| T O P I C R E V I E W |
| ralphyde |
Posted - 01/15/2008 : 11:14:46
A New York Times article on January 14, discusses the controversy over whether Fibromyalgia is a real disease, and the drug companies' hope of making huge profits treating it.
http://www.nytimes.com/2008/01/14/health/14pain.html?ref=health
Some quotes from the article:
"But other doctors — including the one who wrote the 1990 paper that defined fibromyalgia but who has since changed his mind — say 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.
"As diagnosed, fibromyalgia primarily affects middle-aged women and is characterized by chronic, widespread pain of unknown origin. Many of its sufferers are afflicted by other similarly nebulous conditions, like irritable bowel syndrome.
"Because fibromyalgia patients typically do not respond to conventional painkillers like aspirin, drug makers are focusing on medicines like Lyrica that affect the brain and the perception of pain.
"Advocacy groups and doctors who treat fibromyalgia estimate that 2 to 4 percent of adult Americans, as many as 10 million people, suffer from the disorder.
"Those figures are sharply disputed by those doctors who do not consider fibromyalgia a medically recognizable illness and who say that diagnosing the condition actually worsens suffering by causing patients to obsess over aches that other people simply tolerate. Further, they warn that Lyrica’s side effects, which include severe weight gain, dizziness and edema, are very real, even if fibromyalgia is not."
...
"The diagnosis of fibromyalgia itself worsens the condition by encouraging people to think of themselves as sick and catalog their pain, said Dr. Nortin Hadler, a rheumatologist and professor of medicine at the University of North Carolina who has written extensively about fibromyalgia.
“These people live under a cloud,” he said. “And the more they seem to be around the medical establishment, the sicker they get.”
"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, says he has become cynical and discouraged about the diagnosis. He now considers the condition a physical response to stress, depression, and economic and social anxiety.
“Some of us in those days thought that we had actually identified a disease, which this clearly is not,” Dr. Wolfe said. “To make people ill, to give them an illness, was the wrong thing.”
...
"The F.D.A. reviewers who initially examined Pfizer’s application for Lyrica in 2004 for diabetic nerve pain found those results unimpressive, especially in comparison to Lyrica’s side effects. The reviewers recommended against approving the drug, citing its side effects.
"In many patients, Lyrica causes weight gain and edema, or swelling, as well as dizziness and sleepiness. In 12-week trials, 9 percent of patients saw their weight rise more than 7 percent, and the weight gain appeared to continue over time. The potential for weight gain is a special concern because many fibromyalgia patients are already overweight: the average fibromyalgia patient in the 2007 survey reported weighing 180 pounds and standing 5 feet 4 inches.
"But senior F.D.A. officials overruled the initial reviewers, noting that severe pain can be incapacitating. “While pregabalin does present a number of concerns related to its potential for toxicity, the overall risk-to-benefit ratio supports the approval of this product,” Dr. Bob Rappaport, the director of the F.D.A. division reviewing the drug, wrote in June 2004."
...
"But physicians who are opposed to the fibromyalgia diagnosis say the new drugs will probably do little for patients. Over time, fibromyalgia patients tend to cycle among many different painkillers, sleep medicines and antidepressants, using each for a while until its benefit fades, Dr. Wolfe said.
"“The fundamental problem is that the improvement that you see, which is not really great in clinical trials, is not maintained,” Dr. Wolfe said.
"Still, Dr. Wolfe expects the drugs will be widely used. The companies, he said, are “going to make a fortune.” "
Best,
Ralph
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| 5 L A T E S T R E P L I E S (Newest First) |
| art |
Posted - 01/18/2008 : 17:59:16
JUst to clarify, I actually do think it's probably not a disease in the usual sense of the word. On the other hand, I don't fully accept Sarno's model either with these complex and often devastating syndromes like fibro and chronic fatigue. There's probably some very complicated body/mind interplay at work that exists outside the simple TMS realm.
What really bothers me however is how readily the medical establishment dismisses the very real suffering involved. As someone who's suffered with a chronic illness of uncertain origin, I know what that's like...It's no fun, that's for sure...(to put it mildly) |
| lidge |
Posted - 01/18/2008 : 13:18:06
I agree with Art here. The article reeks of arrogance.
Just because a disease was not recognized years ago does not mean it did not exist. I don't think autism was recognized till recent years, and even when it was, the traditional thinking by the medical/psychiatric establishment was that it was poor mothering that caused it. Years ago these children would have just been labeled as mentally retarded, etc. Recent advances in genetic testing has revealed a genetic marker for it.
While I agree with Sarno that the pervasiveness of the fibro diagnosis can lead to it being overdiagnosed, the fact that it was not recognized till recent years has no bearing on its validity as a real disease/syndrome.
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| art |
Posted - 01/17/2008 : 16:34:44
While I agree with Sarno's position, that original article really bothered me, dripping as it was with typical MD arrogance, saying things like, well, most people can deal with life's little aches and pains, but these folks cannot...The clear subtext was that not only does this disease possibly not exist (a position I think is probably accurate), those who complain of it do not have genuinely severe pain...
Clearly, that's not the case. My heart goes out to anyone suffering from this and other chronic illnesses that rightly or wrongly get no respect... |
| qso |
Posted - 01/17/2008 : 15:54:46
As I have mentioned before the man is decades ahead of his time. His time will come. I think he knows that and may find solice in that fact. Unfortunately that's the way huge leaps in science are made. The pioneers are ignored by the sheep until there is an avalanche and the sheep go running, baa baa. |
| amissive |
Posted - 01/17/2008 : 15:23:40
I spoke with Dr. Sarno at the beginning of the week and he mentioned this article. He said something to the effect of it showing how something like this being misdiagnosed can spread the symptoms to people that otherwise would have never known it existed. He also mentioned that the medical condition Fibromyalgia has only been around since the late 80’s early 90’s, adding that it only solidifies what he has been saying for years.
He seemed excited about the article, but I can only imagine he must me somewhat disappointed that he is not mentioned when something like this is written.
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