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  Comments of Fred A. Baughman Jr., M.D. regarding:
  Wall Street Journal WSJ.COM
  January 11, 2001

  Dow Jones Newswires
  AWSJ: Psychiatric Drugs Hard To Sell In Asia
  Staff Reporter
  For Western pharmaceutical
  companies selling psychiatric drugs,
  East Asia's population of two billion
  would seem to represent potentially
  the world's largest market.
  Yet after more than a decade in East Asia,
  Eli Lilly & Co. sells a minuscule
  $5.3 million of the antidepressant Prozac
  in the area annually, compared
  with $2.1 billion in the U.S. Lilly's
  hot-selling antipsychotic Zyprexa
  chalks up only about $5.5 million in
  yearly East Asian sales, but $1.37
  billion in the U.S. GlaxoSmithKline PLC's
  antidepressant Paxil (called
  Seroxat overseas), with more than $1.4
  billion in U.S. sales, achieves under
  $200,000 in annual sales in Indochina,
  despite the region's population of
  about 200 million.
  It isn't that Asians are happier than
  Americans. Norman Sartorius, former
  president of the World Psychiatric
  Association, says the incidence of major
  depression in Asia is about that in the
  U.S. -- roughly 3% of adults. But
  the widespread belief that mental illness
  is a stigma of the worst sort,
  coupled with the popularity of shamans…

[Fred A. Baughman Jr., MD:
Shamans are indian medicine
men, an apt title for the US psychiatrists dispatched to the region, by
the pharmaceutical companies, to sell emotional/behavioral problems as
‘diseases’, ‘chemical imbalances’, needing ‘chemical balancers’—pills;
were it not an insult to the indian medicine men]

  other alternative healers such as
  monks and fortune-tellers, have sharply
  restricted sales of antidepressants
  throughout the region.
  In Thailand, for example, hospital
  referrals for psychiatric treatment rose
  sharply as Asia's economic crisis smashed
  businesses and wiped out jobs,
  although spending on health care abruptly
  fell. Yet at Bangkok's Bumrungrad
  hospital, chief executive Curtis Schroeder
  says that now, as spending on
  private health care shows signs of
  recovery from recession, interest in
  psychiatric care is once again dropping.
  "There were always expectations that the
  market could be big, but the
  reality has proven to be less because of
  the stigma," says Steve Drew,
  GlaxoSmithKline's managing director for
  Indochina. "Companies like ours and
  Lilly are still struggling to understand
  Starting in the late 1980s, the companies'
  first job was to assess the
  prevalence of depression on the continent.
  Lilly researchers began to
  interview medical-opinion leaders in Korea
  and Taiwan and encountered some
  astonishing results. According to many
  doctors, there was no mental
  depression in Asia at all. "It was just
  fascinating," says William V.
  Lawson, Lilly's manager of global market
  research. "It showed that
  depression just didn't exist there."

[Fred A. Baughman Jr., MD:
Not believing US psychiatry’s
inflated, market-friendly view of depression and all mental conditions
as ‘diseases’ when they are not--seeing them instead, for what they
are, symptoms of life’s ups and downs, coming and going with life’s ups
and downs]

  But further examination showed that many
  of these patients, while showing up
  complaining of headaches and stomachaches,
  were depressed. "The incidence of
  depression really is the same as in the
  U.S.," says Bangkok psychiatrist
  Nipatt Karnjanathanalers. "But here,
  people present (it) with somatic
  complaints like pain or lack of sexual
  response. Some even hyperventilate,
  or their hands and arms become paralyzed,
  because they can't express their
  To grapple with this deep-rooted denial,
  Western companies launched
  educational efforts. Lilly has funded a
  program by psychiatrists and
  researchers training Asian doctors in the
  classical definitions of
  depression and schizophrenia

[Fred A. Baughman Jr., MD:
meaning, no doubt that they are brain
diseases, chemical imbalances, each with a chemical balancer, a pill,
for those believing, for those properly educated.]

  , and their
  varying forms in different
  societies. Johnson & Johnson, which sells
  the schizophrenia drug Risperdal,
  brought officials from U.S. schizophrenia
  advocacy groups to meet Asian
  families with schizophrenic relatives.
  J&J has run seminars in Thailand,
  arranging for psychiatrists to teach
  families about schizophrenia, but many who
  could benefit stay away. "Thai
  people think a spirit has possessed the
  patients, and most of the people
  feel shame," says Somgiat Mahapun,
  Thailand managing director for J&J's
  Janssen drug unit.
  That being the case, small wonder that
  monks, shamans and fortune-tellers
  sometimes substitute for psychiatrists in
  the lives of some Thais.
  On a back street of this capital, in a
  room dimly lit by candles, a shaman
  chants to summon ancient spirits. Making
  barking noises, she whips a sword
  around in swooping circles and smacks
  herself on the back with it. The
  shaman, Kaek Dabsomdej, believes she is
  inhabited by spirits of ancient
  Buddhist hermits. Patients with mental
  problems and physical illnesses often
  seek her help in seance-like sessions. Her
  billing rate is $2 per visit --
  or $1.25 plus a pack of cigarettes. "I
  don't smoke," she says in the deep
  voice of one of the hermit spirits. "But
  the other hermits do."
  Ms. Kaek boasts as many patients as any
  psychiatrist, dispensing advice
  along the lines of "Bathe three times with
  holy water on the day of the week
  you were born."
  "I recommend this holy water and it cures
  the patients," she explains. "We
  soothe by words, we show people the way,
  and they get better."
  In Thailand, Eli Lilly and the Thai
  government have made efforts to appeal
  directly to alternative healers to have
  them refer patients with serious
  mental illnesses for treatment. The Thai
  health ministry last fall held a
  daylong seminar to teach fortune-tellers
  -- nearly every village in the
  country has one -- how to recognize
  Western companies also try to reach the
  mentally ill by working with Asian
  psychiatrists. At one recent World
  Psychiatric Congress in Beijing, Lilly
  and other companies gave out
  scientific-magazine subscriptions to many
  the 700 psychiatrists attending. They
  began sending Asian doctors to
  psychiatric meetings. Lilly funds a
  regular seminar at Australia's
  University of Melbourne, where more than
  50 Asian psychiatrists at a time
  gather for postgraduate training.
  Taking another tack, Lilly has retained
  Bangkok's Dr. Nipatt as a paid
  consultant. Under Lilly's auspices, he
  gives about 20 talks a year to
  medical groups in East Asia.
  One recent day, Dr. Nipatt tells 60
  medical professionals at Saraburi
  Hospital, two hours north of Bangkok, that
  major depression is the leading
  cause of disability in the world.

[Fred A. Baughman Jr., MD:
Comparing it to bona fide medical
and surgical diseases just as does WHO—the World Heath Organization, to
the liking of the pharmaceutical industry. If you have ever wondered
where ‘epidemics’ of psychiatric diseases come from, wonder no more.]

  The doctor describes the roles of various
  brain chemicals like serotonin and
  norepinephrine and describes drugs' side

[Fred A. Baughman Jr., MD:
Claims that there are abnormalities of these or other brain
chemicals are fraudulent, but are at the heart of the psychopharm
propaganda campaign. These people, resisting the duplicitous
psychopharm message, are to be seen as more sensible by far than in
‘enlightened’ Western countries, particularly the US.]

  . "General practitioners are receptive to
  these ideas, but the people resist,"
  he says. Will his talk make a difference?
  Saraburi Hospital's chief
  psychiatrist, Siriritana Sukhawana, says
  probably not, because most people
  with depression won't show up at the
  hospital. Dr. Nipatt realizes as well
  as anyone just how extensive the Thai
  belief in alternative healers is: His
  wife patronizes a fortune-teller.
  A limitation of companies' efforts to work
  with psychiatrists is that there
  aren't enough psychiatrists to influence
  change. Thailand has about 300
  psychiatrists for a nation of 62 million,
  or five to one million people. The
  U.S. has about 120 per million -- and New
  York City, 500 per million.

[Fred A. Baughman Jr., MD:
In the US there are an over-abundance of
psychiatrists, all willing propagandists and ‘pushers’ thus serving
themselves and their controlling partner, the pharmaceutical industry.]

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