Tuesday, January 16, 2007

DRUG-COMPANY HATRED AT WORK? Or a medical profession that does not like to admit that it has been wrong?

There is some very confused thinking in the article reproduced below. If you read the report carefully, all that the latest research shows is that "bad" cholesterol may not be so bad after all. People deficient in it seem to be at more risk of Parkinsons. So maybe we NEED that "bad" cholesterol. Pesky!!

The mention of "dangerous" drugs called statins is a red herring -- presumably motivated by hatred of drug companies -- and the idea that they are a risk is actually CONTRADICTED by the research findings!

Research suggesting a possible link between the statin heart drugs being taken by millions of people and Parkinson's disease has prompted scientists to launch an investigation involving tens of thousands of patients. Researchers in the United States have been sufficiently alarmed by the preliminary findings of a small study of 124 patients to plan a full trial with 16,000 participants to examine whether the world's best-selling drugs can heighten the risk of developing the condition.

While previous work has suggested that taking statins, which lower levels of LDL or "bad" cholesterol, might be a risk factor for Parkinson's, there has never been firm evidence of a link, and previous efforts to test it have failed to find one. A study at the University of North Carolina, however, has shown that patients with low levels of LDL cholesterol are more than three and a half times as likely to develop the disease as those with higher LDL levels. Xuemei Huang, who led the research, said that she was very concerned by the finding. Another large-scale trial investigating a cholesterol link with Parkinson's risk is under way at Harvard University.

Millions of people around the world are taking statins. They have relatively few serious side effects, and there is evidence that they reduce deaths from heart disease. They are considered to be so safe that one, simvastatin, is available without prescription in Britain.

David Dexter, senior lecturer in neuropharmacology at Imperial College, London, said: "With the evidence we have at the moment, I would say there is not much cause for concern that statin use may cause Parkinson's disease. Previous studies have demonstrated that statins can increase brain dopamine concentration, the chemical transmitter deficient in Parkinson's. "Also one of the secondary symptoms some patients with Parkinson's experience is dementia, similar to Alzheimer's disease, which may result from vascular changes in the brain. Statins would be expected to protect the brain against such vascular changes."

The apparent link found between lower LDL levels and Parkinson's was worrying, he acknowledged, but the study had been carried out on a small number of subjects and needed confirming. "Lower LDL cholesterol levels may also be a consequence of Parkinson's and not a cause," he said.

Patricia Limousin, consultant neurologist at the Institute of Neurology in London, said: "There is absolutely no evidence that statin drugs cause Parkinson's disease. In fact these drugs were related to a lower occurrence of Parkinson's disease in Huang's study, raising the possibility of a protective effect that warrants further investigations."

Peter Weissberg, medical director of the British Heart Foundation, said: "We are concerned that any suggestion of a link between statins and Parkinson's disease would unnecessarily scare the millions of people benefiting from statins in the UK. There is overwhelming evidence that statins save lives by preventing heart attacks and strokes. "Nobody should stop taking statins on the basis of this report. If they do, they will be putting themselves at increased risk of heart attack or stroke."

Kieran Breen, director of research and development for the Parkinson's Disease Society, said: "We should wary of drawing any firm conclusions from this research."


The other drug war

A comment from Australia

The scourge of drugs in our schools is one of the big fears facing all parents as their children grow up. But increasingly concern is turning to the cocktail of mind-altering substances being fed to youngsters before they leave home in the mornings. Tens of thousands of children are being prescribed drugs for a series of mood and behaviour disorders ranging from attention deficit hyperactivity disorder (ADHD) to depression. "There is a medical civil war going on and the victims caught in the crossfire are the kids who have no say in it," says Dr George Halasz, a Melbourne-based psychiatrist.

Lined up on one side are the GPs, child psychiatrists and other specialists who believe medication is a safe, simple and effective way of relieving the suffering of children and adolescents, and controlling symptoms that cause them to struggle at school and socially.

On the other side are colleagues who criticise what they see as massive over-diagnosis and unnecessary use of potentially dangerous drugs that have a largely unknown long-term effect on developing brains. No anti-depressant has been approved in Australia for the treatment of depression in anyone aged under 19, but they are still prescribed.

Federal figures for 2003 show 250,000 prescriptions for Prozac and similar drugs - selective serotonin reuptake inhibitors (SSRI) - were issued to children and adolescents. That was 30,000 more than the previous year. Three-quarters of them went to people aged 15 to 18, with about 15,000 going to children under 10. The figures do not indicate how young the children on anti-depressants are, but a 2004 study that tracked more than 5000 mothers and their children found that "it is common for children as young as five to be perceived to manifest a variety of symptoms of depression and/or anxiety".

Black Dog Institute chief Professor Gordon Parker has prescribed Prozac to an eight-year-old boy, reluctantly and only after consulting with two other child psychiatrists. "His mother, who also had a very bad depression, had several children and they were all happy except this one boy who would come home from school and say, 'I want to be dead.' " After about three weeks on Prozac, the boy was "wonderful". Several attempts were made to take him off the medication but within three or four weeks his condition deteriorated each time. The use of anti-depressant drugs for children under 12 "should be done rarely and by specialists and with great care", cautions Prof Parker.

A study by Professor Jon Jureidini of the Adelaide Women's and Children's Hospital concluded children and adolescents should not be placed on anti-depressants. "The drugs do not work and there is a possibility they may be dangerous for a small group," he says.

In 2004, the UK banned the use of all SSRI anti-depressants except Prozac for young people and the US Federal Drugs Agency asked manufacturers to include warning labels after experts found a link between anti-depressants and increased risk of suicide in children and teenagers. The danger was said to be greatest at the start of treatment, when there was a change in dosage or if it was suddenly withdrawn. Australia's Therapeutic Goods Administration gave a similar warning and reiterated that the drug companies advise against the use of the medications to treat people under 18 for depression.

The Australian Adverse Drug Reactions Advisory Committee recommended that where anti-depressants were prescribed for children and adolescents it should be carefully monitored and done only as a part of "comprehensive" patient management, preferably with cognitive behaviour therapy. ADRAC documents show that since close monitoring of prescriptions to children began in 2005, more than 1600 adverse reactions had been notified. Of these, 827 related to children aged under 10 and the drugs had been linked to two suicides and a death from heart failure. Another 833 adverse reactions were logged for youths aged 10 to 19, including links to three deaths.

Dr Brett McDermott, director of the Mater Child and Youth Mental Health Service in Brisbane and spokesman for the Royal Australian and New Zealand College of Psychiatrists, says: "I think Australia has got it right. There are very safe anti-depressants and we are not prescribing them lightly. "Depression is a severe condition and I don't think you can withhold treatment because a small amount have side effects." Dr McDermott said GPs were competent to prescribe to adolescents but the younger the child, the more important it was they saw a child psychiatrist. "I would be very reluctant to prescribe anti-depressants to kids in primary school," he said.

Dr Halasz and others fear the use of drugs to treat depression could follow the explosion in ADHD medication. "The US, Canada and Australia are the world gold, silver and bronze medal-holders in terms of prescribing drugs to children," he said. Prescriptions in Australia for the most common medication - dex-amphetamines- rose from 96,000 a year to 232,000 between 1994 and 2004. In August 2005, the other popular ADHD drug Ritalin was added to the Pharmaceutical Benefits Scheme, reducing the cost from $49 to as little as $4.70 for concession card-holders. Over the next six months, the number of Ritalin scripts issued soared from 523 a month to more than 5800, with no apparent decrease in other medications. Queensland prescription numbers have grown at a rate second only to that in Western Australia.

A world authority on ADHD, Professor David Hay from Curtin University in Perth, says one possible reason for the high number of cases is that GPs are allowed to diagnose ADHD in those two states. Elsewhere, it can be done only by child psychologists or psychiatrists. ADHD is "extraordinarily complex", with a high risk of mis-diagnosis, says Prof Hay. "We have to make sure we are measuring a problem in the child and not the parent's perceptions. I don't think it's done well enough."

A Federal Government study found 11 per cent of parents reported their children had symptoms consistent with ADHD. Dr Halasz says the true figure is more like 1 per cent and that many are being wrongly diagnosed. "Parents are between a rock and a hard place. They always want to do the best for their children," he said.

In the US, it is not uncommon for schools to insist parents medicate their children to modify their behaviour as a condition of remaining at the school. Youth Affairs Network of Queensland director Siyavash Doostkhah says it also happens regularly here - even though it is illegal. Denise, a Brisbane northside mother, says that happened to her son John who was branded a "bad" child all through pre-school. "This came to a head when he had only been in Grade 1 for approximately four months when the principal came to me and told me I either put my son on medication or he would be expelled."

Queensland University of Technology education PhD student Linda Graham recently completed a study of school responses and concluded that children who do not fit the "norm" are made scapegoats. "Parents of children who can be described as 'hyperactive' or 'distractable' are under pressure to medicate their children so they can fit into an overwrought, under-funded public education system," she said. "The load is lessened when difficult kids are diagnosed with something that qualifies for support funding or when parents oblige the school by shifting the problem to their local pediatrician."

She backed claims by child psychiatrists to The Sunday Mail of parents being pressured by schools to get diagnoses of conditions such as Autism Spectrum Disorder. Students with ASD qualify for teacher-aide support funding while those with ADHD do not. Proponents of ADHD medication point to the fact that it has helped thousands of children to control their impulsive or hyperactive behaviour, to focus and concentrate better, to improve their school performance and to increase their social skills.

Dr Halasz agrees it would be unethical to withhold the drugs from the very small group of children who really require them but argues that just because a child functions better after taking them is not proof that the child was ever "ill". And he warns there have not yet been any long-term follow-up studies of the effects. "There could be a sleeper effect. In 20 years we could have a whole generation acting differently."



Just some problems with the "Obesity" war:

1). It tries to impose behavior change on everybody -- when most of those targeted are not obese and hence have no reason to change their behaviour. It is a form of punishing the innocent and the guilty alike. (It is also typical of Leftist thinking: Scorning the individual and capable of dealing with large groups only).

2). The longevity research all leads to the conclusion that it is people of MIDDLING weight who live longest -- not slim people. So the "epidemic" of obesity is in fact largely an "epidemic" of living longer.

3). It is total calorie intake that makes you fat -- not where you get your calories. Policies that attack only the source of the calories (e.g. "junk food") without addressing total calorie intake are hence pissing into the wind. People involuntarily deprived of their preferred calorie intake from one source are highly likely to seek and find their calories elsewhere.

4). So-called junk food is perfectly nutritious. A big Mac meal comprises meat, bread, salad and potatoes -- which is a mainstream Western diet. If that is bad then we are all in big trouble.

5). Food warriors demonize salt and fat. But we need a daily salt intake to counter salt-loss through perspiration and the research shows that people on salt-restricted diets die SOONER. And Eskimos eat huge amounts of fat with no apparent ill-effects. And the average home-cooked roast dinner has LOTS of fat. Will we ban roast dinners?

6). The foods restricted are often no more calorific than those permitted -- such as milk and fruit-juice drinks.

7). Tendency to weight is mostly genetic and is therefore not readily susceptible to voluntary behaviour change.

8). And when are we going to ban cheese? Cheese is a concentrated calorie bomb and has lots of that wicked animal fat in it too. Wouldn't we all be better off without it? And what about butter and margarine? They are just about pure fat. Surely they should be treated as contraband in kids' lunchboxes! [/sarcasm].

Trans fats:

For one summary of the weak science behind the "trans-fat" hysteria, see here. Trans fats have only a temporary effect on blood chemistry and the evidence of lasting harm from them is dubious. By taking extreme groups in trans fats intake, some weak association with coronary heart disease has at times been shown in some sub-populations but extreme group studies are inherently at risk of confounding with other factors and are intrinsically of little interest to the average person.

The use of extreme quintiles (fifths) to examine effects is in fact so common as to be almost universal but suggests to the experienced observer that the differences between the mean scores of the experimental and control groups were not statistically significant -- thus making the article concerned little more than an exercise in deception


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