Does anyone really listen to prescription drug commercials on television? Virtually all these ads come with a long list of scary side effects. It’s hard to believe that people would badger their doctors for medications that could cause life-threatening complications.

The pharmaceutical industry clearly thinks the strategy works. It spent over $5 billion in 2024 on television commercials and streaming video ads. So, if you think you have been seeing a lot of messages encouraging you to “ask your doctor” about a brand-name drug, you are right.

The Food and Drug Administration requires such ads to contain information about adverse reactions. Many of these drug commercials start with a serious health problem.

Then we learn about the benefits of the drug in question. After that, an announcer reads a long list of potential problems as quickly as possible. Usually, the spot ends with people having a good time.

For example, the injectable medicine Botox (onabotulinumtoxinA) is being promoted to prevent chronic migraines.

One commercial begins with the question, “Ever feel like a spectator in your own life …?” Then the voiceover quotes a survey: “… 91% of users wish they talked to their doctor and started sooner.”

Next comes the intimidating part: “Botox effects may spread hours to weeks after injection, causing serious symptoms. Alert your doctor right away as trouble swallowing, speaking, breathing, eye problems, or muscle weakness can be signs of a life-threatening condition.

Those with these conditions before injection are at highest risk. Side effects may include allergic reactions like rash, breathing problems, dizziness, neck and injection site pain, and headache. Don’t receive Botox if there’s a skin infection. Tell your doctor your medical history, muscle or nerve conditions like ALS, myasthenia gravis or Lambert-Eaton syndrome and medicines like botulinum toxins which may increase the risk of serious side effects.”

Perhaps people just don’t listen. Or maybe they figure that these problems will not affect them.

Here’s a commercial for Vraylar (cariprazine). It is an “atypical antipsychotic” being promoted as an add-on for the treatment of depression. The onscreen message states that Vraylar is “For adults with major depressive disorder (MDD) taking an antidepressant and still experiencing unresolved depression symptoms.”

A woman is seen riding her bicycle and smiling while the announcer states: “Vraylar is not approved for elderly patients with dementia-related psychosis due to increased risk of death or stroke. Report changes in behavior or suicidal thoughts to your doctor. Antidepressants can increase these in children and young adults. Report fever, stiff muscles, or confusion, which may be life-threatening or uncontrolled muscle movements, which may be permanent. High blood sugar, which can lead to coma or death, weight gain, and high cholesterol may occur. Difficulty moving, tremors, slow or uncontrolled body movements, restlessness and feeling like you need to move, nausea, constipation, insomnia, dizziness, increased appetite, and fatigue are common. Side effects may not appear for several weeks. Visit Vraylar.com to see additional side effects.”

Although such adverse drug reactions seem daunting, they do not appear to slow sales. Drug companies do not throw money away, so these commercials must be working.

They also impact prescribers. This is a surprisingly affordable way to communicate directly with doctors and other primary care providers. We urge everyone to listen carefully to the side effect part of upbeat drug ads.