Showing posts with label pharmaceuticals. Show all posts
Showing posts with label pharmaceuticals. Show all posts
Wednesday, January 26, 2011
Blame the vehicle
I'm on a medicine that helps tremendously with the neuropathic pain associated with Levitis Syndrome. It is often prescribed for neuropathies associated with diabetes, and while there apparently no similarity between the two disorders other than the peripheral neuropathies they cause, this stuff seems to help with both. I recently went to my doctor for a refill, and she prescribed the tablet form, where I had been taking the slow-release capsule in the same dosage. Two days after switching to the tablets, I suddenly started getting these sharp distinctive pains in my hands and wrist again, and the surgical scars on my palms are looking angry. So this morning I went back to my doctor, and this being Germany got to see her within 20 minutes. I am back on the capsules, and I hope the problem is solved. I really would love to understand what is going on with my neurophysiology that the difference between a tablet and a capsule makes such a difference. I don't think it is even understood why neuropathic pain happens, or why some compounds interfere with it, so I don't have much hope of understanding the pharmacokinetics. I just hope the stuff keeps working.
Wednesday, August 05, 2009
Plagaism, homicide and Wyeth
In trying to understand why America's healthcare system is so much more expensive and so much less effective than in other rich nations, I usually blame the insurance companies. But as is common with problems of this magnitude, there is more than enough blame to go around. The New York Times today highlights another major problem: distortion of the scientific literature by moneyed interests, particularly the pharmaceutical companies. Corporate culture, and corporate law, effectively require officers of publicly owned companies to do everything they legally can to maximize profit. A pharmaceutical company, faced with the option of doing something that boosts profits but decreases health, has every incentive to do so, and predictably will do so in many cases. Americans end up spending money to decrease our own health.
The case described in today's article should be shocking, but due to a long standing pattern of this type of thing, is only disgusting and outragous. Pharma giant Wyeth, maker of among many of things, synthetic hormones for hormone replacement therapy, has been paying ghostwriters to write review articles highlighting the benefits and minimizing the dangers of hormone replacement for post-menopausal women. These review articles were then passed to respected medical researchers who published them in their own names (whether for money, or just to boost their publication records, I'm not sure). The ghostwriters are not mentioned. Wyeth used these articles to paint a false consensus that its product was safe, and thereby boost sales and stave of regulation.
"But the seeming consensus fell apart in 2002 when a huge federal study on hormone therapy was stopped after researchers found that menopausal women who took certain hormones had an increased risk of invasive breast cancer, heart disease and stroke. A later study found that hormones increased the risk of dementia in older patients."
Wyeth's behavior is certainly harmful and reprehensible, and may or may not be illegal; they are currently being sued by several thousand former patients or their survivors. What is absolutely clear is that the researchers who went along with this are some seriously sleazy people who should not be allowed anywhere near medicine, or research. One of the first things we tell students in freshman science classes is that you never ever ever put your name on something that someone else wrote. It is fine to quote people, it is fine to collaborate and have everyone involved in the collaboration listed as authors, but we have a name for taking something someone else wrote and claiming it as your own, even with the blessing of the true author: plagiarism.
One of the many reasons plagiarism is illegal, and specifically forbidden in the ethics codes of universities and publishers, is to avoid exactly this kind of nonsense. We are trained to always question the motivation and bias of the author of anything we read. Why does this person take such a sunny view of the medicine? Why isn't that other study that showed increased risk of strokes mentioned? If the author is a well respected medical researcher with no apparent ties to the manufacturer, maybe the medicine really is that good, and the stroke study wasn't done well enough to be worth mentioning. But if the real author is an employee of Wyeth, with the specific goal of boosting sales, our interpretation might be different. This applies as much to the peer reviewers who were tricked into approving these fake reviews as to the average reader. Peer reviewers are supposed to evaluate conflicts of interest which cold make the article less valuable to the reader. Plagiarism makes it impossible to know the interests of the real author, which was undoubtedly the goal of Wyeth's scheme.
All researcher shown to be publishing articles written in part or whole by ghost-writers (a.k.a. plagiarists) should be publicly discredited by both their employer and their publisher. Furthermore, they should be held legally responsible for the harm and deaths caused by their unethical practices. Such sleazebags are bad for science, bad for medicine, bad for patients and bad for America. Although Wyeth is the most identifiable villain in this particular debacle, the "researchers" who shilled for them should lose the reputations they let Wyeth borrow. Laws should be enacted to make it clear that pharmaceutical companies may not produce deceptive scientific literature to boost sales, and are legally and financially liable both for the deception and for any harm that arises from it. Governments and insurers tricked in buying medicines through deceptive practices should be able to collect recompense and penalties from those perpetrating the fraud. If other pharmaceutical companies have been engaging in similar practices, they and their mouthpieces should also be exposed. It took decades and hundreds of thousands of lives lost to kill the Tobacco Institute. I hope that it will take less time to rid Pharma, which uses largely the same playbook, of their homicidal tendencies.
The case described in today's article should be shocking, but due to a long standing pattern of this type of thing, is only disgusting and outragous. Pharma giant Wyeth, maker of among many of things, synthetic hormones for hormone replacement therapy, has been paying ghostwriters to write review articles highlighting the benefits and minimizing the dangers of hormone replacement for post-menopausal women. These review articles were then passed to respected medical researchers who published them in their own names (whether for money, or just to boost their publication records, I'm not sure). The ghostwriters are not mentioned. Wyeth used these articles to paint a false consensus that its product was safe, and thereby boost sales and stave of regulation.
"But the seeming consensus fell apart in 2002 when a huge federal study on hormone therapy was stopped after researchers found that menopausal women who took certain hormones had an increased risk of invasive breast cancer, heart disease and stroke. A later study found that hormones increased the risk of dementia in older patients."
Wyeth's behavior is certainly harmful and reprehensible, and may or may not be illegal; they are currently being sued by several thousand former patients or their survivors. What is absolutely clear is that the researchers who went along with this are some seriously sleazy people who should not be allowed anywhere near medicine, or research. One of the first things we tell students in freshman science classes is that you never ever ever put your name on something that someone else wrote. It is fine to quote people, it is fine to collaborate and have everyone involved in the collaboration listed as authors, but we have a name for taking something someone else wrote and claiming it as your own, even with the blessing of the true author: plagiarism.
One of the many reasons plagiarism is illegal, and specifically forbidden in the ethics codes of universities and publishers, is to avoid exactly this kind of nonsense. We are trained to always question the motivation and bias of the author of anything we read. Why does this person take such a sunny view of the medicine? Why isn't that other study that showed increased risk of strokes mentioned? If the author is a well respected medical researcher with no apparent ties to the manufacturer, maybe the medicine really is that good, and the stroke study wasn't done well enough to be worth mentioning. But if the real author is an employee of Wyeth, with the specific goal of boosting sales, our interpretation might be different. This applies as much to the peer reviewers who were tricked into approving these fake reviews as to the average reader. Peer reviewers are supposed to evaluate conflicts of interest which cold make the article less valuable to the reader. Plagiarism makes it impossible to know the interests of the real author, which was undoubtedly the goal of Wyeth's scheme.
All researcher shown to be publishing articles written in part or whole by ghost-writers (a.k.a. plagiarists) should be publicly discredited by both their employer and their publisher. Furthermore, they should be held legally responsible for the harm and deaths caused by their unethical practices. Such sleazebags are bad for science, bad for medicine, bad for patients and bad for America. Although Wyeth is the most identifiable villain in this particular debacle, the "researchers" who shilled for them should lose the reputations they let Wyeth borrow. Laws should be enacted to make it clear that pharmaceutical companies may not produce deceptive scientific literature to boost sales, and are legally and financially liable both for the deception and for any harm that arises from it. Governments and insurers tricked in buying medicines through deceptive practices should be able to collect recompense and penalties from those perpetrating the fraud. If other pharmaceutical companies have been engaging in similar practices, they and their mouthpieces should also be exposed. It took decades and hundreds of thousands of lives lost to kill the Tobacco Institute. I hope that it will take less time to rid Pharma, which uses largely the same playbook, of their homicidal tendencies.
Sunday, July 13, 2008
Catnip -> Olfaction -> Happy
My Friend Terry Johnson is a lecturer in Bioengeneering at UC Berkeley. He also writes the Ask a Biogeek column for io9.com. Now he is one of the judges for their Mad Science Contest: Build a Lifeform. And, in investigating my idea for an artificial organism, I came across this abstract:
Hart BL, Leedy MG.1985. Analysis of the catnip reaction: mediation by olfactory system, not vomeronasal organ. Behav Neural Biol. 44(1):38-46.
The moral of the story seems to be that:
A. Cats respond to catnip through their olfaction, the type of smelling that humans do fairly well, rather than through the vomeronasal organ, the part of smelling that humans don't seem to do at all.
B. Catnip elicits from cats behaviors associated with almost every active things cats enjoy (eating, playing, sex and hunting). Catnip does not elicit the calming and resting behaviors such as self-grooming and napping that cats also enjoy. Catnip also does not elict behavior associated with things cats don't enjoy (fighting, danger, housechoirs).
Based on this, and my own observations, it seems likely that catnip is a quick-acting stimulant, extremely pleasant to the cat and absorbed through the olfactory epithelium.
Stefanie Schwartz, in her book "Psychoactive Herbs in Veterinary Medicine" list some other useful facts. Catnip response is not associated with any know histological or physiological effect, (meaning that while it certainly does something in the body, it is something subtle) catnip is not toxic even at relatively high doses, and the physiological and psychological effects are very different in cats than in humans. In humans, catnip is mild sedative, and smoked catnip is said to have similar psychtrophic effects to smoke marijiana. In cats, it is clearly a stimulant. In neither species does it have any known side effects.
Nepetalactone, the active ingredient, is also aparrently a powerful insect repellant, driving off both lice and cockroaches many times more powerfully than does DEET.
Pet owners and behavioral scientists alike are fascinated by unique behavioral reactions that cats show in the presence of catnip. These experiments explored the possibility that the catnip reaction might be triggered by chemosensory stimulation of the vomeronasal organ. In the chewing and mouthing of the catnip source, substances might be dissolved in saliva and transported to the vomeronasal organ. The rolling and rubbing during a catnip reaction might be a sexual response activated by the accessory olfactory system since the system projects to parts of the brain involved in mediation of sexual behavior. However, removal of the vomeronasal organ did not attenuate any of the behavioral reactions to catnip. Olfactory bulbectomy immediately eliminated catnip responding, revealing that the chemosensory stimulus evoking the catnip reaction is undoubtedly mediated through the main olfactory system. Catnip activates behavioral elements associated with several species-specific behaviors, including sniffing and chewing as associated with oral appetitive behavior, rolling and rubbing characteristic of female sexual behavior, batting the catnip source characteristic of play behavior, and a type of kicking associated with predatory behavior. These behavioral reactions occur randomly and intermittently.
The moral of the story seems to be that:
A. Cats respond to catnip through their olfaction, the type of smelling that humans do fairly well, rather than through the vomeronasal organ, the part of smelling that humans don't seem to do at all.
B. Catnip elicits from cats behaviors associated with almost every active things cats enjoy (eating, playing, sex and hunting). Catnip does not elicit the calming and resting behaviors such as self-grooming and napping that cats also enjoy. Catnip also does not elict behavior associated with things cats don't enjoy (fighting, danger, housechoirs).
Based on this, and my own observations, it seems likely that catnip is a quick-acting stimulant, extremely pleasant to the cat and absorbed through the olfactory epithelium.
Stefanie Schwartz, in her book "Psychoactive Herbs in Veterinary Medicine" list some other useful facts. Catnip response is not associated with any know histological or physiological effect, (meaning that while it certainly does something in the body, it is something subtle) catnip is not toxic even at relatively high doses, and the physiological and psychological effects are very different in cats than in humans. In humans, catnip is mild sedative, and smoked catnip is said to have similar psychtrophic effects to smoke marijiana. In cats, it is clearly a stimulant. In neither species does it have any known side effects.
Nepetalactone, the active ingredient, is also aparrently a powerful insect repellant, driving off both lice and cockroaches many times more powerfully than does DEET.
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