Ane Psychiatry Akave Akakanganiswa Zvikuru Kugadziriswa?

Zvemukati

• Psychiatry Yakakosha Kuverenga
• Kubatanidza Kuchengetwa kwePfungwa mune Zvekutanga Kuchengeta Maitiro

Isu tinoziva kuti makambani anokwanisa kuratidza zvakapusa pakuvanza kukuvara kunoitwa nezvigadzirwa zvavo. Vagadziri vemidzanga vakavanza chinongedzo checancer yemapapu kwemakumi emakore. Makambani emagetsi nevabatsiri vavo vezvematongerwo enyika vanoramba chero chinongedzo pakati pekutsva kwemafuta uye kudziya kwepasi. Asi hapana indasitiri yanga yakarongeka kana kubudirira semakambani emishonga mukupinza ruzivo rwezvigadzirwa zvavo. Mhedzisiro yacho yave iri purofiti yakakwira. Makambani gumi epamusoro ekugadzira mishonga muFortune 500 anoita mari yakawanda kupfuura mamwe makambani mazana mana nemakumi matanhatu kusanganiswa .

Fungidzira izvi: Ko kana musayendisiti wese achidzidza kudziya kwepasi akabhadharwa naEexon? New York yaizove iri pasi pemvura chero munhu asati aziva kudziya kwepasi kunyangwe kwavepo. Asi zvakadaro, ndiwo mamiriro chaiwo ekutsvaga kwesainzi mune zvepfungwa. Vanopfuura makumi masere muzana ezvepfungwa dzekutsvagisa kwepfungwa dzinoitiswa munzvimbo dzedzidzo dzekurapa dzakabhadharwa neindasitiri yemishonga. Uye ndidzo nhau dzakanaka. Iine kuwedzera kuwanda, Big Pharma iri kubhadhara makambani ekutengesa asina zvisungo kuzvidzidzo kuti vagadzire zvidzidzo zvinoisa zvigadzirwa zvavo muchiedza chakanakisa; ivo vanobva vabhadhara vadzidzi kuti vaise mazita avo pazvidzidzo zvinokonzereswa sevanyori, kunyangwe hazvo vasina kutora chikamu mukutsvaga chero. Kuti uone zvabuda, tora muenzaniso weNeurontin.

Anenge makore gumi nemaviri apfuura, ndakaona kuti vazhinji vevarwere vangu bipolar type II vaiiswa mushonga mutsva, Neurontin. Hapana wevarwere vangu airatidzika kuwana bhenefiti yakawanda kubva kwazviri, uye vazhinji vakatambura mhedzisiro. Zvino, ndinonzwisisa kuti sei.

Isu tava kuziva kubva kune yakazvimirira tsvagurudzo - tsvagurudzo isina kubhadharwa nemakambani emishonga - kuti Neurontin inogadzira zvachose hapana bhenefiti pakurapa bipolar kusagadzikana. Hapana. Asi zvadaro, nei takambotenda kuti zvaiita? Nyaya yeNeurontin ndeye muenzaniso unotyisa wesainzi unomhanya amok, asi kwete imwe yeatypical. Varapi vepfungwa vakafemerwa kuti vape mushonga waive wakachengeteka uye usinga shande.

Chidzidzo chaimboshandiswa naWarner Lambert ratidza Neurontin yaive inoshanda pakurapa bipolar kusagadzikana kwakakanganisa uye yakatumidzwa kumhedzisiro, sekureva kwechinyorwa chazvino chakaburitswa mu Zvinyorwa zveMukati Mushonga . Zvakatoipisisa, humbowo hwemhedzisiro yakaipa muchidzidzo ichi hwakadzvanyirirwa: Varwere makumi manomwe nenomwe mumuedzo uyu vakave nekupokana, uye varwere ve11 vakafa.

Izvi zvakaitika sei? Muna 1993 Warner Lambert akava nedambudziko. Neurontin, yavo nyowani yekurwisa pfari, vanga vapihwa mvumo shoma yeDAA yekushandisa chete seyechipiri mutsara pfari zvinodhaka - zvinogona kungoshandiswa chete kana imwe pfari mishonga yatove pamusika yatadza. "Neurontin aive turkey." Akanyora Daniel Carlat mukati Unhinged . Zvekuita?

Iyo kambani yakashandira makambani ekutengesa - kwete masayendisiti - kuburitsa zvinyorwa zvesainzi zvichiratidza mabhenefiti eNeurontin yebipolar kusagadzikana, uye yakabhadhara varapi madhora chiuru chidimbu kubvumidza mazita avo kunyorwa sevanyori vezvidzidzo zvavasina kuitisa kana kunyora (uye pamwe hauna kana kumboverenga).

Nepo iyo FDA ichida huwandu hwakaringana hwehuchapupu hwesainzi kubvumidza mushonga wekurapa imwe mamiriro, kana mushonga wabvumidzwa, vanachiremba vakasununguka kupa chero mushonga chero mamiriro, off label. Kuti uvatendise kuti vaite izvi, isina kusimba kana yakakwenya data inogona kupfekedzwa kuratidza kuti mushonga unoshanda, uye hapana kuongororwa kweDAA kunodiwa. Imhosva kune kambani yemishonga kushambadzira madhiragi kuna vanachiremba nekuda kwezvinangwa, asi ndizvo chaizvo zvakaitika. Marcia Angell, aimbova mupepeti we New England Chinyorwa cheMishonga , akanyora kuti: "kambani iyi yainge yaita chirongwa chakakura zvisiri pamutemo kukurudzira Neurontin kuti ishandise mazita - kunyanya nekubhadhara nyanzvi dzezvidzidzo kuti vaise mazita avo pakutsvagurudza."

Zvinodhaka zvinodzikira pane vanachiremba vezvepfungwa. Warner Lambert mukuru mukuru John Ford akakurudzira vateveri vake kuti "vabate maoko avo nekuzevezera munzeve dzavo ... Neurontin yebipolar disorder." Akaenderera mberi, achivakurudzira kuti vapfuure iyo FDA yakakurudzira dosi ye1800 mg / zuva, achiwedzera "Ini handidi kunzwa iko kuchengetedzeka." Warner Lambert akabhadhara mamirioni mazana mana nemakumi matatu mufaindi nekuda kwekushambadzira kwavo kwekunyengera uye zvisiri pamutemo kweNeurontin kuvanachiremba vepfungwa.

Icho Neurontin yakasarudzika chiitiko? Yedzidzo chipoko kunyorwa kwezvidzidzo zvakaburitswa nemakambani ekutengesa ndiyo yakajairika maitiro. Muna 2001, makambani emishonga akabhadhara madhora mabhiriyoni manomwe kumasangano ane chiuru emakontrakiti ekutsvagisa dhata dzinoisa mishonga yavo muchiedza chakanakisa. Izvi zvakapinda zvakadii mune zvepfungwa? Dzimwe 57 muzana yezvinyorwa zvesainzi zvakaburitswa nezveZoloft, semuenzaniso, zvakanyorwa nekambani yekushambadzira Yemazuva Ano Medical Directions uye chipoko chakanyorwa nevadzidzi vasina chikamu muzvidzidzo izvi. Izvi zvinyorwa zvakabuda mumagazini epamusoro anosanganisira iyo American Nhoroondo yePsychiatry uye iyo Zvinyorwa zveAmerican Medical Association. "Saka, kune imwechete anti-depressant, yakawanda yezvinyorwa zvekurapa yakanyorwa chaizvo nekambani yezvinodhaka iyo inogadzira mushonga uyu, izvo zvinenge zvichinyengedza kubata kwesainzi semunhu anogona kufungidzira," akanyora kudaro Carlat. Uye mune New York Times op-ed chidimbu Carl Elliot akanyora, "Makambani emishonga anosimudzira mishonga yavo nezvidzidzo zvekunyepa izvo zvine zvishoma kana zvine hunyanzvi hwesainzi."

Psychiatry Yakakosha Kuverenga

Kubatanidza Kuchengetwa kwePfungwa mune Zvekutanga Kuchengeta Maitiro