Furious Seasons

February 10, 2006

Bad News on Dangers of Psych Meds

It must be a rotten week to be Pharma exec or doctor. As I posted yesterday, an FDA advisory panel recommended that black-box warnings be placed on ADHD drugs due to 25 cases of heart related deaths. (It's amusing that's the ever-cautious New York Times describes these as stimulants in its headline not as ADHD drugs.) And, two days ago came news that some anti-depressants have led to lung damage and death in infants whose mothers took the drugs during pregnancy. Although in both classes of drugs the numbers of deaths are small, the reports raise serious questions about their use in tens of millions of Americans. I don't envy psych docs and general practitioners who've been prescribing these for years suddenly being swamped with questions from worried patients. But that's the nature of the job.

Keep in mind that there are already black-box warnings required on all atypical antipsychotics owing to connections between them and diabetes, which had led to 23 reported deaths, and death in elderly patients with dementia. I wonder how long it will be before reports come forth of heart problems in patients taking Risperdal, an atypical antipsychtoic, which made my heart race and beat weirdly from time to time when I took the drug.

As much as I consider these reports small vindication of my drumbeat about problems with these meds, I am not happy to have my bitching confirmed. I'd prefer to be wrong, since this will limit treatment options in many cases. If you are a parent, would you now allow your kid to take Ritalin? Would you continue taking them if you are an adult?

Posted by Philip Dawdy at February 10, 2006 12:15 AM

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Comments

I think that everyone is physiologically different and that ADHD medication may be contraindicated in certain individuals. I think that kids should not take anything like ADHD medication, but as an adult with ADHD, but I know several people that I would never be able to function without it. I would agree that black box warnings should appear on any prescription medication containing Ritalin.

That NYT article does not mention that the 25 sudden deaths reported are over the course of a number of years. The incidence of sudden death from other medications may prove to be narrowly close or slightly greater than those now blamed on use of ADHD medication.

I think the main problem is dosage. People are sheep. They think that when their headache doesn't go away they take more aspirin. They think when they're not drunk they should drink more. They think when their kid is screaming that they haven't given the kid enough of his/her ADHD medication. Putting warning labels on boxes only relieves the FDA of the responsibility that should be levied on parents. I think if there was further investigation of those deaths, we would find out that a number of them were related to going over the recommended dosage on more than one occasion or on the occasion of the death.

Posted by: E.J. at February 10, 2006 08:44 AM

thanks for the comment. yep these things are always complex as to dosages and whatnot. and yes those deaths happened over a 4 year period (99-03). and yep getting more information out there so patients can make informed choices is a great idea. meds are touchy beasts.

Posted by: Dawdy at February 10, 2006 12:22 PM