[puttin' on my doctor hat]
You better believe that they work.
Advertising begins with a generalized statement of symptoms, "If you are feeling [insert general, non-specific symptoms here]," and then goes on to claim that the drug in question will help you cope with those symptoms and urges you to see your doctor. Patients then turn to their doctor and say, "I want a prescription for X." Note that it's not, "I'm feeling unwell and these are my symptoms," but, rather, "I want X." Smart patients will have read a couple of wikipedia pages and will put together the shopping list of symptoms to back up their claim.
The pharmaceutical companies have created an artificial demand, and have incentivized physicians to fill that need. And notice the drugs that they do it with: the ones that are intended to address non-specific symptoms obvious to the patient. Arthritis pain that Tylenol won't help? Well we had better turn to Celebrex. Feelings of fatigue, listlessness and apathy? Zoloft'll fix that. A disappointing night in the bedroom? We have a little blue pill for that.
Now, that's not to say that Osteoarthritis, clinical depression and erectile dysfunction are not significant medical issues for which drug therapies can be beneficial--but drug advertising creates an unrealistic expectation in the public--in two ways. First, it drops the diagnostic bar to a menu of symptoms that can be recited in a 30 second tv spot, and it pathologizes symptoms that might not merit any medical intervention. Second, it creates the impression that a single medication can wipe away those symptoms. For a patient with a genuine medical complaint, we must, in fact, engage in an ongoing investigation of which medication, or combination of medications are going to be effective, with the least impact from side-effects.
And let's face it, if they didn't work, would pharmaceutical manufacturers bother throwing good money after bad?
_________________
--James