CDC Says Americans Fatally Overmedicated (Full Article)f1
NewsMax.com Wires
Monday, April 18, 2005

About 130 million Americans swallow, inject, inhale, infuse, spray, and pat on prescribed medication every month, the U.S. Centers for Disease Control and Prevention indicates. Americans buy much more medicine per person than any other country.

The number of prescriptions has swelled by two-thirds over the past decade to 3.5 billion yearly, according to IMS Health, a pharmaceutical consulting company. Americans devour even more nonprescription drugs, polling suggests.

Recently, safety questions have beset some depression and anti-inflammatory drugs, pushing pain relievers Vioxx and - most recently - Bextra from the market. Rising ranks of doctors, researchers and public health experts are saying that America is overmedicating itself. It is buying and taking far too much medicine, too readily and carelessly, for its own health and wealth, they say.

Well over 125,000 Americans die from drug reactions and mistakes each year, according to Associated Press projections from landmark medical studies of the 1990s. That could make pharmaceuticals the fourth-leading national cause of death after heart disease, cancer and stroke.

The pharmaceutical industry served up more than $250 billion worth of sales last year, the vast majority in prescriptions, according to industry consultants. That roughly equaled sales at all the country's gasoline stations put together, or an $850 pharmaceutical fill-up for every American.

Alice and Ken Heckman each begin their morning by cracking open a rattling plastic tray carting scores of pills in a rainbow of pastel colors.

Between the two of them, they gulp 29 pills every day: a regimen of 14 drugs, with a chaser of dietary supplements.

Here's the curious part: They feel pretty hale for people in their early 70s, working around the house and volunteering with several community groups. They each had heart fixes years ago - him a bypass and her a vessel-clearing stent - but fully recovered. She has well-controlled diabetes. He has worked his way through heartburn, arthritis, an enlarged prostate and occasional mild depression.

Do we need all these drugs? A relative handful yank many people away from almost certain death, like some antibiotics and AIDS medicines. Though carrying some risk, other drugs - such as cholesterol-cutting statins - help a considerable minority dodge potential calamities like heart attack or stroke.

The right balance of risk and benefit is still harder to strike for a raft of heavily promoted drugs that treat common, persistent, daily life conditions: like anti-inflammatories, antacids, and pills for allergy, depression, shyness, premenstrual crankiness, waning sexual powers, impulsiveness in children _ you name it.

"We are taking way too many drugs for dubious or exaggerated ailments," says Dr. Marcia Angell, former editor of the New England Journal of Medicine and author of "The Truth About the Drug Companies."

"What the drug companies are doing now is promoting drugs for long-term use to essentially healthy people. Why? Because it's the biggest market."

In fact, relatively few pharmaceutical newcomers greatly improve the health of patients over older drugs or advance the march of medicine. Last year, the U.S. Food and Drug Administration classified about three-quarters of newly approved drugs as similar to existing ones.

Confronted with mounting costs, drug makers churn out and promote uninspired sequels like Hollywood: drugs with the same ingredients in a different form for a different disease.

Of course, many pharmaceuticals improve American health. "We now have more medicines and better medicines for more diseases," says Jeff Trewhitt, a spokesman for the Pharmaceutical Research and Manufacturers of America.

However, the nation also overindulges far too often, the critics say, and violates the classic proscription of the ancient Greek physician Hippocrates: "First, do no harm."

Drug safety researcher Dr. James Kaye, of Boston University, remembers a medical school teacher telling the class: "All drugs are poisonous!"

The Heckmans found out on their own. Heckman lost his alertness for several months to a depression medication. His wife has come down with a rash from one heart medicine and muscle aches from a statin. But each time they switched medicines and escaped any lingering harm.

Hospital patients suffer seven hard-to-foresee adverse drug reactions and another three outright drug mistakes for every 100 admissions, estimates Dr. David Bates, a researcher at Boston's Brigham and Women's Hospital. That translates into 3.6 million drug misadventures a year.

The dangers potentially escalate when doctors prescribe drugs, as they often do, for uses not formally approved by the FDA. In a recent report, the Centers for Disease Control voiced concern about huge off-label growth of antidepressants. They have expanded to treat often loosely defined syndromes of compulsion, panic or anxiety and PMS.

Drug makers, doctors and patients have all been quick to medicate some conditions once accepted simply as part of the human condition.

Many Americans also assume, often with a nod from sellers or doctors, that new drugs inevitably work better than old ones. "Newer isn't always better, and more isn't always better," warns Dr. Donald Berwick, an adviser to the U.S. Agency for Healthcare Research and Quality.

The Heckmans buy both new and old - nearly $9,000 worth of prescriptions a year, plus hundreds of dollars in cheaper over-the-counter medicines. Even with supplemental insurance, their monthly out-of-pocket share of prescriptions alone roughly equals their food bills.

Around the country, prescription drug sales have pushed relentlessly upward by an annual average of 11 percent over the past five years.

The aging population is partly at fault, with its attendant ailments like cancer, heart attacks, stroke and Alzheimer's disease. Other conditions have mysteriously proliferated, including asthma, diabetes and obesity.

Exercise and better diet ward off heart disease and diabetes just as effectively as drugs do, studies show. However, says Fred Eckel, who teaches pharmacy practice at the University of North Carolina, "There tends to be a reliance on drugs as the first option."

Drug advertising to consumers has also boomed since the late 1990s, thanks largely to relaxed government restrictions on television spots.

For its part, the FDA generally demands only that new drugs work _ not that they work better than existing ones. Dr. Janet Woodcock, an FDA deputy commissioner, says off-label prescribing and allowing similar drugs for the same condition present more options - and "choice is important."

Many safety experts say more new drugs should be tested against marketed ones, with more safety data required and stronger control of consumer ads and off-label promotion.

For now, though, most Americans seem to feel like Heckman: "grateful that there's a pill to take for something."

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Ginkgo biloba may improve memory in MS sufferers (Full Article)f2

4/28/2005 - Scientists in Oregan, US have presented a study that seems to suggest that ginkgo biloba may help improve attention in MS patients with cognitive impairment.

The researchers from the Oregon Health & Science University School of Medicine's department of neurology and the OHSU MS Center of Oregon presented the study this month at the American Academy of Neurology's 57th Annual Meeting in Miami Beach, Florida.

In addition to ginkgo biloba's potential to improve attention, the natural medicine also appeared to have minimal side effects.

The study's lead author, Dr Jesus Lovera, a research fellow in neurology at OHSU School of Medicine, said those receiving ginkgo "performed better on a test that measures a person's ability to pay attention and to sort conflicting information."

Thirty-nine patients completed the study, with 20 receiving ginkgo biloba and 19 receiving placebo. The researchers recorded that there were no differences in results between the two groups in the areas of gender, education, type of MS, years since onset, or baseline performance after a series of neuropsychological tests.

However, the ginkgo group was found to be four seconds - about 13 per cent - faster than the placebo group on a timed colour and word test that measured attention and "executive functions" such as planning, decision making and controlling goal-directed behavior and execution of deliberate actions.

During the so-called "Stroop" test, patients were shown coloured boxes and asked to name the colours. They were then shown the names of colours printed with different-colored inks, such as the word "green" printed in red, and asked to read the word. Finally, patients were asked to describe the ink used for each word.

Lovera said the differences in the Stroop result would be comparable to differences in scores between healthy people aged 30 to 39 and those aged 50 to 59.

The researchers found that Ginkgo appeared to be more beneficial for MS patients who were having specific problems with Stroop exercies. Hence, Lovera said: "we would like to do another study in which we choose patients that are impaired in this particular test".

Ginkgo is derived from the leaves of the ginkgo tree and has been used for thousands of years by the Chinese as a herbal remedy for a variety of ailments. It contains potent antioxidants called flavoglycosides that have been shown to have neuroprotective effects in animal models of spinal cord injury.

It also has terpene-lactones that block a substance known as platelet activitating factor, which is important in regulating blood vessel function as well as the mediating inflammation and the sticking of inflammatory cells to blood vessels.

Many MS patients have long suspected that ginkgo improves disease symptoms. In a recent survey of nearly 2000 patients in Oregon, 20 per cent reported using the supplement and 39 per cent found it to be beneficial. However, until now, there was no evidence the supplement had any effect on memory.

"It has been shown to be of benefit in Alzheimer's, but we did not know if it would work for MS," Lovera said. "We wanted to see if there was any suggestion that it could help patients with MS that are having cognitive problems."

Lovera said the study results demonstrate that ginkgo should not be discounted for treating MS, but its safety and efficacy must be tested in much larger clinical trials before doctors should recommend it to their patients.

"The study suggests that for cognitive problems, it may only help a certain group of patients," he said. "We need to study this further."

Ginko biloba is among several complementary and alternative medicine therapies being investigated by OHSU's Department of Neurology for their effects on symptoms of neurological disease. Studies have ranged from clinical trials of lactoferrin for treating Alzheimer's disease to the use of yoga as a therapy for MS fatigue.

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