Prozac and Paxil – Marketing Research Paper
“Depression is a psychological condition that changes how you think and feel. It affects your social behavior and sense of physical well-being.” (Psychology Information Online). Depression isn’t a normal part of life; it is linked to changes in your brain caused by
an imbalance of certain chemicals. Depression affects teenagers, adults and even children and it is estimated that “more than 10 million Americans suffer from this disorder annually” (Marketing Antidepressants: Prozac and Paxil, 2). Knowing that depression is now regarded as a condition which needs immediate attention, pharmaceutical companies have developed prescription drugs called selective serotonin re-uptake inhibitors (SSRIs) to combat this disorder. The major questions I would like to address here is; it is obvious that these conditions have been existing for a long time, how was it being treated before? Has this condition been exaggerated by makers of drugs such as Prozac and Paxil?
Prozac which was designed to correct chemical imbalances caused by a lack of serotonin, joined the market in 1988 and by 1992 sales had reached 10 million annually. The success of this drug is partly due to the effective marketing and advertising strategies. Salespersons were made aware of modern psychiatric practices and marketed the drug to major psychiatrists. In efforts to increase sales, the drug was later marketed to general practitioners and primary physicians. Management further increased sales by educating doctors on how to diagnose depression and to eliminate stereotypes about this disorder. Advertisements about the wonders of the drug were ran during hours when it was believed more depressed persons, specifically women, viewed television. The press contributed greatly to the drug’s success by highlighting it as a wonder drug and miracle pill. A book published by Kramer reported that “the drug not only treated depression it also transformed personalities” (Marketing Antidepressants: Prozac and Paxil, 5). Although designed to teat depression, Prozac is being used to treat eating, smoking, bulimia and other similar disorders.
Paxil was designed as an alternative to Prozac however in 1999, it received FDA approval to be used as a treatment for Social anxiety disorder (SAD). “This is a disease which is believed to affect approximately 3.7% of the American adult population and symptoms include anxiety, panic attacks and complete avoidance of situations”. For Prozac’s marketers, this was a virtually new market and marketers knew that sales depended on their ability to create public awareness of the disorder. Similar to Prozac, marketers used strategies such as “educating reporters, consumers and physicians about the disease and its treatments” (Marketing Antidepressants: Prozac and Paxil, 7). These public awareness campaigns caused millions of mentions throughout various mediums and featured patients who claimed to be suffering from this disorder. Management focused a direct-to-consumer advertising campaign which highlighted the disorder instead of the pill.
One in 10 American women takes an antidepressant drug such as Prozac, Paxil or Zoloft, and the use of such drugs by all adults has nearly tripled in the last decade, In 2002, more than one in three doctor’s office visits by women involved a prescription for an antidepressant, (Antidepressant Use By U.S. Adults Soars). The demand for such drugs are so high one has to wonder how effective are they? Are there any side effects? If so how serious are they? In order to answer these questions we must look at the pros and cons of using these antidepressants:
Strengths of Prozac and Paxil
• Difficult to overdose on the drug and was therefore safe in the hands of suicidal patients
• Easy to administer and posed less serious side effects than existing brands
• Positive image: management was able to position Prozac alongside nationwide efforts to cut costs.
• Positive word of mouth and feedback about the drugs
• Support from major media houses
• They were considered wonder drugs for treating other disorders
• Right market segmentation, effective marketing strategies and public awareness campaigns.
• Paxil was the first medication to win U.S. approval for SAD.
• The makers of Paxil merged with GSK to become the world’s largest pharmaceutical company
Weaknesses of Prozac and Paxil
• SSRIs didn’t work for everyone, as a matter of fact only about 60% of patients responded to Prozac
• Patients had difficulty in tolerating side effects
• Drugs had not been tested on children during clinical trials
Opportunities of Prozac and Paxil
• Advertising guidelines were more flexible and companies could take advantage of the ability to air broadcast advertisements.
Threats of Prozac and Paxil
• Documents and books were written bout the benefits and dangers of Prozac
• Competition – there were existing competitors in the market such as Zoloft, and Celexa
• Critics were outraged about direct-to-consumer advertising and protested that marketing information was misleading.
Despite SSRIs numerous benefits to patients, namely Prozac and Paxil, these drugs were also faced with several issues including:
• With Prozac’s patent about to expire, Eli Lilly (Prozac’s manufacturer) and Glaxo Smith Kline (Paxil’s manufacturer) needed to decide how to respond to the introduction of generic Prozac into the market
• Concerns that Americans were overusing and overmedicating themselves with these products. An estimated amount of 28 million Americans took these drugs, while it was estimated that only 10 million were suffering from depression (Marketing Antidepressants: Prozac and Paxil 9)
• Concerns that these drugs were not being used properly
• Too much of these drugs were prescribed to patients under the age of 18
• What are the moral and ethical concerns associated with using SSRIs.
In January, Leuchter published a study in the American Journal of Psychiatry, in which he tracked some of the brain changes associated with drugs such as Prozac and Effexor. He compared the brain changes in patients on placebos and was amazed to find that many of them had changes in the same parts of the brain that are thought to control important facets of mood. In research done for a trial to determine the effectiveness of SSRIs in comparism to herbal remedies, findings revealed that a herbal remedy St. John’s Wort fully cured 24 percent of the depressed people who received it, Zoloft cured 25 percent — but the placebo fully cured 32 percent. (Against Depression, a Sugar Pill Is Hard to Beat). What does this research prove? Could it be possible that depression is more a state of mind than a disorder?
We know that one of the major concerns is Americans overusing and overmedicating themselves with these SSRIs. Many reports have associated the execution of serious crimes with the use of antidepressants. In the case of Andrea Yates, who suffered from postpartum depression, she was treated with Wellbutrin, Effexor and Haldol years before she killed her five children. According to Bruce E. Levine, Ph.D., author of “Commonsense Rebellion”, “the combination of medicines that Yates reportedly took, particularly if she was taking them at the same time, may well have been a prescription for a tragic psychotic break.” (Depression is a choice)
Even though SSRIs have not been tested on children, it is constantly being used to treat depression among children. A shocking discovery was made when a study was conducted among kids with depression who were known to have committed serious criminal acts. “Fifteen-year-old Shawn Cooper fired on students and high school staff in Notus, Idaho in April 1999, He was taking an SSRI. Thirteen-year-old Chris Fetters of Iowa was on Prozac when she killed her favorite aunt. Kip Kinkel, a 15-year-old, first shot his parents, then killed two and wounded 22 fellow students at Thurston High School in Oregon. He too was taking Prozac. In September 1999, while on Prozac, Buford O’Neal Furrow, Jr. fired 70 rounds at the North Valley Jewish Community Center in Los Angeles wounding 5 people. Jeff Weise dose of Prozac had just been increased to 60 mg daily when he fired on a school in Red lake, Minnesota. The report further stated that since 1998, eight of the thirteen school shooters were on psychiatric drugs.” (Why Kids Kill? Prozac And Alternatives) With this type of information this question is justifiable; did the drugs cause the violence? If so why are they being prescribed and sold.
Despite these research findings, “In 2003, Canadians spent fifteen billion dollars on prescription drugs, an increase of 14.5% over 2002, while the use of such drugs by Americans has nearly tripled since the last decade.” (Psychology Information Online)
I am left to wonder, what is the reason for this growing increase in antidepressants? Is it appropriate or sustainable? Why aren’t non-drug alternatives that address the emotional distress of patients, such as exercise, support, psychotherapy, and nutritional improvements, being supported, funded and prioritized by therapists and the government? In a study exploring the effects of aerobic exercise and Zoloft on depression, Blumenthal et al, found that 16 weeks of treatment exercise was equivalent to 1 dose of medication in reducing major depression among older people. (effects of exercise and training on Older Patients)
After taking the self test for social Anxiety Disorder, (appendix 1), the results proved that I was not suffering from this disease, however I know if I’d taken this test 10 years ago, the results would be the opposite. I’ve never been on SSRIs, or had I ever heard about such a drug, and what seemed to have been a disorder ten years ago no longer exists. Is it possible then that people go through different stages, or react to things differently as part of the learning and growing process? A Japanese article noted that “there was not even a term for mild depression in Japan until the pharmaceutical company Meiji Seika Kaisha began to promote the SSRI, Depromel, in 1999. Melancholia, sensitivity and fragility were not negative things in a Japanese context. It never occurred to anyone to try to remove them, because it never occurred to them that they were bad.” (Redefining Depression).
Conclusion and Recommendations:
I believe that society, especially those of more developed countries has seen it necessary to place labels and categorize everyone into groups. Many persons in groups other than what has been labeled normal turn to prescribed drugs to return to normal state. The only problem is this abnormality never existed in the first instance.
Kids who reside in less developed countries and show symptoms of SAD, simply outgrow it when they begin to mingle with their peers and begin to mature. Through personal experience and testimonies from colleagues, one of the best ways to unwind is through exercise, be it at the Jim or on the dance floor. Many kids suffer from depression because of abuse and lack of attention. Prescribing SSRIs to these kids cannot assist them in any way because they now have to deal with the drugs side effects and the abuse. I recommend that physicians concentrate on eliminating the root cause of depression rather than trying to treat the disorder. Like the saying goes “precaution is better than cure”. I further suggest that all other natural alternatives such as therapy, exercise, dieting etc. be explored and administered before SSRI’s are prescribed. In the event that they are used, it should be in moderate amounts and should be combined with other natural cures.
Blumenthal et al. 1999,159; “Effects of exercise training on older Patients with major depression.” Arch Intern Med.: 159:2349-2356
Donald J Franklyn, (2002); Psychology Information Online, retrieved July 6, 2006 on the World Wide Web; http://www.psychologyinfo.com/depression/description.html
Shankar Vedantam (May 7, 2002); Against Depression, a Sugar Pill Is Hard to Beat’ retrieved July 6, 2006 on the World Wide Web; http://www.washingtonpost.com/ac2/wp-dyn/A42930-2002May6?language=printer
Amy Benfer’; Depression is a Choice; retrieved July 6, 2006 on the World Wide Web; http://www. Depressionisachoice.com/essays/failure.html
By Dr. Wilson (August 29, 2005); Why Kids Kill? Prozac and Alternatives, retrieved on the World Wide Web on July 6, 2006,
Janet Currie, (May 25, 2005), Redefining Depression. Retrieved on the World Wide Web on July 6, 2006 http://www.whp-apsf.ca/pdf/SSRIs.pdf