By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.
Beware of “Side Effectitis…” More than 1.5 million people are hospitalized and more than 100,000 die each year from largely preventable adverse reactions to drugs. Today, a full 61 percent of adults use at least one drug to treat a chronic health problem, a nearly 15 percent rise since 2001. More than 1 in 4 seniors take at least five medications daily. Side effects often compound the original problem they are taken for. Unfortunately, side effects of drugs are often dismissed by doctors and grossly under-reported.
The Sinatra Spin on Medication Side Effects
“Is it OK to use [a night-time acetaminophen product] to help me sleep?” The question came from the audience at a lecture I gave recently. “Not if you are taking it on a regular basis,” I answered.
Acetaminophen has some negative baggage: liver toxicity and even death when taken at higher than recommended dosages. Moreover, pills containing this active ingredient are have other ingredients hardly in the best interest of health, such as red and blue dyes, common coloring agents used by pharmaceutical makers to make their products look nice.
The person posing the question was a nurse and afterward I got to be thinking that if a medically savvy individual like her was unaware of potential side effects imagine how much the general public is in the dark.
The reality is really quite alarming. The public majority doesn’t have a clue and relies on doctors most likely bamboozled by the statistical skullduggery that goes on with medical studies or who aren’t paying close enough attention to the side effects of the prescriptions they write for patients.
According to a study done by the Institute for Safe Medication Practices in suburban Philadelphia, reports to the Food and Drug Administration (FDA) about adverse drug effects, including drug-related deaths, more than doubled in the last decade. Their list of perilous prescriptions was headed by drugs such as Tylenol, the antidepressant paroxetine (Paxil), the anti-inflammatory drug celecoxib (Celebrex), the powerful opiate analgesic fentanyl, and the anti-smoking drug varenicline (Chantix).
The data came from voluntary reports of adverse effects, which obviously suggests that the real numbers are much higher. In fact, some researchers believe that fewer than one-tenth of adverse events are actually reported. A University of California/San Diego study, for example, found that physicians are more likely to deny than affirm the possibility of a side effect when patients bring it up, even for symptoms with a known drug connection. Moreover, doctors may be reluctant to get involved with the paperwork involved in reporting side effects.
This much we do know: properly prescribed drugs are the fourth leading cause of death in the country. In hospitals, adverse drug events present the single greatest risk of harm to patients. Harmful reactions to some of the most widely used medicines—from insulin to common antibiotics—send more than 700,000 Americans to emergency rooms each year, and among them a very high percentage of individuals 65 and over, according to a study in the Journal of the American Medical Association (JAMA).
As far as my own approach to prescription medicine is concerned, I am always cautious—and you might even say fearful. Very early on, I found that cardiology drugs can cause trouble, including some anti-arrhythmia drugs that generate arrhythmias and have been linked also to sudden death. I have seen many ugly arrhythmias from those drugs. I have been extremely selective about prescribing cholesterol-lowering statin drugs because of their potential for side effects. I’ve also seen adverse effects from ACE inhbitors, beta blockers, diuretics, and antibiotics.
One other fact that needs mentioning and that is always overlooked: Pharmaceutical drugs deplete the body of nutrients, something that doctors never tell you. If you take medications, you need to supplement with at least a high-quality multi-vitamin and mineral formula.
Drugs are often necessary to get a person out of crisis, and in some cases need to be taken long term. If needed on a regular basis, I often recommend taking just a half or quarter of the standard dosage, but always ask your doctor first about doing it. Don’t do it on your own.
Many drugs are too strong and there are often natural alternatives for chronic situations, for getting at the underlying causes of problems, and to minimize or eliminate risky medication usage. The alternatives include eating the right food, taking supplements, engaging in regular exercise, and following a good stress-reduction method. That’s what good medicine is all about.
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- Budnitz DS, Pollock DA, Weidenbach KN, et al. National surveillance of emergency department visits for outpatient adverse drug events. JAMA, 2006;296:1858-1866.
- Golomb BA, McGraw JJ, Evans MA, et al. Physician response to patient reports of adverse drug effects: implications for patient-targeted adverse effect surveillance. Drug Safety, 2007;30(8):669-75.
- Moore TJ, Cohen MR, Furberg CD. Serious adverse drug events reported to the Food and Drug Administration,1998-2005. Arch Intern Med, 2007;167(16):1752-9.
- Lazarou J, et al. Incidence of adverse drug reactions in hospitalized patients: A meta-analysis of prospective studies. JAMA Apr 15, 1998; 279: 1200 – 1205.
- Moore TJ, et al. Underreporting of hemorrhagic and thrombotic complications of pharmaceuticals to the U.S. Food and Drug Administration: empirical findings for warfarin, clopidogrel, ticlopidine, and thalidomide from the Southern Network on Adverse Reactions (SONAR). Semin Thromb Hemost, 2012 Nov;38(8):905-7.
- Golomb BA, et al. Physician response to patient reports of adverse drug effects: implications for patient-targeted adverse effect surveillance. Drug Safety, 2007;30(8):669-75.
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