Finally, an antidote to TV drug ads

If you watch any TV, you've seen the barrage of advertisements for prescription medications. They always start by showing someone in distress—from insomnia, allergies, erectile dysfunction or other medical condition. But after taking the drug, the person is either sleeping soundly or running through the fields, depending on the original ailment,  while the announcer reads a scary list of side effects in a voice so soothing that they almost sound fun.

The problem with such "direct-to-consumer," or DTC, advertisements is that they may generate excessive demand because people go straight to their doctors asking for this or that specific medication. In a 2006 survey by our National Survey Research Center, 78 percent of doctors said that patients asked them at least occasionally to prescribe drugs they had seen advertised on television, and 67 percent said they sometimes did so. And don't expect the ad barrage to let up.  While Congress recently gave the FDA more authority to regulate ads, it rejected a measure that would have allowed the agency to place a moratorium on ads for new drugs that raise safety concerns. The U.S. is one of only two countries in the world (the other is New Zealand) where such ads are legal. 

Well, starting this month, Consumer Reports is introducing an entertaining new online video series that will track and report on such ads. The videos are hosted by Associate Editor, Jamie Hirsh, and produced by the ConsumerReports TV News crew. This first installment concerns an interesting class of medications that are approved to treat something called "restless leg syndrome." That condition may sound fanciful, but it's a real problem. Something like 3 percent of Americans suffer from RLS, which is characterized by an uncontrollable impulse to keep moving your legs even when you are trying to go to sleep—which obviously could make sleep difficult.

Several years ago, doctors discovered that drugs that were originally developed to treat Parkinson's disease could provide meaningful help to people who suffered from moderate to severe forms of this condition.  But the drugs have serious side effects - one of the more bizarre involves a propensity for uncontrolled sexual or gambling impulses, as our video mentions. And while these medications may provide welcome relief to some RLS patients, the ads could leave anyone who ever suffered fidgetiness when trying to go to sleep to wonder whether he or she has RLS and should seek treatment.

We leave the rest to the video to explain, and we urge you to check back next month for the next installment in this fun and informative series!—Kevin McKean, Editorial Director

Learn more
Find more information on drugs commonly used to treat RLS in Consumer Reports' Medical Guide:

• Ropinirole (brand name Requip)
• Pramipexole (brand name Mirapex)

Comments

[S Daniels]

Trilipix is not for everyone. If you have liver damage, asthma, heart trouble, high blood pressure, allergies, gout, rheumatism, cataracts or baldness ask your doctor before taking Trilipix. If you develop severe muscle pain, double vision, migraines, paralysis and hair loss below the neck, discontinue taking Trilipix and call the emergency squad immediately. In rare cases patients who lived more than twelve minutes from an emergency room have died suddenly taking Trilipix, but many have survived with limited mobility.

Some who survived became comatose and required 24 hour nursing care from just looking at 1 more Trilipix pill. Treat Trilipix the same way you would treat Arsenic, or any other prescription medicine.

Drink, smoke and use drugs responsibly.

[Mirapexvictim]

One more comment as I continue on with my research...

Something that was pointed out by CR in this video...'there are easier and cheaper options to treat RLS...'

[Mirapexvictim]

I came across this video while doing research on the drug MIRAPEX. I was looking for 'when the commercial ads for the drug MIRAPEX starting running'.

At first watching the video I felt a little offended (I suffer from severe RLS), then I started laughing - I thought she (CR) did a great job at pointing out the silliness of this drug commercial and drug commercials in general as well laughing along in that 'I didn't know what I had was a medical condition until it was pointed out to me that I had 'RLS',

THEN I cried.

Unfortunately I never saw this commercial or ones like it (for Mirapex) before I started taking MIRAPEX last year 8/08. I did end up with one of the stated very serious side effect that sounds like a joke – compulsive gambling. It's no joke - its real.

Keep up the good work Consumer Reports!! Thanks for the smile today.

[kanal tedavisi]

Well, it's going on a year since this video was posted, and it remains in place, despite a pretty overwhelming negative reaction. That speaks volumes about Consumer Reports. Specifically, it says to me that they can't stomach eating the costs of producing this video, even if it means that RLS patients must repeatedly discover it and be discouraged by its shameful tone.
kanal tedavisi loves your blog.

[burs]

I really like this post. Thanks for this article, Anyone got any more info about it? I am now your blog' s rss follower. you are now in my bookmarks.

[Nancy]

That woman made RLS sound like a joke and it pissed me off, especially when she finger quoted "strange sensations." It's difficult to describe the feelings to someone who doesn't have it, I would go so far as to say there's no word to adequately describe it.

[ehliyet]

Thank you for this informative read, I really appreciate sharing this great post. Keep up your work.

[Rita]

I think it's scary to have people telling their doctors what to prescribe. And I think it's robbery that drugs with two ingredients cost more than the two drugs separately. I’ve seen ads on TV for Caduet. It has two ingredients. One is Amlodipine and the other is Atorvastatin. With my RxDrugCard I can get 30 tablets of Amlodipine for $9 and 30 tablets of Simvastatin for $9. I’ll bet they are charging more than $18 for this new drug! Don’t pressure your doctor into giving you something just because it’s new. Do your homework. Find a drug card like I did at www.rxdrugcard.com. I think that RxDrugCard.com is the best drug card available for prescription discounts.

[Dustin]

Why not just use marijuana Shelly? I'm sure it will help with your apparent agression problems as well as do a fine job of treating your RLS. I would recomend a nice sativa, completely hydroponic, my highest recomendation however, would be for a nice purple kush, or haze. Best of luck.

[Andie]

This is so sad. RLS is a debilitating problem and it is being treated like a sarcastic skit on Saturday Night Live. Shame on you, CR.

The reality? I take Requip and Sinemet to control the severe symptoms I suffer 24/7. Sometimes, it is so bad that I lay on the floor and writhe, my legs and arms being torqued into unnatural, agonizing positions; I just wish that all I had to suffer was a gambling bout or God forbid sudden urges for sex. The meds, which I take periodically all day and all night long, make me fatigued and fuzzy headed and allow me to function adequately for short periods of time. That does not mean that I am functioning well, but this combination of drugs is the best result I have had.

I am able to hold a part time job thanks to a sensitive and understanding employer; previously I have had to leave employment for inability to maintain the same state of activity for hours at a time (either sitting still or repetitious motions invite the same uncontrollable motions and sensations). I often have to sleep in the guest bed so that my partner can have some sleep. As a child, I was criticized for having "ants in my pants," this is my life long agony.

By the way, for those who suggest that it is my choice to have this problem -- I do not drink alcohol or caffeine; I try to live as healthily as possible and possess sound intelligence and judgment. I just also happen to have a very uncomfortable and debilitating problem. I still have feelings and feel angry when my body compromises my desires for life accomplishments that others take for granted.

When my disability became a script for a snide 20-something tv actor to trivialize, the unknowing public laughed at that "funny" problem. That sets back the ability to procure research dollars and quality knowledge to combat it. I guess it is easier to get people to laugh at it than to fund a cure.

Thanks for the setbacks. (Since sarcasm is apparently "correct" now.)

[Susan]

I can understand your point for making the ad but, if you were to put yourself in the place of someone who has severe RLS, I know that your ad would have been done in better taste. It sounds flippant and degrading.

I've had RLS since the age of 9. Until I'd found that someone had given it an actual name, I thought I was crazy. I'm now 58. Through the years the RLS has become more frequent and intense... to the point that if I'm sitting at my desk, my leg will jump enough that my knee bangs against the bottom of the desk... and I don't even dare to think of climbing into bed at that point because there would be no rest. In the past I've tried heat, cold, vitamins C & B, calcium, magnesium, zinc, potassium, magnesium, iron, CoQ 10 -- all in different combinations over many years. Nothing worked. I've also exercised regularly for the past 20 years. About 5 years ago I was referred to a neurologist, I told him of my RLS and he prescribed Mirapex. I felt like I was given a new lease on life. However, the doses have had to be increased regularly in order to give me continual relief. After the last 0.5 mg increase in dosage, I developed severe dry mouth. Now I'm on Requip and need to take almost double the dosage of Mirapex but it doesn't give my RLS near the relief that Mirapex did. I sleep 4 hours a night, if I'm lucky.

My neurologist told me 5 years ago that 10% of the population suffers from RLS... no small number. No it won't kill you... but to me, having RLS is similar to torture. You can't rest, you can't sit and do anything -- read, sew, write -- you have to move all the time, whether that means walking or laying in bed moving your legs constantly. By the way, RLS doesn't only happen with legs, it can also occur in arms. I know.

[Aiken]

Well, it's going on a year since this video was posted, and it remains in place, despite a pretty overwhelming negative reaction. That speaks volumes about Consumer Reports. Specifically, it says to me that they can't stomach eating the costs of producing this video, even if it means that RLS patients must repeatedly discover it and be discouraged by its shameful tone.

Kevin McKean, I wrote you email. You didn't respond. All you did was to come here and make a couple of defensive fluff responses. You took no action. Coward. Be a man. Admit this spot was ill-conceived. Take it down, and re-film it with better taste if you insist on keeping the supposed original message. There's nothing wrong with that message. There's very, very much wrong with how you presented it here.

[Dianne Lindsey]

The Videos are 2without question appalling. Secual addiction, gambling problem? I even laughed as did everyone in the room. I lookded around, changed the stance and explained tht nowevery time a female teacher iscaught with some "boy hot for teacher", if she has RLS and has been given these apparently life savers so they can sleep and live, but have not self control - EVERYONE is going to suffer. Entire families will loose, family or money they will loose. And why? Because this is real, unexplianable, hereditary and ironaically rthe ones who laugh the loudest have end up with the severest for,.
My first electrical shocks in my legs were slight but uncomfortable. I was 33.
There was no pain but just a stubborn feeling of having to move around. I skied, camped, danced, ran - everything everyone else was doing. But I still got them. I drank orange juice which seemed to have it's own way of keeping me awake at night. I lived in Houston Texas and they seemed to come in the fall and leave by the spring. I could not blame that lowered activity due to weather since weather never changed. My weight, fat cound were on the charts. My carreer was Architedctural and MEP project manager so I spent a lot of field time - in heels,on job sites.
My work was beginning to show signs because my only place to sleep was in my tub. When I was 45 years old I went to visit family in Wisconsin. I was there for the first snow (yes this is significant, and NO I am not Danielle Steel). At around 1:00 am after several baths, I walked out to my parents gazebo with just my gown and no shoes and for a while I felt still. At that point I felt I had the answer. COLD!! I saw the inside light come on and founc my father sitting there. He was the first I told. He had a lung transplant, U of W's first and one of the side effects was this RLS syndrome, he was linitied due to drug intake and just stayed up at night and stayed Warm, so no cold theary to reconcile,
Ironaically my mother and sister have it as well and take "iodine substances" The saddest was my sister watching my granmother die of a seperate stoke issues, yet watched her legs just twich and the doctors doing nothing. This wa my father mother.
I ronaicalyy my sister in law who is a nurse with a bachelors degree called my a "drug seeker"!!! now she has to taken the clonozepan even during th day. She calls it crown cake pills,

It was not until I was when I was 50 that I asked a doctor, Doctor Alo, who was treating me for a horrific situation, if he had heard of this he said RLS showed my the body of research and I jumped off the table and squeezed him. I did not know if he could give me thing, I just knew I WAS NOT CRAZY.

He gave me clonazepan.

I have been with consumer reports since it my father sent me that dome "Opinion" 3 page rag that was quite fast and nice to read. I came on your page because I cannot afford the brand name. I get two different batches from time to time, I have gotten some pink ones who I can take as recommended and sleep in front of you and then when I get the yellow generics, sometime they work, most time only at double or even TRIPLE the dose. So if they have the pinks I will ask for them because I get three moths at a time. This get s kind of mixed up also.

Becuase sometime the pinks are non-working, but no-where nieat the way yellows do.

How do I check onthis?

Oh a buy the way - my very frugal, pim proper mother was ver y cheekyy last moth when she siad she truly believes it is tied into the sexual organs. Upon shock came my inner termoil discomfort that this was more accurate than I care to go into

[DD Harker]

I can't believe what I just watched. Having suffered with RLS for many yeasr before anyone put a name to it. I was glad to see that the drug companies and Doctors were finally taking action to help us and the familes of those who have to deal with this very life disruptive problem. Regardless of the intent of this video, it comes across as making fun of those who suffer from RLS and CM should be ashamed to even have their name linked to this even though they have a disclaimer at the end.

[Funny Videos]

This is a great post and i really like the comment's there is so much you can learn from here

[Vicki]

I can understand how people that don't suffer from restless leg syndrome (I won't use the initials to make it sound more important) would make fun of it. I was diagnosed through a sleep study, but even my husband thinks it's a load of bologan. Or I should say, thought it was, until I started taking one of the prescription meds. it has completely changed my life in one week. I have energy I didn't ever have before because for the first time since I was a child, I am actually getting a good night's sleep. I for one am happy that the television ads are out there because it let me know there were new options out there. I had tried meds years ago, but at that time, Sinemet was the only option and it didn't work well for me. Finding the Requip has been a dream come true, so I am very thankful that I saw the ad and asked my doctor (not told him) about the drug. We tried it and it worked...that simple. So, you can't blame the ads, you have to blame the people who see the ads and their doctors if people are running around taking it when they don't need it.

[Elsie Horst]

How I wish my husband could take one of those aforementioned drugs for RLS or a calcium supplement for RLS! His doctor will not subcribe them for him because he is on dialysis and the drugs have not been tested for side effects on patients with kidney failure. And calcium is out of the question for a person on hemodialysis. He must avoid most dairy products as is. I am glad the doctor is looking out for him--but how I wish he could get some relief. He "walks" many miles a night. So much that we have to keep pillows between us at night or I am "kicked" to death if we don't. Our covers are almost always torn apart by morning. He "walks" while sitting at his desk at work, watching TV, and on dialysis. Some of the people above do not understand how devastating this condition is until they have it themselves or live with someone who does. I certainly was one of them and I now know better. My only hope is that with a kidney transplant he will get relief from this condition, as he did not have it before.

So, am I against or for the advertising? It can enlighten consumers that there are various drugs to treat different conditions--but it is up to their doctors to decide if they need it or not. The responsiblity as to whether a person gets a drug or not is up to their doctor. Doctors need to step up to the plate and not let patients talk them into prescribing drugs they do not need or could be harmful to them.

On the other hand, the drug companies need to also not paint this glorious picture of life on their drug if we take it. Show it can bring different degrees of relief but not protray them as the be all, end all they like to show that they are. Helpful, yes. a cure, no.

[Twitchy Witch]

This is how I see it.

If the CR ad was cavalier, it is up to the Restless Legs Syndrome Foundation to EDUCATE them. A boycott doesn't educate anybody. A boycott makes it look as if maybe, just maybe, there is something to the CR ad's mocking. "The lady doth protest too much, methinks." as Shakespeare once said.

RLS is a serious illness because sleep deprivation has so many terrible consequences. I think we can all agree that though the twitches are uncomfortable or even painful, and that sleep deprivation is potentially deadly. If you have RLS, you absolutely need treatment. The drugs in the commercials are one of these treatments.

However, RLS is *not* a blanket diagnosis that you throw over any factor that causes fasciculations. RLS doesn't cover the benign, occasional twitches due to overexertion or stress. Nor does it cover the twitches that occur in ALS as the patient's muscles literally die.

And here is a drug company telling everyone with muscle twitches in their legs to run to their doctor demanding powerful anti-Parkinson drugs! These ads will have devastating results on non-RLS patients who experience muscle spasms and twitches.

First, many folks who would benefit from stress-reduction techniques such as exercise or from mineral supplementation will instead be put on a powerful drug that is completely ineffective for their condition. This class of drug was originally intended to ease the symptoms of Parkinsons, a potentially fatal illness whose sufferers often choke to death on food when their muscular symptoms make it difficult to swallow. Side effects are practically irrelevant in this context.

Second, there will be folks who demand the drugs for muscle twitches of undiagnosed ALS or MS. This will most certainly delay the correct diagnosis and proper treatment of these illnesses. The progression of MS can be slowed down with certain drugs. But not with RLS drugs.

For a more complete list of conditions that can cause twitching in the legs, see
http://wrongdiagnosis.com/r/restless_legs_syndrome/underly.htm

I refuse to allow myself to be associated with the official stance of the Restless Legs Syndrome Foundation on this one. It is simply inconscionable to rely on drug company advertisements to get the word out about your organization. It is pointless to boycott a fine consumer protection organization over a few careless words. rls.org isn't getting another cent from me. Avoid the middleman, I say, and give it right to the fine folks at GSK.

[Jason File]

Jim, the ad wasn't making fun of people who suffer from it. Don't know why that's such a hard point to grasp. The discussion *begins* by saying that it's a real condition, and that about 3% of people suffer from it.

The point - and I'm having a hard time believing so many people simply in good faith missed it - is that the ad is vague enough to pull people in beyond that 3%, who are just fidgety. It's a classic pharmaceutical marketing strategy.

If you're really that offended by stuff like this, then you need to grow a pair.

[Jim Llee]

Regarding the RLS advertisement, I'm surprised by the uneducated and sarcastic slander of RLS. Sure, too many ads and too much hype is not a desired feature, but why not attack the ad as over selling rather than us people who suffer daily. To attack the symptons and the possible bad side effects is assinine. In case you haven't learned, all drugs for all problems have adverse side effects that might appear. That is the purpose of education, doctors and druggists.

Through my 40 years with this infliction, I've learned others have the symptoms and should be properly diagnosed before the pills are prescribed. RLS has made numerous alterations of my life from the inability to sit long at a meeting to extreme difficulty in driving or flying. A good night of sleep of just 5 hours is craved.

Why don't you attack Muscular Dystrophy, Angina, polio and a thousand other things I can't spell. I'm sure those victims start out with a mystery of symptoms, too.

As for me, you have proved your research is shallow and your sarcism is not appreciated.

[James Tweedie]

I am an RLS sufferer on medication (not Requip) to control a condition that would otherwise destroy my life. While I applaud the intent of this CR ad I must also say that I was extemely insulted by the cavalier manner in which the condition itself was treated. Serious matters should be approached seriously. This ad was so flippant and insensitive to the reality of RLS sufferers that I could easily have imagined it to have been written by a "study group" of high school students. The ad reflects very, very badly on CRs reputation as an organization to be taken seriously.

[tom nickle]

Consumer Reports is right.

Please remove my name from the mailing list of the RLS foundation I see no way of unsubscribing on the monthly email itself.

I remain a loyal supporter of Consumer Reports and have just renewed my subscription to them. The TV ad reflects my suspicions developed over the last year and I have lost all trust in your organization especially when I see your reaction to the report.

[Debby Doktor]

I read many of the comments about the video and skipped to the end to read CR's comment. I have not watched the video but I would like to comment to CR about the Requip commercials since they say the lack of information about RLS is what they were trying to point out the most.

Perhaps seeing a commercial with a man or woman trying to sleep and seeing the covers on the bed come off due to the jerking (not a twitch) of the legs (and arms occasionally) might be a good beginning. Tossing and turning and then getting up and pacing the floor, sitting in a chair and rubbing their legs to ease the painful and creepy feelings running up and down both legs. Then finally a trip to the bathroom in a hot tub just trying to get the legs to relax enough that you can get some sleep. Oh yes, it works, for about 15 mins after you finally get back in bed and then it starts all over again. While all this is happening you have the man or woman asking God to please help and take away the pain. Thinking about suicide just to ease the pain (both mental and physical at this point). Oh yes, don't forget the part about the man or woman laying down in the tub trying to go to sleep so they will drown and never have to go through another night like this again. Is this a real life situation with someone suffering from RLS, you bet it is, been there and done it. Maybe this would make a better commercial and open a few eyes to what RLS is really like. However, at the beginning of the commercial you better post a warning of what you are about to see. Oh yes, you can have a second commercial showing those who suffer through it during the day also and what their day is like. Fortunately for me the day episodes don't occur as often.

For the record, the current RLS commercials were enough for me to go to my doctor and tell her what was happening and ask if there was the possibility that I might have RLS. Until then I thought I was losing my mind and not just the sleep my body and mind was craving.

THANK YOU SK BEECHAM for being my manufacturer of Requip. Otherwise I wouldn't be getting any sleep and probably would have drowned, over-dosed or shot myself my now.

[Pam]

I like Consumer Reports and trust their fair, unbiased reporting. I agree that prescription drug advertising on television can be misleading and we seem to be inundated with it now. I also understand that this video regarding the prescription drug, Requip, was meant to enlighten consumers about the drug, not make light of restless leg syndrome.

BUT, I was very offended by the lady's tone in the video. If I took away her tone and listened to her words, I agreed with almost everything. She had a very mocking-type tone that made it SEEM like she was not just mocking the commercial, but also making fun of restless leg syndrome.

I was given samples of Requip by a neurologist. After thoroughly researching the drug, I decided not to take it because of the potential side effects. If my condition were to get worse, though, I would reconsider my earlier decision.

Please keep up the good work, Consumer Reports, on educating the public, but you might want to consider rethinking the tone of these videos, as it can turn off a lot of people.

[Mathy Milling Downing]

It is an interesting assortment of comments, with several key points. DTC ads have created a society of persons with both real and imagined illnesses. We identify ourselves by the persons who profess their various illnesses on our television screens on a daily basis. We do tend to diagnose ourselves based on what we learn from those actors. We want to belive the hype. We want to identify with their symptoms. We would be better off with NO drug ads. If we had a real health issue, then we could go to a medical specialist or doctor, describe the malady, and make more appropriate medical decisions. The general population should not be making medical decisions based on TV. While a law to ban such advertising was vetoed due to the Freedom of Speech Act, we need to redirect our time and energies into better health practices with more natural solutions.

[M Walker Allen]

The AdWatch editorial is perfect...the dialogue it has generated is exactly what is needed. The pharmaceutical companies have far too much influence on physicians, the government and the public...but how are we, the public to learn about what drugs are available? I don't trust the drug companies, but who else has the knowledge? What a riddle! Perhaps this should also be a topic on the afternoon talk shows.

[L. D. Staub]

I am disappointed in this "AdWatch" editorial. Consumer Reports touts itself as unbiased and objective, but it is clear that there is more than just an attempt to provide what CU calls "fact". In particular I found the mocking tone of the lady editorializing over this TV ad rather insulting.

The editors at CU have a short memory: These DTC ads were begun because everyone involved - the medical community, the FDA, the drug manufacturers, and the public at large - felt that a greater good would be served by providing more information to patients about available treatment options for different conditions. Boundaries were placed on the contents of the ads so it was clear that there were limitations to the safety and the efficacy of each drug depending on patient and the condition. How SHOULD you make this point in a 60 second ad?

The issue is a complicated one. You can take the ads off of TV and make the public less well-informed, or leave them on and provide information about possible treatments that people may or may not choose to inquire about. By its very nature this had to be a "mass market" effort since there is no way to restrict TV ads to only those people with a specific ailment or condition.

Let's not forget that each of us has a responsibility to use good judgment, whether this means how much food we eat, how fast we drive, or what we do when we see a drug ad on TV. Perhaps CU doesn't see it that way. If you think the public is too ignorant to get the right message perhaps there is a bigger issue and we need to eliminate TV ads for cars and food as well. Note that for food and cars, however, no doctor's prescription is ever required. (You have your work cut out for you there!)

As it stands it is very clear to this reader that you are not interested in providing unbiased and objective information but instead have some other agenda. I have faith that your readers have a lot more intelligence than you give them credit for.

[Barry B]

Well, one thing is for sure....people with RLS are certainly not getting enough sleep. Most seem to be a cranky bunch with little sense of humor. The video did what it was intended to do, point out in an entertaining way that drug companies are looking for pockets to pick. As an RLS sufferer, I would be angry at the drug companies, not CR. The side effects of this drug are horrendous....not to mention the funny and peculiar side effects of gambling and potential sexual misadventures. A good defense for infidelity or gambling away the weekly pay check....next there will be a drug to cure wandering eye syndrome. Do you think the erectile dysfunction drug makers were dismayed to include the cautionary notice that if while taking the drug you experience an erection "lasting longer than 4 hours" one should be concerned? They know that most men pray for a 4 hour erection, and would pay dearly for one. Lighten up RLS people....the video is informative and entertaining....not condescending.

[Dana]

Full disclosure, I have RLS. I have had it since I was in my early twenties and long before Big Pharma made the discovery that a Parkinson's drug could treat the symptoms. I was diagnosed (in my early thirties) by a doctor at my University's student health clinic. She took the time to listen to my complaint and to make sure it wasn't something else before she told me what she thought I had. At the time the only meds available were basically sleeping pills which she told me had the risk of addiction. I decided it wasn't bad enough to take anything.

After I took my first faculty position, the stress of the move and the thought of the tenure clock led to substantial stress and a severe increase in my RLS symptoms. I saw the ads for Requip and decided to try it. I've been on it for about a year (and initially I thought it was a wonder drug) but have recently started having trouble with side-effects. I stumbled upon this video after visiting the RLS Foundation website while looking for an alternative treatment.

I agree that Big Pharma should lay off the ads that go direct to consumers. I also think that lawyers shouldn't be allowed to advertise the way that they do, but that's an issue for another day. And perhaps one that people (other than lawyers) might respond to more favorably.

My beef with this video is the same one that several people have already mentioned. I understand that CR was going for an attack on Big Pharma. However, in order to do so, they made fun of the condition. And despite the few people who posted that no shots were taken, is very hard not to agree that this video could have been produced with a little more sensitivity to the sufferers.

I have long been annoyed with the drug ads, and think that the idea for this series was great. But as a CR subscriber and an RLS patient, I hope the next time CR has a doctor who is an expert on the condition in the video or at least consult one during its production.

And that they find someone who is less annoying to narrate it.

[laffinbuddha]

Nice to see CU taking the drug companies to task for a change.Usually I have a problem with the way they speak of any other way to treat conditions of the body.
By the way, RLS is a condition, not a disease, you did not catch it from anyone.
RLS can be treated in several different ways with little effort, but is specific to each person. Calcium,magnesium, potassium, alone or in combination has always worked on my clients. However,
I must add they are doing other things to improve health and diet.
In TCM this is a wind syndrome and helped by improving the condition of the liver.{I can hear the snickers already.}Personally, magnesium works within an hour,but,from testing, I know I have too much calcium and RLS is a symtom of this.
Quinine was also used in the past: Do you believe you have RLS because you didn't eat enough Requip or quinine? Maybe a visit to someone who knows more about health than drugs could benefit.

[Catherine Lewis]

I was reading the comments about the Requip ads. I read about a dozen - there are a lot(!) - and they seemed to be in two categories: those who have RLS and think CR was disrespectful of this condition, and those who don't and appreciated the humor, and CR's point of view.
I've had RLS off and on for 40 years, and every single night for the last ten or twelve years. (I don't take Requip; I use Mirapex instead.) Since the pharmaceutical companies have to list side-effects, and these side-effects are so bizarre, the ad comes across as absolutely ludicrous. You almost pity the ad agency trying to find a way to downplay the gambling and sexual side-effects ("Maybe if we try to kind of go with the side-effects, stage it in a Las Vegas casino and show a bunch of gorgeous people having fun gambling with chips, and then gamboling with each other before they fall peacefully into a restful night's sleep. . .") But the truth is that RLS, which is the name it has been called by for the last 15 or 20 years, IS serious, and it certainly was a mystery when it happened to me. Doctors didn't know what I was talking about 30 years ago. Thank goodness people who have been trying to deal with this now have a name and a possible answer. If you haven't experienced it you can't imagine how very uncomfortable something not technically "painful" can be. The best description is feeling as though a swarm of ants are crawling over the insides of the skin on your legs. So, as ridiculous as the ad is, and as much as I dislike the practices and profits of pharmaceutical firms, I also think CR's take is disrespectful.

[Rachael]

Hi - It really scares me how the editors at Consumer Reports can be so insensitive. I have struggled with the symptoms of RLS all of my life and never knew what it was. I am almost 22 and the doctor I went to told me that what was keeping me up at night was growing pains!! After seeing an ad like the one shown, I did some research and discovered I had RLS and began to seek treatments. I see why Consumer Reports did the piece, in order to point out misgivings that drug companies have, fine. However, this is a condition that is already misunderstood. I would love for that smug presenter in the video to spend one night with the tingly, itching feelings in her legs and then stand there and flim that commercial again. There are so many people who struggle with this condition, it is wrong to discredit them. Anyone who had no idea about the condition would see that little video and immediatly think its not a big deal and not take it seriously. It makes me sick how Kevin can allow such a mocking piece to represent Consumer Reports and then when he realizes he is wrong tries to be politically correct. I want him to go to an RLS support group and try listening to the people who suffer with RLS and then tell us how he feels.

[Ronnie D]

Finally, someone has taken notice to these TV ads. I used to get upset watching as drug companies tricker consumers into wanting their drugs. I know look forward to these commerials as a source of amusement. I especially look forward to the side effects portion of the commerecials to see how pleasant sounding the side effects are. This has to be my all time favorite, "increased gambling/sexual impulses". Hopefully other are realizing what these companies are doing and let doctors do what you are paying them for.

Thanks for the laugh!

[Paresh Pandya]

I'm still waiting for CR, Kevin, or Jamie's authoritative response as to how treat RLS and its "symptoms".

The silence is deafening.

[Peter Fotinakes, M.D.]

I am a specialist in Neurology and Sleep Medicine. Over the past twenty years I have been Medical Director of two accredited sleep disorders centers, including a university-based sleep disorder center that is one of the oldest accredited centers in the nation. I am a clinician and have personally diagnosed and treated hundreds of patients with RLS…No, the term “RLS” is not a drug company’s conspiracy to validate a vague condition…Yes, it is the official term physicians, researchers, and patients commonly use to refer to Restless Legs Syndrome for decades before Requip was a FDA approved treatment for RLS. My only allegiance is to sleep medicine and my patients, I have no affiliation to drug companies. I don’t prescribe medications unless I have made a presumptive diagnosis and have reviewed the benefits and risks with my patients. I only prescribe medications that work. Dopamine agonists, such as Mirapex and Permax have been the mainstay of treatment for RLS for more than ten years and were used as off-label drug prior to FDA approval because they worked, in fact, they were a God send. Requip is the first such drug to be FDA approved, followed by Mirapex, even though Mirapex has been in off-label use longer. When a drug is used off-label, a drug company is forbidden by law to market it in any way for the treatment of that condition, so the use of this class of drugs in the treatment of RLS was well-established long before the influence of pharmaceutical marketing.

I am against marketing of pharmaceuticals directly to the general public and I am delighted that CR’s discourages this practice. Unfortunately, I was appalled at how CR chose to present their point. In a zealous effort to ridicule pharmaceutical advertisement they also trashed a well recognized, debilitating disease. I will not spend time itemizing how the video ridiculed RLS patients, those criticisms may be found in the many other blogs. It was clear from the glib, infantile tone of Ms. Hirsh and the manner in which the information was delivered that CR does not think much of RLS and its sufferers. The point of your video was to say that a major pharmaceutical company was advertising some obscure disease with vague symptoms insufficient to require treatment with the advertised drug, which will result in the overdiagnosis and overtreatment of that condition. The few people who did not find the video offensive misunderstand RLS.

RLS is a misunderstood condition because its symptoms sound crazy; an “unpleasant sensation,” compelling movement, temporary improvement with movement, and worsening at bedtime. Worst of all, there are no physical signs on examination. As a result of these factors, most of my RLS patients suffer for years before they have the temerity to seek treatment. Unknowing physicians often labeled RLS patients as neurotic and withhold appropriate treatment. The net effect is that the majority of RLS patients remain undiagnosed. One study cites that RLS remains undiagnosed for an average of 16 years and patients have seen an average of 13 physicians for their symptoms. So, as much as I oppose direct pharmaceutical marketing, I was happy that Requip marketing educated the general public of a disease that has been misdiagnosed, underdiagnosed, and treated incorrectly or left completely untreated.

Depending on the reference, RLS occurs in 3-15% of the general population, in 10% of people over the age of 60, and in 10-30% of patients on maintenance dialysis, so it is by no means an uncommon disorder. The 3% prevalence cited by the CR article refers to “clinically significant RLS,” appears to be based on the Annals of Internal medicine article Kevin McKean recommended as a reference in his blog. If Mr. McKean read and understood that article, he would know that “clinically significant,” make up the percentage of those people who have RLS sufficient to require treatment and does not represent the total number of people suffer RLS symptoms. Mr. McKean would have also noted the conclusion of that study was, “clinically significant RLS is common (prevalence, 2.7%), is underdiagnosed, and significantly affects sleep and quality of life.” As the response letter from the RLS Foundation points out, 3% of the US population represents about 9 million people and is comparable to other medical conditions that CR would not dare ridicule.

The CR report also appears to be based on the second article Mr. McKean cited. That article is primarily a discussion on how media affects healthcare; using RLS as an example. Medical review articles that analyze a disease and its treatment typically cite hundreds of peer-reviewed medical references regarding that disease, this particular article cited three references specifically concerning RLS and eighteen regarding Glaxo, healthcare, and the media. It is hardly literature to base treatment recommendations and that’s just what the CR video does, it discourages seeking treatment by trivializing the disease and the drug. The authors of that article, Drs. Woloshin and Schwartz, are general internists, they are not sleep medicine specialists, and they receive grant money to research the effects of media on medicine. In effect, Drs. Woloshin and Schwartz are not RLS experts and used very little information to base their comments about RLS upon. They accuse the RLS foundation as being “heavily funded by the Glaxo,” as if that is the RLS Foundation’s only reason of existence, when in fact it is a non-profit organization that has been in existence long before the development of Requip.

The criteria Drs. Woloshin and Schwartz used to exemplify how drug companies exaggerate the importance of diseases in their marketing campaign are actually true in the case of RLS. RLS is has been notoriously underdiagnosed, its prevalence is underestimated due to its characteristics, most doctors are ignorant of its existence, and the dopamine agonists have been an effective treatment. Drs. Woloshin and Schwartz act as if Requip was a drug looking for a disease, and that disease was RLS when, in fact, this class of medications have been the mainstay of RLS treatment for more than a decade. It is painfully clear that the good doctors sought out a disease that fit their hypothesis on pharmaceutical marketing. Drs. Woloshin and Schwartz took the characteristics and history of RLS and used it to fit their opinions on how drug companies make distortions in their marketing…in effect, to get their paper published the good doctors and CR have done the same thing they accuse the pharmaceutical industry.

RLS treatment is a symptomatic treatment, i.e., the treatment alleviates the symptoms but do not cure the disease. As such, the appropriate treatment choice is based on an accurate diagnosis by a competent physician and an analysis of treatment benefits verses possible complications from the treatment itself. Most treatments carry potential side effects and pharmaceutical advertisements must disclose some of the more common or more serious side effects. Dopamine agonists (Requip-like medications) were originally developed for Parkinson’s disease, but because RLS is related to dopamine metabolism this same drug class proves effective for RLS.

Compulsive gambling/sexual activity and excessive daytime sleepiness has been described in people taking these drugs, most journal articles concerning these side effects are based upon Parkinson patients who typically take up to ten times the daily dose of the medication spread throughout the day compared to RLS patients who usually take a much smaller dose at bedtime. In the Parkinson’s studies the appearance of these conditions were associated with the dosage of the medication and severity of the disease. Parkinson patients notoriously become more sensitive to the toxic effects of dopamine as their disease progresses and their sleep becomes more disturbed. At least one study has shown decreased daytime sleepiness in RLS patient treatment with dopamine agonists because their underlying sleep disorder has been treated and they now sleep normally.

Anyone who has filled a prescription can tell you that a sticker warning against taking the medication with alcohol and sedatives frequently appears on their bottle. Sedation is a common side effect to many, even over-the-counter, medications. Alcohol itself is a sedative, and if taken in sufficient dosage, may induce sleepiness, sleep, coma, and death. Is CR promoting the continued use of alcohol in favor of treatment of a medical disease causing significant impairment? Probably not, but it was necessary to make an idiotic statement about teetotalers.

CR’s video fails to disclose what easier and cheaper treatment for clinically significant RLS are available. Yes, decreasing caffeine consumption helps some. No, quinine, calcium and magnesium do not treatment correctly diagnosed RLS (People often confuse RLS with nocturnal leg cramps). RLS may be worsened by iron deficiency and all RLS patients should be screened before beginning drug treatment. The fact is, when RLS symptoms are sufficient (the 9 million people) one of the primary treatments is a dopamine agonist like Requip.

I never thought I would defend pharmaceutical marketing, but in this case CR’s video is a greater source of misinformation than that of the drug company they are criticizing. Even though the CR written analysis did better at disclosing facts about the disease the video trivializes and minimizes RLS in a manner that is appalling to the people who have the disease and the professionals who treat them. I take it that the video has appeared on TV with without the written discussion, which is even more troubling.

I do not advocate canceling subscriptions to CR, but I do expect CR to act responsibly. If you don’t know what to say Mr. McKean, let me suggest that you remove the misleading and trivializing video about RLS and replace it with the following statement: “Although it was not CR’s intent, it appears that our recent video may misinform people about the symptoms and treatment of RLS and offends the estimated 9 millions sufferers of RLS. As such, I have decided to remove the video from our web site and not publicize it any further. It is my sincere hope that the CR video has not resulted in the prolonged pain and suffering of RLS patients by delaying their diagnosis and treatment. I highly recommend that any persons believing they suffer from RLS consult the RLS foundation at RLS.org or by calling 877 INFO RLS for additional information about RLS.”

Peter Fotinakes, M.D.

[Fred Brock]

Dear Jamie & Kevin,

I trust that the reaction you've received from the unfortunate 3% and the other people who know RLS well (I'm not one of them) has convinced you that you need to rethink the tone of future videos in this series. And please, let there BE future videos in the series! Done with more sensitivity to the patients, and a less snarky, "edgy" (meant to be hip, huh?) approach, we NEED this series.

I'm among those who believe that drug companies should not be advertising directly to patients. Since the law (and the first amendment) allows it, we need someone to balance out the drug company propaganda. That's you. But it really needs to be done well... Let's hope the next episode is a big step forward.

[Dave Demaree]

To Whom It May Concern (if any are there) and specifically to Kevin Mc Kean and Jamie Hirsh:

I am a Consumer Reports (and CR on Health) subscriber and have been for twenty or so years. I have never witnessed anything from you as disgusting and insensitive as the video you generated and show on your website regarding RLS. As an RLS sufferer myself, I have an understanding of the disorder that you will probably never have (unless justice prevails at some later time) and living in that situation causes your video to be sickening. You may never know what we go through on a daily basis, and for some of us, for many decades, but I can tell you that it involves a certain amount of ridiculing from ignorant and inconsiderate people. I never expected you to be in that group, but this video proves you are.

I will cancel my subscriptions and will advertise my opinion of your integrity (actually lack thereof) to the widest possible audience. I would use the expression of "shooting yourself in the foot," but it would be more complimentary to you than you deserve. There must be a lower form of humanity somewhere, but right off hand, I would not know where to find it.

In total disgust,

Dave Demaree
Denver RLS Support Group Advisory Board Member

[Joseph Lowery]

The Consumer Reports video makes me question the trustworthiness of CR. I suffered with mild RLS for years before meeting an RLS sufferer that recognized my symptoms. After having been treated successfully with Mirapex, I relocated to another town and changed doctors. My new doctor actually laughed when I told him why I was taking Mirapex. He wanted to know who told me I had RLS. Although, he didn't trust the diagnosis or perhaps not even the validity of RLS, he provided me with a prescription for Mirapex, anyway. My RLS symptoms are now severe and I am very thankful for the medication.

Is the producer of the CR video unaware that all medications have side-effects and some of the typical side-effects of many medications are the ones she mentioned in the CR video. The placebo response of RLS sufferers is not limited to RLS.

Shame on CR.

[Mary Lou Faraco]

Your article regarding restless leg syndrome (RLS) is inaccurate and offensive. The disease is real and debilitating, causing grave sleep deprivation and can cause kidney damage. The article was not amusing.

I am not renewing my subscription of many years because I cannot support spreading inaccurate information such as you published.

[J. Faraco]

As a sleep researcher, I must say that your treatment of the Restless Legs Syndrome was inaccurate, ignorant and under-researched. As a mother and a wife, I am shocked at your insensitive and insulting presentation. My husband is severely debilitated by this disorder, which is not imaginary, nor is it mild. It is, however, incurable, and life long.

Actually, in the year 1685, Wilkes described the syndrome's effects "the diseased are no more able to sleep than if they were in a place of the greatest torture". I'd give my testimony that this is true of my family members.

Wilkes didn't work for a drug company, and had no commercial interests in patenting a cure. But he was a fine scientist and a caring human, who carefully studied before he made his presentations.

The recent exciting identification of distinct genes affecting the sensory and motor components of the disease indicate that probably the "course is set" before birth. This is sad news as a family member- we can only look for treatments, not a true cure, and not prevention. Thus it is all the more important to develop appropriate treatments that will work for a lifetime.

I'm going to recommend to my family that they cancel their subscriptions. Nobody needs to subscribe to a magazine that treats important matter with this kind of ignorance and insensitivity. I'll mention you also next time I teach my course on sleep pathology and the under-recognition of this common disorder.

[John S.]

This is my second post, moreover a question; Did Consumer Reports contact the FDA, GSK or Boehringer Ingelheim when devising a their critique of the RLS ads and in particular GSK or the FDA on the Requip ad itself? If so could they please post their findings and their statements about your reports on drug ads? Thank you.

[Gracie G]

One word: caffeine . I had this problem -- and can reproduce it at will by consuming caffeine three days in a row. I found out about the caffeine connection in a book about folk remedies. I read an article by someone recommending drugs to solve RLS. I wrote her and asked her why she never mentioned just quitting caffeine. She wrote me back that she knew of the connection between RLS and caffeine, but that most of her readers would prefer to take drugs. I don't think so. I think most people would prefer to know the truth and be able to make informed decisions.

[Gene]

I'd just like to say that if it wasn't for a brochure that I saw in my doctor's office about RLS, and probably distributed by one of the drug makers (of Requip, or Mirapex), that I wouldn't even have asked my doctor about it.

My wife had been complaining about my kicking, spasms and twitching while I was sleeping, but I had really only noticed it while I was trying to fall asleep. Admittedly, on occasion, my symptoms would be so severe that I'd even wake myself up, but it wasn't until I read that brochure that I knew that my symptoms were an actual medical condition.

There are people suffering the symptoms of RLS that don't have a clue why they twitch, kick, or have a feeling that they need to get up and walk. They know that they shouldn't be feeling that way, but it's a feeling that just won't go away. A feeling that they might believe they have because they are just TOO tired and if it takes a drug maker's ad to point out the symptoms of a medical condition that most people aren't even aware exists, then what's the harm in the ad?

I told my doctor about the symptoms I had and asked if it might be RLS. He said "yes, possibly", and prescribed Mirapex for me. I know what Mirapex was developed for. I am familiar with the side effects. It doesn't matter to me, because if you listen to all of the ads on TV for prescription drugs, you'll notice that almost all of them describe pretty much the same side effects ("may cause nausea, vomiting, cramping, drowsiness, headache, migraine, shortness of breath, etc, etc, etc...". "If you're taking an MAOI, or have an erection for more than 4 hours, etc, etc, etc...").

You joked about the symptoms, "OOOOO, a mystery. Sounds, serious"..."RLS, sounds official, doesn't it?". I'm 54 years old, I'm diabetic, have high blood pressure, high cholesterol, and suffer from apnia. The symptoms I suffered from RLS could have been another symptom of any one of these conditions, or be caused by any of the medications I'm on, (I didn't know, until I read about it).

Do you remember, "The heartbreak of Psoriasis"? Johnny Carson made fun of that expression until someone that suffered from psoriasis confronted him about it. He learned that it's not funny to those that suffer from the illness. I don't remember if he even knew what it was, but I do know that he apologized to those who suffered from it and promised to never make fun of it again. It doesn't matter what it is, or how many people suffer from it, but if it's real, you shouldn't make fun of it either.

[Linda Robertson]

No one who doesn't have this condition can even begin to imagine who maddening it is to read these posts. The video DOES mock the condition in addition to the drug company that made it. The drug company commercial is both accurate and reasonable in presentation. This video is NOT!
I have a severe case of rls. Requip has saved my very life. Thank god the drug companies are bringing this condition to the attention of the general public, although it sounds like most of you don't believe it exists, for Christ's sake.
A curse to the "reporter" who made this video that she gets rls someday. She deserves it..and it really IS a curse...believe me!

[Peter]

I am sorry for CR. Jamie seems to be cute and perky, but she is far from unbiased. She does in fact appear to be far-left. The government already regulates pharmaceutical companies and I could understand the negative implications of the drug ads just fine without Cr's bashing of them. Instead of this agenda-driven activism, CR needs to be looking out for us - the consumer. Does the drup work or not, what are the real problems, what are the alternative treatments, how effective are they ... etc., etc.? CR needs to stick to the facts! we don't need the far left-wing sporting their "fun" with the "establishment". They need to reform their elitist attitude and do the job we subscribe for them to do.

[Ray Cramer]

Well, I suffer from RLS and have for 3 years. I watched the video twice and did feel it was a little harsh for us suffering from the problem. I agree that the ads are "crazy" sometimes with all those side-effects.
All I can say is that I had RLS bad and it was every night. Even though it wears you out, you still cannot sleep. I started to really suffer at work and I could not sleep in the same bed with my wife due to the contractions in my legs.
My doctor subscribed Mirapex and I take one tablet before bed and it stopped the first night. No gambling problems either.

[suzie]

I agree 100% with Shelley Skelton and echo her testimony completely. The best thing that came along for me in the past few years was mirapex, as it has solved a years-long severe RLS that went undiagnosed for me also. My dr. had never heard of it until I told him, and he had tried every known medicine to help leg conditions, like quinine, iron supplements, etc. My RLS began when I was pregnant at age 41, and for almost 10 years it got worse and worse. I couldn't sleep, walked the house at night, and had the most severe malaise you can imagine. It is a documented neurological condition that it way underdiagnosed and tragically undertreated. The CR report is insulting to the large number of us who suffer from the disease. Pull it off the shelf asap. You are doing a great disservice to others who haven't even had the benefit yet of obtaining the correct medicine, oh and yes, that would be mirapex and requip. For once I am actually thanking the drug companies for something they did to help - me at last!

[Bruce Hamilton]

I don't have the time to watch videos. Please post transcripts of all your videos so we can read them.

Thanks,

--Bruce

[Dave Beretta]

Why post anything on this blog. I did on Monday and they did not post it - how many peoples comments are simply not posted - I do not know. Perhaps my comments hit home. I guess they do not want the heart felt comments from people. Perhaps I will ask the people at www.rls.org to post my comments.

[Jodie]

Why attack the Requip ad when it has educated not only RLS sufferers but physicians as well? So many of the comments above have described my condition to a T, particularly those written by RLS Lifer (11/14) and Diane (11/15). I'll just add that the first time I saw the Requip ad, I was so excited that there might be relief for me after many years of sleepless nights. The ad did not convince me that I have a condition I didn't know existed. On the contrary, I knew the name of it from reading and surfing the Internet; unfortunately, every doctor I had ever talked to about it just brushed me aside out of ignorance. I had given up talking to doctors for a few years, then I saw that commercial, and it has changed my life. Now when the ad comes on, I just hope it's helping others as it helped me. My kids see it and say, "That used to be Mom!"