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Old 03-22-2011, 10:23 AM   #41
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Here in Yurp, the drugs companies are not allowed to run ads for prescription-only medicines. So doctors don't get all this carp from "informed" patients dangling magazines in front of them. (These days, of course, they do get the same carp as everywhere else from "infomed" patients dangling printouts from Wikipedia in front of them. )
I wish we had the same rules regarding ads for prescription-only medications here. I wonder if the bombardment by so many of these ads might turn us into a nation of hypochondriacs.

But then, maybe I worry too much.
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Old 03-22-2011, 10:25 AM   #42
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Time for a repost...

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Old 03-22-2011, 10:27 AM   #43
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I posted about this once before here but can't find the post so I can't link to the article but I want to caution you to be aware of a strange possible side effect. A partner at DW's firm took a Parkinson's drug for RLS and was helped but her doctors neglected to mention that a rare side effect was gambling addiction. The partner became addicted to online gambling (she had never even participated prior to this) and blew through most of her and her husband's savings before learning about the side effect. A change to another drug and she was "cured" of gambling. This is not a reason to discontinue an effective RLS drug, but just a caution of something absolutely wierd to be aware of. If DW's partner had known of the problem she could/would? have recognized it when it manifested.

Edit: I found the old post. Here is the article about DW's partner.
Yes I had heard of this. So far no impulse control issues.
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Old 03-22-2011, 11:03 AM   #44
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Yes I had heard of this. So far no impulse control issues.
Don't take any trips to Las Vegas
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Old 03-22-2011, 11:13 AM   #45
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Another thing about drug ads: They'll saturate the airwaves with commercials for a while, and then nothing. For example, there are no ads for RLS anymore, whereas for a while they were very common.

Right now that weird-eyed female doctor for Restasis is on ALL THE TIME.

Why is that? Are the campaigns unsuccessful?
My best guess: They only have a fairly short time when the drug is actually on the market before the patents run out. So you get a few years of really pushing a drug, then the patent runs out, and there's no more need to push that commercial because X just replaced it from their company as needing the big push now.

I don't think I've seen any medical commercials on YouTube, Blip.tv or any other site that runs videos. I wonder if I just haven't been paying attention.
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Old 03-22-2011, 03:58 PM   #46
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Yes I had heard of this. So far no impulse control issues.
But your posting frequency has gone up by 300%!
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Old 03-22-2011, 05:23 PM   #47
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The guy that ran this study was on a bike tour, and stayed at my house:
In the first-ever controlled study measuring the effectiveness of pharmaceutical direct-to-consumer advertising (DTCA), researchers found only a modest effect on drug sales. In some cases, DTCA had no effect at all.


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Old 03-22-2011, 05:35 PM   #48
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I hope the pharmaceutical companies listen to your friend, Al! I'd love for the number of ads for medications to decline over the years.

P.S. - - good looking bunch of people!
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Old 03-22-2011, 05:55 PM   #49
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At a recent physical my BP was 160/95 and my doctor wanted to get me on a hypertension medication. I knew it was a one off due to nervousness, but he insisted. I measure my BP at home for the next week and went back to show him my BP chart, average 115/70. I have a new doctor
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Old 03-22-2011, 06:14 PM   #50
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At a recent physical my BP was 160/95 and my doctor wanted to get me on a hypertension medication. I knew it was a one off due to nervousness, but he insisted. I measure my BP at home for the next week and went back to show him my BP chart, average 115/70. I have a new doctor
Perhaps it is white-coat hypertension - very common.

Or perhaps you were incensed that your doctor didn't pay enough tax.
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Old 03-23-2011, 08:48 AM   #51
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Perhaps it is white-coat hypertension - very common.

Or perhaps you were incensed that your doctor didn't pay enough tax.
Yes it was white coat syndrome. I was disappointed that my doctor immediately put me on hyertension meds for a one time BP measurement. I went out and bough a wrist BP cuff and when I came back a week later to tell him my BP was usually normal and I wasn't talking the meds I calibrated it against his office meter. Sure enough both devices had my BP at 150/90
to within 5mmHg
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Old 03-23-2011, 08:53 AM   #52
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At a recent physical my BP was 160/95 and my doctor wanted to get me on a hypertension medication. I knew it was a one off due to nervousness, but he insisted.
It was the opposite for me. I told the doc that my BP (132/?) was artificially low because I had lifted weights an hour before the exam, but he still treated it as if it were my normal BP.
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Old 03-23-2011, 09:12 AM   #53
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My blood pressure is usually pretty low, but I tell the nurse it's because I'm near death because I've had no coffee...
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Old 03-23-2011, 11:00 AM   #54
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But then, maybe I worry too much.
I think there is a prescription that can help with that!
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Old 03-23-2011, 11:14 AM   #55
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I think with Lipitor and many other drugs for chronic illness, the crux is how much possible benefit has been shown in absolute terms, and how to weigh that against long term ingestion of a powerful drug with known and perhaps unknown side effects.

A helpful book I read is "Worried Sick", by Nortin Hadler, MD, a rheumatologist from UNC with many published papers.

He cites what he says (as of 2008) is the most posiitve large, well designed study, the West of Scotland Study. Then he examines what benefits might be expected in the best case (young to middle aged men), for a person who has not had a previous heart attack.

While possible benefit is there, it does not amount to much. And it likely amounts to less if you are female, or over 65 or 70. A person who is already compromised is in a different category, but Hadler insists that uprating one's categorical risk should not be done solely on the basis of test readings.

I believe many people take statins largely to keep their doctor from getting angry with them.

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Old 03-23-2011, 11:41 AM   #56
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I think there is a prescription that can help with that!
Alas, I put the pharmaceutical commercials on "mute" as swiftly as possible. If I didn't, I would know about such a drug and could badger and pester and push my doctor for such a prescription.
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Old 03-23-2011, 12:10 PM   #57
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One other aspect for men, if you lower your cholesterol too much with statins, it can negatively affect your bodies ability to produce testosterone.
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Old 04-01-2011, 10:39 AM   #58
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Well, I decided to nerd out and read the Cochrane review on use of statins for primary prevention of heart disease. I like Steve Novella's discussion of the review here: Science-Based Medicine » Statins – The Cochrane Review I could have just read his article instead.

As Novella says, there is good evidence that statins substantially reduce risk when you already have had a heart attack (secondary prevention). But if your risk of vascular events is low of course the benefits of taking a statin are not going to be as pronounced. After all, your risk already is low. Nevertheless, there is was a reduction in death and in vascular events in people who had no prior vascular events. And statins were no more risky to take than a placebo. Because people are on a continuum of risk a person has to see where they fall to judge if they should take statins. Given that the cost of statins have dropped tremendously that also effects the cost/benefit analysis. The big controversy from the Cochrane review is that the data actually supports use of statins for primary prevention but the authors were nevertheless pretty negative on the use of statins for primary prevention, from a cost/benefit standpoint, maintaining the effect size is too small to be worth it. This has lead to some people concluding that statins do not work when the data shows that they do. Just maybe not to the extent that the drug companies would want you to believe.

So, I'm staying on the statins.
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Old 04-01-2011, 11:02 AM   #59
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I generally agree with Martha's summary. But questions remain: which lipid profiles do and don't benefit (e.g. low HDL alone improves with atorvastatin but the outcome data are unclear if the LDL is normal); the muscular side-effects (myopathy) may be more prevalent than reported and are of uncertain implication long term.

Overall I do not support their use in primary prevention, and do recommend them for properly selected patients at risk using a pretty low threshhold to treat.
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Old 04-01-2011, 11:04 AM   #60
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So, I'm staying on the statins.
Me too, but with my insurance I only have to pay about $35/month to do so. One reason I'm staying on the statins is that the cost is not much for me, and my mother lived to age 98 on statins so that demonstrates to me that they are probably had a good or neutral effect on her longevity. Granted, that is just one data point.

Continuing with statins could be a tough decision for those who have to pay the full amount for them.

F. had side effects on statins and is taking a non-statin medication to reduce his cholesterol, but the cost is high for that medication too.
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