Antidepressants for Shopaholics?
ALLIANCE FOR HUMAN RESEARCH PROTECTION
(AHRP)
http://www.ahrp.org
Contact: Vera Hassner Sharav
212-595-8974
e-mail: veracare@ahrp.org
FYI
These days, when you read, "new studies indicate" watch out. The latest scam
conceived by psychiatry and Antidepressant drug makers targets the (mostly
feminine) "urge to shop"!
They're prescribing antidepressants to stiffle the urge(no kidding!) and
claiming success: "After taking the antidepressant Celexa as part of a
Stanford University study, she says that she was less driven to shop."
The absurdity of it all is that every drug marketing ploy is provided with an
academic "credibility" seal... Will the Bush Administration allow this
commercial partnership to undermine the American economy by putting chemical
brakes on shopping?
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WSJ On-Line
THE WALL STREET JOURNAL PERSONAL JOURNAL
For Antidepressant Makers, Shopaholics Are New Market
By ANNE MARIE CHAKER
Deborah Rodriguez sometimes gets headaches from trying to resist the
temptation of clearance sales. Once, she came home with six packages of
clothespins even though she didn't own a clothesline.
But recently, she found a new way to rein in her shopping urge. After taking
the antidepressant Celexa as part of a Stanford University study, she says
that she was less driven to shop.
Things may start looking up for more people like Ms. Rodriguez. "Compulsive
shopping" is increasingly being looked at not just as a silly habit or source
of tiffs between spouses, but as a mental disorder. New studies indicate that
antidepressants may help, while a budding movement to get compulsive shopping
formally recognized as a medical problem could convince more insurers to cover
treatments.
Behind much of this is a growing tendency in the psychiatric community to view
as treatable a variety of problems that were once considered lifestyle quirks.
But it's also being driven by antidepressant makers themselves, who are facing
heightened competition. Doctors are combining antidepressants with phentermine
for weight loss. People who are especially nervous about going to parties or
addressing a boss are being diagnosed with social anxiety disorder and given
an antidepressant. There's also Sarafem, essentially repackaged Prozac, for a
severe form of premenstrual syndrome.
In the case of compulsive shoppers, Forest Laboratories Inc., maker of Celexa,
has funded three studies so far that test whether its antidepressants may help
reduce the amount of time people spend obsessing about shopping or prowling
the stores. While larger and more rigorous trials are needed, early results
suggest that Celexa has some benefits.
All this is heating up a debate in the psychiatry world: Should compulsive
shopping be a formally recognized disorder with its own listing in the
American Psychiatric Association's Diagnostic and Statistical Manual of Mental
Disorders, the bible of mental illnesses?
Impulse-control disorder experts who are involved with revising the manual's
next edition say they are already planning to come up with a stand-alone
definition and diagnostic code for the behavior. That would be a big boost for
antidepressant makers, since many insurers are currently reluctant to cover
treatments for compulsive shopping.
Without a separate classification, the problem "is generally not perceived by
the public as a serious issue," says Donald Black, a professor of psychiatry
at the University of Iowa who has also studied compulsive shopping. "Most
insurance companies say, 'It's an unproven condition of questionable validity
and we're not going to pay for it.' "
The notion that compulsive shopping can be considered a medical disorder is a
recent development. In the past, serious cases of compulsive shopping were
typically considered symptoms of other mental problems, such as bipolar
disorder or serious depression.
Some critics don't see any reason for that to change. "There is an absurd and
frightening proliferation of labels for alleged mental illnesses, and that
proliferation is greatly fueled by the drug companies' profit motive," says
Paula Caplan, a psychologist and researcher at Brown University, who has
written extensively about the overlabeling and diagnosing of mental illnesses.
She counted 297 labels for mental illnesses in the previous edition of the
manual, compared with 374 in the current edition. "So you have to ask: Are
they discovering new mental illnesses at the rate of 11 a year, or are they
being invented?"
Some Skepticism
The effort to label compulsive shopping as a mental disorder is being met with
skepticism from some members of the American Psychiatric Association. Darrel
A. Regier, director of research at the association, expects a rigorous
approval process before a new classification can be published. "I don't think
there's been sufficient evidence to warrant consideration for compulsive
shopping as a mental disorder," he adds.
But proponents of the idea say the category could include everyone from those
who can't resist a sale to people who have trouble paying their bills. It's a
"significant public-health problem," if you take into account the number of
people who have trouble controlling their credit cards and debt, says Susan
McElroy, a professor of psychiatry at the University of Cincinnati, who has
published criteria for diagnosing compulsive shopping. One study published in
the Journal of Consumer Research estimates that between 2% and 8% of the U.S.
population are compulsive shoppers or "at risk" of becoming one.
So how do you know if you need a pill to stop shopping? Psychiatrists agree
that plenty of people can take pleasure in shopping without getting into
trouble. "If you like to shop and you're not running up a debt, it's not
interfering with your marriage and you're not getting fired from your job,"
then it's not a problem, says Eric Hollander, a New York psychiatrist who will
be involved in revisions for the next diagnostic manual. But when a person's
shopping "significantly interferes with their functioning, then it's a
disorder," he adds.
The key is determining whether shopping causes emotional distress or impairs
you -- for instance, a graduate student who spends time shopping rather than
working on her dissertation. Other signs of trouble: hiding one's spending or
lying about it to friends and family members.
Studies on antidepressants, while still relatively small, show some promise.
In the Stanford study, Forest Laboratories funded a test of its antidepressant
Celexa's effects on compulsive shoppers.
The 12-week study involved 24 subjects, largely women. Most had struggled with
compulsive shopping for at least two decades, and their debt related to the
habit was as much as $40,000. While taking the antidepressant, most subjects
reported substantially less anxiety and less time spent shopping. And 71% of
the subjects nearly stopped compulsive shopping entirely, reporting such
results as "easy disposal" of catalogs and the "ability to visit shopping
malls without making a purchase," says Lorrin Koran, the lead investigator on
the research.
Positive Response
More recently, Dr. Koran and his colleagues did a more rigorous, controlled
study that indicated a positive response to the medication and will be
published early this year. They also began a Forest-funded study testing the
effects of its new antidepressant, Lexapro, on compulsive shopping in
December.
Meanwhile, Dr. Koran has some advice for potential patients. "If your buying
habits center on things you don't actually use and are causing financial and
familial difficulties, you may want to consider contacting a psychiatrist" to
discuss potential treatment, he says. Still, he points out that the
"occasional impulse purchase to make oneself feel good is not a sign of
compulsive buying."
Updated January 2, 2003.
Last Updated on
04/14/04
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