Marketing 'mind mechanics': decoding antidepressant drug advertisements

Gender display in Scandinavian and American advertising for antidepressants

This study examines whether depiction of users of antidepressants in advertisements for antidepressants in the 1995 issues of the major medical journal in each of Denmark, Finland, Norway, and Sweden differs from that in the American Journal of Psychiatry. The results show that the people shown in the Danish, Finnish, and Norwegian journals are predominantly women, whereas depiction of users in the American and Swedish advertising is predominantly of couples. The portrayals in the 1995 advertising are of antidepressants as female gendered; a feature that was not seen in advertising for psychotropic drugs in the Nordic countries in the 1980s.

Seeing is believing, looks are deceiving: what does one see in images of drugs and drug use(rs)?

Images of drugs and drug use(rs) convey meaning, feelings, and beliefs, and what is being seen is often believed. Images can also deceive in content, meaning, and belief. Drug use(r) researchers, who use images as data, must be cautious in interpreting what is being conveyed and why. As technological advances continue to shape the creation, modification, storage, and analysis of images, researchers must be ever more vigilant about what they are seeing and believing.

`I'd rather not take Prozac': stigma and commodification in antidepressant consumer narratives

This article explores the idea that narrative is the primary vehicle through which antidepressant consumers negotiate their sense of identity and reality. Antidepressant consumers represent a unique consumer culture because of the stigma that society attaches to mental illness. Recent media attention, including direct to consumer (DTC) advertising, appears to decrease the stigma surrounding antidepressant use while at the same time commodifying and branding them for mass consumption. Antidepressant consumers must negotiate the threat of stigma and the threat of commodification through the process of constructing narratives. Exploring the narrative process of identity negotiation reveals how the interconnected cultural processes of stigma and commodification are undergoing historical shifts. Among these shifts are the intensification of branding and an expansion of consumer culture. Implications for health promotion and further research are discussed.

Are direct to consumer advertisments of prescription drugs educational?: comparing 1992 to 2002

We investigate the educational value of direct-to-consumer (DTC) prescription drug advertisements from 58 popular magazines published in 1992 and 2002. We find that the number of DTC prescription drug ads increased nine-fold from 1992 to 2002, while the advertisements for other health care products increased only slightly. We examine changes in 1992-2002 DTC prescription drug ads both quantitatively and qualitatively. We find that the educational value as it relates to serious medical conditions decreases over time based on the media logic that the primary purpose of advertisements is to promote consumption, rather than education. We enumerate and describe the media logic tactics employed, and find a statistically significant increase in the number of such tactics per ad in 2002.

Killing me softly: myth in pharmaceutical advertising

In studies of how drug advertising influences doctors' behaviour, little attention is given to visual and linguistic imagery. The authors argue that myth is often deployed in drug adverts to depict exaggerated therapeutic efficacy and that doctors should be aware of this

The pharmaceutical industry and mental health nursing

Mental health nurses (MHNs) have a long and varied relationship with the pharmaceutical industry, including the attendance of educational seminars and the acceptance of promotional material. This article presents evidence that suggests MHNs may need to review this relationship regardless of their beliefs about the role of pharmacological interventions in the treatment of mental illness. It also explores the influence of advertising within professional journals and calls for greater debate on this issue.

Mass media representations as drug information for patients: the prozac phenomenon

Results of a 20-year study of mass media representations of antidepressant medications and their use are presented. The recent Prozac phenomenon stands out as a primary example of media-generated drug information for patients. Various forms of mass media are important in providing perceptions of the effects, benefits, and safety of these new antidepressant drugs. Clinical research, however, suggests that the latest generation of antidepressant medications is no more effective in treating depressive symptoms than the first generation, tricyclic antidepressants. Yet, these new antidepressants have become the model drug not only for treating depression, but also for cosmetic psychopharmacology.

Radio and the commodification of natural medicine in Ecuador

This paper explores the discourse that is being created around medical commodities in one Ecuadorian city in an effort to understand how desire for new medical products is generated and sustained. Commercial natural medicine, which includes vitamins, herbal remedies and tonics is a relatively new addition to the medical marketplace in Ecuador, yet the popularity of these products seems to be growing rapidly. Much of the success of natural medicines is due to promotional campaigns, most notably radio programs, that emphasize and manipulate, important cultural themes about the body, identity, morality and social success. Although on the surface natural medicine seems to be creating a radically new discourse about the body and illness causation, that discourse ultimately serves only to reinforce the unequal social relations associated with capitalist marketplaces.

THE ANTHROPOLOGY OF PHARMACEUTICALS: A Biographical Approach

▪ Abstract  This review discusses pharmaceuticals as social and cultural phenomena by following their “life cycle” from production, marketing, and prescription to distribution, purchasing, consumption, and finally their efficacy. Each phase has its own particular context, actors, and transactions and is characterized by different sets of values and ideas. The anthropology of pharmaceuticals is relevant to medical anthropology and health policy. It also touches the heart of general anthropology with its long-time interest in the concepts of culture vs nature, symbolization and social transformation, and its more recent concerns with the cultural construction of the body and processes of globalization and localization. The study of transactions and meanings of pharmaceuticals in diverse social settings provides a particularly appropriate empirical base for addressing these new theoretical issues.

The cultural origins of western depression

Focusing on the British cultural vocabulary of guilt, fatigue, energy, stress and depression; this paper argues that such vocabularies have their own unique histories and meanings; deeply embedded, in this instance, within "white British and western European" institutions. Predicated on a western epistemology, these constructs developed in response to prevailing concerns at different periods in western history; but are now assumed to be universal natural entities that await further scientific research and investigation. The cross-cultural validity of depression as a universal disorder is therefore dubious and needs an extensive re-examination.

Whatalotwegot--the messages in drug advertisements

Advertisers are increasingly using symbols to circumvent logical argument when trying to persuade people (the "targets" of the advertisement) to make choices that are not strictly rational. Symbols can convey covert meanings and awaken or exploit subconscious feelings, such as a desire for power or a fear of doing harm. Some of the ways in which pharmaceutical advertisements use these techniques are examined: advertising by contagion; adding to our worries; polarity of choices; teasers; idealisation. Rational prescribing should be based on logic, but advertisements do not depend on logical arguments for their most powerful effects: the advertisers may subvert us by appealing to our unconscious desires.

Social pharmacology: unresolved critical issues

This article describes and analyzes decision-making by patients, physicians, and drug information providers about registered medical drugs. Based on a cognitive psychology perspective, cognitive variables (the individual's mediating system) are assumed to be critical factors determining both patient and physician behavior. The individual's psychological functioning is seen as a continuous reciprocal interaction between behavioral, cognitive, and environmental influences; i.e., an interactional paradigm is applied. The importance of research models including cognitive and situation variables to guide the search for appropriate research methods is stressed. An intensive research strategy with a small sample of respondents will often be necessary. Also, respondents should be asked to describe their reactions to specific medical situations. The drug information sender has to select a set of goals for disseminating information to patients. Among the goals most often selected are: message comprehension, receiver satisfaction, changes in knowledge, attitudes, and drug behavior, as well as health effects. More research is needed on how the patient's mediating system, the actual situation, and the perceived situation steer his search for the use of new drug information. A different set of factors influence the patient's decision to start a medicinal or drug treatment than the factors that influence his decision to continue a treatment. The latter factors include forgetfulness, misunderstandings, and the patient's interpretation of physiological signs. More cognitive-oriented research about drug compliance must be undertaken. In such studies the mediating systems of a group of patients could be considered before and after intervention. There are a great number of types of inappropriate (irrational) prescribing. However, a physician may prescribe rationally in one area but irrationally in another. Face-to-face education of physicians has been shown to be effective in reducing inappropriate prescribing in a number of studies. "Overprescribing" of benzodiazepine has been an issue of intensive professional debate during the last decades. The two groups who criticize and defend the existing use of benzodiazepines build their views on different assumptions about the interaction between mind and brain as well as making different value assumptions regarding the use of a psychotropic drug. There is a need for prescription studies where a cognitive and interactional perspective is combined with an information-processing and a normative perspective. The benzodiazepines dependency problem has provoked lively discussion among professionals and the general public. Long-term benzodiazepine use and personality disorders increase the risk of the patient becoming dependent. A great number of research models have been suggested for the analysis of prescription drug dependency and as guides to the treatment of dependency.(ABSTRACT TRUNCATED AT 400 WORDS)

The construction of patienthood in medical advertising

The purpose of this study was to investigate the dominant symbolic elements, themes, and discourses used in drug advertisements published in a weekly magazine directed toward physicians. The discussion is concerned with both the visual signs and textual format of the advertisements, analyzing their attempts to create images around the drugs that appeal to the medical readership of the magazine. With the premise that the producers of the advertisements drew upon shared knowledge and belief systems of their medical audience to create a meaningful image for the drugs, the focus of the article is upon the portrayal of patients in the advertisements, with particular interest in gendered representations. The author argues that the way in which patients are portrayed visually and verbally in such advertisements is revealing of the ideological dimension of the doctor-patient relationship within the biomedical system of healing, including notions of the mechanical man and the vulnerable woman as archetypal patients.

Advertisements for medicines in leading medical journals in 18 countries: a 12-month survey of information content and standards

The information content of 6,710 advertisements for medicines in medical journals was surveyed to provide a baseline for monitoring the effect of WHO's Ethical Criteria for Medicinal Drug Promotion. The advertisements (ads) appeared during 12 months (1987-1988) in 23 leading national medical journals in 18 countries. Local participants, mostly doctors or pharmacists, examined them. The presence or absence in each ad of important information was noted. In most ads the generic name appeared in smaller type than the brand name. Indications were mentioned more often than the negative effects of medicines. The ads gave less pharmacological than medical information. However, important warnings and precautions were missing in half, and side effects and contraindications in about 40 percent. Prices tended to be given only in countries where a social security system pays for the medicines. The information content of ads in the developing countries differed surprisingly little from that in the industrialized countries. Almost all the ads (96 percent) included one or more pictures; 58 percent of these were considered irrelevant. The authors believe it is a mistake to regard ads as trivial. If they are not considered seriously they will influence the use of medicines as they are intended to do, but read critically they can provide useful information.

Doctoring medicine: Reading between the lines of drug advertisements

With the aid of techniques of art and literary criticism, I investigate the ideological function of drug advertisements. I propose that the deleterious effects of advertising practices on medical care extend well beyond the usual level of critical awareness of physicians.

Advertising for psychotropic drugs in the Nordic countries: metaphors, gender and life situations

Advertisements for psychotropic drugs which appeared in the leading medical journals in Finland, Sweden and Denmark were analyzed to identify the picture content and trends in advertising between 1975 and 1985. The most common picture was a metaphor, the frequency of which increased in the 1980s. The second largest picture category was a patient, the rate of which remained constant during the study period. Both the use of a metaphor and a patient was related to the low sales of the drug in respective country whereas picture of a drug package was related to a stable market position of a drug in the country. The patients were increasingly depicted as men in the Danish and Swedish journal whereas the pictures of females were most common in the Finnish one. The portrayal of working persons, especially office workers and teachers, was a new feature in the advertisements in the 1980s. It is argued that the drug industry still uses gender as a device to expand their market of psychotropic drugs in a new way.

Medicine as metaphor and medium in group psychotherapy with psychiatric patients

A conceptualization is presented which encourages a renewed exploration of the way in which psychiatric patients discuss their medications in the group therapy setting. It is suggested that process-oriented group therapists tend to harbor subtle prejudices which may inhibit examination of this material. If we listen to medication-related discourse more carefully, we find that patients disclose important information about hopes and fears about treatment, self-efficacy, attitudes about control and authority, and other sensitive or disowned parts of experience. The process of interactions about medicines often reveals interpersonal difficulties, particularly around intimacy. Suggestions for intervening more effectively with this type of material are presented. The importance of medication attributions in revealing curative fantasies is discussed.

The metaphorical nature of drugs and drug taking

An inquiry into the role metaphor plays in personal and societal conceptions of drugs and drug taking reveals that drug metaphors and symbols are quite pervasive in individual thinking, social discourse, and the cultural media. They appear to influence beliefs and attitudes regarding drugs, the nature and meaning of drug experiences, and the reasons behind drug-taking behaviors. Some drug metaphors are common to different cultures and historical periods, while others are specific and exclusive to particular individuals and groups or drug-taking situations. These metaphors can carry positive as well as negative connotations. Further study is needed to delineate the metaphorical structuring of our thinking about drugs, and the process whereby these metaphors are generated and spread throughout society.