Posts
Oh, it is on now. A New York Times piece recently questioned the very existence of fibromyalgia (http://www.nytimes.com/2008/01/14/health/14pain.html). The debate has come up because Pfizer has been off and running with “evidence” that their medication helps this designer disease. Pfizer reps, by the way, can be very touchy as they live and breathe their company. I remember seeing them at a conference, before it started, and they were gathered in groups doing some Amway like cheers to get motivated. Scary. Anyway, I recently had one of their reps, whom I have known for many years, get real testy as I started to question the facts behind the Fibro Phenomenon. Oh no, he says. It certainly does exist and he ripped off all the Pet Scan evidence he could think of. Now the Times article brings the whole issue to light because there is going to be big money for Pfizer when docs start prescribing Lyrica for fibro. The question on most physicians’ minds will always be whether fibro really exists. The article points out that the researcher and physician who wrote the 1990 paper that defined fibromyalgia has since changed his mind saying that the disease does not exist and that Lyrica and the other drugs will be taken by millions of people who do not need them. Wow. That has set off the fibro advocacy groups because they feel the drug will actually legitimize this disease. I highly recommend you read this link and tell me your thoughts. On one hand you have the fibro followers linking up with Pfizer and on the other you have doctors; many of which still aren’t fully committed to believing that fibro is nothing more than a label.
Here are some quotes from the doctors in the NY Time piece:
“The diagnosis of fibromyalgia itself worsens the condition by encouraging people to think of themselves as sick and catalog their pain. These people live under a cloud and the more they seem to be around the medical establishment, the sicker they get, “said Dr. Nortin Hadler, a rheumatologist and professor of medicine at the University of North Carolina who has written extensively about fibromyalgia.
“Some of us in those days thought that we had actually identified a disease, which this clearly is not. To make people ill, to give them an illness, was the wrong thing” , said Dr. Frederick Wolfe, the director of the National Databank for Rheumatic Diseases and the lead author of the 1990 paper that first defined the diagnostic guidelines for fibromyalgia.
Wolfe thinks the condition a physical response to stress, depression, and economic and social anxiety. I tend to agree but it doesn’t matter what I think because the commercials from Pfizer are on their way. Will it succeed in the long run? Since Lyrica causes weight gain (sometimes over 7%), I have some suspicions. The one thing that will beat the pain of fibromyalgia is the possibility of gaining weight. Patients will realize that maybe the symptoms of fibro weren’t so bad after all.
Here are some quotes from the doctors in the NY Time piece:
“The diagnosis of fibromyalgia itself worsens the condition by encouraging people to think of themselves as sick and catalog their pain. These people live under a cloud and the more they seem to be around the medical establishment, the sicker they get, “said Dr. Nortin Hadler, a rheumatologist and professor of medicine at the University of North Carolina who has written extensively about fibromyalgia.
“Some of us in those days thought that we had actually identified a disease, which this clearly is not. To make people ill, to give them an illness, was the wrong thing” , said Dr. Frederick Wolfe, the director of the National Databank for Rheumatic Diseases and the lead author of the 1990 paper that first defined the diagnostic guidelines for fibromyalgia.
Wolfe thinks the condition a physical response to stress, depression, and economic and social anxiety. I tend to agree but it doesn’t matter what I think because the commercials from Pfizer are on their way. Will it succeed in the long run? Since Lyrica causes weight gain (sometimes over 7%), I have some suspicions. The one thing that will beat the pain of fibromyalgia is the possibility of gaining weight. Patients will realize that maybe the symptoms of fibro weren’t so bad after all.
9 comments:
If you don't have fibromyalgia and don't know someone who has suffered with it, keep your opinions to yourself. As someone who suffered for many years with sleep deprivation and resultant tension headaches - that 4,000 mg of ibuprofen didn't touch - I tell you it's real! I now have medication that has given me my life back - and it's not Lyrica. Different medications work for different people.
This is hilarious...I have long since become numb to the listing of "Fibromyalgia" in the medical hsitory when a patient comes to my ER. Either they have an undiagnosed condition (!), or they want a rationale for their chronic pain or other perceived symptoms. Physicians can question the mechanism by which FM patients receive external validation for their symptoms, provoking howls of anger; or we can continue to enable by buying into a widely, eagerly embraced "diagnosis."
I started on Lyrica and noticed 2 lbs of weight gain but I really blame that on holiday eggnog. I can say that I was able to decrease my Effexor XR dosage by half (150 mg to 75 mg) since being on 75 mg of Lyrica. It's helped my fibro pain by 4 points on a 10 point pain scale, and I actually feel like staying awake after working out, instead of crashing from the fatigue and increased pain from actually being mobile for freaking once. Woo!
Whether fibro is actually a disease, a syndrome, or something that makes drug companies rich(er), I can say it's helped this patient more than the other drugs I've tried (Elavil, Flexeril), and it seems to help me most by enabling better sleep without the zombification the next day.
Counting down till it comes out in generic form.... heh, I crack myself up. :-\
pat--please see what the first anonymous poster said.
I do not have fibromyalgia, but have practicing physician and nurse prac friends who do, as well as patients. It is very real, as is chronic pain (which I do not have either) and it is the callous, uncaring attitude of people like you who give medicine a bad name. I know perfectly well there are malingerers and drug seekers out there, but unless you have experienced these conditions or watched a friend or family member suffer, you should not pass judgment. Try a little compassion--it will make you a better physician. Or whatever sort of healthcare provider you purport to be. Primum no nocere.
And Doug, I am not renewing my subscription to the placebo journal because I have been increasingly offended by your attitudes towards patients who do not have "dipstick diseases."
I was the second anonymous poster on this.... still haven't gained weight, still feeling WAY better than I did before Lyrica.
Holy shit. :(
I didn't know fibro had such a bad name among the medical society!
I feel for people with fibromyalgia since I have a somewhat-related disease called Cushing's. I have all of the tests & scans that confirm my diagnosis, so I don't get called out with nasty statements such as: by encouraging people to think of themselves as sick and catalog their pain. These people live under a cloud and the more they seem to be around the medical establishment, the sicker they get.
That is some harsh stuff. Uh, maybe they just get... oh, let's reach for this... actually get SICKER and it has nothing to do with a catalog of any sort, Sears et al included.
Hmmmn, that mindset reminds me of the 40 doctors I saw before my pathology-confirmed diagnosis. I was just 'making it all up', I'm sure. You know, nothing better left to do in my life by play sickie while that tumor was growing up against my ICA.
1 in 5 people have pituitary tumors.
Taking away hope from people with a true disease, may it be fibro or any another invisible and rarely diagnosed item? Disturbing.
Of course fibromayalgia exists...as a somatic manifestation of depression.
As such, it should be treated with SSRI's - when appropriate. The average middle aged, middle manager who complains of fatigue and aches? That's not fibromyalgia, that's me! As an individual entity fibromyalgia is complete BS. Most people labeled with it are just getting a little older, a little achier and a little more tired. For the severe cases, generic fluoxetine will work as well, or better, than brand Lyrica at a cheaper price.
Of course, it's so much easier to get paid for a visit if you have a diagnosis. Fibromyalgia, Irritable bowel, Chronic fatigue. Thank god for yuppie medicine!
Just dropping back by to read comments... I eventually had to quit the Lyrica because I couldn't get the Effexor XR to balance with it (way too sleepy, way too PMDD hormonal). Now I'm back on the Effexor XR and whatever depression I may have is effectively treated. I still have fibro and chronic fatigue symptoms though... wonder how that somatization really works.
I meant to include in that last post (whoops, fibrofog) that I'm 34 and coordinate disaster preparedness for a large non-profit organization. I was also diagnosed with breast cancer at age 30, thanks to feeling a lump on a routine monthly self-exam, so I'm thankful to have a team of physicians who care about what I'm feeling in my own body.
Post a Comment