Sunday, 22 February 2009

Prescripton Drugs - Kill or Cure?

Are We Being Naive In Our Faith With The Drug Industry

When you get to read my book, (I am awaiting a conference call at the moment to go over the finer details of the pending publishing of it) you will see that I mention prescription drugs, especially anti-depressants and I tell you about all the alternatives you can take to help yourself.
You can read all about my book on my November post.

You do get the impression, early on, that I do not believe in drugs (unless given in a life and death situation, of course) and fought against being prescribed anti-depressants because I knew that I did not need them and this was confirmed by a psychiatrist (it's ok, I was pronounced as 'sane' and having no mental illness)! You will read on a post further down how I recently had these 'foisted upon me' against my will and so refused to take them.

This is not to mean that you can just suddenly stop taking any that you may have been prescribed because this is dangerous. They have been shown to help in major depression so they may be helping you ok, but I was only ever in the mild depression bracket because I have been taking alternative remedies for many years.

I have just read an article that can only add even more substance to my claim that a lot of prescription drugs may not be fit for their purpose. The only winners are the drugs companies and the billions of dollars that pour into their coffers each year. I will refer to extracts taken from my Candis (health/charity) magazine.

In the UK we spend out £8.2 billion (GBP) on prescriptions and it is said that GP's hand out an average 14 prescriptions per person which will increase for the over 65's. We accept our medication without even querying it. Would we just grab any old car, house or holiday without looking for a good deal. We trust our doctors and accept whatever they may hand out with a rather childlike trust.

Whilst drugs can help and heal, they can also hurt and harm us and we don't even give the fact another thought. Well, I have done and have also researched the subject in great depth.

In the UK alone, prescription drugs kill between 10 and 15,000 people a year and when you think this is 3-5 times the number of people who die on the roads here, the enormity of it will surely hit you. They also cause an astonishing one million admissions to our hospitals, which is a staggering 6.5 per cent of the total. A number of these may be accidental overdoses but unfortunately the rest is down to adverse drug reactions - from heart attacks to hallucinations.
In Canada, a study showed that the type of drugs to cause problems are:

  • pain relief drugs (based on opium)

  • heavy tranquillisers (known as antipsychotics)

  • sleeping tablets

  • anti-depressants

If road safety was treated in the same way as drug safety is, then we'd be driving with few traffic lights, without seat belts, no white lines or street lighting - and crashes would never be investigated, says Charles Medawar, director of the charity 'Social Audit', which monitors the pharmaceutical industry.

It is naive to think that every available drug has been trial tested and not only that, that interaction with other drugs has also been widely tested as this is just not possible. It costs the drug companies £300-600 million for the different trial types and would needs years and years of testing. Needless to state, the drugs companies have found ways around the rigorous process and can be set so they are more likely to show favourable results. Shocked? so you should be. They are likely to use volunteers who are younger and fitter then the elderly people who have the bulk of the prescriptions.

In a study, the 'New England Journal of Medicine' found that only 2 per cent of the people included in trials of aspirin-like anti-inflammatory drugs were over 65, despite the fact that this age group is more likely to use them. Also the elderly are more likely to suffer from drug reactions as when we age we get less efficient at handling toxins.

Women are also under represented in trials so reactions that women are vulnerable to, such as problems with heart rhythm, are less likely to show up in trials until after a drug is considered safe.

20 per cent of the most commonly prescribed drugs do not have a licence for the condition they are being used for. This is known as 'off label prescribing'. This means a drug may be prescribed for another purpose from that which it was intended.

For example: heavy tranquillisers that are licensed for use with schizophrenia are now also being routinely prescribed in the treatment of elderly patients with dementia and children with behavioural problems.

I have my own example where I was prescribed a drug that was supposed to help with my hot flashes (but it did not), which was marketed to treat high blood pressure! (belonging to a group of med's called vasodilators - which cause blood vessels to dilate (widen) thereby increasing the blood flow). These were originally trialled as an anti-depressant but were found not to be of much use. The leaflet says that it should not be taken if 'you have a history of depression or you are depressed' with such possible side effects as: low blood pressure, tiredness, difficulty in sleeping, hallucinations, confusion, nightmares, depression, anxiety, etc., etc., so be warned!

This 'off label prescribing' is widely practiced both in the UK and the US but it's one that is widely abused and it must be recalled the drug disaster stories that were around at the time - the link between HRT and heart disease and suicides and anti-depressants drugs for children - which were prescribed 'off label'.

As many as 200,000 dementia patients are being prescribed antipyschotics even though large scale studies have shown that they are not suitable for such people and can increase their risk of a stroke. There are also bad side effects such as: involuntary or repetitive movements, large weight gain, very low blood pressure, intense dreams or nightmares, lethargy or seizures.

They are also being prescribed to children with behavioural difficulties and is like giving chemotherapy for a headache.

The average person over the age of 65, is taking 29 different prescriptions! and as mentioned above, none of these multiple combinations have ever been tested in clinical trials and taking such a combination is likely to do more harm than good (Dr Malcolm Kendrick, a columnist for GP magazine 'Pulse'). Nobody is going to test them all because it would cost billions plus the drugs are made by different companies so co-operation between them all would be a problem.

It is mentioned that most elderly patients would be far healthier with fewer prescriptions. In-fact, an Israeli study in 2008 found that when a group of elderly patients reduced the number of drugs they took, they were 3 times less likely to have an emergency dash to hospital.

Relative and Absolute Risk

As well as becoming aware of the possible dangers from drugs, there are two things that can help you get a better idea of how effective a drug is. The first is the difference between relative and absolute risk. Your GP may tell you that a certain drug reduces your risk of some conditions by 25-30 per cent making it sound worth taking, but they might not mention how big the risk is to start with.

In trials of the risk of having a first heart attack, for example, it is 4 per cent on a placebo and 3 per cent on a cholestrol-lowering statin. That is a drop of 25 per cent - known as the relative risk. But the real (absolute) risk reduction is only 1 per cent. Not so impressive.

The second is something known as NNT (numbers needed to treat). This tells you how many people have to be treated with a drug over a certain period for one to benefit. So an NNT of one means that everyone who is treated benefits; NNT2 means that it works for one in two. e.g. head lice lotion has an NNT of one, aspirin has an NNT of two for reducing the pain of a sprain. Preventative treatments like the cholestrol-lowering statin drugs have very high NNT's, such as 641 to prevent one stroke.

So, it is up to us to ensure that we know everything we can about the drugs we are taking. My book stresses the fact that you must thoroughly read the leaflet accompanying your prescription. Do not be afraid to ask your GP questions about your med's and if you do suffer any of the side effects then it is vital you go back and tell him.

10 Questions to ask your Doctor (taken from Candis) - make an informed decision

  1. Is this a drug that has only recently been licensed?
  2. Is it a replacement for one that has just run out of patent?
  3. Is this drug being prescribed 'off label' or not?
  4. Have there been any trial of the drug run by researchers who are not financed by the drug manufacturers?
  5. Was the drug tested on the same sort of people who are most likely to use it?
  6. Has the drug been tested against any drugs already in use and how did it perform in those tests?
  7. Are there any non-drug treatments that could be more effective than drugs for this condition?
  8. Have all the trials carried out on the drug been registered anywhere so we know what all the results were? Did any trials show no effect or signs of problems?
  9. What is the actual percentage figure for this drug's absolute risk versus relative risk and what is it's NNT?
  10. What side effects are there and what serious side effects should I make sure I report immediately

I personally think that we probably won't have much luck in getting answers to some of these questions! Number 7 particularly interests me because when I told my doctor I was taking an alternative to anti-depressants he made it more than clear (on more than one occassion) that he did not believe in these alternatives, so I would be very suprised if your doctor recommends a 'non drug treatment that could be more effective'. If they do, then I suggest you hang on to them!

Remember - you must never just stop taking any medication that you have been prescribed as it is dangerous and could even be fatal. - I am not a doctor.

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Bonnie

The Truth About Depression and How You Can Beat It






























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