Posts about drugs
animals bacteria biology Career Cats cool curiouscat Economics economy Energy Engineering engineering education engineers evolution experiment food fun Funding government green Health Care human health K-12 kids Life Science medical research MIT nature ocean physics Products Research Robots Science science education science explained science facts science webcasts scientific inquiry Students Technology university research USA water webcasts

Drugmakers Are Desperate to Know Why Placebos Are Getting More Effective

Posted on June 19, 2013  Comments (0)

Fascinating article from Wired: Placebos Are Getting More Effective. Drugmakers Are Desperate to Know Why.

The fact that an increasing number of medications are unable to beat sugar pills has thrown the industry into crisis. The stakes could hardly be higher. In today’s economy, the fate of a long-established company can hang on the outcome of a handful of tests.
…
Potter discovered, however, that geographic location alone could determine whether a drug bested placebo or crossed the futility boundary. By the late ’90s, for example, the classic antianxiety drug diazepam (also known as Valium) was still beating placebo in France and Belgium. But when the drug was tested in the US, it was likely to fail. Conversely, Prozac performed better in America than it did in western Europe and South Africa. It was an unsettling prospect: FDA approval could hinge on where the company chose to conduct a trial.
…
In one study, Benedetti found that Alzheimer’s patients with impaired cognitive function get less pain relief from analgesic drugs than normal volunteers do. Using advanced methods of EEG analysis, he discovered that the connections between the patients’ prefrontal lobes and their opioid systems had been damaged. Healthy volunteers feel the benefit of medication plus a placebo boost. Patients who are unable to formulate ideas about the future because of cortical deficits, however, feel only the effect of the drug itself. The experiment suggests that because Alzheimer’s patients don’t get the benefits of anticipating the treatment, they require higher doses of painkillers to experience normal levels of relief.

Benedetti often uses the phrase “placebo response” instead of placebo effect. By definition, inert pills have no effect, but under the right conditions they can act as a catalyst for what he calls the body’s “endogenous health care system.” Like any other internal network, the placebo response has limits. It can ease the discomfort of chemotherapy, but it won’t stop the growth of tumors. It also works in reverse to produce the placebo’s evil twin, the nocebo effect. For example, men taking a commonly prescribed prostate drug who were informed that the medication may cause sexual dysfunction were twice as likely to become impotent.
…
Moreover, a pill’s shape, size, branding, and price all influence its effects on the body. Soothing blue capsules make more effective tranquilizers than angry red ones, except among Italian men, for whom the color blue is associated with their national soccer team—Forza Azzurri!

Medical research presents significant difficulties. The funding of the health care system also distorts behavior and pushes companies to focus on being able to justify selling drugs instead of focusing on finding effective solutions. Even without incentives distorting behavior, the challenges are difficult enough. Adding the distortions just makes it worse.

It is wonderful we have so many scientists accepting these challenges and spending their careers fighting the odds to help find us wonderful health breakthroughs.

Related: The Majority of Clinical Trials Don’t Provide Meaningful Evidence – System for Approving New Medical Options Needs Improvement – Medical Study Integrity (or Lack Thereof) – Discussing Medical Study Results

CDC Again Stresses Urgent Need to Adjust Practices or Pay a Steep Price

Posted on March 8, 2013  Comments (0)

Untreatable and hard-to-treat infections from Carbapenem-resistant Enterobacteriaceae (CRE) germs are on the rise among patients in medical facilities. CRE germs have become resistant to all or nearly all the antibiotics we have today. Types of CRE include Klebsiella pneumoniae Carbapenemase (KPC) and New Delhi metallo-beta-lactamase (NDM). By following the United States Center for Disease Control (CDC) guidelines, we can slow the penetration of CRE infections in hospitals and other medical facilities and potentially spread to otherwise healthy people outside of medical facilities.

The CDC has worked with hospitals to successfully apply these measures. The CDC worked with Florida to stop a year-long CRE outbreak in a long-term acute care hospital. With the improved use of CDC recommendations (such as educating staff; dedicating staff, rooms, and equipment to patients with CRE; and improving use of gloves and gowns) the percentage of patients who got CRE at the facility dropped from 44% to 0.

One travesty has been how poorly health care professionals have been about prescribe antibiotics wisely We need to improve and follow CDC antibiotics guidelines (stop the overuse of antibiotics) and use culture results (for patients undergoing treatment) to modify prescriptions, if needed. Antibiotic overuse contributes to the growing problems of Clostridium difficile (c-diff) infection and antibiotic resistance in healthcare facilities. Studies indicate that nearly 50% of antimicrobial use in hospitals is unnecessary or inappropriate (per CDC web site).

Israel decreased CRE infection rates in all 27 of its hospitals by more than 70% in one year with a coordinated prevention program. The USA is at a critical time in which CRE infections could be controlled if addressed in a rapid, coordinated, and consistent effort by doctors, nurses, lab staff, medical facility leadership, health departments/states, policy makers, and the federal government.

As I have been saying for years the damage we are creating due to our actions around the use and abuse of antibiotics is likely to kill tens of thousands, or more people. Because the deaths are delayed and often not dramatic we have continued dangerous practices for years when we know better. It is a shame we are condemning so many to increased risks. The CDC, and others, are doing good work, unfortunately too much bad work is continuing in the face of evidence of how dangerous that is.

Related: CDC Urges Increased Effort to Reduce Drug-Resistant Infections (2006) – Key scientific articles on Healthcare Associated Infections via CDC – Our Dangerous Antibiotic Practices Carry Great Risks – Dangerous Drug-Resistant Strains of TB are a Growing Threat

How Caffeine Affects Your Body

Posted on November 15, 2012  Comments (15)

From the video by Alex Dainis: Caffeine prevents adenosine from slowing down your nervous system, by binding to the same receptors adenosine would. Caffeine also stimulates the production of adrenaline. And it increases the amount of dopamine present. The average half life of caffeine in the human body is about 6 hours.

Related: Does Diet Soda Result in Weight Gain? – Mental Pick-Me-Ups: The Coming Boom – Ritalin Doesn’t Show Long Term Effectiveness for ADHD

I have been curious about the caffeine content of various drinks and writing this post is a good enough reason to actually look it up.

  • expresso (2oz) 100 mg (varies – 60 mg to 180 mg)
  • coffee (8oz) 100 mg – this can vary quite a bit, 50 to over 100 mg is common. Brewed coffee has more caffeine 100-200 mg.
  • Red Bull (8.2 oz) 80 mg
  • tea (8oz) 20 to 80 mg (depending on strength and type, can also be higher, green tea is on the lower end)
  • Mountain Dew (12 oz) 54 mg (diet has 54 mg also)
  • Diet Coke 46 mg (regular Coke 34mg)
  • Pepsi 38 mg, Diet Pepsi 36 mg

Sprite, 7Up and some root beers have no caffeine.
Chocolate can also be a significant source of caffeine – dark chocolate can have over 80 mg per 100 g (approximately 4 ounces).

Man in Coma for 7 Years was Given a Sleeping Pill and Woke Up

Posted on September 9, 2012  Comments (3)

Lazarus pill miracle for E Cape man, 9 September 2012

After reading a report in City Press last month, his wife, Nomfundo, insisted that he be given a prescription for the sleeping pill Stilnox, which has the opposite effect on those with brain injuries.

It worked – and brought him out of a seven-year coma.
…
But on August 12, family friend Nceba Mokoena came across an article in City Press about a miracle recovery made by another car crash victim, hundreds of kilometres away in Gauteng.

Louis Viljoen was given the sleeping pill by chance by his mother, Sienie.

She had noticed he wasn’t sleeping peacefully and asked her doctor if she could give him half a sleeping tablet. After she did, Louis opened his eyes and said “Hello Mamma”, his first words in five years.

Very cool anecdote and example that modern medicine has many miraculous cures but the medical system can’t always use them as well as we would hope. Even with all the knowledge we have today just getting that information into the right doctor’s minds is very hard. And the complexity of diagnoses and interactions makes medical care still an art as well as a science.

So is this just some freak accident. Partially, in the mother giving her son a sleeping pill to reduce his seeming restlessness in the coma. But the effect of Stilnox in bringing coma victims out of a coma has been documented previously.

Reborn from persistent vegetative state, 12 September 2006

Four three years, Riaan Bolton has lain motionless, his eyes open but unseeing. After a devastating car crash doctors said he would never again see or speak or hear. Now his mother, Johanna, dissolves a pill in a little water on a teaspoon and forces it gently into his mouth. Within half an hour, as if a switch has been flicked in his brain, Riaan looks around his home in the South African town of Kimberley and says, “Hello.” Shortly after his accident, Johanna had turned down the option of letting him die.

Three hundred miles away, Louis Viljoen, a young man who had once been cruelly described by a doctor as “a cabbage”, greets me with a mischievous smile and a streetwise four-move handshake. Until he took the pill, he too was supposed to be in what doctors call a persistent vegetative state.

Across the Atlantic in the United States, George Melendez, who is also brain-damaged, has lain twitching and moaning as if in agony for years, causing his parents unbearable grief. He, too, is given this little tablet and again, it’s as if a light comes on. His father asks him if he is, indeed, in pain. “No,” George smiles, and his family burst into tears.

It all sounds miraculous, you might think. And in a way, it is. But this is not a miracle medication, the result of groundbreaking neurological research. Instead, these awakenings have come as the result of an accidental discovery by a dedicated – and bewildered – GP. They have all woken up, paradoxically, after being given a commonly used sleeping pill.

Medical care is still today an extremely difficult area where highly trained and continuously learning doctors still have a great deal of trouble keeping up with the latest medical knowledge.

Related: Hospital Reform, IHI’s efforts to get good practices adopted – Norway Reduces Infections by Reducing Antibiotic Use – Majority of Clinical Trials Don’t Provide Meaningful Evidence – Continual Learning – Physical Activity for Adults: Inactivity Leads to 5.3 Million Early Deaths a Year

Dangerous Drug-Resistant Strains of TB are a Growing Threat

Posted on March 28, 2012  Comments (1)

Drug-resistant strains of TB are out of control

The fight against new, antibiotic-resistant strains of tuberculosis has already been lost in some parts of the world, according to a senior World Health Organisation expert.
…
Dr Paul Nunn, head of the WHO’s global TB response team, is leading the efforts against multi-drug resistant TB (MDR-TB). Nunn said that, while TB is preventable and curable, a combination of bad management and misdiagnosis was leaving pharmaceutical companies struggling to keep up. Meanwhile, the disease kills millions every year.

“It occurs basically when the health system screws up,” said Nunn. “Treating TB requires a carefully followed regime of medication over six months. In places where health services are fragmented or underfunded, or patients poor and health professionals ill-trained, that treatment can fall short, which can in turn lead to patients developing drug-resistant strains. It’s been estimated that an undiagnosed TB-infected person can infect 10 others a year.

We tend to do a poor job of dealing with systemic effects of poorly functioning systems. Direct present threats get out attention. And we are decent at directing brain power and resources to find solutions. We are not very good at dealing with failures that put us in much worse shape in the long term. For small threats we can wait until it becomes a present threat and then deal with it. There are costs to doing this (economic and personal) but it can be done.

Some problems though become enormously complicated to deal with once they become obvious. Global climate change, for example. And often, even once they are obvious, we won’t act until the costs (economic and in human lives) are very large. It is possible that once we decide to get serious about dealing with some of these issues that the costs (economic and in human lives) will be catastrophic.

The failure to use anti-biotics medicine properly is a very serious threat to become one of these catastrophic societal failures. While tuberculosis failures may be larger in poorer countries, rich countries are failing probably much more critically in the misuse of anti-biotics (I would guess, without having much evidence at my fingertips to back up my opinion. I believe the evidence exists I am just not an expert). These failures have huge costs for all of humanity but we are risking many premature deaths because we systemically fail to deal with issues until the consequences are immediate.

Related: Extensively Drug-resistant Tuberculosis (XDR TB) (2007) – What Happens If the Overuse of Antibiotics Leads to Them No Longer Working? – Antibiotics Too Often Prescribed for Sinus Woes – Overuse of Antibiotics (post from 2005) – CDC Urges Increased Effort to Reduce Drug-Resistant Infections (2006)

Ritalin Doesn’t Show Long Term Effectiveness for ADHD

Posted on February 2, 2012  Comments (1)

From the New York Times opinion piece, Ritalin Gone Wrong, by L. Alan Sroufe is a professor emeritus of psychology at the University of Minnesota’s Institute of Child Development:

Attention-deficit drugs increase concentration in the short term, which is why they work so well for college students cramming for exams. But when given to children over long periods of time, they neither improve school achievement nor reduce behavior problems. The drugs can also have serious side effects, including stunting growth.
…
To date, no study has found any long-term benefit of attention-deficit medication on academic performance, peer relationships or behavior problems, the very things we would most want to improve. Until recently, most studies of these drugs had not been properly randomized, and some of them had other methodological flaws.

But in 2009, findings were published from a well-controlled study that had been going on for more than a decade, and the results were very clear… At first this study suggested that medication, or medication plus therapy, produced the best results. However, after three years, these effects had faded, and by eight years there was no evidence that medication produced any academic or behavioral benefits.

As I have written before I am skeptical of the amount of drug use our health care system encourages: Lifestyle Drugs and Risk.

Related: Long Term ADHD Drug Benefits Questioned (2009) – Nearly 1 million Children Potentially Misdiagnosed with ADHD in the USA – Diet May Help ADHD Kids More Than Drugs – Over-reliance on Prescription Drugs to Aid Children’s Sleep? – Epidemic of Diagnoses

Diet May Help ADHD Kids More Than Drugs

Posted on March 13, 2011  Comments (2)

Diet May Help ADHD Kids More Than Drugs

Kids with ADHD can be restless and difficult to handle. Many of them are treated with drugs, but a new study says food may be the key. Published in The Lancet journal, the study suggests that with a very restrictive diet, kids with ADHD could experience a significant reduction in symptoms.

The study’s lead author, Dr. Lidy Pelsser of the ADHD Research Centre in the Netherlands, writes in The Lancet that the disorder is triggered in many cases by external factors — and those can be treated through changes to one’s environment. “ADHD, it’s just a couple of symptoms — it’s not a disease,” the Dutch researcher tells All Things Considered weekend host Guy Raz.

The way we think about — and treat — these behaviors is wrong, Pelsser says. “There is a paradigm shift needed. If a child is diagnosed ADHD, we should say, ‘OK, we have got those symptoms, now let’s start looking for a cause.’ ”
…
According to Pelsser, 64 percent of children diagnosed with ADHD are actually experiencing a hypersensitivity to food. Researchers determined that by starting kids on a very elaborate diet, then restricting it over a few weeks’ time. “It’s only five weeks,” Pelsser says. “If it is the diet, then we start to find out which foods are causing the problems.”

Teachers and doctors who worked with children in the study reported marked changes in behavior. “In fact, they were flabbergasted,” Pelsser says.

Related: Nearly 1 million Children Potentially Misdiagnosed with ADHD in the USA – Lifestyle Drugs and Risk – Over-reliance on Prescription Drugs to Aid Children’s Sleep? – Epidemic of Diagnoses
Continue reading →

Monarch Butterflies Use Medicinal Plants

Posted on October 14, 2010  Comments (6)

Monarch butterflies eat toxic plants (that they have evolved to tolerate and make the butterflies themselves toxic to predators). They use medicinal plants to treat their offspring for disease, research by Emory biologists shows. When the butterflies are infected by certain parasites the butterflies have a strong preference to lay their eggs on a plant (tropical milkweed) that will help the caterpillar fight the parasite when it eats those leaves (it serves as a drug for them). Their experiments may be the best evidence to date that animals use medication.

Related: Monarch Migration Research – Monarch Butterfly Migration – Evolution at Work with the Blue Moon Butterfly

Scientific Illiteracy Leaves Many at Risk in Making Health Care Judgements

Posted on September 8, 2009  Comments (5)

Scientific literacy is important for many reasons and that importance has increased greatly over the last century. Medical research is often difficult to interpret. Often various studies seem to contradict each other. Often the conclusions that are drawn are far too broad (especially as the research conclusions are passed on and people hear of them overly simplified ways).

Many health care options are not obviously all good, or all bad, but instead a mix of benefits and risks, both of which include interactions with the individuals makeup. So we often see contradictory (and seemingly contradictory) advice. Without a level of scientific literacy it is very difficult for people to know how to react to medical advice.

We have numerous posts on the scientific inquiry process showing that acquiring scientific knowledge is complex and can be quite confusing in many instances. While understanding things are often less clear cut than they are presented it is still true that most often strategies for healthy living have far better practices that will provide far better results than alternatives.

The scientific illiteracy that has some think because their are risks no matter what is done that means there is no evidence some alternatives are far superior is very dangerous. As you can see in action now with those that risk their and others lives and health by doing things like not vaccinating their children, or driving when drunk, or driving when talking on a cell phone.

Without a scientifically literate society even completely obvious measures like not using antibiotics on viral infections are ignored.

Related: Long Term ADHD Drug Benefits Questioned – How Prozac Sent Science Inquiry Off Track – Lifestyle Drugs and Risk – Correlation is Not Causation: “Fat is Catching” Theory Exposed
Continue reading →

Long Term ADHD Drug Benefits Questioned

Posted on March 27, 2009  Comments (0)

Debate Over Drugs For ADHD Reignites by Shankar Vedantam

New data from a large federal study have reignited a debate over the effectiveness of long-term drug treatment of children with hyperactivity or attention-deficit disorder, and have drawn accusations that some members of the research team have sought to play down evidence that medications do little good beyond 24 months. The study also indicated that long-term use of the drugs can stunt children’s growth.
…
One principal scientist in the study, psychologist William Pelham, said that the most obvious interpretation of the data is that the medications are useful in the short term but ineffective over longer periods but added that his colleagues had repeatedly sought to explain away evidence that challenged the long-term usefulness of medication. When their explanations failed to hold up, they reached for new ones, Pelham said.
…
Peter Jensen, one of Pelham’s fellow researchers, responded that Pelham was biased against the use of drugs and was substituting his personal opinion for science.

Jensen said Pelham was the only member of the team of researchers who took away “the silly message” that the study raised questions about the long-term utility of drugs, but interviews and e-mails show that Pelham was not alone.
…
In a telephone interview, Jensen denied that the researchers had misled the public, pointing out that some children getting the drugs did do better over the long term. Looking at overall results was not as useful as studying how particular groups of children fared, he said.

Jensen and another co-author, L. Eugene Arnold at Ohio State University, who are both psychiatrists, emphasized the importance of individualizing treatment — and warned parents against abruptly terminating drug therapy.

The subgroup analysis found that children in homes that were socially and economically stable did the same in the long term with or without medication. Children from troubled or deprived backgrounds slid backward as soon as the intensive therapy stopped and they went back to their communities. About one-third — those with the least impairment to begin with — continued to improve over the long term.

Jensen and co-author Benedetto Vitiello at the NIMH said drugs may not have shown an overall long-term benefit because the quality of routine care that children received may have been inferior to the care they got during the initial part of the study. Jensen said the take-home message is that community care needs improvement.

I have said I believe we too frequently reach for drug solutions. In the right situations drugs are wonderful tools. But they also have consequences and risks and it seems to me those negatives are given far too little weight.

Related: New Antipsychotics Old Results – Lifestyle Drugs and Risk – Over-reliance on Prescription Drugs to Aid Children’s Sleep? – How Prozac Sent Science Inquiry Off Track

Mental Pick-Me-Ups: The Coming Boom

Posted on February 25, 2009  Comments (1)

I am not a fan of lifestyle drugs. People seem to forget that drugs have side effects that are quite large. Being surprised when a drug has adverse consequences shows a failure to understand the risks. You should assume adverse effects and take them only when that risk is outweighed by significant tangible benefits. A Boom in Memory-Enhancing Drugs?

A whole generation has come of age using attention-deficit drugs such as Adderall and Ritalin, a category valued at nearly $4.7 billion in 2007. A lot of teenagers have used them casually as study aids, often buying them on the Internet. And now, overworked professionals are seeing the appeal.

And when they almost certainly have significant adverse effects on many people, then people will get upset. Granted the drug companies pushing sales for negligible benefits do deserve condemnation. However, the larger problem is people that choose to risk their health as though they don’t have the ability to learn and can just ignore evidence of risks.

Related: Over-reliance on Prescription Drugs to Aid Children’s Sleep? – Marketing Drugs – New Antipsychotics Same Old Bad Results – How Prozac Sent Science Inquiry Off Track

  • Recent Comments:

    • rizky indra: is this bad ??? what will happen to earth if the plasma reach here
    • Brian: A lot of younger kids seem to have a uncanny ability to learn things faster and faster. A lot of...
    • here: I wonder how many people a year would be saved from certain types of cancer if they just ate better...
    • himanshu: I would like to question now a days it has been seen that teenagers are having some white hairs...
    • Can: I totally agree with you. I had research position in one of the top European public R&D centers in...
    • Bhatti: Very nice information about this.. first time i am reading about rubber tree.. keep it up..
    • Nick: I agree with Guy. The pharma co’s have to be disassembled and maybe one day we will be treating...
    • Felipe Porto Alegre: Brazil really tried to defend it’s ground on the rubber battlefield, but Malay...

  • Recent Trackbacks:

  • Links