Posted by SLS on February 10, 2006, at 12:46:41
In reply to FINALLY! Stimulants will be investigated, posted by AC75 on February 9, 2006, at 21:18:24
Oops.
Sorry.
> > > Well, I'm glad someone blew a whistle that caught some attention.
I do apologize. Reading too quickly, I thought you had said "blew the whistle" rather than what you wrote, "blew a whistle". What a difference a single word can make.
I tend to agree with you. There is quite a bit of research available on these drugs as neuroscience has continued to investigate them through the years. What has not happened, though, is the use of longitudinal investigations to follow a cohort of children through their development into adults while taking ADHD medications to evaluate clinical efficacy versus adverse events. It is difficult to judge potential benefit versus unknown cost when trying to evaluate the appropriateness of bringing a drug through development and marketing it. It is a gamble of sorts, especially with drugs that have been out for such short periods of time. However, if we wait years and years to observe the long-term effects of drugs on rats as a condition for approval, no new drugs would become available to relieve suffering in the here and now.
Perhaps the COSTART program and Phase IV surveillance protocols should be encouraged more than they are right now. Even so, some of the most important life-saving drugs have some of the worst and potentially fatal side effects. It is appropriate that they be made available in the absence of alternatives. However, patient education seems to be largely ignored by a great many clinical practicioners, such that patients are not given the information necessary to grant a truly informed consent. Then, when adverse events do materialize, the patient becomes understandably concerned and less compliant as they are taken completely by surprise. Of course, things are made worse when the physician invalidates the patient's concerns by describing them as being medically unfounded or otherwise acceptable. Acceptable as they may be, a patient might remain unprepared to accept them for as long as their doctor fails to appreciate the significance of the adverse experiences produced by the drugs they prescribe.
Uninformed consent really is a problem.
- Scott
poster:SLS
thread:608122
URL: http://www.dr-bob.org/babble/20060205/msgs/608327.html