Monday, January 12, 2009

Sadly, It Appears My Customers May Remain In Their Vegetative State For Quite Some Time

How the hell did anyone fall asleep before the advent of Ambien? I know if you're in the profession you have a keg of it on your shelf. I know you whip the Ambien around like snowflakes in a New England blizzard, and I know if the insurance doesn't cover it there are fewer ways to make a credit card appear more quickly. I believe the economist's term is inelastic demand. People love the Ambien. That's what I'm saying. 

By the way, am I the only person left on Earth who remembers when Ambien came with strict warnings in the prescribing information that it was not to be used for more than 7 consecutive days except under exceptional circumstances, or did I just show my age here? 

At any rate, a little over two years ago, I reported to you exciting news about that little white pill that has taken the country by storm. It seemed a doctor in South Africa inadvertently stumbled upon evidence that Ambien, the same sleep aid essential for millions of lawyers to get a good night's sleep after a hard day of screwing members of the general public, just might be of use in waking people from persistent vegetative states. You can just imagine what the response was from Big Pharma to the news that one of their meds soon to lose patient protection could have a dramatic impact on people undergoing an incredible amount of suffering:

The company that first developed zolpidem, Sanofi-Aventis, was contacted...but appears to have chosen not to become involved in the trials or the use of the drug on brain-damaged patients

Not to worry though, if Big Pharma's idea of medicine has nothing to do with the possibility of almost literally waking people from the dead, I'm sure Medium Pharma will step up to the plate. A company  like NovaDel Pharma for instance. I hear NovaDel Pharma is doing some research with zolpidem now that its patient is free and clear. Lets go take a look at their web page:

Zolpimist™ (zolpidem oral spray) uses NovaDel’s proprietary formulation technology to deliver zolpidem tartrate, which is currently marketed as Ambien®, the leading hypnotic for the treatment of insomnia. NovaDel has announced positive results from its clinical studies comparing zolpidem oral spray with Ambien® tablets. Zolpimist™ has been approved by the FDA for the short-term treatment of insomnia characterized by difficulties with sleep initiation.
Zolpimist™ offers the potential benefit of a faster rise in drug blood levels potentially leading to a faster onset of action, without having to take water.

I'll translate that for you. NovaDel's research involves a way to separate people from their money by promising to put them to sleep about 15 minutes faster. And without having to take water! If that sounds like the dude who's been lying in a coma for the last 15 years is getting screwed, that would be because he is. 

I contacted fictional Washington insider Vernon P. Carmichael to get his take on the coma screwing situation.  "In Washington it's all about power and influence" Carmichael explained to me in an interview that took place in my mind. "And to be honest, the coma lobby is among the least effective in the industry, outranking only APhA, an organization too inept to even manage to get all the letters in its name capitalized."

It's true. I called the fictional headquarters of the Association For The Advancement Of The Consciousness Impaired and the phone rang for half an hour before anyone picked up. And the person who finally did answer sounded really sleepy.

"Meanwhile we all know the influence of the 'more money than brains' demographic" Carmichael continued. "Bottled water for sale, need I say more? Spell 'evian' backwards. Hell, you can even mock them and they still line up to give you their dollars." 

"So I would advise any of my clients that the future for any company that can develop a sleepytime nose spray out of a dirt cheap product that already exists, and charge out the ass for that nose spray, as well as any company that cares for people expected to stay in vegetative comas for a long time is very bright indeed." Carmichael never said.

In America that is. I should add there is research being done on using zolpidem in comatose and other brain-damaged patients. In South Africa. By a British company, ReGen Therapeutics

Damn good thing we don't have socialized medicine like those Brits though. Otherwise important scientific research would be crippled.  Enjoy your sleepytime nose spray sucker. That sound you hear as you drift off is the rest of the industrialized world laughing their ass off at us.

Thanks to the alert reader who pointed me in the direction of the story.


Utah Savage said...

Two 5 mg diazepam works for me. But I'm a novice.

Anonymous said...

Just saw a great product on the 11 o'clock news that you should review--Latesse(sp?). It's Lumigan BUT it is specifically indicated to grow eyelashes...and it's only $120. SERIOUSLY!!!! WTF! I'll stick with mascara. Look for it to appear on pharmacy shelves within 6 weeks---think insurance will cover it?? HAH!


Soupdaloup said...

Sounds like the perfect thing for forcefully sedating combative little old ladies

Pharmacy God said...

APhA, an organization too inept to even manage to get all the letters in its name capitalized,

I love it

Jaded Rx Intern said...

1) I remember the 'no more than 7 consecutive days' warning, and I'm 25. If you want to say it shows your age, use this little fact...

2) Crawled across the Zolpidem/comatose phenomenon last summer. Weird how the brain works sometimes.

3) I'm surprised Sanofi-Aventis hasn't thought to market Ambien *CR* for the comatose. More indications = more use = more $$ = longer patent life. Thinking in the mindset of the pharmaceutical companies; I feel kinda dirty now...

The Alert Reader said...

The eyelash meds (Latisse):

Best thing I ever did for my lashes was perm them. Didn't have to wear makeup for a month, it was awesome.

The Ole' Apothecary said...

Showing your age? When I started out as a pharmacist, Dalmane (flurazepam) was still competing with Tuinal and Nembutal for sleeper of the month.

If I was on Xanax 0.5 mg tid, I'd take the third dose at bedtime. Guaranteed zzzzzzzz. But, oh, no, there have to be benzodiazepines and benzoids for bedtime.

Jared Combs said...

I am a pharmacist- I became quite addicted to Ambien at one time. Sonata was another fav. I loved the way it made the lamp move across the table without it ever actually falling off- after ingesting three 10mg tablets that is. I loved the way it nearly instantly calmed me after snorting 20-30mg of the stuff. I'm in recovery now- 8 years clean/sober.
I had to look up this Zolpimist stuff myself- I thought it must be ficticious as well (because it's a stupid idea), but no; sure enough it's for real. What a waste of money and research time! I think I'll just teach my patients how to crush up a tab and snort the dirt-cheap generic ones! (no...not really)

beadybaby said...

I just scared myself when the names Noludar and Doriden popped into my head...think I got a year or two on you though, DM. Damn I'm old! (BS Pharm URI '91)

Shalom said...

Beady: I only saw Doriden once, and that was when I was writing up the paperwork to get rid of expired C-IIs that had come over to the chain from an acquisition.

I asked one of my professors about it, who had been a long-time retail pharmacist. She said "Oh yeah, I remember Doriden. It was great, gave you at least five hours of good quality sleep, not much hangover the next day either." I said "So how come I never see it prescribed?" and she said "Because it only took a week to get hooked on it..."

Noludar? Was that those humongous green gelcaps? (My preceptor called them "dill pickles".) Somewhere in my basement I have a 1969 PDR, I'll have to look that up and see what it was.

It's sometimes fun to read that and see what the practise of medicine was like 40 years ago... no beta blockers, calcium channel blockers or ACE inhibitors, twenty kinds of sulfonamides, meprobamate in everything (including some blood pressure meds, apparently they thought that if you were zonked on tranquilizers your blood pressure went down), some kind of bizarre tonic that had testosterone, ethinyl estradiol, vitamin B12, and Ritalin in it... It was like the dark ages, and it's only 40 years ago, within my own lifetime. (BSPharm, UB '96... yeah, pharmacy was my second career.)