Posts Tagged ‘risks’

JAMA: Spotty results with off-label antipsychotic use

Wednesday, September 28th, 2011

FiercePharma
By Tracy Staton
September 27, 2011

Off-label use of powerful antipsychotic drugs has come in for plenty of debate in recent years. The expensive, newer-generation “atypicals” have been used to treat dementia, depression, anxiety, post-traumatic stress disorder, dementia, attention-deficit hyperactivity disorder…the list goes on. And all this while the Justice Department was investigating Big Pharma for off-label promotion of the drugs.

An updated analysis now finds that antipsychotic drugs’ utility in off-label uses is minimal, but the risks are significant, Medscape reports. Several illnesses didn’t respond at all to antipsychotic therapy, the data showed, including eating disorders and addiction problems. The evidence for treatment of personality disorders was a toss-up. Meanwhile, side effects were sometimes severe, including weight gain, metabolic problems, fatigue, urinary tract symptoms and even an increased risk of death, the researchers said.

A few off-label uses won support from the new data. Anxiety patients got moderate benefit from AstraZeneca’s ($AZN) Seroquel, and OCD sufferers were helped by treatment with Johnson & Johnson’s ($JNJ) Risperdal. Elderly patients with dementia saw a small benefit with antipsychotic use.

“We need to use this information and be wary of prescribing when it isn’t warranted,” said Dr. Alicia Ruelaz Maher, lead author of the JAMA-published study. “I think the biggest takeaway is that instead of just prescribing blindly, we now have evidence to guide us.” And, as Maher told Reuters, “Each individual patient needs to be considered as opposed to, ‘This is good for this condition.’”

http://www.fiercepharma.com/story/jama-spotty-results-label-antipsychotic-use/2011-09-28

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Study finds 85% of new drugs offer few if any benefits & are significant cause of US deaths due to toxic side effects

Monday, August 23rd, 2010

Pharmalot
By Ed Silverman
August 23, 2010

The lemon, of course, is a metaphor and is not a pretty one. But Donald Light, a sociologist and professor of comparative health policy at the University of Medicine and Dentistry of New Jersey, contends that the spate of instances in which drugmakers hid or downplayed info about serious side effects – or overstated benefits – has transformed the market for medicines into one for lemons.

“The basic idea is simple but arresting: just as there are hidden dangers and flaws in used cars, so there are in drugs. And just as used car salesmen have an incentive to profit from not disclosing risks the consumer cannot see under the shiny exterior, so drug companies and their reps have an incentive to profit from not disclosing risks the physician and patient cannot see inside a shiny new pill. In a number of ways, however, drug markets differ from used car markets. One way is that bad drugs do not drive good drugs out of the market, as Akerlof famously predicted in the article that helped him win the Nobel Prize. Rather, they stay in, mixed with higher risk drugs,” Light tells us, after presenting a paper on the subject at the American Sociological Association annual meeting last week.

According to his study, which is not yet published, independent reviewers found that about 85 percent of new drugs offer few if any new benefits. At the same time, though, prescription drugs are now a significant cause of death in the US due to toxic side effects or misuse. He notes that drugmakers spend “two to three times more on marketing than on research,” which are dollars used to persuade docs to prescribe new drugs. But the docs, he maintains, may get misleading info and then pass along the same info to patients. In his view, this is a “two-tier market” for lemons.

And in his study, Light says drugmakers have taken advantage of this two-tier system information market and monopoly rights to create what can he calls “the risk proliferation syndrome,” which consists of corporate, government, and medical practices that maximize the number of drugs put on the market with risks of adverse reactions and then maximize the number of people induced to take them.

Read entire article here:  http://www.pharmalot.com/2010/08/drugmakers-actually-make-lemons-not-medicines/

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Lawyers & Settlements—Mom Alert: Would you want a 68% Higher Risk of Miscarriage? (Antidepressants & Pregnancy study)

Thursday, June 3rd, 2010

Lawyers & Settlements
By LucyC
June 2, 2010

A new study out yesterday—June 1, 2010—has revealed a higher rate of miscarriages in women who were taking antidepressants during pregnancy. How much higher? Sixty-eight percent—yes —that’s 68%—higher. Frankly, that is nothing short of shocking.

Published in the Canadian Medical Association Journal, the study was done in Canada through the University of Montreal. FYI—This was no small study either—the investigators used data from 5,124 women who are part of a large, population-based study of pregnant women who had clinically verified miscarriages, and a large sample of women from the same registry who did not have a miscarriage. Among the women who miscarried, 284 or 5.5 percent, had taken antidepressants during their pregnancy.

In fact the findings are so robust that the physicians who did the study are suggesting that this is a class effect—in other words the effect could be attributed to all selective serotonin reuptake inhibitors—or SSRIs. Here’s what’s being reported in the press:

“These results, which suggest an overall class effect of selective serotonin reuptake inhibitors, are highly robust given the large number of users studied,” the study’s senior author, Dr. Anick Berard, said in a statement. (UPI.com)

The antidepressants that showed a particular association with miscarriage in the study were paroxetine (trade names: Seroxat and Paxil) and venlafaxine (trade names: Effexor, Efexor, Alventa, Argofan, Trevilor). The investigators also found that the risk of miscarriage doubled with a combination of different antidepressants.

Just for the record, the antidepressants “investigated” in the University of Montreal study are serotonin reuptake inhibitors (citalopram, fluoxetine, fluvoxa-mine, paroxetine and sertraline); tricyclic antidepressants (ami-triptyline, clomipramine, desipramine, doxepin, imipramine, nortriptyline, trimipramine), serotonin– norepinephrine reuptake inhibitors (venlafaxine) and “other antidepressants” (serotonin modulators, monoamine oxidase inhibitors, tetracyclic piperazino-azepines, and dopamine and norepinephrine reuptake inhibitors).

This study is just the latest to show an association between, well, for lack of a better term let’s say “serious adverse events” and SSRIs and SNRIs in particular.

Read entire article:  http://www.lawyersandsettlements.com/blog/mom-alert-would-you-want-a-68-higher-risk-of-miscarriage-03819.html

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New Study—Taking Antidepressants While Pregnant More Than Doubles Risk of Miscarriage

Tuesday, June 1st, 2010

Los Angeles Times
By Thomas H. Maugh II
May 31, 2010

Taking antidepressants during pregnancy increases the risk of spontaneous abortions by about two-thirds, Canadian researchers reported Monday. The increased risk was greatest with the family of drugs known as selective serotonin reuptake inhibitors (SSRIs), especially paroxetine and venlafaxine, and when more than one family of drugs were used.

Depression in women is most common during the child-bearing years, and estimates suggest that as many as 15% of pregnant women suffer from it. Because of fears about the effects of drugs, particularly psychiatric drugs, during pregnancy, only about 3.7% of women use them during the first trimester. Most studies looking at the use of antidepressants during pregnancy have focused on their effects on the fetus. Small studies of their effects on abortion have produced inconsistent results. Expecting mothers cannot routinely stop using the drugs, however, because that also presents risks to both the mother and the fetus.

Producing a controlled clinical trial examining the effects of the drugs is virtually impossible because few women would be willing to participate, experts said. The only way to get at the data is to examine it retrospectively.

In the new study, Dr. Anick Berard, director of the University of Montreal’s Research Unit on Medications and Pregnancy at University Hospital Center Sainte-Justine used information from the Quebec Pregnancy Registry to identify 5,124 women who had a spontaneous abortions between 1998 and 2003 — before warnings about the risks of the drugs became more common — and compared them with about 10 times that many carefully matched women who did not have abortions. A separate database provided information about prescriptions the women had filled.

Read entire article:  http://latimesblogs.latimes.com/booster_shots/2010/05/antidepressants-during-pregnancy-increase-risk-of-sponaneous-abortion-study-finds.html

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The Daily Mail: UK Drug Regulatory Agency warns pregnant women of antidepressants danger to their unborn child

Monday, May 17th, 2010

The Daily Mail
By Jo MacFarlane
May 16, 2010

Women who use antidepressants while pregnant are being warned by health chiefs about the risks to their unborn child.

The Government’s medicines watchdog advised doctors there is an increased risk that babies will be born with a rare lung condition if expectant mothers take drugs such as Prozac and Seroxat.

The Medicines and Healthcare products Regulatory Agency (MHRA) is recommending they are monitored more carefully because of the risk of developing persistent pulmonary hypertension after birth.

The condition normally affects up to two in 1,000 births – but the latest research suggests the risk is more than doubled in women taking antidepressants, affecting five in 1,000 births. The life-threatening condition means infants do not adapt to breathing outside of the womb.

The risk is greater if the medicines known as SSRIs – a new generation of depression wonder drugs – are taken later in the pregnancy.

The warning comes five years after studies first showed there may be a link between the drugs and birth defects. The MHRA advised doctors not to prescribe the drugs to pregnant women unless necessary.

However, it was revealed last year that GPs were still prescribing them to women considering becoming pregnant.

Read entire article:  http://www.dailymail.co.uk/health/article-1278675/Pregnant-women-warned-antidepressants-danger-unborn-child.html?ito=feeds-newsxml

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Illinois Department of Public Health: 5 things to know about psychotropics (including the right to informed consent)

Tuesday, October 27th, 2009

Illinois Dept. of Public Health
Chicago Tribune
October 27, 2009

Your rights: Nursing homes cannot give a psychotropic drug without a doctor’s order, informed consent and an adequate diagnosis, according to federal and state regulations. Drugs cannot be administered simply because a resident is disruptive or restless. Rules and guidelines dictate that staff must first try to calm patients; root causes of agitation, such as an infection, must be ruled out. When drugs are given, facilities must check for side effects and reduce dosages when possible.

The consent: Consent forms must be signed by patients or someone with power of attorney. In general, consents must say what drug will be given, how much and how often. If a doctor wants to add a drug, the consent must be re-signed. The patient must be fully informed of risks.

Read entire article: http://www.chicagotribune.com/health/chi-nursing-home-tips-27-oct27,0,7460931.story

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