Like most Rx drugs these days, Cymbalta started life approved for one specific indication — major depressive disorder — and was later approved for another — diabetic neuropathic pain — and now yet another — generalized anxiety disorder (GAD).
GAD is one of those “real medical conditions” that no one has heard of until a drug has been approved for its treatment.
But it may surprise you to learn that you may suffer bouts of GAD without even knowing it! Here’s a patient story taken from the Web site of the National Institute of Mental Health (NIMH):
“I always thought I was just a worrier. I’d feel keyed up and unable to relax. At times it would come and go, and at times it would be constant. It could go on for days. I’d worry about what I was going to fix for a dinner party, or what would be a great present for somebody. I just couldn’t let something go.”
People with GAD, says NIHM, “are overly concerned about health issues, money, family problems, or difficulties at work.”
If you are like me — one teenager in college constantly overdrafting his expense account and another teenager spending his savings pimping his ride — you’d be a worrier about money and family problems too! And every day!
But to be truly diagnosed with GAD “a person [must worry] excessively about a variety of everyday problems for at least 6 months,” according to NIMH. GAD affects about 6.8 million adult Americans and about twice as many women as men.
Now I just know that Lilly, the company that markets Cymbalta, will make the most of these numbers and portray ordinary worriers like you and me as GAD sufferers.
There some precedent in how Lilly markets Cymbalta that makes me believe it will exaggerate the GAD indication. Lilly’s clever “depression hurts” marketing campaign, IMHO, is based on an indication — ie, pain associated with depression — for which Cymbalta is NOT approved.
There may be some truth that pain is associated with depression — Lilly’s animated video for physicians says “[depression] is also often associated with a physical component including low energy, changes in sleep and appetite, as well as vague aches and pains of varying degrees of severity…”
Recasting depression’s association with “vague aches and pains of varying degrees of severity” into “Depression Hurts” is a stretch in my opinion. Also, I am at a loss as to how “vague aches and pains” fall under the approved labeling for diabetic neuropathic pain. It seems to me that the Depression Hurts campaign smacks of off-label promotion.
Given that, I am worried that Lilly will engage in a bit of GAD disease mongering to sweep as many unsuspecting worriers into doctors’ offices demanding Cymbalta. I know I sure would like to stop worrying about my kids every day!