Meds

Benzodiazepine addiction is real. This physician shares his story.

David Mokotoff, MD

Meds

July 24, 2016

Say the words, “drug addiction,” and most of us think of heroin, alcohol, cocaine, or opiates. However, lurking in the shadows is a less talked about epidemic: addiction to benzodiazepines, commonly known as “benzos.” I should know because after taking a nighttime dose of lorazepam (Ativan) for about ten years; I finally weaned myself off this and all other prescription sleep medications.

About twelve years ago, my father died and then …

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Saving billions of dollars in health care: The story of Avastin and Lucentis

Meds

July 17, 2016

I sometimes worry that my wife Paula won’t be able to see me grow old. Not that I expect to outlive her. She is four years my junior and has the blood pressure of a 17-year-old track star. It’s her eyesight I’m worried about, because she is at risk for a form of blindness called macular degeneration. Paula is the youngest in a long line of redheads, several of whom …

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Why not make antibiotics over the counter?

Dana Corriel, MD

Meds

June 27, 2016

Bacteria are rapidly becoming resistant in our antibiotic-loving society. This statement is a fact. We are facing a threat not only to our country, but to the world.

I have a proposal to make: over-the-counter antibiotics.

(Insert tongue-in-cheek here.)

Will this help us deal with the falsely popular notion that antibiotics are a cure-all? I don’t know, but here’s something I do. I’ve had patients storm out because I’ve said no, and I …

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Are essential oils safe for children?

Justin Morgan, MD

Meds

March 13, 2016

On January 5, 2016, emergency crews were called to Our Kids Daycare and Learning Center in Middleton, Idaho. The reason: concern for carbon monoxide poisoning. The daycare center’s director Robin Hagaman noted that some of the 12 toddlers in the classroom were acting strangely when they awakened from their naps and were also noted to have dilated pupils. In addition, two of the teachers were simultaneously experiencing headaches and …

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A gastroenterologist shares practical advice on probiotics

Matthew Ciorba, MD

Meds

March 10, 2016

The microbiome is among the hottest topics in medical and scientific research. The National Institutes of Health and private foundations have invested hundreds of millions of dollars in research to define and characterize the human microbiome. In the next decade, billions more will be devoted to deciphering how microbes influence human health in a positive manner. The White House even issued a national call to action for …

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Vaginal marijuana for menstrual cramps. Does it really work?

Jennifer Gunter, MD

Meds

February 11, 2016

Foria wants you to know they are selling vaginal suppositories of THC (tetrahydrocannabinol) and CBD (cannabidiol) called Fiora Relief for menstrual cramps. Each suppository contains 60 mg of THC and 10 mg of CBD.

Foria claims they can treat the pain of menstrual cramps and endometriosis. Is this possible?

THC and cannabidiol (CBD) are compounds found in marijuana. The psychoactive (i.e., high) from marijuana is believed to be due to …

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This doctor won’t prescribe Addyi, the “female Viagra.” Here’s why.

Jennifer Gunter, MD

Meds

January 9, 2016

Addyi (flibanserin), the drug to increase female libido had a timid entry into the market with very few prescriptions considering the “hype.” Bloomberg Business reported 227 prescriptions in the first month. That’s a pittance considering Valeant paid $1 billion for the drug.

I am unlikely to help Valeant recoup their investment, because the more I read about this drug, the worse it looks. Here’s why:

It barely works

One of the study endpoints (meaning …

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There is no oversight for prior authorizations. There should be.

Dinah Miller, MD

Meds

December 6, 2015

The letter from the insurance company was addressed to my patient. The two pages of information boiled down to one simple sentence: “After a thorough review, our decision to not cover the medication Provigil (modafinil) is unchanged.”

The letter went on to explain that there was no further recourse, and that the medication would not be approved because it was not Food and Drug Administration–approved for the condition my patient had: …

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The story of the pot-smoking neurosurgeon is more complicated than you think

Vamsi Aribindi, MD

Meds

September 20, 2015

A brief article recently posted the name and picture of a neurosurgery resident accused of smoking marijuana on the job. Dr. Gunjan Goel, MD is a neurosurgery resident at University of California, San Diego, and the list of her awards and publications alone is almost as long as my entire CV. The article is brief, and rather uninformative. The only facts that are known are this: The …

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Discussing the side effects of medications: How can doctors do better?

Brian J. Secemsky, MD

Meds

September 9, 2015

While studying for a certification exam, I came across a question that stayed with me well after taking the practice test. The case discussed a patient who was prescribed antibiotics by his physician for a presumed bacterial illness and then returned the following week with an antibiotic-associated diarrheal infection. The test question then asked what could be concluded from this case. The answer: informed consent (i.e., patient permission for a …

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Kim Kardashian’s first trimester nausea: The truth behind Diclegis

Jennifer Gunter, MD

Meds

September 2, 2015

It was only a matter of time before Kim Kardashian posted a picture on her Instagram account with a bottle of Diclegis, basically announcing her brand partnership with Duchesnay, the manufacturer of the prescription medication for nausea and vomiting in pregnancy. Duchesnay had been tweeting for ages that they were so relieved Kim had found help with Diclegis — so much so that I was wondering if Ms. …

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Don’t use essential oils for asthma. Here’s why.

Meds

April 22, 2015

Alright, we need to talk. Those of you who follow my blog know that I don’t shy away from controversial topics and that I don’t have a problem speaking my mind. I try to do it in a respectful, informative, and somewhat humorous way. But I saw something this morning that needs to be addressed, and it’s not funny at all.

As I was eating breakfast before work, I saw a …

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How are drug companies making millions from generic drugs?

Meds

April 17, 2015

It is well accepted among health economics wonks that the lion’s share of pharmaceutical company profits come when these companies hold exclusive rights to their products. Once their blockbuster pills go “generic,” competitors enter the marketplace and profits plummet. Consider captopril, a groundbreaking heart failure medication introduced in the early 80s by Bristol-Myers Squibb under the trade name Capoten. After making a fortune for the company, captopril went generic in 1996. …

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What does it mean to live in the age of Abilify?

Steven Reidbord, MD

Meds

March 23, 2015

I learned recently that the antipsychotic Abilify is the biggest selling prescription drug in the U.S. To be a top seller, a drug has to be expensive and also widely used. Abilify is both. It’s the 14th most prescribed brand-name medication, and it retails for about $30 a pill. Annual sales are over $7 billion, nearly a billion more than the next runner-up.

Yes, you read that right: $30 a pill. A little more …

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We are overprescribing statin medications for high cholesterol. Here’s why.

Richard Young, MD

Meds

March 16, 2015

The American Heart Association (AHA) recently proposed new guidelines for all doctors to screen and treat for high cholesterol. For doctors and patients to follow, this would result in a large increase in the number of Americans taking statins.

One of the things I like about the new proposal is that there is no more chasing a number. This was frustrating for doctors and patients to keep having lab draws and medication …

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Don’t be scared: Let’s see what’s really in vaccines

Katie Noorbakhsh, MD

Meds

March 7, 2015

Let’s talk about vaccine ingredients. I am reading less about vaccines causing autism (we all know that theory is utter nonsense, right?) and more about vague concerns regarding the chemicals in vaccines. To begin with, we are surrounded by chemicals. Water (H2O), caffeine (C8H10N4O2), sugar (C12H22O11) are all chemicals. But perhaps it is the unfamiliar ingredients that people find intimidating.

Let’s tackle the ingredients in the measles, mumps, rubella and varicella (MMRV) vaccine …

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A domperidone dilemma: A patient’s perspective on ordering from Canada

Meds

March 5, 2015

Three years ago I received some of the best news of my life — that I have dopa-responsive dystonia. (Yes, a neuromuscular disorder was welcome news.) Painful, life-interrupting muscle contractions had made the dystonia diagnosis likely several years before, despite poor response to standard treatments, and I was fighting through graduate school: trying to compensate for medication-induced memory problems, increasing need to work from bed, and a disappearing social life. …

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Ask for Dilaudid, get Dilaudid. No questions asked.

Meds

February 28, 2015

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A local hospital is trying a new, controversial but more efficient approach to medical care. “We have changed our guidelines, if you want Dilaudid you get Dilaudid, if you want Valium, you get Valium. No questions asked,” CEO Michael Shoemaker told reporters Wednesday.

In what experts are calling pure genius, emergency …

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How the advent of propofol changed the meaning of the term “sedation”

Karen S. Sibert, MD

Meds

February 19, 2015

“Twilight! She has to have twilight,” insisted the adult daughter of my frail, 85-year-old patient. “She can’t have general anesthesia. She hasn’t been cleared for general anesthesia!”

We were in the preoperative area of my hospital, where my patient — brightly alert, with a colorful headband and bright red lipstick — was about to undergo surgery. Her skin had broken down on both legs due to poor circulation in her veins, …

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The truth about Miralax in children

Natasha Burgert, MD

Meds

February 12, 2015

Parents are appropriately expressing concern about the safety of Miralax®, a commonly used stool softener in kids, after a recent New York Times article exposed a potential association with long-term use of the drug and undesired behavioral side effects. As the article explains, the FDA has awarded a research grant to a team at the Children’s Hospital of Philadelphia (CHOP) to directly address these concerns.

Miralax® has been used …

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