News & Research

In the News

I’ve had a couple terrible, horrible, no good, very bad weeks, so I’m trying to take it easy right now. Fortunately Kevin, MD has had several links to interesting stories in the last few days that I’ve wanted to share.

P.S. Alexander and the Terrible, Horrible, No Good, Very Bad Day, which I allude to in the first sentence of the post, is quite an entertaining book.

Society, Treatment

Good Old Days of Meds Not So Good

Longing for the days of safe, reliable medications? A drug discovery researcher says those days never existed. The health risks of drugs like aspirin, penicillin and acetaminophen, he claims, are great enough that many older meds wouldn’t have received FDA approval. Some wouldn’t have even made it to FDA review.

He concludes with, “What are we to make of all this? It’s possible to be both glad and worried. We can be relieved that we’ve learned so much more about pharmacology, ensuring that the drugs that manage to gain approval today are the safer than ever. Or we can think about how people seem to use aspirin and the other legacy drugs anyway, safety problems and all, and wonder how many more useful medicines we’re losing by insisting on a higher bar.”

I lament how how often drugs are approved on on the market before serious health risks are found (or revealed). But before any product is marketed a company (and the FDA in this case) considers the known risks and benefits. If a drug or medical procedure potentially helps significantly more people than it might harm, the benefits may outweigh the costs. It’s the same approach that insurance companies use.

If someone accepts that’s medications can’t be totally harmless and chooses to take a drug anyway, shouldn’t he or she know all of the risks beforehand? Truly it wouldn’t be difficult for drug companies to hide information about a drug’s harmful effects in plain sight. Isn’t that what’s been done with aspirin?

via Kevin, MD and Medpundit

Mental Health, News & Research

Depression is a Chemical Imbalance… or Not

Depression is caused by a chemical imbalance in the brain and antidepressants work to correct that imbalance, right? Not so fast. A chemical imbalance is a theory of depression — and one that drug companies who make SSRIs push — but that doesn’t make it fact.

An article in the December issue of PLoS Medicine examines direct-to-consumer ads for SSRIs that make this claim. Using existing medical research, the authors conclude “[T]here is no such thing as a scientifically established correct ‘balance’ of serotonin….” and that there is “a growing body of medical literature casting doubt on the serotonin hypothesis.” In fact, they say that “Not a single peer-reviewed article … support[s] claims of serotonin deficiency in any mental disorder.”

Hopefully Shrinkette will give us her insight into this topic. The Wall Street Journal weighs in with Some Drugs Work to Treat Depression, But it isn’t Clear How.

News & Research, Treatment

Clinical Trials Galore

After months of fruitless searches for headache or migraine related on NIH‘s clinical trials database, there’s a plethora of trials. The database currently has 43 headache and 36 migraine studies listed. Topics include:

  • Improving migraine treatment in the ER
  • New preventives and abortives
  • Headache-specific studies of preventives and abortives currently used off-label
  • Studies specifically for adolescents and children
  • Nerve blocks
  • Menstrual migraine
  • Steroids for breaking rebound headaches
  • Controlling nausea
  • Marinol (a synthetic version of THC) as abortive
  • Contrast imaging for diagnosis
  • Nerve stimulation

And there are a lot more. Many are for drugs, but others have minimal risks.You can search by which phase trails are in, I, II and III. The website breaks down how the trials differ:

  • In Phase I clinical trials, researchers test a new drug or treatment in a small group of people (20-80) for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.
  • In Phase II clinical trials, the study drug or treatment is given to a larger group of people (100-300) to see if it is effective and to further evaluate its safety.
  • In Phase III studies, the study drug or treatment is given to large groups of people (1,000-3,000) to confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information that will allow the drug or treatment to be used safely.

To learn more about clinical trials and for definitions, visit the site’s resources page.

The best feature is the map, where you can click on your state or nearby states for studies close to home.