Posted by Larry Hoover on December 18, 2004, at 16:44:12
In reply to Re: Lilly Adds Warning to Strattera Label - Liver, posted by yxibow on December 18, 2004, at 16:01:00
> My point was to address the gentleman who said "I'm throwing mine out today." I should have been more clear on that. Tests for liver function while on medication are fairly easy, I routinely have a panel of things for the polypharmacy that I face. Yes... if you look at severe trainwrecks like Vioxx then my argument doesnt hold, I agree. I was trying to carefully phrase things but its hard to phrase things carefully enough online. My point was more towards drugs like Geodon which were pulled because tests showed an elongation in the QTc interval --- which I fully agree is a bad thing --- before being returned to the market... however, drugs still prescribed routinely like Mellaril which elongate the QTc have never been examined in that light. I guess my point is that until Strattera is shown to have any more than a miniscule degree of reaction severity, if it overwhelmingly helps a patient, I would think the patient should still continue -- perhaps with a modest interval of ALT and Bilirubin tests. An average drug takes a number of years and countless millions to get to market; there is the flipside... the vast majority who aren't affected by a drug but who are faced with no other choice when it is pulled. Then people have to petition for orphan drug status. I'm just creating a healthy argument here. I speak for no side and I certainly don't want people to have liver injuries. I hope that clears things up.
I think the pendulum has swung too far.
For many years, no one questioned medication. Nor, for that matter, did they question adverse effects. It was all part of medical treatment.
Suddenly, the spotlight is on medication, and drug company profits. The litigious culture we inhabit today virtually demands spotless and perfect drugs. But there are no perfect drugs. There will always be adverse effects, some serious, occasionally fatal.
What strikes me most about the Vioxx information making it to press is that no article that I saw even mentioned the fact that only those people taking Vioxx above the recommended dose level had this adverse cardiac effect. Arguably, these individuals were sicker than those not taking high doses, but the drug is blamed for what really is not a huge effect, but which may also be due to confounding medical factors. More people die from tylenol every year than have allegedly died in the entire exposure to Vioxx, over all those years combined.
Under current medication guidelines, aspirin would never make it to market. I fear we've lost perspective.
Lar
poster:Larry Hoover
thread:430942
URL: http://www.dr-bob.org/babble/20041217/msgs/431337.html