Sunday, June 5, 2011

Nuvigil Radio Ad: Pitching a world in which nobody ever heard of coffee

I am not one to say that a medication can't help you out.  Heck, the meds I'm on keep me from going on a merciless rampage through the city on a daily basis.

The other day, driving home from work, I heard an ad for a pill called "Nuvigil" which pitched itself as a solution for "Work Shift Disorder".   I don't often call shenanigans on other people's medical woes, but Nuvigil sounds like, dare I say?, a bunch of malarkey.  Or at least what its supposedly treating.

Now, even according to Nuvigil's own site, "Work Shift Disorder" seems to be an issue striking people who work the graveyard shift, which is in conflict with the normal pattern of sleeping at night and being up during the day.  While its not hard to agree that for those whose clocks don't adjust well, feeling logy on the job can't be much fun, but last I checked, we've had a solution for this problem for a few hundred years.  Its called "coffee" and "adjusting your schedule". 

This isn't to mention the few dozen other options available from a strong tea to Vivarin to 5-Hour Energy Drink. 

All this aside, what's most striking about the ad isn't that a pharmaceutical company is making up an issue for which it is providing a solution.  Thanks to advertising rules, the ad is about 80% list of warnings and possibel side-effects.

These include (from the ad and Nuvigil website):
NUVIGIL may cause serious side effects including a serious rash or a serious allergic reaction that may affect parts of your body such as your liver or blood cells, and may result in hospitalization and be life-threatening. If you develop a skin rash, hives, sores in your mouth, blisters, swelling, peeling, or yellowing of the skin or eyes, trouble swallowing or breathing, dark urine, or fever, stop taking NUVIGIL and call your doctor right away or get emergency help.
  • Stop taking NUVIGIL and call your doctor or get emergency help if you get any of the following serious side effects:
    • Mental (psychiatric) symptoms, including: depression, feeling anxious, sensing things that are not really there, increase in activity (mania), thoughts of suicide, aggression, or other mental problems
    • Symptoms of a heart problem, including: chest pain, abnormal heart beat, and trouble breathing
  • Common side effects of NUVIGIL are headache, nausea, dizziness, and trouble sleeping. These are not all the side effects of NUVIGIL.
  • Tell your doctor if you get any side effect that bothers you or that does not go away. Talk to your doctor for medical advice about side effects.
This IS a wonder drug!  Let me pull one phrase out here:  "These are not all the side effects of NUVIGIL."

No?  What else?  Your toes may fall off?  You may develop lizard scales on your eyelids?  Lay it on me, Nuvigil.  Don't keep me in suspense!

I can't find the radio ad online to link to, but Consumer Reports discusses the ad a bit in this YouTube video, including clips from the radio commercial.

I don't dismiss the challenges of my fellow humans who do work a late-night shift.  I know that the 3rd shift anywhere has got to be a problem for anybody if they want contact with humanity outside of work, and being awake for a few hours in the middle of the day must cause problems. 

By the way, as near as I can tell, Nuvigil is the New Coke of something else called Provigil, which, yes, is used to treat "Work Shift Disorder", but also Narcolepsy and ADD and ADD-like symptoms.  We're no medical professionals, but those are things that a cup of coffee and 8 hours of sleep don't clear up.

My guess, however, is that this isn't the same as just having two cups of coffee.  So, look forward to your local suburban kids delving into mom and dad's nuvigil supply to increase their power of partying on a Saturday night.


Michael Corley said...

One of the many other side effects is the implantation of an alien symbiote with a problem closing its mouth.

Amy C. said...

I dunno, it doesn't seem like a total exploitation to me.

I take Provigil for drug-induced narcolepsy (true story), and it doesn't really have enough pharm-power to be fun. It does make your head really clear, though, which is nice for knowledge workers, and you are awake until you want to go to sleep. It isn't tweaky like caffeine or Ritalin or Strattera or Adderall.

When I was still neuro-typical, I used to work some shifts from midnight until 4a or 8a. Working until 8a was the worst, not because of the length of time, but because I could see the sun as I was going home. The human brain uses light as a part of the feedback system that controls circadian rhythms, so... once I saw the sun, I was usually unable to go to sleep easily after, which led to some dreadful times.

For shift workers, it's not unheard of to have to take a sleeping pill of some sort during the day, and then some sort of stimulant at night to wake up and work. Caffeine won't always cut it (people habituate to it pretty quickly), and you can only adjust your personal schedule so much (as a single person, you still need to account for banking hours and auto maintenance shops and other 9-5 places-- and if you have kids, add another magnitude of complexity)-- and you can't adjust the sun at all.

The League said...

The intended use of Provigil, for narcolepsy and managing ADD is fine, especially when prescribed by a doctor. Them's the brakes, and that's what the medication is for. And I don't discount the exhaustion caused by scheduling and sleeping complications.

I'm no industry followers, but at what point are we choosing not to notice the strategy of pharma to describe everyday issues as maladies to solve with all-new uses of existing drugs? Everything you describe is well known, but it is not a "disorder" or an illness to be treated with medication like penicillin for an infection or stabilizers for the mentally ill. Its a lousy sleep schedule due to a lousy work schedule, not something that won't clear up if you get on 1st or 2nd shift (unlike ADD or Narcolepsy).

We've dealt with this issue since Ugg the Caveman had to sit and watch at the edge of camp and make sure the sabretooth tigers didn't come and eat us during the night when everyone else was sleeping. We need these people up at 4:00 AM for when we wake up with pains in our chests or to come put out the fire in our living room. Let's not exploit that population with a $300/ month pill originally intended for other issues if we can avoid it. Especially if that pill is going to wreck their liver or give them horrible mood swings or any of the other promised three dozen side-effects.

J.S. said...

I actually agree with both points. I've read about some legitimate sleep issues that are caused by people having to adopt to unnatural sleep patterns, which can lead to various problems when your actual schedule doesn't fit the biorhythmic schedule that a person's natural body falls into. On the other hand, I still don't think medication is a very good solution. Most people who work nights eventually learn how to adjust, and I would argue that if the problems caused by a nighttime work schedule are serious enough to require long term medication, then a job with that sort of schedule probably isn't the job for you. For short term, transitional situations while a person is getting adjusted, it might be okay, but over the long term it just can't be a good idea to remain on that sort of a drug simply in order to accommodate a work schedule (as opposed, to say, taking it for a more chronic condition like narcolepsy). By the way- a whole bunch of coffee isn't necessarily great for you, either. It can raise blood pressure, increase cholesterol, raise anxiety, interfere with sleep patterns, and have negative impacts on digestive health. Also, it makes your teeth brown.

Vickie said...

I heard the radio ad for the first time and googled it as I take this drug.

First of all I'll state I have hypersonnia - which is like narcalepsy, but you feel the sleep coming on. And unlike narcalepsy, you don't wake up refreshed - in fact you're more tired than when you went to sleep. Some people experience this condition due to shift work, but their body grows accustomed and adjusts. In rare instances, such as mine - the condition becomes a part of life (over a year for me). Very dangerous condition - imagine sleeping 8 hours with no interruptions, waking up exhausted, shower, several cups of strong coffee, get behind the wheel and within 15 min you find yourself fighting to stay awake. Without Nuvigil, I fell asleep at the most inopportune times, couldn't remember things, was so irritable, (most hypersomniacs rarely enter REM sleep - which is essential to good physical & mental health.). It took two sleep studies, and almost an act of congress to get my insurance co. to pay for this (no generic till 2013) it's OVER 11.00 per pill (1a day). Many hypersomniacs are prescribed anti-depressants which somehow helps the condition. Because I've had several kidney surgeries, I'm unable to take these because of how they metabolize. I'm happy to say I have not experienced any side effects - NONE! it has changed my life back to what it was - ordinary. You don't get jumpy, fidgety's NOT speed or caffeine. Due to the cost, the half dozen conversations your doctor might have to have with ones insurance company to approve it, and the possible side effects - this drug should (in my opinion) not be taken by anyone who doesn't have a serious condition - which is life threatening on it's own. suggesting it in ads is really incomprehensible.

The League said...

Again, for legitimate medical conditions, I don't see any problem and do hope its working for you.

In general, I'm against advertising for non OTC meds, anyway. And this is precisely why (it sounds like we're in agreement?). Those meds are intended for some specific outcomes for specific conditions. The radio ad clearly warps the symptoms until anybody who gets the 2:30pm blood sugar drop sounds like a candidate.

Anonymous said...

When I first heard this ad I thought it was a "radio bit". I don't know if I have started work at the same time in years, I start anywhere from 11:00 pm to 11:00 am and I am a tanker driver Normally hauling NH3 (Anhydrus Ammonia) I think I like my chances better of falling asleep behind the wheel better then taking this product....

Anonymous said...

First off, comparisons with amphetamine and speed are completely appropriate due to the action of the drug on how the brain uses dopamine. Cocaine addicted monkeys WILL substitute nuvigil. Nuvigil will inspire stimulant drug seeking behavior in some people. The drug has euphoric properties similar to amphetamine type drugs as well. Nuvigil will get you high.

The biggest problem I have is that they are marketing a "Job performance enhancing pharmaceutical". I do not want to have to ingest chemicals in order to reach the level of performance of my coworkers.

Anonymous said...

I was just looking for the video of the radio ad after I had a good laugh listening to it as well - this is the perfect article i was looking for to share with my friends.

Nuvigil is a great idea! ...... to help another drug company get kids addicted to an unnecessary 'medication'.

No good America... No good.

Rothermel said...

I am a resident physician (Anesthesiology) and I work anywhere from 12-36 hours shifts. I have been taking Nuvigil for 3 months now. I love it. It doesn't make you feel stimulated or high. It makes you feel awake! I will still drink coffee or Mountain Dew when needed. Also, The side effects listed such as "rash" that is actually SJS - only occurred in one person in the clinical trials. That is WAAAAY less than most other medications out there. the only side effects I have experience are headaches and mild aggression.

Anonymous said...

Be careful, I took nubigil for almost a year until I started passing blood and developed arthritis like conditions. I wish I had never heard of this medication, on top of being tired I live in constant pain.