin (Ximaol), pheniprazine (Catron), phenoxypropazine (Drazine), pivhydrazine (Tersavid), and safrazine (Safra) were used as antidepressants in the past, but have since been discontinued.

Selective for MAO-B

Reversible

Non-selective

Caroxazone (Surodil, Timostenil) was formerly used as an antidepressant, but has been discontinued.

Selective for MAO-A

These drugs are sometimes described as reversible inhibitors of MAO-A (RIMAs).
Eprobemide (Befol) and minaprine (Brantur, Cantor) were also formerly used as antidepressants, but have been discontinued.

Others

Marketed

Discontinued/withdrawn from the market

Over-the-counter

The following antidepressants are available both with a prescription and over-the-counter:

Adjunctive treatments

This category includes drugs that are generally not considered to be significantly effective as treatments for depression alone, but have demonstrated effectiveness in the augmentation of other antidepressants.

Atypical antipsychotics

Others

Combination products

Currently in clinical trials (investigational)

It is thought antidepressants work by increasing levels of a group of chemicals in the brain called neurotransmitters. Certain neurotransmitters, such as serotonin and noradrenaline, can improve mood and emotion, although this process is not fully understood.
Antidepressants Pills Names
This information about antidepressants, take in the sites:

http://www.nhs.uk/conditions/Antidepressant-drugs/Pages/Introduction.aspx
http://en.wikipedia.org/wiki/List_of_antidepressants
Before treatment antidepreesantami, you should consult a physician.

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Thursday, 11 December 2014

Antidepressants Medicines

Not only does it take time to get an accurate depression diagnosis, finding the right medication to treat depression can be a complicated, delicate process. Someone may have a serious medical problem, such as heart disease or liver or kidney disease, that could make some antidepressants unsafe. The antidepressant could be ineffective for you or the dose inadequate; there may not have been enough time to see an effect, or the side effects could be too bothersome -- leading to a failure of treatment.
As you approach taking antidepressants to treat depression, it is important to keep these points in mind:
Only about 30% of people with depression go into full remission after taking their first course of antidepressants. That’s according to a 2006 study funded by the National Institutes of Health. Those who got better were more likely to be taking slightly higher doses for longer periods.
Some antidepressants work better for certain individuals than others. It's not uncommon to try different depression medicines during treatment.
Some people need more than one medicine for depression treatment.
Antidepressants carry a boxed warning about increased risk compared to placebo for suicidal thinking and behavior in children, adolescents, and young adults 18-24 years old.
Working with your doctor, you can weigh the risks and benefits of treatment and optimize the use of medication that best relieves your symptoms.

 What is an antidepressant?

Antidepressants, sometimes in combination with psychotherapy, are often the first treatment people get for depression. If one antidepressant doesn't work well, you might try another drug of the same class or a different class of depression medicines altogether. Your doctor might also try changing the dose. In some cases, your doctor might recommend taking more than one medication for your depression.

antidepressants Medicines Cause Certain Side Effects:

Although all antidepressants can cause side effects, some are more likely to cause certain side effects than others.
Side Effect Medicines Most Likely To Cause This Side Effect
Nausea/vomiting
  • Venlafaxine (Effexor, Effexor XR)
  • Paroxetine (Paxil)
Weight gain
  • Mirtazapine (Remeron, Remeron SolTab)
    • Between 2 and 7 pounds in 6 to 8 weeks
Diarrhea
  • Sertraline (Zoloft)
Sleepiness
  • Trazodone (Desyrel)
Sexual problems (such as decreased sex drive or difficulty getting an erection)
  • Paroxetine (Paxil, Paxil CR)
  • Escitalopram (Lexapro), fluoxetine (Prozac, Prozac Weekly), paroxetine (Paxil, Paxil CR), or sertraline (Zoloft) had more sexual side effects than bupropion (Wellbutrin, Wellbutrin SR®, Wellbutrin XL)
What happens if I stop taking my antidepressant?
Some people have symptoms after they stop taking certain antidepressant medicines. These are called withdrawal symptoms. Withdrawal symptoms include headache, dizziness, light-headedness, nausea, and anxiety. You should never stop taking your medicine without first talking with your doctor.
More people had these symptoms after they stopped taking paroxetine Paxil, Paxil CR and venlafaxine Effexor, Effexor XR.
Fewer people had withdrawal symptoms after they stopped taking fluoxetine Prozac, Prozac Weekly).
Antidepressant medication, used under the guidance of a mental health professional, may relieve your depression symptoms. But antidepressants also come with side effects and dangers. What’s more, recent studies have raised questions about their effectiveness. At the very least, it’s clear that medication alone usually isn’t enough—you also may need therapy and lifestyle changes. Learning the facts about antidepressants and weighing the benefits against the risks can help you make an informed and personal decision about what’s right for you.
http://www.helpguide.org/articles/depression/antidepressants-depression-medication.htm

 

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Common side effects with most antidepressants, including atypical antidepressants

Common side effects with most antidepressants, including atypical antidepressants

Atypical antidepressants are not typical - they don't fit into other classes of antidepressants. They are each unique medications that work in different ways from one another.

How atypical antidepressants work
Atypical antidepressants ease depression by affecting chemical messengers (neurotransmitters) used to communicate between brain cells. Like most antidepressants, atypical antidepressants work by changing the levels of one or more of these naturally occurring brain chemicals.
Atypical antidepressants affect neurotransmitters including dopamine, serotonin and norepinephrine. Changing the balance of these chemicals seems to help brain cells send and receive messages, which in turn boosts mood.
Atypical antidepressants approved to treat depression
The Food and Drug Administration (FDA) has approved these atypical antidepressants to treat depression:
Bupropion (Wellbutrin), Mirtazapine (Remeron), Nefazodone, Trazodone (Oleptro)

Side effects of atypical antidepressants
Common side effects with most antidepressants, including atypical antidepressants, include dry mouth, constipation, and dizziness or lightheadedness. For antidepressants that cause sleepiness, be careful about doing activities that require you to be alert, such as driving a car, until you know how the medication will affect you. Because of the different way atypical antidepressants work, each also has unique characteristics and side effects.
Bupropion may be a good choice if you have low energy caused by depression or if you're trying to quit smoking. It's sometimes prescribed to ease nicotine cravings under the brand name Zyban. Bupropion doesn't cause sexual side effects or weight gain as several other antidepressants do, and it's sometimes prescribed to counter the sexual side effects of another antidepressant. However, bupropion can cause or worsen anxiety in some people. Additional side effects, among others, may include:
Headache, Weight loss, Nausea and loss of appetite, Increased heartbeat, Insomnia
Mirtazapine is generally taken before bed because it can make you sleepy. Additional side effects, among others, may include:
Increased appetite, Weight gain, Increased cholesterol and triglycerides.
Nefazodone may help ease anxiety as well as depression, but it can make you sleepy. It seems less likely to cause sexual side effects than do some other antidepressants. Additional side effects, among others, may include:
Headache, Insomnia, Weakness, Agitation, Nausea, Low blood pressure, Blurred vision.
Trazodone causes sleepiness and can help with anxiety. Like mirtazapine, it's usually taken at bedtime. It may be prescribed alone or along with other antidepressants to help with sleep. Additional side effects, among others, may include:
Blurred vision, Headache, Extreme tiredness (fatigue), Nausea, Muscle aches or pains, Diarrhea, Irregular heartbeat. Sudden drop in blood pressure when standing (orthostatic hypotension)
Information is taken on the site: http://www.mayoclinic.org/diseases-conditions/depression/in-depth/atypical-antidepressants/art-20048208 

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We are sick with one of the most misunderstood epidemics, Depression.

This documentary is a very useful explanation for people who have depression to understand what is normal and what is not in our thoughts and mind. Also, and I think more important is for people who do not have depression, to understand us and that really is not in our brain.  

 
We are not crazy, we are sick with one of the most misunderstood epidemic of the 21st century depression.
If you’re taking an antidepressant, there’s a good chance it’s not necessarily for depression.
According to recent data released by the National Center for Health Statistics, antidepressants are the third most common prescription drug taken by Americans. However, not all these drugs are administered to patients for depression and anxiety – nor does a psychiatrist always prescribe them. Instead, doctors say, antidepressants are often recommended to patients by primary care physicians and are used to treat a surprising assortment of non-psychological condition.

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Wednesday, 10 December 2014

Generic Mirtazapine Remeron Pill

Suicidality and Antidepressant Drugs

Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. 
Anyone considering the use of REMERON® (mirtazapine) Tablets or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24 - there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. 
Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. REMERON is not approved for use in pediatric patients.


Mirtazapine (brand names: Avanza, Axit, Mirtaz, Mirtazon, Remeron, Zispin) is a noradrenergic and specific serotonergic antidepressant (NaSSA) that was introduced by Organon International in the United States in 1996 and is used primarily in the treatment of depression. It is also commonly used as an anxiolytic, hypnotic, antiemetic and appetite stimulant. In terms of structure, mirtazapine can also be classified as a tetracyclic antidepressant (TeCA) and is the 6-aza analogue of mianserin. It is also racemic and comes as a combination of both R and S-stereoisomers.
Its patent expired in 2004 and hence generic versions are now availableREMERON® (mirtazapine) Tablets are an orally administered drug. Mirtazapine has a tetra-cyclic chemical structure and belongs to the piperazino-azepine group of compounds. It is designated 1,2,3,4,10,14b-hexahydro-2-methylpyrazino [2,1-a] pyrido [2,3-c] benzazepine and has the empirical formula of C17H19N3. Its molecular weight is 265.36. The structural formula is the following and it is the racemic mixture: http://en.wikipedia.org/wiki/Mirtazapine

REMERON® (mirtazapine) Structural Formula Illustration
Mirtazapine is a white to creamy white crystalline powder which is slightly soluble in water.
REMERON is supplied for oral administration as scored film-coated tablets containing 15 or 30 mg of mirtazapine, and unscored film-coated tablets containing 45 mg of mirtazapine. Each tablet also contains corn starch, hydroxypropyl cellulose, magnesium stearate, colloidal silicon dioxide, lactose, and other inactive ingredients.
http://www.rxlist.com/remeron-drug.htm

What are the precautions when taking mirtazapine Remeron!

Before taking this medication, tell your doctor or pharmacist if you are allergic to it, or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: history or family history of psychiatric disorders (e.g., bipolar/manic-depressive disorder), history or family history of suicide attempts, liver disease, kidney disease, seizures, high blood cholesterol or triglyceride levels, heart disease (e.g., recent heart attack, angina), stroke, severe loss of body fluids (dehydration), low blood pressure.
Systematic (IUPAC) name
(±)-2-methyl-1,2,3,4,10,14b-hexahydropyrazino[2,1-a]pyrido[2,3-c][2]benzazepine
Clinical data
Trade names Remeron, Avanza, Axit, Mirtazon, Zispin
AHFS/Drugs.com monograph
MedlinePlus a697009
Licence data US FDA:link
Pregnancy cat.
Legal status
Routes Oral
Pharmacokinetic data
Bioavailability 50%
Protein binding 85%
Metabolism Liver (CYP1A2, CYP2D6, and CYP3A4)
Half-life 20–40 hours
Excretion Urine (75%)
Faeces (15%)
Identifiers
CAS number 61337-67-5 Yes
ATC code N06AX11
PubChem CID 4205
DrugBank DB00370
ChemSpider 4060 Yes
UNII A051Q2099Q 
KEGG D00563 Yes
ChEBI CHEBI:6950 
ChEMBL CHEMBL654 Yes
Synonyms 6-Azamianserin, Org 3770
Chemical data
Formula C17H19N3 
Mol. mass 265.35 g/mol
Physical data
Density 1.22 g/cm³
Melt. point 114–116 °C (237–241 °F)
Boiling point 432 °C (810 °F)
Solubility in water Soluble in methanol and chloroform mg/mL (20 °C)

What are the possible side effects of mirtazapine Remeron!

Get emergency medical help if you have any of these signs of an allergic reaction: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

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Monday, 8 December 2014

Doctors and Drug Companies — Scrutinizing Influential Relationships — NEJM

On September 2006, 2007, Senators Charles Grassley (R-IA), the ranking member of the Committee on Finance, and Herb Kohl (D-WI), chairman of the Special Committee on Aging, introduced the Physician Payments Sunshine Act - so named because it aims to shine a much needed ray of sunlight on a situation that contributes to the exorbitant cost of health care, according to cosponsor Senator Charles Schumer (D-NY). The bill would require manufacturers of pharmaceuticals and medical devices with annual revenues of more than $100 million to disclose the amount of money they give to physicians whether in the form of a free dinner or vacation or a consulting fee. This bill is about letting the sun shine in so that the public can know, says Grassley.
  
The move
was stimulated in part by activity in Minnesota and Vermont, which have made the reporting of such relationships mandatory - Minnesota in 1993 and Vermont in 2003. Three additional states (Maine, West Virginia, and California) and the District of Columbia have now enacted similar disclosure laws, and many other states are considering doing so. Although beliefs vary widely about the overall usefulness of the data collected under state mandates, the movement toward increased transparency is gaining steam. Indeed, the nature, extent, and consequences of physicians' relationships with industry have become one of the most fiercely debated issues in health care today. At the simplest level, such a relationship exists whenever a physician accepts anything from a company whose products or services are related to the practice of medicine. And such interactions are ubiquitous: according to a recent survey, although the frequency and intensity of the ties vary according to physicians' personal and professional characteristics, virtually all physicians (94%) have some type of relationship with industry.

Most commonly, physicians report receiving food and beverages in the workplace (83%) or being given drug samples by a manufacturer's representative (78%). More than one third of physicians (35%) receive reimbursement for costs associated with professional meetings or continuing medical education, and more than one quarter (28%) receive payments for consulting, speaking, or enrolling patients.



Doctors and Drug Companies — Scrutinizing Influential Relationships — NEJM

From a policy perspective, the debate centers on the overall effect of these relationships on patient care. Although most physicians deny that receiving free lunches, subsidized trips, or other gifts from pharmaceutical companies has any effect on their practices, research has shown that physician–industry relationships do influence prescribing behavior. (Brennan TA, Rothman DJ, Blank L, et al. Health industry practices that create conflicts of interest: a policy proposal for academic medical centers. JAMA 2006;295:429-433). After all, if these relationships didn't affect physician behavior in such a way as to increase sales, companies wouldn't spend $19 billion each year establishing and maintaining them.

Read more Read. Information taken from here: Doctors and Drug Companies - Scrutinizing Influential Relationships

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