Like Wall Street trying to replace the credit default swap/ high risk mortgage gravy train, pharma is cooking up new diseases to sell.

While the "disease" of menopause and aging filled pharma coffers for forty years--Over 35? You Might Be At Risk for Menopause!--hormone replacement therapy was found to cause not prevent the host of symptoms women feared.

Pharma tried to replace HRT dollars with a thinning bones fear campaign until its bone wonder drugs, bisphosphonates like Fosamax, Boniva and Actonal, were found to cause not prevent fractures and osteonecrosis of the jaw bone at times. Nor did it help that Boniva czar Sally Field allegedly broke a bone. Oops.

Enter the replacement diseases of depression-with-pain and pain-with-depression (fibromyalgia) for which Cymbalta, Lyrica, Savella, Effexor and Pristiq just happen to be available.

Of course pharma has received bad ink over its SSRI/SSNI antidepressants which often cause and not prevent suicide--not to mention spectacular mass shootings with assault style weapons by people who should never have been sold guns to begin with not to digress. They are also implicated in the Iraq war soldier suicides since 80 percent get the antidepressants for post traumatic stress disorder.

In fact suicide has become such an "image" problem for pharma--660 people have killed themselves on antidepressants in newspaper reports since "SSRIs" debuted-- the American Foundation for Suicide Prevention (AFSP), a drug company founded and operated organization, is staging "grassroots" anti-suicide walks in June against an epidemic it has largely created.

Pharma is also behind automatic depression screening initiatives in schools and in health care settings for new moms (watch for an epidemic of post partum depression and the newer post partum "anxiety.")

But since the drugs often don't work or don't work as, well, intended pharma now says its defective drugs just don't work as monotherapy. You need to add a second or third drug to the mix.

"Monotherapy" and its kissing cousin "Treatment Resistant Depression" (TRD) combine the marketing of the 1960's television upsell--not one TV; one in every room!--with the opacity of the 1980's fuel additive marketing--it may improve your gas mileage or make it worse but how do you know which?

In three short letters--like successful diseases GAD (general anxiety disorder), MDD (major depressive disorder) ADD (attention deficit disorder) RLS (restless legs syndrome) GERD (gastroesophageal reflux disease) and PMDD (Premenstrual dysphoric disorder)--TRD puts the blame squarely on the patient and keeps the patient buying more: it's not our drug that's not working, it's your Treatment Resistant Depression.

Still pharma's worst disease mongering is with children.

As long as parents have more guilt over "what's wrong" with their kid than giving kids unneeded and dangerous drugs they'll fall for the ADHD, major depression, obsessive compulsive disorder, generalized anxiety disorder, personality disorder, bipolar disorder and "psychosis" pediatric labels. Children have even been diagnosed with the conditions in utero.

Despite the billions a year schizophrenia drugs like Seroquel make in off label marketing, schizophrenia is a rare disease affecting only 2.4 million US adults and normally emerging during young adulthood.

At least it was.

"Awareness of childhood-onset schizophrenia is rapidly increasing, with a more precise definition now available of the clinical picture and early signs, the outcome and the treatment strategies," writes Gabriele Masi, MD in the journal CNS (2007;21(12):1035-8)

"And with a Lilly drug available," the Lilly consulting doctor might have added.

Does your child have "social deficits"? "Delusions… related to childhood themes"?
An imaginary playmate? Rampant creativity?

Your child may be At Risk writes Masi-- especially due to the "hesitancy on the part of clinicians to make a diagnosis of schizophrenia."

But don't worry. Lilly's Zyprexa will work just fine in conjunction with "social, scholastic, and familial interventions,"--once called bringing a kid up--writes Masi.

Masi's parenting turned lab experiment would be funny--if the FDA weren't considering schizophrenic drugs for children this spring.

Martha Rosenberg is a columnist/cartoon who writes about public health.