Consumer Reports corrects "restless leg" drug TV ad
Consumer Reports has launched a new online video series that plays TV commercials for prescription drugs, inserting information that the manufacturers forgot to include. They call it an "antidote to TV drug ads."
Their first video is about a TV commercial for a drug called Requip, which is offered as a way to reduce symptoms of "restless leg syndrome." Consumer Reports explains that Requip reduces symptoms in up to 73% of people (with scary potential side effects) , while a placebo is effective on 57% of people with RLS ("restless leg syndrome").
Link (Via Mind Hacks)This first installment concerns an interesting class of medications that are approved to treat something called "restless leg syndrome." That condition may sound fanciful, but it's a real problem. Something like 3 percent of Americans suffer from RLS, which is characterized by an uncontrollable impulse to keep moving your legs even when you are trying to go to sleep —- which obviously could make sleep difficult.
Several years ago, doctors discovered that drugs that were originally developed to treat Parkinson's disease could provide meaningful help to people who suffered from moderate to severe forms of this condition. But the drugs have serious side effects - one of the more bizarre involves a propensity for uncontrolled sexual or gambling impulses, as our video mentions. And while these medications may provide welcome relief to some RLS patients, the ads could leave anyone who ever suffered fidgetiness when trying to go to sleep to wonder whether he or she has RLS and should seek treatment.
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Just a quick note for folks with RLS who may get here: I have a mild form of RLS, and my 'cure' is to do squats just before bed until my thigh muscles are fatigued (i.e. I can't do anymore).
It's worth a try instead of meds. Especially if you're going to go have sex with random craps croupiers afterwards.
My wife has suffered from RLS for years (she didn't find out there was a name for it until a few years ago). She found that Ambien works just fine for her, though she's had a few of the usual 'Ambien' moments, the most dramatic being baking a batch of cookies (after having taken Ambien) and not realizing she had done it until she walked out into the kitchen the next morning. Mostly, though, the side-effects have been limited to not remembering conversations or phone calls that have happened after she took her medication for the night.
She's highly amused by the ads for Requip, especially the sexual/gambling side effects, but has no interest in trying it. ..bruce..
While the ad is obviously dissection-worthy, I'm not crazy about the "made-up illness quote-marks" around the phrase Restless Leg Syndrome. It's very real. My wife has had it for ten years--she chases bunnies all night long--and it's been at times a very serious disruption in both of our sleep patterns. We own a king-size bed so she can sleep WAY over there and I can sleep WAY over here. Even so, I've been in the guest room more nights than I can count.
That said, we're clear that Requip's side-effects put it out of the running for us. We've found that keeping her iron up with supplements very much cuts down on it, as there's been shown to be a causal link there. By the way, did you know that habitually crunching ice is another common symptom of iron deficiency?
My wife has had RLS as well. Her doctor first put her on iron supplements which may help. She has gotten a sample of Requip though, without ever seeing this commercial. I must say I just hope she goes with the sexual impulses instead of gambling away our life savings!
"a propensity for uncontrolled sexual or gambling impulses,"
Jeebus, what a weird side-effect, what's next, a propensity for speaking with a Swedish accent, or a propensity for collecting clown paintings? Reminds me of the drug clomipramine, used as an anti-depressant, its side effect? it induces an orgasm if you yawn.
Overeating, compulsive gambling and hypersexuality--how long 'til they start putting this in the water supply in Vegas?
I love these made up 'syndromes' that people come up with. There has to be some pharma think tank sitting around asking themselves: "So, what *other* human oddities can we make up names and sell cures for?"
"IBS" -- Itchy Balls Syndrome
"NADS" -- Nausea After Drinking Syndrome
I'm sure the list goes on and on and on. Find a bunch of hypochondriacs who: don't eat right, don't exercise, have too much time and money on their hands, watch television, live in America -- and sell them a bunch of crap that they don't really need. The best part is they convince them that they need this crap.
I'd like to think that most doctors would advise a patient to try these other things (excercise, more iron) before prescribing this drug, only as an absolute last resort...Does it ever work that way?
God, those side effects read like a piece of satire! Priceless.
But seriously, folks. I am really glad that some entity came out to speak out against these ads. They have been bugging my bullshit-detecting-organ for a few months now.
And flickersticks. That is how doctors work in a morally sound, logical world. But remember where we live. Bribes exist in many forms. It's sad but true.
CBS Sunday Morning did a show dedicated to medicine. They had a segment where they filmed an ad company doing a brainstorming session to come up with abbreviations for an illness in order to sell a drug. They also mentioned that only in New Zealand and the USA is it legal for drug companies to advertise prescription medicine via TV. I keep thinking of how much the doctors are getting for prescribing these so called cures which require a cocktail of other medicines to keep the side effects in check? Although you can't really just blame them since the patients demand these drugs after watching the ads on TV.
I would just like to point out that I don't actually believe this product will make a person say, "Hmm, I gotta get my ass to casino!" Rather, if you're the type of person who sits at slots for 10 hours at time, and you take pills to make your legs capable of sitting still for longer periods of time, you could end up with a more serious gambling issue.
In 2003 the NIH diluted the formal diagnostic criteria for RLS to basically include anyone who suffers from an uncomfortable impulse to move his or her legs. Phase III clinical trials for treatment of RLS with ropinerole (requip) began in September of that year [on 360 patients diagnosed prior to the effect of this shift].
The scare quotes are a little unfair. I know it's fun to take a dig at the pharma companies, but RLS is a real disease -- in fact, researchers in Germany recently identified a genetic component: http://www.nytimes.com/2007/07/19/health/19leg.html
Surely there wouldn't be a common genetic link among suffers if this disease were invented by the drug companies, no?
I would like to note that commercials for rival RLS drug Mirapex mention the increased propensity for gambling/sexual urges. Trying to get the upper hand in the RLS market?
And while I like to take shots at the pharmaceutical biz as much as the next guy, it kills me when people labels syndromes as BS because they find them to be unworthy. Physicians have been presenting findings on RLS for at least one hundred years.
Personally, I think this lady sounded kind of dumb when she slammed the company for advertising treatment for a condition that affects "only" 3% of the population. There's plenty of well-marketed conditions that affect far fewer people.
The side effects aren't as crazy as they sound; there's actually a good reason why gambling addiction or hypersexuality may result. Parkinson's Disease is marked by a decrease in brain cells that release the transmitter dopamine, so most Parkinson's treatments try to produce an increase in dopamine (the adminstration of L-dopa in _Awakenings_, for example). However, dopamine is also involved in reinforcing behavior that makes you feel good, such as gambling, sex, eating, getting praise, or gaining levels in World of Warcraft. Using a dopamine-targeting drug to treat RLS will most likely increase the rewarding (but not the adversive) aspects of these behaviors, forming addictions more quickly, though it won't make you start hitting the craps table out of the blue.
"....it kills me when people labels syndromes as BS because they find them to be unworthy. Physicians have been presenting findings on RLS for at least one hundred years."
And amazingly enough, prior to 100 years ago you never heard of this f*cking 'syndrome'. You know why? Because people were trying to figure out where their next meal was coming from. People were working in the field for 12 hours a day. People were hauling food and goods to the market. People were busy leading a hard life and trying to survive.
Enter the "modern world". Suddenly, you have a population who is over-educated, lazy, and soft. The only thing they got going for them is that they have lots of time and lots of money on their hands.
Do you have "RLS"? Do you feel you want to run? Get your fat ass out and run 10 miles. Try biking 50 miles. Try hiking a mountain. Try hauling heavy things up and down the stairs for awhile. I guarantee you that if you work hard (like the previous generations did) then you won't be thinking about "RLS" at night...... you'll be sound asleep because you are too tired to move.
I see a lot of guys saying "my wife has this..." What about the guys? Where are the guys who have "RLS"? And, what do these women who have RLS do? My guess is that they lead a sedentary lifestyle in a household that makes over $100,000K / yr. and they spend at least 3 hours a day watching TV.
My mom has been told that she has RLS, but she's in generally poor health and doesn't exercise. (@ binaryloop - my parents are poor, but I suppose 2 of 3 isn't too shabby.) From all that I have read and heard, RLS is more of a set of symptoms than an illness with direct cause/effect relationship. I understand that many people suffer under what has been classified as RLS, but it is upsetting that most doctors are content to slap a label on these symptoms instead of more thoroughly investigating their cause. That is because most doctors have been taught to (or are content to) simply prescribe a drug instead of going the more difficult route of prescribing exercise and dietary changes. I'm still working on my mom.
If you have RLS, make sure to do some research into magnesium deficiency. It is thought to be a widespread problem that not many know about, and magnesium is a critical mineral. http://www.drlam.com/A3R_brief_in_doc_format/1999-No3-MagnesiumandAging.cfm is a good place to start. Also realize that a blood test for magnesium deficiency isn't going to tell you what you need to know. "One's blood test can be "normal" while the intracellular level is "deficient." "
Also, too much iron can be as bad as too little iron. Before taking iron for this problem, or anything else, I would make surre that you are truly iron deficient.
BINARYLOOP: The disparity in the apparent gender gap could be explained by the general tendency for women to seek medical care and discuss their symptoms in public or with friends more often than men do, who see this as a sign of weakness.
This trend's been reported on for a few years now, as far as I know.
@binaryloop - You're a jerk and troll. RLS is not like feeling like you want to go for a run. I have it, so I can tell you first hand. Indeed the more physical activity I do (and the more tired I am) the worse it is.
I had never heard of the disease before I was diagnosed with it (so much for the drug companies "giving" me the disease). It wasn't until a doctor referred me to a neurologist to figure out why I often had trouble falling asleep and woke up still tired. (You see, I did not realize it was abnormal to frequently have an uncomfortable twitchy feeling in my legs because I'd had it my whole life and had never heard of RLS)
Also, if you bothered to read my earlier comment, you would know that there is a genetic component to the disease that makes it rather difficult to explain away.
I have RLS and I had no idea what it was until a few years ago. It's not "the urge to run" or a twitch. For me it's a horrible pain that you feel can be relieved by writhing around. It's not so bad now, but when I was a kid I'd wake up in the middle of the night screaming and crying and in complete agony.
Like Eli,I find the more active I am, the more physical work I do the worse it gets. It also seems to happen when I've been drinking.
I am not trying to offend anyone who may have a legitimate medical condition. I'm just ranting about the drug and pharmaceutical companies who push their drugs on television. Since when is a noob at home qualified to diagnose, treat, and prescribe medications for themselves? It really irritates me to see drug companies making commercials and saying "Ask your doctor about...." Instead of a medical professional deciding treatment you have people going in and telling their doctor what drugs they want.
@Bazilisk: makes sense. I noticed it wasn't the women themselves coming out to talk about it... but rather their husband/boyfriend who volunteered the info to the public for them.
@lautaylo: No offense to your mom. I do believe that there are a VERY SMALL percentage of people who may have a series of medical symptoms called "RLS". But, this percentage is so small that you would barely notice it. The problem is that everyone gloms on to the latest syndrome and likes to pretend they have it too. I also worked in a building once where there were a bunch of doctor's offices. These amazingly beautiful women would come in all the time. I thought they were models! I started talking to them and found that they were from the drug companies. They were there to visit the doctors (who were mostly middle-aged men). I'm sure that there were spiffs, incentives, and payola working all through the system. It's no wonder these doctors hand out drugs like Pez. Not only do they get to talk to a beautiful sales rep... they probably get kickbacks when they sell some. Just throw in a whole bunch of people who saw the TV commercial.... and you end up with the US Healthcare system.
My point is that our system is corrupt, the television doesn't help, and that people have become a bunch of hypochondriacs who's problems mainly stem from poor diet and exercise.
"...the more physical work I do the worse it gets"
Ding! Ding! Ding!
We have a winner.....
How convenient. Three hundred years ago you would have either:
* married someone rich
* been killed by the towns people
* died of starvation.
I still think its a bunch of bullshit.
Binaryloop, you're a fucking jerk, and you have no clue what you're dribbling on about.
Where are the guys who have "RLS"?
Well, my uncle is one of them.
And, what do these women who have RLS do? My guess is that they lead a sedentary lifestyle in a household that makes over $100,000K / yr. and they spend at least 3 hours a day watching TV.
I don't own a car, and I walk and ride my bike evrywhere. So no, I don't lead a "sedentary lifestyle". Nor do I make anywhere near $100,000/year. I do watch a lot of TV though, you got me there!
I'm a dialysis (kidney machine) patient, and suffer from RLS from time to time. RLS is very common in people with End Stage Renal Disease. I admit that from the name "Restless Leg Syndrome," the condition does not sound very serious. The name simply does not due the condition justice.
I started suffering from RLS in my teens, by which time the disease I had contracted as a child had gotten very much worse. In those days, the doctors and nurses who treated me did not have a name for it. They just assumed that it was "cramps." However, treatment for cramps did nothing to help the situation, one just had to deal with it.
A little less than a decade later, I encountered a nephrologist who said "Oh, that's Restless Leg Syndrome." I have to say that I was shocked, because I was so used to just living with it, that I had not even brought it up. I had mentioned the symptoms by chance. She prescribed a pill, and all of a sudden I had recourse from the misery RLS had periodically been causing me. It would be hard for me to describe how life-changing that moment was.
Well, dialysis technology has progressed over the years, and it does a better job of cleaning one's blood. I still get RLS from time to time, but I don't have a prescription for it, because the symptoms are a little aggravating sometimes, but I can deal, and am not that concerned about it.
I have a very active lifestyle, and from all outward appearance, am very healthy. But I look back with a feeling of dread to the time when I was much younger, and much sicker. In those days I was used to prolonged periods of serious, what you might call 'classical' pain. Let me tell you, I'd rather suffer that classical pain at its worse, than to have to deal with my RLS at its worse, again.
The reason the name RLS is so non-specific, is because the symptoms are hard to describe in normal terms. A sufferers' legs move because a miserable feeling builds up in them until he or she tenses their muscles. One has a second of relief, and them the process starts over. That miserable feeling is not 'classical' pain like a cramp, but you can see how they might be confused. In my mind, the feeling is like eels slithering between the muscles. A light case will keep you from sleeping (which of course, stinks), a heavy case will occur whenever you legs are somewhat at rest: sitting, driving, standing, and will drive you nuts. As with the usual sensation of pain, there is a difference in the intensity of the feeling. I have to say, that just how I was so relieved for that doctor to have put a name to my condition that day, I was happy when commercials for RLS prescriptions started to appear on television. I even liked the computer animation of ants marching inside a womans' leg, featured in one ad, heh. I hope more sufferers will find relief because of such consciousness-raising.
I am a guy and I have had RLS off and on my entire life. I actually had no idea that there was a name for it until I saw some article online making fun of big pharma for their "invented" disease, ironically. And for the record, I bike 20-30 miles daily so I'm not some lardass playing WoW all day.
I think part of the reason why people can't understand it ("You feel like you need to move your legs? You must be lazy!") is because it's so hard to explain in words. I don't know how to describe the sensation, it's kind of like ice water running through the veins in your legs. Only you can make it go away immediately by kicking... but that only makes it come back worse. It's terrible. The longer you try to hold out without moving your legs, the more unbearable it gets (kind of like pressure building only it's the most uncomfortable sensation in the world). Getting up and walking around just makes it worse.
When I was a kid sometime I would wake up in the middle of the night kicking my legs and screaming it was so unbearable. I think I have mostly grown out of it as I get older but I still have nights ocassionally where it comes back. It's a terrible thing to have, I can't believe people derive pleasure from insulting others unfortunate enough to have it.
I'm a physician who's been in practice for over 10 years and I have a particular interest in sleep medicine. I can assure you that Restless Legs Syndrome is a disease, and a disabling one. People who suffer from it have sleep deprivation, which can lead to depression, accidents, and poor work performance.
The diagnostic criteria are subjective. It's often said that people with it have a hard time describing the symptoms. Renal disease and iron deficiency should be ruled out. Some try iron pills as a first line of therapy, although its effect is probably that of a placebo.
The next line of therapy is the much older anti-Parkinson's drug Sinemet (generically levodopa/carbidopa), which is fairly effective for most people but has a tendency to cause "augmentation" in the majority. Augmentation is the development of symptoms earlier in the day.
The next line of therapy is Requip or Mirapex, which are similar. They are generally effective at doses below that which causes significant side effects. I.e., most people get relief of symptoms without side effects.
As with any chronic disease, you should work closely with your doctor to find the regimen that's best for you.
Oh, and BinaryLoop? You should read this book.
To avoid twitchy legs at night put a bar of soap (any kind) in your bed down by your legs, a little strange but it works a treat. No drugs, no gambling, all the weird sex you can get after a decent nights sleep...
M.
#7 posted by Binaryloop , November 12, 2007 10:59 AM
I love these made up 'syndromes' that people come up with. There has to be some pharma think tank sitting around asking themselves: "So, what *other* human oddities can we make up names and sell cures for?"
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Dude, don't be an ass. It's a very REAL condition that affects the lives of many people. Seriously, knock it off.