Stanford Study: Drug Side Effects are Potentially 5 Times More Than Advertised.

"New research on Drug Side Effects done at Stanford School of Medicine has discovered nearly 5 times the 70 or so potential reactions that are listed on the average drug insert." 

March 24, 2012

Prescription medications usually always carry a rather frightening (and long) list of possible side effects. These drug side effects may range from mild symptoms like headache or nausea to more serious risks such as seizures or temporary blindness. New research suggests that the side effects listed on the label often represent just a small portion of what users are really experiencing.

Results of the Study

Two separate databases were created to organize the findings of this research and both are available to the public. The first, OFFSIDES, discovered an additional 329 side effects on average for each of the 1,332 drugs that were studied - nearly 5 times the 70 or so potential reactions that are listed on the average drug insert.

The TWOSIDES database relates to drug interactions and is based on more than 50,000 possible medication combinations. An additional 1,301 contraindications were discovered. One of the most important findings is a previously unknown risk of fatal cardiac conditions in patients taking SSRI class antidepressants at the same time as a commonly prescribed blood pressure medication.

While the results of this study are quite alarming, this method of analyzing data will be very beneficial to the medical industry as well as the patients taking the drugs. It may take several years before many of the newly discovered side effects and interactions are mandatorily included in the medication packaging, but doctors and their patients can use the knowledge to determine the most effective prescription combinations for the specified conditions.

Expert Study: Elderly patients in USA are over prescribed anti-psychotic drugs.

In the United States, elderly patients with dementia are too often prescribed anti-psychotic drugs to calm their disruptive behavior, a costly and risky practice that should end, experts said Wednesday.

Instead, more care should be taken to determine why dementia patients may be acting up and treat those underlying causes, lawmakers were told at a hearing of the Senate Committee on Aging.

"As the baby boomer generation ages, it is imperative to address the overuse and misuse of antipsychotic drugs among nursing home patients," said Daniel Levinson, Health and Human Services Inspector General.

Levinson said recent government audits have raised concerns about the use of antipsychotics by elderly people with dementia in nursing homes, raising their risk of death and wasting money for the US healthcare system.

For instance, more than half of such prescriptions were wrongly paid for in 2007 by government Medicare because the patients did not exhibit symptoms of schizophrenia or bipolar disorder, amounting to about 230 million dollars in waste.

One audit showed 14 percent of nursing home residents had Medicare claims for antipsychotic drugs, he said.

But another panel member, Toby Edelman, senior policy attorney in the office of the Center for Medicare Advocacy, said that audit's estimate was low because it only included some kinds of anti-psychotics.

"Nursing facilities' self-reported data indicate that in the third quarter of 2010, 26.2 percent of residents had received antipsychotic drugs in the previous seven days. That is approximately 350,000 individuals," she said.

"Facilities reported they gave antipsychotic drugs to many residents who did not have a psychosis, including 40 percent of patients at high risk because of behavior issues."

Edelman also pointed out that this issue is far from new, and that the same Senate committee had issued a report on the misuse of drugs in nursing homes back in 1975, and held a workshop on the topic two decades ago.

The practice persists, even though it is against federal law, because of serious understaffing in nursing facilities, high turnover of staff, and "aggressive off-label marketing of anti-psychotic drugs," she said.

The pharmaceutical giant Eli Lilly in 2009 paid a nearly 1.5 billion dollar settlement, in which it admitted no wrongdoing, for off-label promotion of its drug Zyprexa as a treatment for dementia. The drug is FDA-approved for bipolar disorder and schizophrenia.

According to Tom Hlavacek, executive director at Alzheimer's Association's southeastern Wisconsin chapter, elderly people with dementia are sometimes prescribed these potent drugs for behaviors that have other causes.

Urinary tract infections, tooth decay, arthritic pain, or simply moving a patient from one place to another can lead to agitated behaviors.

"Our experience indicates that these care transitions can exacerbate behaviors and often lead to escalating drug treatments," he told lawmakers.

Experts said solutions could include creating stronger penalties for inappropriate prescribing, and a renewed focus on trying non-pharmacological approaches to a problem first.

"Most doctors treat unwelcome behavior in all settings as a disease that requires medication. These drugs are used as chemical restraints," said Jonathan Evans, a doctor who specializes in caring for frail elders.

"Behavior is not a disease. Behavior is communication. And in people who have lost the ability to communicate with words, the only way to communicate is through behavior," he added.

"Good care demands we figure out what they are telling us and help them."