Biology

Why Do Drug Commercials List All Those Crazy Side Effects?

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All of us have seen those commercials. They begin with a peaceful, happy scene as a soothing voice tells us about a new pharmaceutical breakthrough. This medication will do wonders to make things so much better than the bowels-of-hell existence to which you are currently cursed.

Just as you start to think this medication might be the answer to your problems, that same soothing voice continues, without skipping a beat, to tell you some truly horrifying side effects that come with that medication. The initial side-effects are troubling, but probably something you’d be willing to risk if you can experience the previously-touted benefits. As the list of potential bad-nastiness continues, however, your attitude changes to alarm. The same soothing voice that lured you into believing you need that drug continues, not pausing for so much as a breath, describing such a horrible laundry list of side-effects that you wonder why anyone would ever consider being in the same room with that medication.

Consider the 2011 commercial for Lunesta, a prescription-strength medication for insomniacs.

The 60-second commercial begins with a nighttime view of the exterior of a two-story house. Depending on your point of view, what happens next is the sight of a calming ethereal butterfly entering through the window and settling upon those who are struggling to fall asleep, gently sending them into the comforting realm of Morpheus.

Alternatively, you may still be suffering the emotional consequences of a misspent childhood and interpret the scene as a terrifying disembodied demonic spirit invading the sanctity of the home and entering, uninvited, to possess its unsuspecting occupants, making their every waking and sleeping moments a living nightmare.

In support of the latter view of this commercial, consider the words of the calm, soothing voice as these events take place:

“If your racing thoughts keep you awake, sleep is here on the wings of Lunesta. And if you wake up often in the middle of the night, rest is here on the wings of Lunesta. Lunesta helps you fall asleep and stay asleep so you can wake up feeling rested.”

No harm in that, right? Hold on. That just gets us 20 seconds through this 60-second commercial. The remaining two-thirds is spent regaling us with the decidedly-dark consequences of ingesting this medication:

“When taking Lunesta, don’t drive or operate machinery until you feel fully awake. Walking, eating, driving, or engaging in other activities while asleep have been reported. Abnormal behaviors may include; aggressiveness, agitation, hallucinations, or confusion. In depressed patients, worsening of depression, including risk of suicide, may occur. Alcohol may increase these risks. Allergic reactions such as tongue or throat swelling occur rarely and may be fatal. Side effects include unpleasant taste, headache, dizziness, and morning drowsiness. Ask your doctor if Lunesta is right for you… Sleep well on the wings of Lunesta.”

Seriously, who could possibly sleep soundly, knowing that one little pill could turn you into a depressed, suicidal, hallucinating zombie with a swollen tongue and an unpleasant taste in your mouth? Oh, on top of that, when you wake up in the morning, you’re going to be drowsy. Are you really going to ask your doctor if Lunesta is right for you?

“Sleep well on the wings of Lunesta.” Right. Wait here while we finish boarding up our bedroom windows to keep that little demon butterfly outside.

Why do drug companies make commercials like this, and why do they have such a long and seemingly-ridiculous list of side effects? And why are the commercials aimed at the general public? It isn’t as if you can go into a store and purchase the drugs; they have to be prescribed by a physician. Shouldn’t the doctor know what is best for the patient?

You will find these commercials only in the United States and New Zealand. These are the only countries that allow pharmaceutical companies to market prescription drugs directly to consumers. The regulations that permit the commercials also specify certain requirements about what the commercials can and can’t say.

Most prescription medications have multiple potential uses, but only one or two have been approved by the Food and Drug Administration (FDA). Prazosin, for example, is a medication that has FDA approval for the treatment of high blood pressure. It has also been found to be useful in treating people who suffer nightmares from post-traumatic stress disorder (PTSD). The PTSD treatment is called “off-label” because it has not received FDA approval.

The FDA allows advertisements for approved use only — the treatment of high blood pressure. Although doctors may prescribe Prazosin for PTSD patients, that aspect of the medication is off-label and may not be advertised.

The FDA also requires drug commercials to warn potential users of all potential risks associated with the use of the medication. While the first part of the commercial may promote the benefits of the FDA-approved use of the medication, the latter part has to identify all of the potential side-effects of use, including those who might be taking it for off-label use.

The laws regulating drug advertisements date to the 1990s. Critics point out several things about the regulations that leave much to be desired.

For one thing, the absurd laundry list of side-effects puts the public on overload, to the point where the warnings are ignored. Additionally, there is no requirement of weighing the benefits against the risks. If, for example, an insomnia medication was proven to put people to sleep, but only for 10 minutes, and that morning drowsiness was experienced by 80% of those who used the medication, that could make a difference in whether you would be willing to accept the associated risks. Since the probability of side effects isn’t mentioned, the unending list of incredible side effects becomes incomprehensible and tends to be disregarded.

Neither is there any requirement of advertising the cost of the medication, whether there is a cheaper or generic alternative, or whether a change in lifestyle (exercise and better eating habits) could bring comparable or better results.

The result of all of this is an industry geared around providing consumers with just enough information to get them excited and to demand treatment from their physicians. In this age of Dr. Google, patients are increasingly likely to go to a doctor only to get confirmation of what they have already diagnosed on their own.

Until this issue is addressed, we offer our tried-and-true cure for insomnia. If you are having difficulty sleeping, turn on C-SPAN and listen to whatever politician is speaking at that moment. We guarantee you will be asleep in no time.

WARNING: Listening extensively to politicians is not for everyone. In some cases, prolonged exposure to political discourse has resulted in diminished IQ, impairment of social skills, poor hygiene, philosophical near-sightedness, and an inexplicable urge to push everyone out of the way as you run to the nearest camera.


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