Cure It With Drugs !!!!!!!!

[Daanyeer]

Source: NYT
October 15, 2000 Author: Maggie Jones



........ "Compulsive shopping has had a lackluster reputation compared with its sister pathologies: it isn't as risky as kleptomania, as sexy as gambling or as provocative as sex addictions. It is more like a Saturday morning errand gone bad. "It's called the smiled-upon addiction," says April Lane Benson, a therapist and the editor of the recent book "I Shop, Therefore I Am." "We smile in a wry, condescending way." The culture also smiles, she says, because shopping helps fuel prosperous times"




If and when compulsive shopping takes its place among these ills, Barbara G. could be a case study.

Her cravings for ethnic clothes, chunky jewelry and artwork landed her in $60,000 of credit-card debt and bankruptcy several years ago. But she still shops hard (paying by check) for what experts say are all the wrong reasons: loneliness, boredom, anxiety. After a friend's trip to Africa, Barbara decided to buy a $20 African headband. But once inside the incense-drenched boutique, she grabbed a sky blue shirt -- it matched her eyes. Then she scooped up five more in the same pattern but in different colors. She slipped on a necklace of Tibetan prayer beads. Then another with African mud beads. And another of black rope and silver Indian rupees. As the saleswoman totaled the items, Barbara grabbed two more necklaces. And then two more. In less than an hour, she spent $2,487 (and put a $900 ring on layaway).

To curb her hunger to shop, Barbara G. dropped her 13 credit cards in a jar, filled it with water and put the plastic cocktail in her freezer. On other occasions, she sealed her credit cards in an envelope and locked them in a box. And once, she cut them into pieces. But all for naught: she'd drive to Nordstrom, ask a saleswoman to look up her account number and charge more clothes.

Imagine how much easier it would be if, rather than fight -- and often succumb to -- the temptations in malls, ads and mailboxes stuffed with catalogs and credit card come-ons, compulsive shoppers like Barbara could salve their shopping itch with a pill.

There just may be such a pill. Drugs may do what willpower sometimes can't: dampen the impulse to buy. The New York-based pharmaceutical company Forest Laboratories and Stanford University are testing a selective serotonin reuptake inhibitor, or S.S.R.I., on the women-who-shop-too-much population. In the study, 24 compulsive buyers are taking Celexa, already approved by the Food and Drug Administration as an antidepressant, over a 12-week period. Though the trial won't be complete until later this year, the early results look "very promising," according to Dr. Lorrin M. Koran, a professor of psychiatry and the head of Stanford's study. That's good news for those afflicted with shopping fever. And it's great news for the drug companies that manufacture S.S.R.I.'s; they may have found their best market yet.

Compulsive shopping has had a lackluster reputation compared with its sister pathologies: it isn't as risky as kleptomania, as sexy as gambling or as provocative as sex addictions. It is more like a Saturday morning errand gone bad. "It's called the smiled-upon addiction," says April Lane Benson, a therapist and the editor of the recent book "I Shop, Therefore I Am." "We smile in a wry, condescending way." The culture also smiles, she says, because shopping helps fuel prosperous times.

In this and in other ways (impulsiveness, the role played by money, the tendency to binge), shopping shares ties with its daredevil cousin, gambling. Yet pathological gambling has long been treated as the more serious disorder, perhaps because it is considered a man's disease and something that happens outside the daily routine. Shopping, on the other hand, is typically part of the humdrum of women's lives. (Of course men shop, too, but they're less inclined to view buying stereos and suits and cars as a problem in need of fixing.)

Nonetheless, compulsive shopping is being nudged into the medical mainstream. It is "a hidden epidemic," according to Koran, while another doctor calls it "a public health problem." Buying a cashmere sweater to soothe a broken heart is no longer an indulgence; it's a potential addiction. And in our Prozac culture, we may have a drug to fix it.

Fewer than 12 years after S.S.R.I.'s hit the market, they've become America's aspirin for the psyche. Prozac was the third-best-selling drug in the country last year. And more than 76 million prescriptions for S.S.R.I.'s were filled in the United States just last year.

Though S.S.R.I.'s have slightly different molecular structures and varying side effects, they work similarly. The drugs prolong the presence of the neurotransmitter serotonin, which is associated with better moods. In the broadest sense, too much or too little serotonin has been implicated in how happy, satiated or aggressive we are. But how this applies to compulsive shopping is still guesswork. In theory, if a person shops because she's depressed, an S.S.R.I. could lift the depression and curb the shopping. But some psychiatrists think that depression isn't always the root problem, theorizing instead that some extreme buyers can't regulate their impulses because of a biochemical imbalance.

"Serotonin is a modulator," says Dr. Larry Siever of the Mount Sinai School of Medicine in New York. "It smooths things out and suppresses behaviors that are undesirable."

[Drug Companies are working day and night to find a cure]

On the surface, the Stanford Celexa trial hardly seems to warrant attention. Even a Forest Laboratories representative admits the study won't prove much. "We funded the trial because it's an interesting question," says Paul J. Tiseo, a director of central nervous system clinical development for Forest. "But no one thinks these types of trials are hard science."

But even without science to back it up, linking Celexa to shopping could help a vague disorder metastasize into an epidemic. If news about the study makes you think that you shop too much, who's to say you don't? Clinical trials are often a company's first opportunity to "educate" the public about a disease or disorder, says David Healy, the author of "The Anti-Depressant Era" and the director of the North Wales Department of Psychological Medicine. Healy notes a pattern in recent psychopharmacology: once a drug is shown to be effective in treating a disorder, the number of diagnoses for that disorder increases.

In other words, drug-company marketing affects how we perceive mental illness.

No one is suggesting Forest Laboratories is deliberately marketing or expanding the definition of compulsive shopping in order to sell Celexa. But the company doesn't have to. "Pharmaceuticals just have to make a little noise and the sales will follow," Healy says. "Compulsive shopping is novel; it catches the media's interest. A lot of therapists and lots of people who think they have this problem will get together, seeking treatment or seeking to provide treatment -- without a pharmaceutical rep ever coming through the door."

Indeed, this new market should be a slam-dunk for drug companies. Here's an audience that by definition loves to buy. And S.S.R.I.'s are just the capstones of the consumer marketplace: the Gap convinces shoppers they need gray T-shirts and khakis; then, the therapy industry persuades them they have a problem for buying so many clothes, and finally, the drug companies influence them to take pills to cure their pathological desire for gray T-shirts and khakis. Never mind that these consumers may not need the clothes, the books or the drugs. For compulsive shoppers, that's never the point.