Disease Mongering for Restless Leg Syndrome (RLS) by Jeffrey Dach MD

[Jeffrey Dach MD]

Original article with illustrations and video:
http://jeffreydach.com/2008/04/02/restless-leg-syndrome-requip-and-disease-mongering-by-jeffrey-dach-md.aspx

A perfect textbook example of disease mongering by the pharmaceutical
industry is the case of Requip for Restless Leg Syndrome.

What is Requip and Mirapex?

Requip is used to diminish the drug-induced movement disorder caused
by Parkinson's drugs. Requip is also used to treat and diminish the
movement disorders caused by anti-psychotic drugs for mental patients
(such as Prolixin and Haldol). Mirapex is similar to Requip.

Image at left courtesy of Bill Sardi KnowledgeofHealth Blog.

Magnesium Deficiency, Not Requip Deficiency

According to the USDA Agricultural Research Service, 68% of Americans
are Magnesium deficient. People who have leg muscle cramps at night
during sleep don't need a psycho-active drug, when all they really
need is magnesium supplementation which usually resolves the problem.
Using a drug like Requip instead of supplementing for magnesium
deficiency is the height of lunacy, and would be comical if it wasn't
tragic. This is the typical drug mongering indicative of a broken
medical system.

In this medical study, people with Restless Leg Syndrome (RLS) had
significant improvement after supplementing with magnesium (about 300
mg each evening for four to six weeks). (Hornyack) And IV Magnesium
was curative for Restless Leg Syndrome when IV magnesium was
incidentally given to pregnant women as a treatment for eclampsia.
(Popoviciu) We have found in our experience that oral magnesium
supplementation works quite well, resolving the problem promptly in
most cases.

Adverse Side Effects of Requip

Adverse side effects of Requip includes compulsive gambling and
hypersexual behavior.

What is Disease Mongering?

Step One: Create an Illusory Disease called a "syndrome"

Disease mongering describes a marketing program that creates the
illusion of disease where in fact, there is none. Instead, there may
be a symptom or a "risk factor" for development of disease.

We saw disease mongering in a previous report on Bisphosphonate drugs
(Fosamax, Actonel and Boniva), with Sally Field as television
spokeswomen. These Sally Field ads create the fear of a real disease
called osteoporosis in millions of women who have a lesser diagnosis
called osteopenia. Fracture rates actually increase in this
Osteopenia group when they take bisphosphonates.

A true disease requires definite pathologic markers that clearly
differentiate normal form abnormal. An example of a real disease is
heart disease in which arteries are blocked, cancer in which abnormal
cells can be seen on biopsy, and hypothyroidism in which there are
typical symptoms of fatigue, weakness, puffy face, dry skin, cold body
temperature and abnormal lab values.

Step Two: Market the new illusory disease with a phoney Grassroots
Organization

To popularize the new illusory disease condition, a pretend grassroots
organization is created such as the Restless Legs Syndrome Foundation,
a phoney organization sponsored with money from the GlaxoSmithKline
(GSK) and Boehringer Ingelheim, makers of the RLS drugs. This is a
pure marketing ploy.

Step Three: Create A Phoney Marketing Gimmick called "Awareness Week"

In order to make the "worried well" fear they have the new syndrome
and need the drug, RLS Awareness Week was invented. and supports
groups set up to offer symptom checklists so that the masses could
self-diagnose themselves as victims and 'sufferers' of the illusory
disease.

Step Four: Direct to Consumer Advertising

These Television ads imply that your doctor missed your symptoms and
failed to diagnose your new syndrome called "Restless Leg". The ads
are not required to be truthful and instead convey misleading, false
or incomplete information. (see below)


Consumer Reports Evaluates the Requip Ad Video
(shown below)





Here is the OriginaL Requip Ad:



Where are the Responsible Prescribing Physicians?

Dr. Moira Dolan says:


"The Restless Legs Syndrome campaign includes all of the essential
ingredients for successful disease mongering. Annual Mirapex
(Boehringer) sales are over $324 million and Glaxo's Requip makes over
$500 million a year. The astounding transparency of the whole-cloth
invention of RLS for the sales of the corresponding drugs reflects
poorly on the prescribing physician. It represents a gross abdication
of the responsibility of doctors to act as advocates and at least
sentient information managers for their patients."
How to Make Money in the Drug Industry

Identify a nutritional deficiency in the population (such as magnesium
deficiency), create a new syndrome caused by the nutritional
deficiency (such as Restless Leg), and then start a disease mongering
campaign to convince the masses to take an expensive, dangerous,
powerful drug (Requip and Mirapex) instead of an inexpensive mineral
such as magnesium, or a vitamin that actually solves the problem.
This template can be copied and repeated many times over, and it is.


Jeffrey Dach MD
4700 Sheridan Suite T
Hollywood Fl 33021
954-983-1443
http://drdach.com
http://www.jeffreydach.com

References:

Television Ads, Videos

http://www.requip.com/tv_commercial.html
Requip TV comercial

http://blogs.consumerreports.org/health/2007/11/finally-an-anti.html
November 01, 2007 Finally, an antidote to TV drug ads consumer reports
Jamie Hirsch evaluates the Requip Ad.

http://www.youtube.com/results?search_query=requip&search_type=
Requip videos on U-tube

http://www.dailycomedy.com/videos/567
Comedy video discussing requip reatless leg and their marketing

Disease Mongering

http://medicine.plosjournals.org/perlserv?request=get-document&doi=10.1371/journal.pmed.0030170
Giving Legs to Restless Legs: A Case Study of How the Media Helps Make
People Sick Steven Woloshin*, Lisa M. Schwartz

http://www.medicalaccountability.net/essay_RLS.html
http://www.medicalaccountability.net/
Disease Mongering Restless Leg Syndrome By Moira Terese Dolan, M.D.

http://www.pbs.org/kcet/wiredscience/story/76-the_business_of_disease.html
The Business of Disease

http://www.consumerreports.org/cro/health-fitness/health-care/medical-ripoffs-11-07/requip-commercial/requip-commercial.htm
What the ad doesn't tell you Excerpts from a Requip ad, deconstructed

http://www.knowledgeofhealth.com/report.asp?story=Disease+Mongering+and+the+American+Health+Movement
Bill Sardi on Disease mongering

http://www.bmj.com/cgi/content/full/324/7342/886
BMJ 2002;324:886-891 ( 13 April ) Selling sickness: the pharmaceutical
industry and disease mongering Commentary: Medicalisation of risk
factors
Selling sickness: the pharmaceutical industry and disease mongering
Ray Moynihan, journalist a, Iona Heath, general practitioner b, David
Henry, professor of clinical pharmacology c.

http://www.diseasemongering.org/downloads/abstracts.pdf
ABSTRACTS FROM THE INAUGURAL CONFERENCE ON DISEASE MONGERING


http://jeffreydach.com/2008/03/09/bisphosphonates-for-osteoporosis-a-closer-look-at-the-data-by-jeffrey-dach-md.aspx
Bisphosphonates for Osteoporosis, A Closer Look at the Data by Jeffrey
Dach MD

http://www.yourlawyer.com/topics/overview/requip
Suffered from Requip Side Effects?

http://www.cbsnews.com/stories/2007/04/05/health/webmd/main2650648.shtml?source=RSSattr=Health_2650648
24-Hour Parkinson's Drug: Longer Relief? Longer-Acting Requip May
Reduce Need For Commonly Used Levodopa April 5, 2007

http://deliverrants.blogspot.com/2006/08/we-have-nothing-to-fear-but-pharmas.html
WE HAVE NOTHING TO FEAR BUT PHARMAS THEMSELVES I was watching TV the
other night and saw a commercial for some new medication for something
that sounded serious ... "RLS"! They went on to explain that RLS was
"restless leg syndrome."WHAT?

http://us.gsk.com/products/assets/us_requip.pdf
REQUIP(R) (ropinirole hydrochloride) Tablets REQUIP (ropinirole
hydrochloride) is an orally administered non-ergoline dopamine
agonist.It is the hydrochloride salt of 4-[2-(dipropylamino)ethyl]-1,3-
dihydro-2H-indol-2-one monohydrochloride and has an empirical formula
of C16H24N2O*HCl. The molecular weight is 296.84 (260.38 as the free
base).

http://www.mirapex.com/
Mirapex web site

http://www.rls.org/
Restless Leg Foundation Web Site

Magnesiun Treats Restless Leg Syndrome

http://www.aasmnet.org/JCSM/Articles/020213.pdf
Intravenous Magnesium Sulfate May Relieve Restless Legs Syndrome in
Pregnancy, Sharon Bartel1; Sarah Zallek, M.D.Saint Francis Sleep
Disorders Center, Illinois Neurological Institute, Peoria, IL;
2University of Illinois College of Medicine at Peoria, Peoria, IL

http://www.purecaps.com/healthnotes.asp?org=pureencaps&ContentID=1255009
Treatable causes of restless leg syndrome

http://www.consumerlab.com/tnp.asp?siteid=consumerlab&docid=/tnp/pg000817
Consumer Labs Restless Leg Syndrome Treated with Magnesium

http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&uid=9703590
Hornyak M, Voderholzer U, Hohagen F, et al. Magnesium therapy for
periodic leg movements-related insomnia and restless legs syndrome: An
open pilot study. Sleep. 1998;21:501,505.

http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&uid=8363978
Popoviciu L, Asgian B, Delast-Popoviciu D, et al. Clinical, EEG,
electromyographic and polysomnographic studies in restless legs
syndrome caused by magnesium deficiency. Rom J Neurol Psychiatry.
1993;31:55,61.

http://www.springerlink.com/content/u51346w213147836/
Magnesium depletion in patients on long-term chlorthalidone therapy
for essential hypertension

http://www.ars.usda.gov/Services/docs.htm?docid=11219
USDA Agricultural Research Services, 68 % of people in US do not meet
DRI for MAgnesium

http://www.mgwater.com/
Magnesium Information Web Site

http://www.mbschachter.com/importance_of_magnesium_to_human.htm
The Importance of Magnesium to Human Nutrition
by Michael B. Schachter M.D., F.A.C.A.M.


Genetic Marker for Restless Leg Syndrome: Financed by Drug Companies
to Market Requip. This is a rare marker affecting a small number of
people. Magnesium Deficiency is far more common.

http://brain.oxfordjournals.org/cgi/content/full/126/6/1485
Brain, Vol. 126, No. 6, 1485-1492, June 2003 Autosomal dominant
restless legs syndrome maps on chromosome 14q Maria Teresa Bonati1,
Luigi Ferini-Strambi2, Paolo Aridon1, Alessandro Oldani2, Marco
Zucconi2 and Giorgio Casari1 1 Human Molecular Genetics Unit,
Department of Neuroscience, Dibit-San Raffaele Scientific Institute,
Milan and 2 Sleep Disorder Center, University Vita-Salute San
Raffaele, Milan, Italy

Jeffrey Dach MD
4700 Sheridan Suite T
Hollywood Fl 33021
954-983-1443
http://www.drdach.com
http://www.jeffreydach.com

(c) 2008 Jeffrey Dach MD All Rights Reserved
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Disease Mongering for Restless Leg Syndrome (RLS) by Jeffrey Dach MD