Clinical trials

The British Medical Journal recently released several papers looking into the problem of unpublished data, including one study from Yale University, which found that fewer than half of the 635 the clinical trials funded by the National Institutes of Health were actually published in medical journals within 30 months of trial completion.

Drug companies that delay publishing these findings or even deliberately hide trial data are breaching their ethical duty, says lead researcher Joseph Ross. “The evidence we publish shows that the current situation is a disservice to research participants, patients, health systems, and the whole endeavor of clinical medicine,” he said.

Drug companies have often been caught withholding data, especially with drugs that are widely prescribed and bring in billions in profits. Drugmaker Grunenthal, now part of GlaxoSmithKline (GSK) and Sanofi, is currently being sued by 13 Americans who were born with birth defects after their mothers took the drug Thalidomide to treat morning sickness. The lawsuit claims that the drug company hid results of studies that would have revealed the drug caused birth defects.

Now, makers of the most commonly prescribed antidepressants are feeling some of the same wrath. New studies have linked selective serotonin reuptake inhibitors (SSRIs) to birth defects, particularly of the heart and lungs. Women who took the drug during pregnancy and gave birth to babies with these serious birth defects allege the drug companies did not reveal just how dangerous the drugs were to developing fetuses.

It wouldn’t be the first time these SSRI drug companies reportedly tried to cover up data that could hurt sales. In 2006, a U.S. court found drug maker GSK guilty of promoting Paxil or Paxil CR for children and adolescents while withholding and concealing information about the medication’s safety and effectiveness for minors. The lawsuit stemmed from a consumer advocate protest against GSK, which alleged that consumers were not sufficiently warned in advance of the drug’s side effects and addictive properties.

“Most clinicians assume that the complex regulatory systems that govern human research ensure that (clinical data) is relevant, reliable and properly disseminated,” Dr. Richard Lehman from Oxford University and the British Medical Journal’s Dr. Elizabeth Loder told the Daily Mail. “It generally comes as a shock to clinicians, and certainly to the public, to learn that this is far from the case.”

Sources:
Daily Mail
Wikipedia
The Dr. Rath Health Foundation

SOURCE: Paxil and Pregnancy › Do drug companies cover up data about drugs’ safety, efficacy?

It was the question posed recently on BabyCenter.com, a website resource for expectant mothers, new mothers, and women hoping to become pregnant in the near future. The question sparked numerous responses from women who were faced with making that decision. Some women commented that they needed the medication because they struggled with severe depression and anxiety. But they still worry about the effects the drug may have on their unborn babies.

The concerns are valid. Two recent studies reported that selective serotonin reuptake inhibitors (SSRIs), a commonly prescribed class of antidepressants, increase the risk for congenital malformations and developmental disorders among children whose mothers took SSRIs while pregnant.

The first study, published in the journal Obstetrics and Gynecology, found a two- to four-fold increased risk of cardiac and neural tube defects with some SSRIs, and fetal alcohol spectrum disorders were also 10 times more likely in children exposed to an SSRI while in the womb.

The second study, published in the Archives of General Psychiatry, found a two- to three-fold increase in autism spectrum disorders among children exposed to SSRIs during pregnancy. The risk was greater when the SSRI was used during the first trimester of pregnancy.

Most SSRIs are classified as Category C drugs, meaning that either studies in animals have shown adverse affects on the fetus but there are no controlled studies in women, or studies in women and animals are not available. These drugs are only given if the potential benefit justifies the potential risk to the fetus.

Paxil is the only SSRI classified as a Category D drug, meaning that there is positive evidence of fetal risk in humans when used during pregnancy. The classification was only recently downgraded. While dangerous to fetuses, the FDA says these drugs may be acceptable if they are needed in a life-threatening situation or for a serious disease where safer drugs cannot be used or are ineffective.

Source: www.BabyCenter.com

SOURCE: Paxil and Pregnancy › Women question safety of antidepressants while pregnant

The study, which was published in the Health Affairs journal, was co-authored by Mark Olfson, a professor of clinical psychiatry at Columbia University. The results were reported by the Wall Street Journal.

Antidepressants were the second-most widely prescribed class of drugs in 2010, second only to cholesterol-lowering statins. Zoloft or a generic version of the drug known as sertraline was the most prescribed antidepressant with 36 million prescriptions written in 2010.

Zoloft is in a class of drugs known as selective serotonin reuptake inhibitors (SSRIs), and are approved by the Food and Drug Administration (FDA) to treat depression, anxiety disorders and some personality disorders. Other drugs in the class include Paxil, Celexa, Lexapro, and Prozac.

A 2010 meta-analysis of SSRIs found that the drugs worked best for patients with severe depression. Patients with mild or moderate symptoms may receive little or no benefit from the medication. Yet, taking SSRIs put users at risk for side effects that include nausea and vomiting, headache, strange dreams, changes in appetite and weight, changes in sexual behavior, increased feelings of depression and anxiety which may provoke panic attacks, and suicidal ideation.

The drugs also put expectant mothers at risk for delivering a baby with serious birth defects. SSRIs cross the placenta and have been associated with congenital malformations, in particular septal defects. Some evidence suggests that SSRIs are linked to neonatal abstinence syndrome and persistent pulmonary hypertension.

All SSRIs except Paxil are listed as Pregnancy Category C drugs, meaning that risk cannot be ruled out because adequate, well-controlled human studies are lacking and animal studies may or may not have shown a risk to the fetus. Paxil was recent downgraded from a Category C to a Category D drug, indicating that there is positive evidence of risk to fetuses.

Source: Wall Street Journal

SOURCE: Paxil and Pregnancy › Widely used SSRIs raise concerns of birth defects

SSRIs (selective serotonin reuptake inhibitors) are antidepressants that affect serotonin levels in the brain. It’s not fully understood how they work but it is thought they provide higher levels of serotonin at the brain receptor site. SSRI discontinuation syndrome can occur during or following interruption or the lowering of dosage or the discontinuation of an SSRI or SNRI (serotonin-norepinephrine reuptake inhibitor) antidepressant.

Side effects can occur between 24 hours to one week after reduction or stoppage of dosage and they can be overwhelming. Side effects may include dizziness, electric shock-like sensations or “zaps,” sweating, nausea, insomnia, tremor, confusion, and vertigo.

If you are considering coming off your antidepressant, Summer Beretsky on PsychCentral.com offers some tips on how to make the process in a blog that details her challenges when she came off Paxil. Her weaning process was a months long ordeal that involved tapering down her dosage by splitting or shaving pills over the course of seven months. During that time of weaning off she says she suffered from side effects headaches, lethargy, depression, dizziness, the “zaps,” and nausea, to name a few. Read her personal story and tips on gradually weaning off SSRIs on the site’s blog.

SOURCE: Paxil and Pregnancy › Coming off antidepressants can take months of effort