One of the most egregious attacks against the pharmaceutical industry is that it invents diseases by medicalizing conditions in such a way that it convinces healthy people that they are sick. Such behavior results in companies being able to fatten their sales and profits by selling drugs to people who really don’t need them. Critics refer to this as “disease mongering”. In making their arguments, they use “high cholesterol” and “bone thinning” as prime examples of how companies do this.
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Is bone thinning a disease? Of course not. But, if you are a petite female of Asian or northern European background, bone thinning is the first sign of osteoporosis and should be treated. Similarly, an overweight male with a strong family history of heart disease and who has high LDL-cholesterol needs to diet and exercise – and perhaps take a statin – to reduce his risk of a cardiac event. These are not cases of “disease mongering”. Rather, it’s preventative medicine.
Another example of “disease mongering” often cited by industry critics is Restless Legs Syndrome (RLS), which some believe is a nuisance and not a real condition. In fact, RLS is a sensorimotor disorder characterized by an unstoppable desire to move one’s legs and is usually accompanied by irritation in the lower extremities. The biology underpinning RLS is not well understood. However, RLS is associated with poor sleep, depression, cardiovascular disease, ADHD, and obesity – all contributing to a poorer quality of life. Here are some descriptions by RLS patients of their condition.
“Imagine dragging a stiff bristled hair brush across the sole of your foot, over and over for 6 – 8 hours. Now try to imagine that sensation inside your legs.”
“It’s like having white faced wasps in your leg bones stinging and stinging…. People who don’t have it will never, ever, understand the PAIN.”
The seriousness of RLS has now been elevated thanks to a recent study carried out by researchers at Penn State. The authors looked at a cohort of 169,373 participants in the U.S. and found that individuals with RLS had a higher risk of suicide and self-harm than did those without RLS. This association was independent of age, sex, geographical differences, depression, sleep disorders, other chronic medical conditions, and medication use.
The authors stressed that the underlying mechanisms between the association of RLS and suicide and self-harm are unclear. While one might speculate that depression might be the driver, the authors found that the increased risk of suicide and self-harm in RLS patients were independent of depression. Comorbid sleep problems (sleep disturbance, insomnia, obstructive sleep apnea) may be playing a role in elevating suicide risk in RLS patients, but research focusing on this as a possible cause remains scarce.
While the drivers of increased suicide risk and self-harm in RLS patients are not defined, what is clear is that RLS is not a condition concocted by the pharmaceutical industry, nor is it simply a nuisance. RLS is a syndrome that affects roughly 5% of the population in Western countries and, in its severe form, can be crippling. Given the increasing incidence of suicide in the U.S., it is imperative that RLS patients be treated rigorously and their health issues not be dismissed.
