Side Effects


By David Joel Miller.

What about those drug side effects.

The other night as I was walking by the Television in the family room I heard a frightening commercial in which they described a long list of possible side effects for a medication they were advertising. This experience combined two things that I try to avoid, television and commercials that interrupt my train of thought. Fortunately, I recovered enough from the trauma to start thinking about what they were portraying in their commercial. Here they had paired a positive commercial with a quick legal disclaimer of all kinds of possible side effects.  They also had a “call to action” saying “ask your doctor” if you should be taking our med.

With that graphic warning would anyone buy this medication? Then it occurred to me that yes indeed people were buying the med despite some pretty extreme side effects. I won’t give the name of the med but here is what I remember of the list of side effects. Remember I was walking by the family room when I heard this so I may have gotten some of these side effects wrong.

This med may cause sexual impotence, sudden death and the loss of body parts, presumably because after taking this drug sometimes arms and legs or other members fall off. It also has caused blindness, deafness, and loss of memory. These side effects alone caught my attention though the list was considerably longer. Could any possible benefit outweigh a side effect like death and impotence?

This drug was not a warning for some illegal drug. I know that people might take a drug that causes their teeth to fall out and their skin to develop scabs along with the loss of home and family. Illegal drugs like Methamphetamine result in these kinds of effects all the time. But why do legally prescribed drugs have so many terrible side effects and get prescribed anyway? Here are some thoughts about how side effects are discovered and what the risks are.

Let’s say for example sake that a company approached the college where I teach and offered the students a chance to test some new drugs that had been shown in lab tests to increase concentration and intelligence. Set aside for a second the ethical issues about should we do this test and let’s say that someone thinks that testing this drug is worth the ethical risks. Maybe it also prevents cancer. So we do the test.

There are two things we want to know. Does it work? Is it safe? For the does it work issue we want to know if it improves test scores and makes students more alert in class. For the “is it safe issue” we want to know if there are side effects, like death, that outweigh the benefits.  So we do two things, we give some students one drug and the rest another drug. Preferably we make them look-alike so no one knows who is taking which drug. An even better procedure might be to make up a third test group who get a pill with no drug in it. During the test we also want students to record any health problems they develop.

So if we test these drugs on thousands of students what might happen? During the course of the test could any students have nights where they could not sleep? Sure. Would other students have a night where they were so tired they fell asleep early? Some of the students would gain weight during the semester and some might lose weight. There might be people who got constipated or who got diarrhea. Some students would also catch colds and flu during the test.

At this point we might have a list of side effects that reads like this:

May cause insomnia or drowsiness

May cause constipation or diarrhea

May cause weight gain or loss

May cause repertory symptoms

Now we need to check a few things. Did one drug produce more of any one side effect than the other? Even more importantly how did the side effects of the two active drugs compare to the side effects reported by people who were taking the inactive pill?

So in considering whether to take a drug and run the risk of the side effects, you also need to know how much the drug increases the risk over the risk from not taking the drug.  So rather than relying on what you hear about a drug’s side effects on a brief commercial or even by reading about side effects on blogs of people who have taken that drug you also need to discuss the risks and benefits with your doctor.

Sometimes people tune out the warnings about side effects thinking that the benefit is so great that they are willing to run some risks. We all like to think that bad things won’t happen to us. If you want to be an informed consumer it pays to consider the risks also.

In my thinking, you need to balance the risks and the benefits and your doctor can help you do this. Getting two minutes extra sleep a night may not be worth the risk of a sudden heart attack. Some people avoid psychiatric medication because of weight gain, but the risk of the weight gain, even if you end up with diabetes may be worth it if the med keeps you out of the psychiatric hospital and lets you have a life. Don’t be scared off from a potentially helpful medication by the list of side effects, but please, do discuss the med with your doctor and decide if the risks are worth the benefits for you.

And do I need to say this? Don’t ever take a med that was not prescribed for you!

Till next time, wishing you a happy life.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog, there is also a Facebook authors page, in its infancy, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. Thanks to all who read this blog.

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One thought on “Side Effects

  1. David:
    I loved this especially coming from someone in the field. As a consumer with Bipolar or Schizoaffective depending on the Dr I have had to take Atypical Anti psychotic medications. These drugs are horrors with their side effects and knock on wood I am now with a Dr who is allowing me to try life without them.

    But I think the profit machine of Big Pharma takes drugs to market way too soon. If I ever feel the need for Anti-psychotics I most likely will go back to the ones my Dad worked with in medical school. Sure there is the risk for Tardive Dyskenisha but that is nothing compared to the horrors of Diabetes, Suicidal ideation, prolactemia, etc. that the atypicals cause.

    Perhaps if they were more into service the drug companies could go back to the old stand by drugs when they did not have the science we have today and work out the side effects of those older drugs. Because in my opinion Atypical Anti-psychotics are just as horrible as the disease that you are trying to cure. The old adage “The cure is worse than the disease.” But profit runs the world and Big Pharma will turn out more and more drugs that are just as pernicious as the disease itself.

    That said I agree with you nobody should ever stop taking any medication without the supervision of their DR. Been there, Done that, Lost the t-shirt.

    Like

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