Fibromyalgia is the result of a chronic, morbid lack of sleep. (Too much work eating into sleep time, whatever.)

As a long standing, actively practicing consult-liaison psychiatrist it is fairly simple to explain "fibromyalgia". The fact that Pfizer advertises Lyrica as NOT AN ANTIDEPRESSANT is somewhat curious, as their soon to be generic antidepressant, Zoloft, would do a better job in treating "fibromyalgia".

If one takes a history from a patient with these types of pain complaints, you find that they have trouble sleeping, changes in energy and appetite; poor concentration, lack of interest in daily activities, increased pain complaints, changes in weight and appetite. Now, go to the DSM-IV TR (a document with enough problems of its own, but somewhat established) and look up Major Depression. Note that these are the symptoms of that illness. Hence, since it looks, quacks, swims and walks like a duck, it is most likely A DUCK.

Now add Somatoform Pain Disorder, and you have "fibromyalgia". Enough good studies have shown that antidepressant therapy along with good cognitive-behavioural therapy will treat the symptoms of this illness. For unclear reasons, people don't want to be "labeled" with a psychiatric disorder, but even in them, there IS something wrong with the brain.

"Fibromyalgia" is an illness invented by Rheumatology along with Pharma for somewhat unclear reasons. Good psychiatric care would take care of all of these suffering folks.

Is the argument that 'Big Pharma' should not advertise their drugs or that they should not make them in the first place? Because the way the article is written, I get the impression that the author is demonizing 'Big Pharma' for making a drug that treats symptoms. Personally, if I have symptoms that significantly compromise my quality of life (which I cannot treat by other means), I would like someone (and 'Big Pharma' is the best someone to do this) to make a drug that treats them. It should be the responsibility of your doctor to only prescribe the drugs if you need them. If you go to your doctor and beg for these pills because the commercial said so, then the doctor should treat you for being a hypochondriac and perhaps a bit paranoid, not for fibromyalgia. (On the other hand, if the doctor does give you this pill, it might reduce your anxiety so you won't want to continue pill-popping, and perhaps will actually decrease the number of drugs you ask for, punching a hole in any conspiracy theory one might concoct.) I think pharmaceutical companies get a lot of flack for doctors mis-prescribing their products. It is like getting mad at the paint company because the hardware store sold you the wrong colour.

How you treat it is subject to debate.

"If you go to your doctor and beg for these pills because the commercial said so, then the doctor should treat you for being a hypochondriac and perhaps a bit paranoid, not for fibromyalgia. (On the other hand, if the doctor does give you this pill, it might reduce your anxiety so you won't want to continue pill-popping, and perhaps will actually decrease the number of drugs you ask for, punching a hole in any conspiracy theory one might concoct.)"

@ esteban

What you don't know is that if explain to a patient that they don't need the drug they will go to someone else who will give them the drug. This creates a cycle of reward for doctors who prescribe according to commercial recommendations. This isn't good for anyone except pharmaceutical companies.

Yet another crackpot telling us that a belief that every decent, responsible, sober-minded, Time-reading citizen rightfully holds is actually completely bogus and being used to take advantage of us by out of control forces.

Who keeps giving Salon the money they spend digging this stuff up?

Just curious -- is there a "little pharma?"

Look, drug companies are primarily interested in money. They're secondarily interested in helping people get better (conspiracy theories aside). In a perfect world, would that order be flipped? Sure. But given that most industries are interested ONLY in making money...I'm willing to cut pharmaceutical companies some slack.

More importantly, I'm willing to make my own health decisions in consultation with my doctor, and choose what's right for me from the available options. (I'd prefer, of course, that the available options be as broad as possible.)

I guess I just don't see what's so bad about Pfizer offering a product that they think will alleviate pain -- even if they get rich in the process.

The DSM-IV manual does not have a "increased pain complaints" criteria for major depression.

If you're wrtting about health and present as fact : "High cholesterol is a serious health problem"; then you obviously have no idea what you're talking about, and it's impossible to take the rest of the article seriously.

If you believe you have a condition that makes you more sensitive to painful stimuli, you may well experience more pain than those who believe they aren't sensitive to painful stimuli.

This an interesting exercise in circular reasoning.

Or, perhaps people who actually experience more pain somehow "believe" they have a condition that makes them sensitive to pain. What a bizarre concept! But it certainly makes more sense than the premise that people subconsciously invent this syndrome. Or shall we call it "hysteria" for short?

It seems like the real issue here isn't that a pharmaceutical company is trying to fill a perceived niche with an existing drug, but that the FDA is complicit in approving that treatment on what the author believes is shoddy evidence.

It's true that under both Clinton and Bush, FDA oversight of drug approvals seems to have fallen by the wayside in the interest of getting drugs to the market faster. This is almost certainly due to pressure exerted by the pharmaceutical industry and with good cause - the extremely limited time a company can make money on a new drug before it goes off patent can be severely compromised if the FDA drags its feet for years waiting for convincing data.

That seems to be the whole source of the problem. Perhaps there's a way around it that would be satisfying for both parties? There's a real health issue in getting safer drugs to the marketplace (Vioxx anyone?) but companies need to maintain their financial incentive to continue making new drugs, many of which are exorbitantly expensive to research and test before they ever earn a dime. So perhaps the patent office and the FDA can collaborate - a scheme by which the patent life is extended during FDA testing? So the longer the drug sits in FDA-mandated clinical trials, the longer the patent life is? Just a thought.

As for using psychiatric drugs to treat clinical conditions - there's ample precedent for that already. Gabapentin (aka Neurontin) is becoming an increasingly popular treatment for neuropathic pain despite its popularity as an anxiolytic.