Posted by Larry Hoover on June 7, 2005, at 8:36:48
I really dislike the concept. I really dislike the representation itself.
Drugs have effects. Period.
Among the effects, some of them are ones we are glad to see, and some of them we wish did not occur. When someone takes an SSRI, I'm sure that sexual dysfunction isn't often greeted with a "Hooray!" I think it unlikely that I'll ever seen a television advertisement proclaiming this particular drug effect. However, declaring it to be a side effect trivializes it. My own psychiatrist, upon hearing of my antidepressant neutering, asked me, "Would you rather be depressed?", as if it was somehow a reasonable trade off. The success and popularity of Viagra and Cialis (despite their price) would answer that question.
When you read a drug monograph, you will see a long list of "adverse reactions" or "side effects", as compared to placebo, in clinical trials. Why are those not listed right together with positive reactions? Why is it not possible to just see the effects of the drug? If it is twice as likely that a person might have sexual dysfunction than it is that they might find relief from depression, then why is it that the drug is marketed as an antidepressant, rather than as a chemical neutering agent?
I just did a drug trial, of topiramate (Topomax). It was brief, and perhaps I exceeded the most conservative titration schedule. I think it is moot, as one drug effect I experienced simply cannot be ignored. It could be permanently disabling or fatal. In any case, here is my list of drug effects:
fatigue
flu-like symptoms
hot flushes
dizziness
speech problems (both aphasia and motor)
paresthesia
tremor
involuntary muscle contractions
reduction in neurasthenia/neuralgia
nausea
dyspepsia
abdominal pain
dry mouth
gingivitis
nervousness
memory problems
somnolence
confusion
emotional lability
difficulty with concentration
pharyngitis
sinus headache
taste perversion
micturition frequency
pruritus
oligohydrosis (inability to sweat)The last one on the list is dangerous. Some on the list are merely nuisances. Many are of sufficient intensity to interfere with affairs of daily living. One effect was beneficial.
On this basis, the effect of the drug did not improve my quality of life. There are no side effects. These are all main drug effects.
Some main drug effects are rare, but that doesn't matter one whit to the person who has those rare effects, because in that individual, the incidence is 100%.
I say, to hell with the concept of side effect. Let's talk drug effect, and get on with assessing the quality of life, before and after the drug.
Lar
poster:Larry Hoover
thread:508986
URL: http://www.dr-bob.org/babble/20050606/msgs/508986.html