Tag Archives: medication

Hormonal Contraception and Depression

Association of Hormonal Contraception With Depression – JAMA Network – Charlotte Wessel Skovlund, MSc1; Lina Steinrud Mørch, PhD1; Lars Vedel Kessing, MD, DMSc2; et al. – November 2016

Question:  Is use of hormonal contraception associated with treatment of depression?

Spoiler alert: the answer is a resounding “yes”.  all the patients who didn’t get antidepressants (which require a pain or depression diagnosis).

Progesterone is in all birth-control pills, yet women seeking contraception are given these pills almost routinely, and never with the warning that they could cause depression.

This could explain why women tend to be more depressed than men.

Findings:  In a nationwide prospective cohort study of more than 1 million women living in Denmark, an increased risk for first use of an antidepressant and first diagnosis of depression was found among users of different types of hormonal contraception, with the highest rates among adolescents.   Continue reading

Cochrane Reveiws of Gabapentoids to Relieve Pain

Here are some Cochrane reviews on the efficacy (or lack thereof) of gabapentin (Neurontin) and pregabalin (Lyrica):

These medications seem mildly effective for their FDA-approved conditions, but much less so for chronic pain. Yet… I’ve found Lyrica helpful for episodic pain flares when I take it on an “as needed” basis.

A few new pain drugs in development

Spurred by opioid epidemic, new pain drugs may lower the risk of overdose and addiction | Science | AAAS By Robert F. ServiceAug 2018

This article gives a good summary of new opioid and non-opioid drugs being developed to treat our chronic pain.

multiple research groups are claiming progress in devising novel opioids—or alternatives—that seem to offer pain relief with far less risk of addiction or of the opioid-induced respiratory depression that all too commonly leads to death.

Most of these studies, reported at a meeting here and in a paper released this week, have only been done in animals, so the experimental compounds face significant hurdles before they can become approved medications.   Continue reading

Scant Evidence Gabapentin Works for Pain

Millions Take Gabapentin for Pain. But There’s Scant Evidence It Works. – The New York TimesBy Jane E. Brody – May 20, 2019

There is very little data to justify how these drugs are being used and why they should be in the top 10 in sales,” a researcher said.

One of the most widely prescribed prescription drugs, gabapentin, is being taken by millions of patients despite little or no evidence that it can relieve their pain.

In 2006, I wrote about gabapentin after discovering accidentally that it could counter hot flashes. [that article is posted below]    Continue reading

The Many (Surprising) Health Benefits of Meth

The Many (Surprising) Health Benefits of Meth – Pacific Standard – by Troy Farah – May 2019

Before fentanyl was the demon drug du jour, meth was seen as the worst, most destructive, most evil chemical you could find on the streets.

we’re constantly warned never to try meth—”not even once,” goes the refrain—or it will instantly cause addiction and ruin your life.

Here’s a secret: Meth is an incredible medicine. Some preliminary research suggests that meth can be neuroprotective against stroke and traumatic brain injury, even stimulating the growth of brain cells.

Stimulant-related deaths are indeed on the rise in North America—in some regions, meth is even more prevalent than heroin

Other Americans are prescribed actual, pure meth by their doctors.

It happens less frequently these days, but in ADHD, obesity, or narcolepsy cases where nothing else has worked, a drug called Desoxyn (methamphetamine hydrochloride) can sometimes help. It can even be prescribed to children as young as seven.

Meth didn’t make a “comeback”; it never left.

It can’t return with a “vengeance” and it can’t be “evil” because we’re talking about a chemical compound here. It has no personality, no feelings, no intentions.

Thus it does a disservice to science and to medicine, as well as to the people who use these drugs responsibly, to treat a molecule with dualistic properties purely as a poison.

‘It’s Just a Stimulant, Like Any Other Stimulant’

For Jordan*, the meth he’s prescribed works better against his ADHD with fewer side effects than the Adderall he’d been on for 20 years.

Jordan, a middle-aged man from North Carolina who works in clinical research, now switches every three months between Adderall and Desoxyn to prevent building a tolerance to either stimulant.

Jordan says. “I’ve been on the medications for years, but I can take Adderall or methamphetamine and take a nap afterwards. I don’t have any noticeable side effects.”

So can I! I have ADHD and am prescribed a relatively low dose of Adderall. I’ve noticed that I can take a full dose and it seems to make me less frazzled, to the point that I also can fall asleep with it in my system.

Jordan also doesn’t feel “high” from the doses he takes—approximately 10 to 15 milligrams of meth per day.

When I read articles and books by people who have grappled with an addiction to methamphetamine, I’ve always heard about the euphoria and the ability to stay up for days, be super productive and energized.

Not so for me.

I suppose mine is a “paradoxical reaction” (like I have to antihistamines), where it feels like it’s slowing my brain to a speed I can actually follow instead of zipping all over crazily (like a BB in a boxcar).

Part of the reason Jordan asked to try Desoxyn in the first place was to see if he’d develop any of the “stereotypical meth addict problems,” as he puts it. He hasn’t.

For Joan*, a 66-year-old grandmother living off the grid in northern Georgia, Desoxyn makes her feel normal. “Not high, not hyped up, just normal,” she tells me.

But Desoxyn has not only helped her socialize, manage bills, and finish her master’s degree in social work; it’s also helped with Joan’s depression and self-esteem.

“The only downside is the cost,” she says. “It’s one of the oldest drugs on the market, but even generic, it is outrageously expensive.”

How Meth Can Treat Brain Injury—and Much More

Street doses of meth can be extremely damaging to your health. The purity of such drugs is often unknown, and repeated, high doses of meth have been proven to be neurotoxic.

But in low, pharmaceutical-grade doses, meth may actually repair and protect the brain in certain circumstances.

This was first discovered in 2008, when researchers at Queen’s Medical Center Neuroscience Institute in Honolulu, Hawaii, unexpectedly found that patients who tested positive for methamphetamine were significantly less likely to die from the injuries.

To learn more, in 2011, a different team from the University of Montana applied meth to slices of rat brain that had been damaged to resemble the brains of stroke victims

  • At low doses, the meth gave better behavioral outcomes and even reduced brain-cell death.
  • At high doses, the meth made outcomes worse.

Because meth stimulates the flow of important neurotransmitters

  • dopamine,
  • serotonin, and
  • norepinephrine

—the Montana researchers theorized that methamphetamine may provide neuroprotection through multiple pathways.

To test the proposition, Poulsen and colleagues gave TBI to rats. The rats given meth performed better at a task called the Morris water maze,

But the team also found that low doses of meth were protecting immature neurons, while also promoting the birth of new brain cells that are important for learning and memory. The same was also true for rats that were given meth, but not injured.

a wide variety of stimulant therapies for TBI is being explored, with positive results. These include trials with

  • modafinil, a narcolepsy drug;
  • amantadine, a Parkinson’s drug; and
  • dextroamphetamine, one of the components of Adderall.

Methylphenidate, also known as Ritalin, seems to be the stimulant most popular in these trials. For example, in 2004, researchers at Drucker Brain Injury Center at MossRehab Hospital in Pennsylvania gave methylphenidate, better known as Ritalin, to 34 patients with moderate to severe TBI. They reported significant improvements in information processing and attention.

Twelve years later, in Gothenburg, Sweden, another 30 patients suffering from prolonged fatigue following TBI were given methylphenidate and observed for six months. They also showed improved cognitive function and reduced fatigue.

But the reason meth isn’t studied more rigorously—for TBI, for Alzheimer’s and Parkinson’s, for stroke—could also come down to money. Methamphetamine is off-patent, meaning there may be less financial incentive for pharmaceutical companies to explore the drug’s potential uses.

While Methamphetamine may not be widely recognized as medicine, it clearly has potential to heal as well as harm.

Recognizing the duality of meth is arguably all the more essential in the face of a rising stimulant overdose crisis.

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“Stigma regarding any substance use or substance use disorder is counterproductive,” says Dan Ciccarone, professor of family medicine at the University of California–San Francisco

“Everything will kill you, if you take enough of it,”

Yes, this is even true of water: Hyponatremia

Poulsen says. “Some things don’t require a lot to do that. Meth is one of those things. But just like any drug, the difference between a poison and a cure is the dose.

New device determines whether Rx drugs are fake

This startup built a device to figure out if prescription drugs are fake

The World Health Organization estimates that in sub-Saharan Africa, between 64,000 and 154,000 people die per year from taking fake anti-malaria medications, and other counterfeit drugs claim thousands more lives.

Adebayo Alonge’s was nearly one of them. Over 15 years ago, as a student in Nigeria, he suffered a severe asthma attack. At the hospital, he was given Ventolin, a medication which should have helped him breathe, but instead, because it was counterfeit, put him in a coma for three weeks.

He survived, “but this was the specific experience that stayed with me–it was clear that my life could’ve been ended by a drug that wasn’t what it was supposed to be,”   Continue reading

Alternatives to Opioids in Medication for Pain

Alternatives to Opioids in the Pharmacologic Management of Chronic Pain Syndromes: A Narrative Review of Randomized, Controlled, and Blinded Clinical Trials – free full-text /PMC5785237/ – 2018 Nov

This recent review finds that there is very little evidence beyond a few weeks for the “effectiveness” [see qualification at end of review] of any non-opioid medication that has some beneficial effect on pain.

The goal of this review was to report the current body of evidence-based medicine gained from

  • prospective,
  • randomized-controlled,
  • blinded studies

on the use of non-opioid analgesics for the most common non-cancer chronic pain conditions.    Continue reading

Fast-Acting Depression Drug Approved

Fast-Acting Depression Drug, Newly Approved, Could Help MillionsBy Benedict CareyMar 2019

This is wonderful news because it’s from a different drug class than what’s been available.

This new approach brings fresh hope for those of us who have been hanging on, gritting our teeth, and tolerating our treatment-resistant depression because we can’t get sufficient relief from the current medications.

A nasal spray version of the drug ketamine has shown promise as an antidepressant, even if its properties still aren’t well understood. Continue reading

Guidelines, Pharma, And The Biological Paradigm Shift

Guidelines, Editors, Pharma And The Biological Paradigm Shift – free full-text /PMC3192391/ – Dec 2007

Private investment in biomedical research has increased over the last few decades. At most places it has been welcomed as the next best thing to technology itself.

Much of the intellectual talent from academic institutions is getting absorbed in lucrative positions in industry.

Applied research finds willing collaborators in venture capital funded industry, so a symbiotic growth is ensured for both.

Already in 2007, money was exerting a powerful influence. By now, it’s becoming clear that financial interests are shaping (and often corrupting) the proper practice of medicine.  Continue reading

Fluoroquinolones Overprescribed Despite Dangers

Fluoroquinolones Overprescribed Despite Dangers – Matt McMillen – Feb 2019

This is the strongest warning I’ve seen about these common antibiotics and it makes me wonder why they don’t mention it to us when the drugs are prescribed.

In 2006, Rachel Brummert developed a sinus infection, and her doctor prescribed Levaquin, one of a class of powerful antibiotics called fluoroquinolones.

Shortly after she began taking the drug, she went on an errand. While crossing a parking lot, her Achilles tendon ruptured. Her foot went limp. The agony felt unbearable.   Continue reading