Wednesday, May 28, 2008

The Drugmonkey Tries His Hand At A Book Review. Because Someone Gave Me A Free Book In Recognition Of The Awesome Power I Wield With This Blog.

This may be my favorite Big Pharma ad ever:

"Modern man is the victim of this era" reads the headline.

"War...rumors of war...atomic devastation...too much government...economic uncertainty- all part of a complex pattern, all part of these troubled times. Today, countless factors are taking their psychic toll in your patients. Mental depression is one of the most common results.

'Dexedrine' Sulfate can do much to help the depressed patient. By restoring mental alertness and optimism, by inducing a feeling of energy and well being. 'Dexedrine' lifts your patient out of the gloom of depression and helps him face the future."

Dexedrine, for those of you not in the profession, is a brand name for a type of amphetamine. If nothing else, Nicholas Rasmussen's new book, On Speed, The Many Lives of Amphetamine will forever serve as documentation that there was a time when Big Pharma said the appropriate response to the threat of nuclear war was to start passing out crank.

The book is more than a collection of amusing historical pharmacy anecdotes though. (Another favorite - the tale of an early generic version of amphetamine produced in defiance of Smith, Kline & French's patent and sold in many cases "without the significant savings passed along to the customer." The name of the knockoff? Profetamine. Get it? Profet...Profit? It would be a few more years before pharmacy became the nation's most trusted profession.) In it, Rasmussen makes the case for amphetamine as a key marker of the end of the period of "snake oil" medicine and the beginning of the evidence-based medical era. He isn't shy about the downside of modern pharmaceutical marketing, although at times it seems as if he is trying a bit too hard, such as when he says the Cox-2 inhibitors Bextra and Celebrex "promised to make arthritis suffering obsolete" (they never claimed to be more effective than older arthritis meds, only to be easier on the GI tract) or that the original contraceptive formulas "probably cause cancer" (recent studies show that being on birth control tablets actually cut a woman's overall lifetime cancer risk) The documentation of amphetamine as "a drug in search of a disease," however, will sound familiar to anyone in the health care field, and may well beg questions such as why Attention Deficit Disorder was not nearly a problem on today's scale back when Dexedrine faced no competition as an anti-depressant.

While the book also follows the trends of amphetamine abuse in general society, from cramming college students, ramped up soldiers, jazz musicians, beat poets, hippies who figured out "speed kills" through today's ecstasy raves and crystal meth epidemic, it's most valuable as a chronicle of how where we've been in medicine explains a lot about where we are today.

Personally, if we were about to get nuked, I'd think I'd rather just quietly go to sleep.


Billifer von Raptor said...

Nice review, DrugMonkey. Sounds like an interesting book. I'll add it to my stack. It definitely sounds more interesting and at least a wee bit less biased than Peter Breggin's books.

Here are my two favorite vintage ads (click for images):

Thorazine ad

Lysol ad

DrugMonkey, Master of Pharmacy said...

Holy crap i just shot scotch through my nose looking at those ads....

ireynoldsss said...

I think that what Pfizer was implying with its ads for Celebrex and what it was showing in clinical trials to get it passed by the FDA were two different things. Yeah, they got it approved by the FDA for pain relief and improving gastrointestinal safety (don't mention the heart attacks!). But when you're talking about consumer advertisements there is certainly no clear distinction that "this is a new drug no better than ibuprofen, but with increased gastrointestinal safety for some people." The ads look more like this:
Not sure my grandfather wouldn't think that was an implicit promise to make is arthritis go away. I haven't read the book, but there is usually no "trying to hard" when showing insidious PhRMA marketing can be.

Anonymous said...

If you're looking for a good book, check out The Traveler by John Twelve Hawks. Nothing to do with pharmaceuticals, but an interesting sci-fi type novel with a political spin. Thanks for the site, btw. Totally helps kill the boredom for us overnight hospital pharmacists!

Anonymous said...

Sheesshh! When I worked hospital overnights, we were so busy that internal smooth muscles gained in size from holding all sphincters closed.

One of the older pharmacists mentioned that amphetamines were widely available on campuses in the 50s-60s especially around final exam times.

OTR truckers could pick them up at truck stops, I heard, and drive from coast-to-coast. If astronauts can get by with Depends undergarments on long-distance rides, it makes one realize the reality of defensive driving.

DrugMonkey, Master of Pharmacy said...

Got a note from the author today:

Dear Mr Drugmonkey

Thanks for reading my book and I do appreciate the review. However I think you are a little harsh with the 'trying too hard' critique given that the offending comments were from my Introduction, where glib and breezy is the norm, and actually required by some publishers. Also 1) I was indeed thinking of implied claims in Celebrex (etc) advertising and 2) the net cancer impact of contraceptives epidemiology finding that you are talking about dates, I think, to Sept 2007 a year after writing! True, proofing was done in early Oct 2007 and I admit I did not focus on updating the Intro.

Fair enough. Maybe I should have said something like "After an introduction that's a bit too glib and breezy, Nicholas Rassmussen gets down to business in his new book....."

Because honestly, after that introduction I was expecting a semi-propaganda piece.

Which I'm happy to say I didn't get. No one reading this should get the impression I thought it was a bad book. It wasn't. I enjoyed reading it, and I'm not just saying that because you gave me a color version of that Dexedrine ad....:)