Tricks of the Trade

I am constantly bombarded by requests to prescribe the newest, latest medications. But I am here to tell you that the newest and latest is not the greatest. The pharmaceutical industry as many of you know is primarily driven by marketing. Now I have many friends in the industry and I hope I don't offend any of them. However, I think the public deserves a bit of advertising to forward the use of time tested treatments. Pharmaceutical reps and direct to consumer advertising should not drive prescribing practices, and doctors and patients should make the final decision for medication. Many times, a good 'ole $4 cheap generic is just as helpful (or hurtful) as the $200 brand name drug. I'm a big proponent of generic meds

One of the recent tricks of the trade is the introduction of medications that are purified versions of older medications. Most medications contain a mix of molecules of the drug that are mirror images of eachother, like a right and a left hand. One of the "mirror images" is more active in the body than the other. The industry is able to take an old drug and purify it to only the active ingredient and create a new patent allowing them to continue to charge brand name prices for the medication. Common examples are Lexapro and Focalin which are no more effective than their older brothers: Celexa and Methylphenidate.

Another trick is the introduction of fancier coverings for meds. ADHD stimulant meds are essentially made from only two medications (methylphenidate and amphetamine). But there are over a dozen brand names. The main difference between the medications is their "delivery system" which basically means how the pill is coated.

My message to the average consumer is DON'T PAY ATTENTION TO ADS, COMMERCIALS, AND BILLBOARDS when it comes to medicating your kids. Find a good doctor and have a nice long talk about the options and choose the one that makes the most sense medically, financially, and ethically.