Jarvik karma.

May the phenomenon of metaphysical blow-back that has whisked Dr. (non-practicing-non-rowing) Jarvik out of our lives likewise propel Eli Lilly and Co. and their heart-rending and brilliantly scored Cymbalta TV commercials into deserved oblivion. If traffic on this Website is any measure, people are still captured and intrigued -- haunted, even -- by the quasi-classical music of these antidepressant pitches. All the direct-to-user TV advertising for prescription remedies has so muddied the practice of medicine that formerly important, potent, risk-managed drugs are now sold like Preparation H. All those mumbled voice-over warnings about side effects, including really serious, life threatening ones -- even four hour erections (you don't want to know how they fix that) -- go right past us and we run to our docs asking for them. We take responsibility for our own care, now don't we. So we have only ourselves to blame. And now that studies are saying antidpressants, maybe, work no better than sugar pills against depression, hell, we might as well be swigging Lydia E. Pinkham's. It's at least got an alcoholic side effect to make up for the taste. And has all this made us trust the FDA more? I saw a commercial that used "...and it's FDA approved..." like it was a recommendation. I'd think twice about that. Yes, bring on the karma. This is the way America takes care of problems of misrepresentation and just plain BS. Very Republican. Expose the hype and let the marketplace decide.

Gut check.

First of the year. Seems like a good time to consider what this site's about. Hype is not going away. The question: how to live a relatively sane, sensible life when you're surrounded by it. I think most of us succeed, actually. The early start to our Presidential season actually makes me feel pretty good. Politics don't seem to be nauseating me so much. I think we're a little more awake. Surely, the Republican machine doesn't seem so strident this year. That's smart of them. Even the most jaded of them seem to realize they can't do things the same way as before and expect to command the loyal. Likewise the Democrats. The presence of Obama seems to have changed the tone of their primary campaign. The media people are trying to whip up some fear and loathing, but I think the Clinton-Obama War story is a non-starter. I think they're lobbing macaroons at each other and the voters aren't paying attention to that stuff. I think both parties have learned something from the past six and a half years (Year One being 2001), and I hope the press and TV media do too, eventually. Me, I've slacked off in recent times on this site, though a lot of you come around looking for info on Cymbalta and Dr. Jarvik. Mostly, you're curious, and not much interested in my chronic outrage at drug advertising. It has helped ruin our health care system, but it isn't the only thing. We've put up with it. We share a major part of the blame. Even with all the hooha about all the issues and politics, only about half of us vote. No amount of hype has gotten the rest of us participating in cleaning up our various messes. How about checking your gut. If you spend one minute a year wondering how some of this stuff'll get fixed, shut up. Unless you at least know what's going on, and cast a vote. Thanks for dropping by.

YourTimeForChange?

It's a classic marketing challenge. You've got a good product, but it's just like all the others. You weren't the first into the market, so you don't have brand name recognition. What do you do?

There are lots of prescription drugs for depression. It's one of the miracles of pharmacology. First, there was Prozac. But, of course, there couldn't be just one drug -- all the drug companies had to have one, to get a piece of the depression market. Wyeth wasn't the first on the market. And Lilly, the Prozac company, beat them to the "new-improved" space with Cymbalta, touted to be the first drug that replaces norepinephrine, as well as serotonin. So, now, what does Wyeth do to elbow into this mature market with their me-too Cymbalta-type drug, Effexor XR?

Well, they found a way. See, a particular drug doesn't always work for every patient. Doctors often have to try several with a patient before something clicks. So, Wyeth has just rolled out a TV-Internet campaign, suggesting that if you're taking an antidepressant and still have depression symptoms, it may be "Your time for a change." The TV spots mention no drug. The pitch is to talk to your doctor, and/or go see YourTimeForChange.com. The site doesn't mention a drug name either, just gives you information, offers you a checklist of symptoms, and talking points to use with your doctor. Subtle, no? Wyeth's name is on the TV spots and the site. Nothing illegal here. Oh, they do have another site, or at least a domain name, TheChangeYouDeserve.com, in a Google search ad, which takes you to the Effexor XR site.

You might call this the Ricochet School of Marketing -- finding work-arounds for a heavily regulated advertising marketplace. Wyeth is spending millions to, like, drop a few hints. As a public service? No, folks. Something tells me a depressed person already under a doctor's care would know to go back if she's not feeling better. Remembering that most meds take six or more weeks to kick in, right? And, of course, don't docs who prescribe powerful medicines know to tell you all these things? Ignore drug ads, folks. Things have gotten all out of balance. Focus on getting the most attention from your doctor.

MORE ON MEANINGLESS CYMBALTA MYSTERY.

A dehype reader writes:

I was just discussing what I thought the melody on the Cymbalta ad was with my wife and decide to look it up on the net. I came across your site and would like your opinion. Sounds like portions o"Poor Little Buttercup" from Gilbert and Sullivan's "HMS Pinafore". My wife says it sounds nothing like it, check it out and please give me your opinion. If it is, I would think it could be considered somewhat insensitive.

regards,

Al Fien

And I answer:

Golly, Al. I never thought of "Buttercup." You're right, the first six notes are pretty close, if not identical. Could some ad-music guy be playing a little prank on us? Lilly isn't saying. But, knowing how risk-averse advertisers are, and how closely they scrutinize every detail of a commercial or ad for signs of trouble, I think it's likely what they say about the music is true: that it's "original" music written for the commercial. Still, there's nothing new under the sun, and I'm pretty sure the "composer" was looking for familiar, evocative phrases, and his memory supplied this tune, maybe a snippet of Schumann, maybe a taste of Gilbert. In any case, it's a clever job of pushing our emotional buttons, which, when used to sell a drug directly to people with depression, I believe, is the very definition of insensitivity.

Thanks for writing.

Dave

What's new? If you've arrived at this post by searching for a subject, I invite you to see what I'm up to today. Click here to go to the top of the blog.

LIGHTEN UP, DAVE.

I think I've been taking my mission too seriously. I'm gonna have more fun. Why am I writing this? Because I looked at one of the Google searches you people use to look up information on the Cymbalta TV campaign and its insidious music. Here it is.

When I read what the bloggers are saying about Cymbalta's music, and other commercials, like the Abe Lincoln and beaver spot for Rozerem, I feel a lot better about how gullible people who use the Web are not. Like this one, for example.

I'm getting mostly hits from people looking up these and other pharma commercials. Dr. Jarvik's Lipitor campaign is probably the number two search I see on my hit counter. Keep looking. Keep talking about it. When everybody realizes drug ads don't make drugs work better, maybe they won't sell drugs either.

CYMBALTA MUSIC: IS IT SCHUMANN?

The drama continues. I don't have an accurate count of the Internet searchers who've wondered what the music is on the Cymbalta TV commercial, but it's a lot. Several commenters to my posts on the subject have suggested that the theme was heard in "Sophie's Choice," the movie, but until now, nobody has identified an actual piece of classical music by name. This week, an anonymous commenter has suggested it's a rearrangement of Robert Schumann's "Kinderszenen [Scenes from Childhood] Op. 15 No. 1 that was played in "Sophie's Choice" by Nathan while sitting on the piano bench with Sophie." Well, it could be. I went here and listened, and it sure sounds like the "composer" of the TV music created something that sounds very much like Schumann's piano piece. There are other places to listen. Just Google "Schumann" and the title above. Unless there's another very similar piece of music out there, I think we've solved the riddle. Just remember why I started posting about this...music and other attention-getting devices have nothing whatever to do with which medicine is right for you.

LINK: Other dehype posts on Cymbalta.

What's new? If you've arrived at this post by searching for a subject, I invite you to see what I'm up to today. Click here to go to the top of the blog.

IMPRESSIONS -- CYMBALTA REVISITED

Marketing and advertising people are mainly interested in the manufacture of impressions. When producing an ad, they concentrate on developing words, images and sounds that further the persuasive goal of the marketing campaign. Nothing in an ad is present by accident.

Cymbalta commercials not only promote the use of this prescription drug, but have successfully introduced a new way of diagnosing and treating depression -- based on the presence of physical pain in persons suffering from serious clinical depression. There is medical literature to support this diagnosis, but I believe this marketing position is based upon Cymbalta's having been approved by the FDA for the treatment of diabetic pain as well as depression. The Lilly marketers clearly have used this dual approval to create the impression that Cymbalta is superior to other anti-depressant drugs. "Depression hurts...."

Add a little research to your consideration of whether you ask your doctor about Cymbalta, or, if you're a physician, whether you prescribe this drug over an alternative treatment. Here's a starter link for you. This Google search raises several questions in its first page of results. It's also obvious that the association of pain with depression is not a universal diagnosis. Of course, the Cymbalta ads don't say it is. It's only one impression the commercials create.

The most powerful impression created by the Cymbalta TV campaign is musical. The Cymbalta music generates hundreds of Web searches every time the commercials air. Cymbalta is one of the most widely prescribed antidepressants. What impression do you have about the intelligence of doctors, and their patients?

Update: We may have the answer to the what's-that-music mystery. See here.

Update 08/11/06: Government scientists think they've found an "instant cure" for depression. Here's my post.

O.K., CYMBALTA MUSIC FANS. . .

Here's the latest. A little while ago, I spoke with a nice lady in the PR department at Eli Lilly & Company, makers of Cymbalta, the prescription depression medication whose commercials are so captivating. The lady in Indianapolis politely explained that the music on the Cymbalta commercials, as we've heard before from others, was composed and recorded especially for the commercial campaign.

Lilly hears from lots of people who want to know more about the music, but they're unwilling to disclose the name of the composer, the musicians, the production company or their advertising agency to those who inquire.

As I get time, I'll continue to look for these answers. I don't know why Lilly is treating this as such a secret. I could engage in all kinds of guessing games, but it doesn't really matter. They're within their rights. If you run across any new information, you're welcome to post a comment to this entry. Thanks in advance for your help.

A reminder: music isn't a bad treatment for some forms of depression, and it has no known side effects. Ask your doctor if music is right for you. And, please don't ask for prescription medicine just because you like the music on its TV commercial.

UPDATE 092106: We may have the musical answer. See here.

UPDATE: More on Cymbalta and drug ad techniques here.
Another Update 08/11/06: New post on the lastest depression medication breakthrough (maybe).

At last, we know what that "depression hurts" music isn't.

A member of a Stringworks.com discussion board actually called Eli Lilly and asked them what that music on their Cymbalta TV commercial is. The answer: created for the commercial, no plans to release it as a single. I was going to call them, but I was too lazy. And jaded, from years in media and ad biz--you never know what's going to click with people--but you can be pretty sure that music goes straight to the emotions. You may ask, What's all this got to do with the selection of the right prescription drug for depression? Answer: nothing, of course. See my earlier posts, please.

Cymbalta? Zoloft? Wellbutrin? M&Ms?

[02/05/06 UPDATE BELOW]
I've been railing about the prescription drug marketing scene, and hadn't gotten around to asking a key question: What's the difference between one antidepressant and another? I did that this morning, and even my inch-deep Google search pulled up two significant pieces of reportage from journalistic sources (as opposed to people with commercial or ideological axes to grind):

1. A September 2005 article in Forbes, reporting on a study of the clinical trials of many of the best known antidepressants, (including Cymbalta, by the way) which concluded that there's little difference among them in terms of effectiveness. Even the differences in side effects are small. The greatest difference among them is price.

2. An article in September 2002 Psychiatric Times--which says it's the leading trade publication in the field--reporting on another study of some of the same FDA clinical trials data, noting that none of the trials showed the antidepressant being tested was significantly more effective than a placebo. This doesn't mean antidepressants aren't effective...just that they're apparently no more effective than placebos. Read it for yourself.

Full disclosure: I've been on Zoloft for over ten years, and I'm damn glad my doctors prescribed it. My point in bringing this information to your attention is, medicine isn't all science. And, advertising is the wrong way to decide which drug to prescribe. No calm voice telling you about side effects, with moaning violins playing in the background, balances the emotional sell of the commercial. "Ask your doctor if ______ is right for you" is the wrong advice. They're telling you to demand that your doctor justify not giving you a particular drug. Slick, huh. If the drug rep can't make the sale, they'll send in the patient.

Ask your doctor, "Doc, what can I do about the way I feel?" Then, "How did you decide that drug is right for me?" Why did my doctor prescribe Zoloft in the first place, when there were other drugs out there? Prozac, for one. This was before direct-to-consumer drug advertising was legal. Maybe it was because the Zoloft guy was the last drug rep he saw. I wish I'd asked him then.

All the TV advertising the pharmaceutical companies run--by some accounts, around $4 billion a year--is only a fraction of what they spend to sell directly to doctors. They spend even more billions to lobby governments.

UPDATE: Or, if you like, addendum. Recently, a group of physicians wrote in an article in the Journal of the American Medical Association that medical schools should ban gifts, samples and contributions to continuing education from pharmaceutical companies. Read about the article here.

This was going to be a short post. It's not. I hope it doesn't depress you. If it does, take a walk and buy some chocolate.

I'm looking, I'm looking.

There is more interest in the identity of the music played behind the Cymbalta "depression hurts" TV commercial than in depression itself. That is, if you can trust the hit count of this blog.

Which, in itself, is a little depressing. "Kira" even nagged me about finding out what it is. You'd think somebody would have found it by now. I haven't been able to locate the info in the usual ways (Google, etc.).

But, sigh, I'm working on it.

Never mind the music on the Cymbalta TV commercial. Look at this.

Because so many people are searching the Net, trying to find out what that music is, I decided to see if I could find it for you. I'm still looking...but I found this: an article in the Indianapolis Star, in Eli Lilly's hometown. It says Lilly is trying to get Cymbalta approved for use against "generalized anxiety disorder." it's already a smash as the latest drug of choice for depression and diabetic pain. Lilly's done a masterful positioning job with "depression hurts." And if they released the music, it'd go through the roof, too. If you were in marketing, wouldn't you want to get Cymbalta approved for everything short of the common cold? Don't forget, though, to ask your doctor if all this is right for you.

10/13/06 -- If you've come here searching for answers to why music makes you want a depression drug, please read my post about how and why advertising works. Here.

UPDATE 5/18/06 -- For the latest on the search for information on the Cymbalta music, see my 5/17/06 post on the subject.

What's new? If you've arrived at this post by searching for a subject, I invite you to see what I'm up to today. Click here to go to the top of the blog.