Pharmaceutical industry, antidepressants

The medical success of these drugs gave new emphasis to the pharmaceutical industry, which was boosted further by the commencement of industrial-scale penicillin manufacture in the early 1940s. Around this time, many of the current leading pharmaceutical companies (or their forerunners) were founded. Examples include Ciba Geigy, Eli Lilly, Wellcome, Glaxo and Roche. Over the next two to three decades, these companies developed drugs such as tetracyclines, corticosteroids, oral contraceptives, antidepressants and many more. Most of these pharmaceutical substances are manufactured by direct chemical synthesis. 

Healy, David. Let Them Eat Prozac The Unhealthy Relationship between the Pharmaceutical Industry and Depression. New York New York University Press, 2004. The psychiatrist author prescribed Prozac when it first came out but found that many patients who took it became agitated and a few attempted suicide. His book reviews the history of Prozac and similar antidepressants, describes the controversies over the drugs, and ultimately criticizes the pharmaceutical industry for overstating the benefits and minimizing—or hiding—the risks. 

Hoping to avoid such side effects as the sleep disruption and the occasional cardiac complications of the tricyclic antidepressants, and following the principle that clean drugs are theoretically preferable to dirty ones, the pharmaceutical industry has developed the selective serotonin reuptake blockers, a third generation of chemical agents to relieve depression. 

It is interesting to note that despite the very widespread use and the generally accepted efficacy of antidepressants in pain therapy, at present not all antidepressant drugs are formally approved for the treatment of pain. Thus, the widespread use of these drugs is, to some extent, off-label, and there does not seem to be much effort in the pharmaceutical industry to market antidepressants explicitley as analgesic drugs. 

Along with this emphasis on particular disorders, recent pharmaceutical industry literature for conditions like depression and psychosis refers increasingly commonly to imbalances in brain chemicals, echoing the statements of official psychiatric literature described in Chapter 1. On depression, Eli Lilly s website claims that a growing amount of evidence supports the view that people with depression have an imbalance of the brain s neurotransmitters. .. many scientists believe that an imbalance in serotonin may be an important factor in the development and severity of depression (Eli Lilly 2006a, accessed 10.02.2006). Wyeth, makers of the antidepressant Venlafaxine (brand name Effexor... 

Phospholipidosis, a phospholipid storage disorder, is characterized by an excessive accumulation of intracellular phospholipids. Compounds that induce phospholipidosis include a wide variety of pharmacological agents (antipsy-chotics, antidepressants, antiarrhythmics, and cholesterol-lowering agents). These compounds are of concern for the pharmaceutical industry because a candidate pharmaceutical agent can be rejected because of evidence of inducing phospholipidosis in a preclinical animal study. Phospholipidosis is widely reported in rats and is identified by the accumulation of phospholipids in the lysosomes of many cell types. 

Proponents of conspiracy theories often claim that many dmgs can only be sold because of the political clout of the pharmaceutical industry (often called Big Pharma). This story usually goes on to say that most of these drags have more risks than benefits, and some of them even lack positive, medicinal effects. Antidepressants are the most frequent taigets of these attacks, and skeptics say that they not only lack arty beneficial effects, but also make patients suicidal. 

Because many have suggested that the beneficial effect of antidepressants is based on their ability to block the uptake of NE and 5-HT, pharmaceutical companies screen potential antidepressants for their ability to block neurotransmitter uptake. Partially as a result of this paradigm (i.e., reuptake blockade), the industry has developed agents that can specifically block NE uptake, 5-HT uptake, or both. More recently, drugs that also affect specific receptors or receptor subtypes have been... 

The use of herbs has also been fueled by the increased awareness of clinical depression and its treatment as a result of the marketing efforts of major pharmaceutical companies. That effort has transformed prescription antidepressants into one of the largest dollar sales category in pharmaceuticals such that the sales for a block buster antidepressant can be more than 2 billion dollars per year. Not surprisingly, then, herbal remedies or phytomedicine has also become a multibillion dollar industry in the United States with an estimated one in ten Americans having used herbal agents within the past year, with or without their physician s knowledge. 

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