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Dec 16, 2022Liked by Nick Jikomes

This is a great take on the inside down state of the pharmaceutical industry. Add in PBM’s and insurers and we have the most profitable healthcare system in the world.

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This is a really interesting, well considered piece of writing- thank you for sharing it. I’m going to have to read it again to take it all in.

Direct to consumer advertising of prescription drugs isn’t legal in Australia, and for that I’m grateful. However, the same messages have still been coming through peer to peer interactions social media which I think is also challenging.

I think it’s so important for consumers to be informed but that needs to include maintaining a healthy level of scepticism regarding the information sources. I think this applies to all drugs- prescribed or otherwise.

Thanks again, you’ve given me something to think about.

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I’m a physician. Your hypothetical Karen is on 3 psychotropic meds. She’s lucky. I see patients every day on two antidepressants (usually an SSRI + an “atypical” like trazodone), a low dose antipsychotic (Rexulti is very “in” right now), plus a “mood stabilizer” such as tegretol, lyrica or depakote. You’ll not be surprised that a benzodiazepine (usually Ativan or Xanax) is part of the regimen. It wouldn’t be unheard of to find Adderall on the list also. If any chronic pain syndrome is on the problem list, look for tramadol, or when that stops working, an opioid such as oxy- or hydrcodone.

Now gaze upon the patients problem list. Anxiety, depression, panic attacks will invariably be there. Not uncommon to see suicidal ideation on the list. Bipolar disorder is essentially de rigueur these days. The hot new diagnosis is PTSD. Formerly confined to survivors of Nagasaki and Khe Sahn, now everyone has it. Don’t forget about gender confusion and history of sexual abuse. Chronic pain, chronic fatigue, fibromyalgia, irritable bowel, migraine, CRIPS.

The experience of being human has been thoroughly pathologized, medicated, and monetized.

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