Fibromyalgia Doctors Chose Pfizer Over You

[Skyler]

Fibro Doctors Chose Pfizer Over You

by Kristin Thorson, Editor, Fibromyalgia Network

Posted: May 30, 2012

Editorial

 

Do you like Lyrica, Cymbalta or Savella? Have any of these meds cured you? Or has cognitive behavioral therapy been the answer for your fibromyalgia symptoms? According to the FibroCollaborative, a program funded by Pfizer and made up of 25 physicians, these would be your only options.1 This is what they promote as the roadmap to success, but actually, it is the roadmap to doom for all fibromyalgia patients.

 

You may have initially viewed the FDA-approval of Lyrica as a milestone, but chances are you did not know what was brewing behind the scenes. Soon after the FDA-approval of the three drugs, new criteria for fibromyalgia appeared in print in early 2010.2,3,4 They don’t require a doctor to examine or talk to you; identifying your illness has been reduced to filling out a 2-page form. The criteria were disguised as an easier way for primary care providers to diagnose fibromyalgia, but more than likely, it expands the diagnosis to anyone who has muscle pain and trouble sleeping.

 

This new way to sell more drugs (even though each one only works in one out of 8 to 15 patients) can be credited with one of the big chiefs of the FibroCollaborative, Daniel J. Clauw, M.D., of the University of Michigan in Ann Arbor.5 Clauw is the author of many research papers, but lately, the majority have just been about pushing certain drugs. He and his Pfizer-affiliated colleagues want all primary care doctors to know there are three drugs for treating fibro: Lyrica, Cymbalta, and Savella. Although many medicines are available to treat you, few others are mentioned." Read more.

[Altostrata]

And that's how you get diagnosis creep for fibromyalgia -- and the sale of a lot of brand-name drugs to treat it.

 

Note where Lyrica, Cymbalta, and Savella are among these polls of patients:

 

- Cymbalta dead last among 85 treatments for fibromyalgia. Savella and Lyrica slightly better, but still at the bottom. http://curetogether.com/blog/2011/08/10/patients-say-fibromyalgia-drugs-make-things-worse-rest-is-best/

 

- Cymbalta dead last among 35 treatments for neuropathy. Lyrica better, but still subpar. http://curetogether.com/blog/2011/08/16/neuropathy-study-results-800-people-rate-35-treatments/

 

- Cymbalta (and Wellbutrin) very mediocre among 83 treatments for depression (Effexor and Paxil barely effective) http://curetogether.com/blog/2011/05/03/23-surprisingly-effective-treatments-for-depression-one-year-later/ -- exercise, pets, art therapy, talk therapy rate much higher.

[Skyler]

And that's how you get diagnosis creep for fibromyalgia -- and the sale of a lot of brand-name drugs to treat it.

 

Note where Lyrica, Cymbalta, and Savella are among these polls of patients:

 

- Cymbalta dead last among 85 treatments for fibromyalgia. Savella and Lyrica slightly better, but still at the bottom. http://curetogether.com/blog/2011/08/10/patients-say-fibromyalgia-drugs-make-things-worse-rest-is-best/

 

- Cymbalta dead last among 35 treatments for neuropathy. Lyrica better, but still subpar. http://curetogether.com/blog/2011/08/16/neuropathy-study-results-800-people-rate-35-treatments/

 

- Cymbalta (and Wellbutrin) very mediocre among 83 treatments for depression (Effexor and Paxil barely effective) http://curetogether.com/blog/2011/05/03/23-surprisingly-effective-treatments-for-depression-one-year-later/ -- exercise, pets, art therapy, talk therapy rate much higher.

 

Yup, I have to read these more carefully when there is more time, but Big Pharma is behind a good bit of this, no question. I was surprised Lyrica worked as I did not expect it would. It is very effective dealing neuropathic pain that comes for me only during a flare, after the trigger points become highly sensitized, but does not help with the actual trigger point pain. I'm thinking this is the reason so many give poor ratings for Lyrica.. at least that was my take when last reading the material you reference above.

[btdt]

Fibro Doctors Chose Pfizer Over You

by Kristin Thorson, Editor, Fibromyalgia Network

Posted: May 30, 2012

Editorial

 

Do you like Lyrica, Cymbalta or Savella? Have any of these meds cured you? Or has cognitive behavioral therapy been the answer for your fibromyalgia symptoms? According to the FibroCollaborative, a program funded by Pfizer and made up of 25 physicians, these would be your only options.1 This is what they promote as the roadmap to success, but actually, it is the roadmap to doom for all fibromyalgia patients.

 

You may have initially viewed the FDA-approval of Lyrica as a milestone, but chances are you did not know what was brewing behind the scenes. Soon after the FDA-approval of the three drugs, new criteria for fibromyalgia appeared in print in early 2010.2,3,4 They don’t require a doctor to examine or talk to you; identifying your illness has been reduced to filling out a 2-page form. The criteria were disguised as an easier way for primary care providers to diagnose fibromyalgia, but more than likely, it expands the diagnosis to anyone who has muscle pain and trouble sleeping.

 

This new way to sell more drugs (even though each one only works in one out of 8 to 15 patients) can be credited with one of the big chiefs of the FibroCollaborative, Daniel J. Clauw, M.D., of the University of Michigan in Ann Arbor.5 Clauw is the author of many research papers, but lately, the majority have just been about pushing certain drugs. He and his Pfizer-affiliated colleagues want all primary care doctors to know there are three drugs for treating fibro: Lyrica, Cymbalta, and Savella. Although many medicines are available to treat you, few others are mentioned." Read more.

Lyrica was useless for me made me more stupid cymbalta I could not tolerate at all and I am not trying savella never heard of it but done trying ... I would like to read the rest do you have a copy of the link the one posted did not work for me. 

Thanks B

[westcoast]

I come to the site to post this...in the same vein. I was gobsmacked as they say in the old country. 

The title links to the page. 

 

Using Antidepressant Medications to Treat Your Pain

The single most useful medication in treating pain problems is the group of antidepressant medications called "

tricyclic antidepressants.

" Yet sometimes these medications can be difficult to use, especially when you first start them. Patients may say they don't understand how they work, what they're supposed to do, or how to take them. So here's information on tricyclic antidepressants, how to use them, and why they're so important in treating pain symptoms.

I'm not depressed. Why do you want me to take a medicine for something I don't have?
Tricyclic antidepressants are far and away the best medication for treating chronic pain, whether or not you're depressed. The dose required for treating pain is about 50-75 mg per day, about half what you need to treat depression.

I'm not crazy! Don't give me psychiatric medications!
Medical practice is full of drugs which were originally developed for one reason, but which turn out to be useful for all kinds of other problems. Aspirin started out just to treat pain, but it has many other uses, like helping to prevent strokes and heart attacks. Tricyclic antidepressants are proven in laboratory experiments to treat and prevent real physical pain. And they're among the more useful agents for those having trouble sleeping or severe fatigue.

What are tricyclic antidepressants?
This group of medications was first introduced to medical practice in about 1960. They are generally extremely safe. But they don't work like many drugs you've used in the past. Once you get used to them, however, you may discover that they are the best treatment yet.

Here are the five medications commonly used, listed by trade name and then generic name, in order by most sedating first and most stimulating last:

• Sinequan (doxepin)
• Elavil (amitriptyline)
• Tofranil (imipramine)
• Pamelor (nortriptyline)
• Norpramin (desipramine)

I don't want to become dependent on any drugs. Shouldn't I worry about taking antidepressants?
Tricyclic antidepressants are not addicting in the slightest. You couldn't become addicted to them if you wanted to. They are not dope or speed. They are not happy pills. They don't make you high or low, happy or sad. The aim of using them is so that you'll feel normal. That's it.

In fact, the way that you know that these medications are working properly is that every time you take a pill or capsule, you ask yourself, "I feel great! Why do I have to take this stuff?"

With addicting drugs like Valium or Vicodin, it can be murder to get people to stoptaking them. But with the tricyclic antidepressants, it can be hard to get them to startthem.

What's so hard about starting tricyclic antidepressants?
With some drugs, you get the best results the first time you take them. The longer you're on them, the less well they work, and the more side effects you have.

Tricyclic antidepressants are completely the opposite—when you first start taking them, you get side effects and little benefit. As you continue on them the side effects go away and the benefit increases. The longer you take them, the better they work.

Once you understand how they work, taking tricyclic antidepressants is not difficult. You start at a low dose, wait until side effects go away, and then gradually increase the dose until the benefits kick in. It may take a few weeks before you notice the maximum improvement.

What kind of side effects are we talking about?
Mostly people notice dry mouth and constipation. Also, some of these medications cause drowsiness, which is why they are useful to help you sleep. Some of them cause certain people to be more awake or alert or to have difficulty sleeping. Occasionally, patients notice slightly increased heart rate or sweating. Rarely, for the first few days people feel slightly tired and achy, like the day before you come down with a cold. None of these side effects is serious; they are merely pesky or possibly annoying.

Each drug in this family is different. As a rule, doxepin and amitriptyline are more apt to make you groggy. Nortriptyline and imipramine may make you sleepy for eight to ten hours, then give you more energy thereafter. Desipramine tends to be stimulating and may at first make some people feel anxious.

Each person is completely different in the type and severity of the side effects they experience, particularly whether they wake you up or make you sleepy or both. Often, these medications make you sleepy for a few hours and then give you more energy. So if you take them in the evening, you'll sleep better and be more refreshed in the morning.

Quite a few of our patients have been on so many medications that they develop severe side effects to sugar pills (placebos)! So if you get a headache, an upset stomach, more depression, or more stress, these side effects are not caused by tricyclic antidepressants.

Are there any serious side effects?
Certain people with serious heart rhythm problems should not take tricyclic antidepressants, since they may make the heartbeat even more irregular. (Unless you have heart disease, your risk of heart rhythm problems is extremely low.) Occasionally, elderly men with existing prostate disease may find tricyclic antidepressants make it even more difficult or impossible to empty their bladders. If you have glaucoma or epilepsy, talk with your doctor before taking tricyclics.

Like any drug, you should keep these medications out of the reach of small children.

Will tricyclic antidepressants injure my kidneys or liver or heart or brain?

No (except for the very rare idiosyncratic reaction you can get with virtually any medication, approximately 1 patient in 100,000).

What benefits can I expect from their use?
Many people experience one or more of the following:

• Less pain—on occasion, the pain completely goes away.
• Improved sleep.
• More energy.
• Improved memory and concentration.
• Fewer problems with jaw joint pain or irritable bowel syndrome.
• Improved moods. If present, your depression just seems to clear up.
• Less irritable. It takes a lot more stress before you become upset, cranky or overwhelmed.

How long do I need to take it?
Most people can take tricyclic antidepressants safely as long as they need them. Often, people do best if they use the initial period of pain relief to exercise and stretch and regain their ability to cope. Just becoming physically fit and flexible can relieve many people's pain for good. Then sometimes you can reduce the dose of medication or perhaps stop it entirely.

Unfortunately, many people decide to stop this medication as soon as they feel better, and then their symptoms return with a vengeance.

How do I use this medication?
We'll discuss the specifics during our appointment. Here are some general principles:

• This medication doesn't work if you take it only when needed, when you feel the pain. You need to take it on a regular basis every day.
• Remember, the only way you'll get any help from tricyclic antidepressants is if you give it a chance to work! The most common reason for failure of this medication to help is not taking a sufficient dose for long enough, or stopping as soon as you feel better.
• Start with a low dose, wait until any possible side effects go away, increase the dose, wait, and so forth, slowly increasing the amount you take until you get the benefits you want.
• Whatever you do, don't stop this without talking with me, unless a single dose produces overwhelming side effects. For example, sometimes people take one pill and feel nothing. They increase to two pills, and still not much. But taking three pills causes side effects and so they quit and say the medicine doesn't work. Wrong—you should cut back to the dose you could tolerate, two pills a day, until your body adapts.
• The most important principle is everybody responds differently to this medication. We'll work together to help you modify the dose to get the best results. You may have to take the medicine all at once in the evening, all at once in the morning, or spread out through the day. Change the time of day you take it to minimize side effects.
• Once patients figure out how this medication works for them, we find they are great at deciding for themselves how much they need and what time of day they should take it.
• Sometimes patients do very well on a low dose for weeks or months, and then it seems like it just stops working. This generally means your body has become used to the amount you were taking, and you need to increase the dose slightly.

Here's additional information on tricyclic antidepressants. Two alternatives may have fewer side effects: Wellbutrin and Effexor. In an upcoming discussion, I'll describe a promising new pain-relieving antidepressant medication, Cymbalta. Note that for most patients, SRI-type antidepressants do not help pain, though sometimes I'll add an SRI when a patient is still depressed despite taking an adequate dose of a tricyclic-type drug.

 

Last updated Fri, Jun 19, 2015

Send feedback, comments, or discussion about this page.

 

 

[westcoast]

B, is this it? The read more link doesn't work--the original site isn't there. I googled a long phrase in "double quotes" and found so people had posted what seems to be the whole thing.

 

Do you like Lyrica, Cymbalta or Savella? Have any of these meds cured you? Or has cognitive behavioral therapy been the answer for your fibromyalgia symptoms? According to the FibroCollaborative, a program funded by Pfizer and made up of 25 physicians, these would be your only options.1 This is what they promote as the roadmap to success, but ia trazodone good for cramps actually, it is the roadmap to doom for all fibromyalgia patients.

 

You may have initially viewed the FDA-approval of Lyrica as a milestone, but chances are you did not know what was brewing behind the scenes. Soon after the FDA-approval of the three drugs, new criteria for fibromyalgia appeared in print in early 2010.2,3,4 They don’t require a doctor to examine or talk to you; identifying your illness has been reduced to filling out a 2-page form. The criteria were disguised as an easier way for primary care providers to diagnose fibromyalgia, but more than likely, it expands the diagnosis to anyone who has muscle pain and trouble sleeping.

 

This new way to sell more drugs (even though each one only works in one out of 8 to 15 patients) can be credited with one of the big chiefs of the FibroCollaborative, Daniel J. Clauw, M.D., cramps of the University of Michigan in Ann Arbor.5 Clauw is the author of many research papers, but lately, the majority have just been about pushing certain drugs. He and his Pfizer-affiliated colleagues want all primary care doctors to know there are three drugs for treating fibro: Lyrica, Cymbalta, and Savella. Although many medicines are available to treat you, few others are mentioned.

 

While everyone thinks of researchers as working on the patient’s behalf, when it comes to the 25 members working on Pfizer’s behalf, it is hard to believe that your interests will trump profits. But don’t think this money-making plan was solely cooked up by Clauw. He shares the podium with:

Lesley M. Arnold, M.D., of the University of Cincinnati,
Bill H. McCarberg, M.D., of Kaiser Permanente,
L. Jean Dunegan M.D., JD, of Brighton, MI,
and Dennis C. Turk, Ph.D., of the University of Washington.

What’s more, there are another 20 members who dance to Pfizer’s tune that deserve acknowledgment as well:

Kenneth Barrow, PA–C, MHS – Wilmington, NC
Lucinda Bateman, M.D. – Salt Lake City, UT
Larry Culpepper M.D., MPH, – Boston University
Cassandra Curtis, M.D. – Greenfield, IN
Yvonne D’Arcy, M.S., CRNP – Johns Hopkins
Kevin B. Gebke, M.D. – Indiana University
Robert Gerwin, M.D. – Bethesda, MD
Don L. Goldenberg, M.D. – Newton-Wellesley Hospital
James I. Hudson, M.D., ScD – McLean Hospital
Rakesh Jain, M.D., MPH – Lake Jackson, TX
Arnold L. Katz, M.D. – Overland Park Medical Center, KS
Andrew G. Kowal, M.D. – Burlington, MA
Charles Lapp, M.D. – Charlotte, NC
Michael McNett, M.D. – Chicago, IL
Philip J. Mease, M.D. – Seattle, WA
Danielle Petersel, M.D. – Pfizer, NY
I. Jon Russell, M.D., PhD – San Antonio, TX
Stephen M. Stahl, M.D., PhD – San Diego, CA
Roland Staud, M.D. – Gainesville, FL
Alvin F. Well, M.D., PhD – Oak Creek, WI

 

Those with an asterisk used to advocate for fibromyalgia patients (along with Clauw), but how can anyone view their actions with integrity given their alliance with a drug initiative that only promotes three medications for treating fibro? If you need something to help you fall asleep at night, you best get hip with Lapp’s behavior modification program.

 

Perhaps it is good news that Lapp’s behavior program is free on his website. Of course, once you have given all of your contact details on the website, who is to say they won’t get passed along to Pfizer?

 

While talented physicians and researchers have placed their loyalty to the drug company, rather than remaining independent-minded scientists, the question is: why? There had to be a draw to the drug company’s scheme. Money? Power? Or maybe a little of both? Regardless of the reasons, it appears that treating patients is no longer their primary interest.

 

These days, one may automatically assume patient organizations are working in collaboration with the drug companies. It can be a sneaky way of connecting you to Pfizer’s initiative, to collect info about you as a fibro consumer in order to improve their marketing strategies. Is that really what you want as a patient, to be viewed as marketing income from the organizations you trust to have your back?

 

Take for example, the National Fibromyalgia Association (NFA), who even in the midst of legal troubles keeps sending out emails to patients to collect more data on you. They have a disconnected phone number and an address that is nothing more than a box. Now the National Fibromyalgia and Chronic Pain Association (NFMCPA) out of Utah has taken over the patient-related reins of the NFA. They promote the FibroCollaborative on their website, so perhaps they sit at the same table with the NFA, the American Chronic Pain Association, and others to help Pfizer’s bottom line.

 

This is not the case for the Fibromyalgia Network (or the American Fibromyalgia Syndrome Association). There is a price to pay for not being a puppet on Pfizer’s or anyone else’s string. Although the Network makes lots of info available for free, we have to charge for our publications. That’s the price you pay for objectivity.

1. Arnold LM, Clauw DJ, et al. Mayo Clin Proc 87:488-96, 2012.
2. Wolfe F, Clauw DJ, et al. Arthritis Care Res 62:600-10, 2010.
3. Wolfe F, Clauw DJ, et al. J Rheumatol 38:1113-22, 2011.
4. Arnold LM, Clauw DJ, et al. Mayo Clin Proc 86:457-64, 2011.
5. Clauw DJ, et al. Mayo Clinic Proc 86:907-11, 2011.

Source: http://www.fmnetnews.com/latest-news/fibro-doctors-chose-pfizer-over-you .

[btdt]

I think that might be it thanks West Coast..

peace