Posts about drugs

Monarch Butterflies Use Medicinal Plants

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 ResearchMonarch Butterfly MigrationEvolution at Work with the Blue Moon Butterfly

Scientific Illiteracy Leaves Many at Risk in Making Health Care Judgements

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 QuestionedHow Prozac Sent Science Inquiry Off TrackLifestyle Drugs and RiskCorrelation is Not Causation: “Fat is Catching” Theory Exposed
Continue reading

Long Term ADHD Drug Benefits Questioned

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 ResultsLifestyle Drugs and RiskOver-reliance on Prescription Drugs to Aid Children’s Sleep?How Prozac Sent Science Inquiry Off Track

Mental Pick-Me-Ups: The Coming Boom

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 DrugsNew Antipsychotics Same Old Bad ResultsHow Prozac Sent Science Inquiry Off Track

Searching for More Effective Tuberculosis Drugs

In India: A Search for More Effective Tuberculosis Drugs

The multi-drug regimen is a major problem for several reasons. It requires TB patients to manage taking four drugs exactly as prescribed over six to nine months. If patients don’t take the full course of the medicines, the TB bacteria may develop resistance to the drugs and become even more difficult to treat. To reduce that risk, many countries require that patients go to a clinic so a healthcare professional can watch them take the medication and ensure they are complying with their drug-treatment regimen. This is both expensive and time consuming. Gokhale said that a single drug that targets multiple pathways could save time and money by eliminating the need to take so many drugs over such a long period of time.

To create their new compound, Gokhale and his colleagues exploited an evolutionary quirk in the way Mycobacterium tuberculosis builds the lipid layer that coats its surface. Unlike other organisms, M. tuberculosis displays a suite of complex lipids on its outer membrane. Some scientists have suggested that these long lipid molecules contribute to the bacteria’s ability to maintain long-term infections by confusing the host’s immune system.

Related: Fighting TuberculosisTB Pandemic ThreatExtensively Drug-resistant Tuberculosis (XDR TB)Virtually untreatable TB found

New Antipsychotics Old Results

Risks Found for Youths in New Antipsychotics

A new government study published Monday has found that the medicines most often prescribed for schizophrenia in children and adolescents are no more effective than older, less expensive drugs and are more likely to cause some harmful side effects. The standards for treating the disorder should be changed to include some older medications that have fallen out of use, the study’s authors said.

“I think the reason the use of these newer drugs has gone up so fast is that there was this widespread assumption that they were safer and more effective than what we had before,” Dr. McClellan said. “Well, we’re seeing now that that’s not the whole story.”

Related: Lifestyle Drugs and RiskHow Prozac Sent Science Inquiry Off TrackOveruse of Antibiotics

How Prozac Sent Science Inquiry Off Track

I post often on examples of scientific inquiry in action. I think it is an important way to see how science works while searching for answers. The process is not a simple one, but after a solution is found it can often be presented as obvious. But while trying to find answers it is quite difficult.

How Prozac sent the science of depression in the wrong direction

But the success of Prozac hasn’t simply transformed the treatment of depression: it has also transformed the science of depression. For decades, researchers struggled to identify the underlying cause of depression, and patients were forced to endure a series of ineffective treatments. But then came Prozac. Like many other antidepressants, Prozac increases the brain’s supply of serotonin, a neurotransmitter. The drug’s effectiveness inspired an elegant theory, known as the chemical hypothesis: Sadness is simply a lack of chemical happiness. The little blue pills cheer us up because they give the brain what it has been missing.

There’s only one problem with this theory of depression: it’s almost certainly wrong, or at the very least woefully incomplete. Experiments have since shown that lowering people’s serotonin levels does not make them depressed, nor does it does not make them depressed, nor does it worsen their symptoms if they are already depressed.

In this sense, Prozac is simply a bottled version of other activities that have a similar effect, such as physical exercise.

It is jarring to think of depression in terms of atrophied brain cells, rather than an altered emotional state. It is called “depression,” after all. Yet these scientists argue that the name conceals the fundamental nature of the illness, in which the building blocks of the brain – neurons – start to crumble. This leads, over time, to the shrinking of certain brain structures, like the hippocampus, which the brain needs to function normally.

Related: Lifestyle Drugs and RiskOverrelience on Prescription Drugs to Aid Children’s Sleep?

Big Drug Research and Development on Campus

Big Drug R&D on Campus

Merck and Harvard just signed an agreement to develop treatments for the bone disease osteoporosis. On Apr. 25 rival Pfizer (PFE) invested $14 million in an alliance with four universities to study diabetes and obesity.

Drugmakers are counting on these deals to solve a persistent problem: underperforming product pipelines. Merck, Pfizer, and others have been losing sales of one blockbuster drug after another as patents expire and competitors charge in with generics. Big drug companies have fought back by spending more on research, yet the number of new medicines approved each year is falling. In the last week of April alone, the U.S. Food & Drug Administration rejected two of Merck’s experimental drugs, prompting the company to lay off 1,200 salespeople.

Past deals between industry and academia have been hampered by patent disputes and tussles over publication rights, as companies tried to thwart academics who want to share their discoveries with colleagues around the world. So now the companies have devised policies allowing their Ivory Tower partners to patent and publish their discoveries, even as they draw the professors more deeply into corporate affairs.

Funding university activities this way can lead to conflicts and problems but realistically huge amounts of funding are entangled with possible conflicts of interest. The biggest concern I is that universities will bow to the almighty dollar instead of their missions. And inadequate oversight can damage their credibility (not one failure, most likely, but if a pattern emerges). For example: Researchers Fail to Reveal Full Drug Pay (“The Harvard group’s consulting arrangements with drug makers were already controversial because of the researchers’ advocacy of unapproved uses of psychiatric medicines in children.”). Then find out the companies were paying them well, the professors failed to disclose that and the advocacy is rightfully questioned.

Related: From Ghost Writing to Ghost Management in Medical JournalsFunding Medical ResearchMedical Study Integrity (or Lack Thereof)Marketing Drugs

Marketing Drugs

Melody Petersen, author of Our Daily Meds: How the Pharmaceutical Companies Transformed Themselves into Slick Marketing Machines on Bill Moyer’s Journal:

I actually thought that they were a lot about science. That’s what they tell the public. They are all about science and discovering new drugs. But as I started to follow their daily activities and talk to executives, I learned that really it was marketing that drove them.

According to Petersen, the rewards have been large. America has become the top consumer of prescription drugs in the world, with nearly 65% of the population on physician-prescribed medication. In 2005, Americans spent $250 billion dollars on such drugs. This consumption made pharmaceuticals the most profitable business sector in America from 1995-2002.

We’ve come to a time when decisions on how to treat a disease have as great a chance of being hatched in a corporate marketing department as by a group of independent doctors working to improve the public’s health.

Unfortunately patients are driven more by marketing than medicine. Much worse though, doctors seem to bend to these patients marketing driven desires. Plus the corrupting influence of money on research and marketing to doctors seems likely a significant reason for the poor performance and high cost of USA health care.

Related: Lifestyle Drugs and RiskOverrelience on Prescription Drugs to Aid Children’s Sleep?Drug Price CrisisLack of Medical Study Integrity

Warning on Two Cholesterol Drugs

Journal Issues Warning on Two Cholesterol Drugs

Two widely prescribed cholesterol-lowering drugs, Vytorin and Zetia, may not work and should be used only as a last resort, The New England Journal of Medicine said in an editorial published on Sunday.

The journal’s conclusion came as doctors at a major cardiology conference in Chicago saw for the first time the full results of a two-year clinical trial that showed that the drugs failed to slow, and might have even sped up, the growth of fatty plaques in the arteries. Growth of those plaques is closely correlated with heart attacks and strokes.

Merck and Schering-Plough, the companies that make Vytorin and Zetia, said on Sunday that despite the results of the trial, they would continue to promote their medicines as first-line treatments for high cholesterol.

Related: Drug Price CrisisNew Questions on Treating CholesterolLifestyle Drugs and Risk

Drug Price Crisis

I don’t think the suggestion below really solves the drug price crisis. But I do think it is an example of an educational and research institution actually proposing sensible role for themselves. As I have said too many universities now act like they are for-profit drug or research companies: Funding Medical Research. For some background on drug prices read my post on the Curious Cat Management blog from 2005.

Solving the drug price crisis

The mounting U.S. drug price crisis can be contained and eventually reversed by separating drug discovery from drug marketing and by establishing a non-profit company to oversee funding for new medicines, according to two MIT experts on the pharmaceutical industry.

Following the utility model, Finkelstein and Temin propose establishing an independent, public, non-profit Drug Development Corporation (DDC), which would act as an intermediary between the two new industry segments — just as the electric grid acts as an intermediary between energy generators and distributors.

The DDC also would serve as a mechanism for prioritizing drugs for development, noted Finkelstein. “It is a two-level program in which scientists and other experts would recommend to decision-makers which kinds of drugs to fund the most. This would insulate development decisions from the political winds,” he said.

Book – Reasonable Rx: Solving the Drug Price Crisis by Stan Finkelstein and Peter Temin

Related: Lifestyle Drugs and RiskFrom Ghost Writing to Ghost Management in Medical JournalsUSA Spent $2.1 Trillion on Health Care in 2006Measuring the Health of NationsEconomic Strength Through Technology LeadershipUSA Paying More for Health Care