Ngabe i-Psychiatry Yonakaliswe Ngaphezulu Kokungalungiswa?

-Delile

• Ukufundwa Okubalulekile Kwe-Psychiatry
• Ukuhlanganisa Ukunakekelwa Kwengqondo Nemikhuba Yokunakekelwa Okuyisisekelo

Siyazi ukuthi izinkampani zingabonisa izidalwa ezimbalwa ekufihleni umonakalo owenziwe yimikhiqizo yazo. Abenzi bakagwayi bafihla isixhumanisi somdlavuza wamaphaphu amashumi eminyaka. Izinkampani zamandla nabalingani bawo bezepolitiki bayaphika ukuthi kukhona ukuxhumana phakathi kwamafutha asetshenziswayo nokushisa komhlaba. Kepha ayikho imboni eye yahleleka futhi yaphumelela njengezinkampani zemithi ngokufaka ngesisekelo solwazi maqondana nemikhiqizo yazo. Imiphumela ibe inzuzo ephezulu. Izinkampani eziyishumi eziphezulu ezithaka imithi ku-Fortune 500 zenza imali eningi kunezinye izinkampani ezingama-490 kuhlangene .

Cabanga ngalokhu: Kuthiwani uma wonke usosayensi ocwaninga ukufudumala kwembulunga yonke akhokhelwa yi-Exxon? INew York ibingaba ngaphansi kwamanzi ngaphambi kokuthi noma ubani azi ukuthi ukufudumala kwembulunga yonke kukhona. Kodwa-ke, leso yiso kanye isimo socwaningo lwesayensi kwezengqondo. Ngaphezu kwamaphesenti angama-80 ocwaningo lwezifo zengqondo olwenziwe ezikhungweni zezokwelapha zezifundo zixhaswa yimboni yezidakamizwa. Futhi izindaba ezimnandi lezo. Ngokuvama okwandayo, iBig Pharma ikhokha izinkampani zokumaketha ezingenabo ubuhlobo nezifundiswa ukuze zenze izifundo ezibeka imikhiqizo yazo ekukhanyeni okungcono kakhulu; bese bekhokhela izifundiswa ukuze zibeke amagama azo ezifundweni ezingumphumela njengababhali, noma ngabe bezingabambi qhaza ocwaningweni. Ukubona ukuthi yimiphi imiphumela, thatha isibonelo seNeurontin.

Cishe eminyakeni eyi-12 edlule, ngabona ukuthi eziningi zeziguli zami zohlobo lwe-bipolar type II zazifakwa kumuthi omusha, iNeurontin. Azikho iziguli zami ezazibonakala zithola inzuzo enkulu kukho, futhi iningi lahlushwa imiphumela emibi. Manje, ngiyaqonda ukuthi kungani.

Manje sesiyazi ocwaningweni oluzimele - ucwaningo olungasekelwa ngezimali yizinkampani zemithi - ukuthi iNeurontin ayikhiqizi nhlobo inzuzo ekwelapheni ukuphazamiseka kwengqondo okuguquguqukayo. Akukho. Kepha-ke, kungani sikholwa ukuthi kwenzeka? Indaba kaNeurontin yisibonelo esibi kakhulu sesayensi egijima i-amok, kepha hhayi i-atypical. Odokotela bezengqondo bakhuthazwa ngamanga ukuthi banikeze umuthi owawungaphephile futhi ungasebenzi.

Isifundo esasenziwa nguWarner Lambert fakazela INeurontin ibisebenza ekwelapheni i-bipolar disorder ibinamaphutha futhi ibizwa ngemiphumela emihle, ngokusho kwendatshana yakamuva ekhishwe ku Izinqolobane Zemithi Yangaphakathi . Okubi kakhulu, ubufakazi bemiphumela emibi kulolu cwaningo bucindezelwe: Iziguli ezingama-73 kuleli cala zibe nokusabela okungekuhle, kanti kwafa iziguli eziyi-11.

Kwenzeke kanjani lokhu? Ngo-1993 uWarner Lambert waba nenkinga. INeurontin, isidakamizwa sabo esisha sokulwa nesithuthwane, babenikezwe imvume elinganiselwe kuphela ye-FDA ukuthi isetshenziswe kuphela njengomuthi wesibili wesifo sokuwa - yayingasetshenziswa kuphela uma ezinye izidakamizwa zesifo sokuwa ezazivele zisemakethe zehluleka. "INeurontin ibiyiTurkey." Wabhala uDaniel Carlat ku Unhinged . Okufanele ngikwenze?

Le nkampani yaqasha amafemu wokumaketha - hhayi ososayensi - ukukhiqiza izindatshana zesayensi ezibonisa izinzuzo zeNeurontin yesifo sokuphazamiseka kwengqondo okuguquguqukayo, yakhokhela odokotela u- $ 1,000 ucezu lokuvumela amagama abo abhalwe njengababhali bezifundo abangazange bazenze noma bazibhale (futhi mhlawumbe ungakaze ufunde).

Ngenkathi i-FDA idinga izinga eliphakeme kakhulu lobufakazi besayensi ukwamukela umuthi wokwelashwa kwesimo esithile, uma umuthi usuvunyelwe, odokotela bakhululekile ukunquma noma imuphi umuthi nganoma yisiphi isimo, off ilebula. Ukubakholisa ukuthi benze lokhu, imininingwane ebuthakathaka noma ebhucungwe ingagqokiswa ukufakazela ukuthi umuthi uyasebenza, futhi akukho kudinga ukuhlolwa kwe-FDA. Kuyicala enkampanini yezidakamizwa ukuthengisa izidakamizwa kodokotela ngezinhloso ezingekho kwelebula, kodwa yilokho kanye okwenzekile. UMarcia Angell, owayengumhleli we I-New England Journal of Medicine , ubhale wathi: "inkampani ibenze uhlelo olungekho emthethweni lokukhuthaza iNeurontin ngokusetshenziswa kwamalebula - ikakhulukazi ngokukhokhela ochwepheshe bezemfundo ukuze babeke amagama abo ocwaningweni olungelutho."

Izidakamizwa ziyehla kodokotela bengqondo. Isikhulu esiphezulu seWarner Lambert uJohn Ford ukhuthaze abomthetho bakhe ukuthi "babambe izandla bahlebe ezindlebeni zabo ... INeurontin ngesifo esiyi-bipolar." Uqhubekele phambili, ebakhuthaza ukuthi badlule umthamo ophakanyiswe yi-FDA ka-1800 mg / ngosuku, wengeza ngokuthi "Angifuni ukuzwa lokho kudla." UWarner Lambert ukhokhe inhlawulo eyizigidi ezingama-430 ngokukhangisa kwayo okukhohlisayo nangokungemthetho kochwepheshe bezengqondo.

Ngabe isigameko sodwa seNeurontin? Ukuqanjwa kwesipoki kwezemfundo okwenziwe yizinkampani zokumaketha kuyinqubo ejwayelekile. Ngo-2001, izinkampani ezidayisa izidakamizwa zakhokha amaRandi ayizigidi eziyizinkulungwane eziyisikhombisa ezinhlanganweni eziyinkulungwane zezinkontileka zokucwaninga ukuze zikhiqize imininingwane ebeka imishanguzo yazo endaweni enhle kakhulu. Lokhu kungene ngokujule kangakanani ekufundweni kwengqondo? Amaphesenti angama-57 ezindatshana zesayensi ezishicilelwe mayelana neZoloft, ngokwesibonelo, zabhalwa yinkampani yezentengiso i-Current Medical Directions kanye nesipoki esabhalwa yizifundiswa ezazingenayo ingxenye yezifundo. Lezi zihloko zivele kumajenali aphezulu kufaka phakathi i- Ijenali yaseMelika Yezokwelapha kanye ne- Ijenali ye-American Medical Association. "Ngakho-ke, okungenani i-anti-depress eyodwa eyodwa, iningi lezincwadi zezokwelapha lalibhalwe ngokoqobo yinkampani yezidakamizwa eyenza lo muthi, okucishe kufane nokukhwabanisa kwesayensi ngendlela umuntu angacabanga ngayo," kubhala uCarlat. Futhi ku- New York Times u-op-ed u-Carl Elliot ubhale wathi, "Izinkampani ezenza imithi zithuthukisa izidakamizwa zazo ngezifundo-mbumbulu ezinokuncane okuncomekayo kwesayensi."

Ukufundwa Okubalulekile Kwe-Psychiatry

Ukuhlanganisa Ukunakekelwa Kwengqondo Nemikhuba Yokunakekelwa Okuyisisekelo