7/24/2000 – Prozac [Sarafem] and PMS – What’s in a name?

Once again we thank Vera Hassner Sharav, President, CIRCARE: Citizens for
Responsible Care & Research, a Human Rights organization, for passing on this
interesting commentary on Prozac’s name being changed to Sarafem for PMS. The
dangers of interaction leading to serotonin syndrome – a life threatening
complication of serotonergic medications – is most obvious in all of these
name changes.

Ann Blake-Tracy

~~~~~~~~~~~~~~

http://mentalhealth.about.com/health/mentalhealth/library/weekly/aa071700a.htm

Prozac and PMS – What’s in a name?
Leonard Holmes, Ph.D.

Drug companies are doing some interesting things to the names of their
products. The FDA recently approved the chemical fluoxetine for the treatment
of symptoms related to PMS – Premenstrual Syndrome (officially known as PMDD
– pre-menstrual dysphoric disorder). Fluoxetine is sold by Eli Lilly and
Company under the name Prozac. Will women with PMS be taking prescriptions
for Prozac to their pharmacist? Not likely. Lilly has decided to rename the
drug Sarafem when it is prescribed for this problem. Why the new name?
Lilly’s official position follows:

The additional trademark will help with educational efforts for this largely
underrecognized disorder while reducing confusion about the differences
between depression and PMDD. (Lilly Newsroom 7/00)

What about the confusion that is added by two different names for the same
chemical? What happens when a patient gets Prozac from one doctor and
Sarafem from another?

Prozac has a mixed reputation. While some have hailed it as the first in a
class of wonder drugs others have implicated it it in some cases of suicidal
behavior. There have never been any substantiated cases of suicidal behavior
traced to Prozac or any other antidepressant. Lilly has a response to these
rumors too:

Concerning media allegations of Prozac and suicide there is no credible
evidence that establishes a causal link between Prozac and violent or
suicidal behavior. In fact, in September 1991, a panel of experts appointed
by the FDA found no credible evidence of a causal link between the use of
antidepressant drugs, including Prozac, and suicidal or violent behavior.
(Lilly Newsroom quoted 7/00)

This is not the first time that a drug company has given a new name to the
same medication. In 1997 bupropion was approved for smoking cessation. This
medication, better known by the trade name Wellbutrin was re-christened Zyban
when used for smoking cessation. That’s why the Zyban ads warn you not to
take it if you are taking Wellbutrin. Not much fuss was made about this at
the time, but it seems to have started a trend.

Steve Cartun, M.D. did write to protest the renaming back in 1997. His logic
still rings true, and there is a great deal of irony in the example that he
used at the time. An excerpt:

New indications for old medications have become a staple of
psychopharmocology. Prozac, for example, originally introduced as an
antidepressant, has since garnered FDA approval for the treatment of
obsessive-compulsive disorder. Eli-Lilly, the company that manufactures and
holds the patent for Prozac, did not rename it’s product simply because it
had earned a new indication. Even though Prozac had been subjected to false
and damaging statements, Eli-Lilly chose not to fashion it in newer clothes.
The renaming of Wellbutrin by the same company that manufactures it, simply
because research studies show that it has a new and valuable use, gravely
concerns me….

The renaming of medications is a dangerous semantic. While a pharmaceutical
company can argue that a new name that gains wider use will ultimately help
the patient, I believe that such a measure treats physicians like naive
consumers who care more about a logo than the gritty science that logo
represents. Perhaps this is an alarming symptom of how trivialized the
importance of reality, at the expense of marketing, is becoming. Physicians
have already been renamed health care providers. Wellbutrin is now being
named Zyban for a new use. An industry insider once told me that the letter
“Z” is particularly useful for gaining audience attention. I hope that Zyban
gains all the attention it can to prevent this naming process from becoming a
trend. Enough misrepresentation. Convolution must be resisted. If it
continues, the meaning of health care will become even more lost than it is
now. (Cartun, 1997)

I’m afraid that Dr. Cartun’s hopes have not been realized. Lilly has renamed
Prozac to appeal to women with PMS who might otherwise shy away from the
medication. It’s hard enough to keep track of all of the different
medications out there. We shouldn’t have to keep track of multiple trade
names for the same medication from the same company.

Excerpt from a 1997 letter by Dr. Steve Cartun:

New indications for old medications have become a staple of
psychopharmocology. Prozac, for example, originally introduced as an
antidepressant, has since garnered FDA approval for the treatment of
obsessive-compulsive disorder. Eli-Lilly, the company that manufactures and
holds the patent for Prozac, did not rename it’s product simply because it
had earned a new indication. Even though Prozac had been subjected to false
and damaging statements, Eli-Lilly chose not to fashion it in newer clothes.
The renaming of Wellbutrin by the same company that manufactures it, simply
because research studies show that it has a new and valuable use, gravely
concerns me….

The renaming of medications is a dangerous semantic. While a pharmaceutical
company can argue that a new name that gains wider use will ultimately help
the patient, I believe that such a measure treats physicians like naive
consumers who care more about a logo than the gritty science that logo
represents. Perhaps this is an alarming symptom of how trivialized the
importance of reality, at the expense of marketing, is becoming. Physicians
have already been renamed health care providers. Wellbutrin is now being
named Zyban for a new use. An industry insider once told me that the letter
“Z” is particularly useful for gaining audience attention. I hope that Zyban
gains all the attention it can to prevent this naming process from becoming a
trend. Enough misrepresentation. Convolution must be resisted. If it
continues, the meaning of health care will become even more lost than it is
now. (Cartun, 1997)

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