Restless depression.

The two omnipresent TV drug advertising campaigns right now are for Requip and Cymbalta. I know, because, having written about both here, I get visits from people searching for information on both. Requip is GlaxoWellcome's drug for Restless Legs Syndrome (RLS), and Cymbalta, from Eli Lilly, is approved for treating depression.

Both afflictions have been around for eons. These brain-chemistry drugs are fairly new. The pain and suffering of RLS and depression is real. The expense of treating them with these drugs is, too.

Advertising works. I've seen lots of hits on the phrase "depression hurts," which is the theme of Lilly's campaign, addressing physical pain associated with depression, as well as "restless legs" or "RLS," among other keywords. One person even searched on "Cymbalta" and "RLS" -- confusing the drug and/or the disease.

This is an interesting mistake, since both campaigns talk about the affliction more than the drug, so it's easy to see how you could forget whose commercial is whose. So, what if you go to your doctor and tell him you know you have RLS and you want that new drug Cymbalta for it. What happens next: the doc should say "Oh, you mean Requip." Hope he does.

But wait a minute. What's supposed to happen in real pre-marketing life is, you have this funny feeling in your legs that's keeping you awake, or you have neck or back pain and you're also feeling anxious or depressed, and you go to the doctor and ask him-her to examine you and figure out what's wrong. Period. It's up to the doc to decide what, if any, drug you should take.

There are other non-drug treatments for both these disorders. I'm not saying they're better, but they don't have side effects. I've been taking an antidepressant for about ten years. It worked--works--well. Miraculously, in fact. But I still feel a little strange about how I got started on it.

I went through a hospital depression screening event, then went to my doctor, who said, "Well, I can run some tests or I can start treating you." Since I was feeling bad and it takes about six weeks for your typical antidepressant drug to start working, and neither of us had a lot of time to waste, he wrote the prescription, I started taking pills that day, and six weeks later my anxiety and hysteria switched off. The "marketing" in this case was a screening event I visited because I was tired of being miserable. And whatever marketing contact made the doc comfortable with the packaged diagnosis I brought him.

But, a couple of years later, I went to the next doctor to take my case at clinic I went to then, and he said, "Hmmm, I want to run a test." Turned out I had an underactive thyroid. Probably contributed to my depression, and could have caused greater problems. Now I'm also taking synthetic thyroid pills every day. I wonder, could I have started on these cheap thyroid pills two years earlier and saved my insurance plan the cost of expensive antidepressants, which did nothing for the root cause of the depression and delayed getting treatment for something that could have hurt me worse?

What's this got to do with TV ads? Requip and Cymbalta, you'll discover if you read past the home pages of their Web sites, were both developed first to treat other diseases besides the conditions they're being promoted for now. Sure, drugs are found to be effective for second and third conditions all the time. But you have to wonder, after the famous Prilosec-Nexium marketing ploy, are these new applications of Requip and Cymbalta the result of medical research or necessity, or brand development?