Disconnect Between Ads and Scientific Literature

In the Old West the wagon selling Snake Oil as a cure for everything went from town to town, then got out before people realized it was a swindle.

Today the big drug companies are much more sophisticated. But as Abraham Lincoln once said, "You can fool some of the people all of the time, and all of the people some of the time, but you can't fool all of the people all of the time." And some of the people are catching on.

"Serotonin and Disconnect between the Advertisements and the Scientific Lieterature" is the name of a new essay by Jeffrey R. Lacasse and Jonathan Leo.

Their attack on the drug industry is brutal: "In the United States, selective serotonin reuptake inhibitor (SSRI) antidepressants are advertised directly to consumers. These highly successful direct-to-consumer advertising campaigns have largely revolved around the claim that SSRIs correct a chemical imbalance caused by a lack of serotonin. For instance, sertraline (Zoloft) was the sixth best-selling medication in the US in 2004, with over $3 billion in sales likely due, at least in part, to the widely disseminated advertising campaign starring Zoloft's miserably depressed ovoid creature. Research has demonstrated that class-wide SSRI advertising has expanded the size of the antidepressant market, and SSRIs are now among the best-selling drugs in medical practice," the report says, pointing up the fact that the antidepressant market is largely created, not preexisting.

The essay goes on to say that given the multifactorial nature of depression and anxiety, and the ambiguities inherent in psychiatric diagnosis and treatment, some have questioned whether the mass provision of SSRIs is the result of an over-medicalized society. These sentiments were voiced by Lord Warner, United Kingdom Health Minister, at a recent hearing: “…I have some concerns that sometimes we do, as a society, wish to put labels on things which are just part and parcel of the human condition."

Subsequently, British regulators have forbidden the use of SSRIs on patients under 18 years of age.

The essay says that sentiments such as Lord Warner's, about over-medicalization, are exactly what some pharmaceutical companies have sought to overcome with their advertising campaigns. For example, Pfizer's television advertisement for the antidepressant sertraline (Zoloft) stated that depression is a serious medical condition that may be due to a chemical imbalance, and that “Zoloft works to correct this imbalance”. Other SSRI advertising campaigns have also claimed that depression is linked with an imbalance of serotonin, and that SSRIs can correct this imbalance.

The shocking truth is that no one has ever discovered a way to measure such an imbalance or even to prove that it exists. It has never been anything more than a theory. And that's not because they haven't tried to prove it exists. There have been dozens of experiments and tests. Even the attempt to induce depression by artificially reducing the amount of serotonin didn't produce any significant results, and huge increases in serotonin were ineffective at relieving depression. Despite this, the industry still sells their snake oil on the basis that it "controls" the serotonin levels in the brain, thereby inducing sanity.

In short, there exists no rigorous corroboration of the serotonin theory, and a significant body of contradictory evidence. Far from being a radical line of thought, doubts about the serotonin hypothesis are well acknowledged by many researchers, including frank statements from prominent psychiatrists, according to the essay.

Consumer advertising for SSRI drugs started in 1998. Since then the specious theory of "chemical imbalance in the brain" as a source of mental illness has been widely promulgated, with cute bouncing animated figures and convincing scenarios with people suffering from symptoms said to be curable with SSRIs. But this very advertising may be the thing that backfires for Big Pharma. Eventually people see through the lies. Abe Lincoln had it right; sooner or later people are going to want to run snake oil salesman out of town on a rail.