Marketing a Disease, and Also a Drug to Treat It
By ANDREW POLLACK
The New York Times
Published: May 9, 2005
Is it a drug in search of a disease, or simply an affliction in need of better publicity?
One of the afflicted is Peter Pagan. After suffering a severe brain injury in a fall, he would burst into tears at the slightest provocation, even when he was not feeling sad.
"The physical therapist would say, 'You're doing well' and he would just start crying," said his wife, Julie. "He cried, I would say, 40 or 50 times a day. It was awful. I just didn't know what to do."
But Mr. Pagan, 73, a retired engineer from La Palma, Calif., who still has trouble speaking, has been keeping his tears in check, his wife said, since he started taking an experimental drug developed by Avanir Pharmaceuticals of San Diego.
Avanir hopes that the drug, Neurodex, will win federal approval by the end of this year as a treatment for the uncontrollable laughing or crying that can be caused by various neurological diseases or injuries. As one doctor described the odd syndrome in a 1989 article, "Pathologic laughter is devoid of any inner sense of joy and pathologic weeping of any feeling of inner sorrow."
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Pathological laughter or crying is a fascinating manifestation of certain types of brain damage or disease. It is a reflection more of a disorder in emotional expression than in any way reflective of feelings per se and, by extension, mood.