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Healthy Skepticism Library item: 18168

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Journal Article

Shulman KI, Rochon P, Sykora K, Anderson G, Mamdani M, Bronskill S, Tran CT.
Changing prescription patterns for lithium and valproic acid in old age: shifting practice without evidence.
BMJ 2003 May 3; 326:(7396):960-1
http://www.bmj.com/cgi/content/full/326/7396/960?view=long&pmid=12727769


Abstract:

Over the past decade, valproic acid (prescribed as divalproex in North America) has been marketed as an alternative to lithium for treating bipolar disorders. For elderly patients, however, there is no clear evidence that valproic acid is more beneficial than lithium. Moreover, the evidence for the superiority of valproic acid in treating bipolar disordersmixed episodes and rapid cyclinghas been challenged in a recent Cochrane review.1 Valproic acid has not benefited patients with manic and psychiatric symptoms in dementia, despite the growing use of the drug in the management of these conditions.2 Recently, the relatively rapid shift in prescription patterns has been questioned.3 We describe trends in the use of lithium and valproic acid in a large population of people over 65.

Keywords:
Aged Antimanic Agents/therapeutic use* Bipolar Disorder/drug therapy* Dementia/drug therapy Humans Lithium Carbonate/therapeutic use* Physician's Practice Patterns/trends Valproic Acid/therapeutic use*

 

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As an advertising man, I can assure you that advertising which does not work does not continue to run. If experience did not show beyond doubt that the great majority of doctors are splendidly responsive to current [prescription drug] advertising, new techniques would be devised in short order. And if, indeed, candor, accuracy, scientific completeness, and a permanent ban on cartoons came to be essential for the successful promotion of [prescription] drugs, advertising would have no choice but to comply.
- Pierre R. Garai (advertising executive) 1963