Meds

Psychedelic-assisted therapy: science, safety, and regulation

Meds
January 4, 2026

We are hearing stories about mushrooms and MDMA and see clinics advertise ketamine. We hear of friends chasing a spiritual reset. Many in America feel the weight of depression, trauma, and addiction inside families. Psychedelics sit at the center of this pressure, with hope on one side and hype on the other.

KevinMD already published multiple essays on psychedelic medicine since 2022, including pieces on what physicians need to know, prudence …

Read more…

The anticoagulant evidence controversy: a whistleblower’s perspective

Meds
December 29, 2025

My partner broke her femur in a Zumba class just before Christmas 2025 and had successful surgery. Following successful surgery, physicians prescribed Lovenox (an anticoagulant) and Plavix (an antiplatelet drug), the standard regimen for preventing or treating venous thromboembolism (VTE). However, the intervention proved very risky: She lost three pints of blood into her leg and required a two-pint blood transfusion, direct complications of the Lovenox and Plavix.

Physicians adopted anticoagulants …

Read more…

Is tramadol really ineffective and risky?

Meds
December 29, 2025

For nearly half a century, tramadol has been used as a pain reliever. It is not perfect, no analgesic is, but it has helped millions upon millions of patients with chronic pain. That is why recent headlines declaring tramadol “less effective” and “more risky” caught my attention. These stories were based on a single meta-analysis, which concluded that this medication offers “limited analgesic benefits” and that its harms, …

Read more…

Unregulated botanical products: the hidden risks of convenience store supplements

Meds
December 25, 2025

Walk into a convenience store. You will see sleek bottles, gummies, shots, and powders in bright wrappers. Companies market them as calm, focus, energy, sleep, pain relief. People treat them like upgraded vitamins. They swipe a card and head home. Nobody runs a checklist on dose, interactions, tolerance, withdrawal, or contamination.

This culture runs on a simple story. Natural means safe and plant means gentle. Legal means regulated while a label …

Read more…

“The meds made me do it”: Unpacking the Nick Reiner tragedy

Meds
December 25, 2025

“The meds made me do it” has become a familiar refrain whenever psychiatric treatment intersects with tragedy. It is a phrase heavy with implication, suggesting loss of control, a sense of medical betrayal, and a system that failed at its most basic task: keeping people safe. When cases like the Nick Reiner tragedy enter the public consciousness, that phrase resurfaces almost reflexively, offering a deceptively simple explanation for something incredibly …

Read more…

The dangers of oral steroids for seasonal illness

Meds
December 25, 2025

“I’m here (cough) to pick up (cough) the steroid,” says the visibly sick patient at the pharmacy. The pharmacist tries not to breathe in too deeply to catch the contagion as she hands over the box of pills. The patient has no idea that others have nicknamed it “poison” or “the Devil’s drug,” because it’s not worth it. The risks of casually prescribing prednisone or Medrol Dosepaks for seasonal illnesses …

Read more…

L-theanine for stress and cognition

Meds
December 22, 2025

As a medical student, I’ve seen firsthand how stress and cognitive overload can wear people down, both in patients and in myself. During one particularly difficult exam block, a friend casually mentioned L-theanine, a supplement found in green tea, that supposedly helps with focus and calm. That got me curious: Was this just hype, or is there actually something to it?

So I took a closer look at the research.

L-theanine is …

Read more…

The AI innovation-access gap in medicine

Meds
December 22, 2025

Artificial intelligence has transformed pharmaceutical science more rapidly than any other part of health care. AI can now:

  • Identify molecular targets faster than human researchers
  • Compress early discovery timelines from years to months
  • Simulate how millions of compounds might behave in the body
  • Predict toxicity or poor efficacy before a drug is ever synthesized
  • Help design personalized therapies built on real-world clinical data

Recent analyses in Drug Discovery Today and …

Read more…

How deprescribing in psychiatry offers a path to safer care

Meds
December 19, 2025

America learned to add medications. Add one for sleep. Add one for nausea from the first. Add one for weight gain from the second. Add a second antidepressant when the first loses effect. Add a stimulant when a mood stabilizer slows a teenager down. Add an antipsychotic when anxiety erupts in the clinic room. Add a statin because a lab number sits outside a guideline range. Patients, however, feel the …

Read more…

The economics of medical weight loss

Meds
December 11, 2025

Most know me for my insights about medical malpractice litigation. However, ever since the 2000s, my practice has focused on medical weight loss management, and I have developed other insights. I developed these insights as a private practitioner, as an employee of a medical weight loss clinic, which may have gone out of business because it no longer has a public persona, and as a general contractor for a weight …

Read more…

Why the cannabis ethics debate is really about human suffering

Meds
December 10, 2025

Most discussions about cannabis stay on the surface: legality, crime, or medical claims. But the core question is this: What suffering does a society allow? After watching a recent documentary with police, lawyers, physicians, and families, I found cannabis is the stage. The real drama is the system behind it. When ethics is pushed far, inconsistencies become impossible to ignore.

1. Legal ethics: When the law punishes pain instead of harm

Some …

Read more…

Testosterone cardiovascular risk: FDA update 2025

Meds
December 1, 2025

Testosterone therapy is receiving renewed attention, not only from patients but also from regulatory agencies. In recent months, the U.S. Food and Drug Administration (FDA) updated the safety information for testosterone products, reflecting new evidence on cardiovascular risk. This has generated understandable questions among men who are considering therapy and clinicians who prescribe it.

As a urologist, I frequently meet patients who are uncertain about the safety of testosterone treatment, particularly …

Read more…

Are you neurodivergent or just bored?

Meds
November 18, 2025

Do you get bored when reading a boring book? Do you struggle to concentrate when you haven’t had enough sleep? Do you have difficulty following instructions, make careless mistakes and forget to return calls? Are you sometimes the last one to “get” a joke?

You may be “suffering from” with Autism Spectrum Disorder (ASD) and are “neurodivergent” and “on the spectrum.”

Today’s ASD “neurodivergence” craze has spawned at least two lucrative and …

Read more…

ADVERTISEMENT

Pharmacy benefit manager reform vs. direct drug plans

Meds
November 6, 2025

Much has been made of the move by President Donald Trump and the pharmaceutical industry to offer direct-purchase drug programs at heavily discounted rates. Following the announcement of these new programs and TrumpRx, we’ve heard news and opinion pieces from every major outlet, but missing in the conversation is one of the most important voices: the patient. Key questions remained unanswered:

“What does this mean for my care?”

“Does this work with …

Read more…

A cautionary tale about pramipexole

Meds
November 4, 2025

I never thought I’d be the cautionary tale.

For decades, I worked at a financial company. I’m a youth sports coach, a husband, and a father of two. I’ve spent decades coaching, mentoring players, and proudly producing high school sports telecasts. I built a life around leadership, precision, and community.

But none of that prepared me for what happened when I was prescribed pramipexole (Mirapex) to treat Parkinson’s.

The warnings were there: compulsive …

Read more…

My persistent adverse reaction to an SSRI

Meds
November 2, 2025

Two years ago, I took a single 20 mg dose of escitalopram. Like millions of others, I was prescribed this antidepressant with the expectation that it would help, or at worst, have mild side effects that would pass. Instead, I experienced an immediate and severe adverse reaction. What I could not have imagined then was that the symptoms would not resolve; they have persisted and, over time, have only worsened.

Since …

Read more…

Tofacitinib: a lesson in heart-immune health

Meds
October 6, 2025

When the FDA put a black box warning on tofacitinib in 2021, the message was blunt: more heart attacks, more cancers, and more blood clots. The warning came from the ORAL Surveillance trial, which followed over 4,000 patients with rheumatoid arthritis already at high cardiovascular risk. Compared to TNF blockers, patients on tofacitinib had:

  • Heart attacks and strokes: About one extra event for every 111 patients treated over four years.

    • …

    Read more…

The case for regulating, not banning, kratom

Meds
October 3, 2025

Kratom (Mitragyna speciosa) has become a topic of significant debate among clinicians, policymakers, and the public due to differing views on its safety, pharmacology, and regulatory requirements. A recent article raises important concerns about kratom’s pharmacological actions, potential for addiction, psychiatric risks, and regulatory challenges. Although the goal of protecting public health is admirable, it is crucial that discussions around kratom are rooted in current scientific evidence and avoid …

Read more…

How India-Pakistan tensions could break America’s generic drug pipeline

Meds
September 25, 2025

With over 270 active drug shortages and growing global instability, the United States must protect itself from a worsening crisis in cancer care. The fragile supply of generic chemotherapy drugs like cisplatin, which is important for treating bladder, lung, and testicular cancer, could collapse if geopolitical tensions between India and Pakistan escalate further. To preserve this diminishing supply, the U.S. must reduce its overreliance on Indian pharmaceutical manufacturing and …

Read more…

The unfair war on buprenorphine

Meds
September 23, 2025

In my years as a physician on the front lines of addiction and pain medicine, I have never encountered a medication as transformative as buprenorphine (Suboxone). I have seen patients, broken by years of opioid addiction, have their lives change within an hour of their first dose, ready to reclaim a life they thought was lost. For these patients, buprenorphine is as essential as insulin is for a person with …

Read more…

18
pages