The problem with media headlines on pharma is that they are rarely subtle or nuanced, instead they smear and cripple some of our best medications. The latest pronouncement involves some of our best anti-convulsant drugs, which have now raised alarms because they have significantly increased suicide risk.
The review of close to 300,000 cases, was published in the Journal of the American Medical Association and it is likely to cause a reluctance to prescribe two of the popular drugs cited, neurontin and lamictal.
Unfortunately, both of these drugs have important uses in medical practice that now may be put at risk. Neurontin is a very versatile treatment for everything from mood disorders, peripheral nerve problems and pain syndromes. It is mostly well tolerated except for drowsiness, and many patients find that it is the only drug that works for them. Lamictal is one of the most effective mood stabilizers and anti-seizure drugs available. Fear could cripple it, which would be tragic for those who benefit greatly from its use.
Whenever one of these observational studies comes out, and the FDA tightens its belt and issues a warning or a restriction, I receive calls from all my patients on the drug wondering whether they should stop it. Rather than having the ability to make a determination on a patient by patient basis, I am pressured into an all or none situation. Patients have been led to believe by the media that either a drug will kill them or it will save them. The media is a powerful force for doctors to have to contend with. Marc Siegel, MD, is an internist and professor of medicine at New York University and the author of False Alarm: The Truth About the Epidemic of Fear