Part of a series on WDDTY’s “free” advertorial report “100 ways to live to 100“
10 drugs to avoid whenever possible
WDDTY frame this with a truly staggering statement of faith:
After 24 years of publishing WDDTY, we’re still searching for one single drug out there besides antibiotics that actually cures something. We still haven’t found one. Virtually all drugs are for maintenance—that is, they manage, ease or suppress symptoms, but they do not cure. In spite of assurances from the pharmaceutical industry that drugs can target certain receptors in the body with laser-like accuracy, the fact is that many unrelated systems in the body have identical receptors—which is why drugs invariably affect other parts of the body indiscriminately and cause side-effects.
There is a better, alternative solution to virtually every chronic health problem except emergency medicine, which is where orthodox medicine comes into its own. If you’ve been shot, stabbed or run over, or suffer a heart attack or stroke, then modern Western medicine is without parallel for fixing you. In those cases, get to a hospital without fail. Otherwise, here are the10 drugs you might be better off avoiding. In no particular order:
We’re pleased to be able to help WDDTY out here. Again, since this is not the first time WDDTY have made this claim.
- Tetanus antitoxin cures tetanus.
- Antimalarials cure malaria.
- Chemotherapy cures liquid tumours especially in children.
- Antivenins cure venomous bites.
But why exclude antibiotics? Not only are they the best known and least ambiguous example of drugs that cure, but WDDTY also disputes their utility. The exclusion of this class of drugs seems to be capricious and specifically designed to assert that, excluding the vast number of illnesses they can cure, doctors can’t cure anything. Of course, unlike quacks, doctors don’t claim to cure disease unless they actually can, but n the end this reminds us of something:
But ultimately this is a categorical fallacy. Think for a moment: what is the definition of a chronic disease? It’s one that cannot presently be cured. A hundred years ago, syphilis was a chronic disease. Now it’s not. So WDDTY are taking a class of diseases defined by the fact that medicine cannot currently cure them, and asserting that, shockingly, medicine cannot cure them.
Is maintenance and management of symptoms necessarily a bad thing? Ask a type I diabetic or an asthmatic.
Are there better alternative solutions to “virtually every chronic health problem”? No. Minchin’s Law applies: these things are alternative because they have not been demonstrated to be better. In most cases they haven’t been demonstrated to be as good. Many of them don’t work at all, and several are actively harmful.
These can cause cancer and definitely cause muscle weakness.
So they might, but the benefit outweighs the risks according to large studies.
A meta analysis of randomised controlled trials found:
Conclusion In patients without established cardiovascular disease but with cardiovascular risk factors, statin use was associated with significantly improved survival and large reductions in the risk of major cardiovascular events.
WDDTY has a long-standing agenda against statins, leading to its promotion of the idea that cholesterol is OK as long as it’s the “good” kind, but this is mainly arguing backwards from ideological opposition to statins. As always, the NHS has more nuanced and more accurate information.
72 Prozac and other antidepressants
These can cause rebound anxiety, suicide and addiction, and have been sold to us on a faulty premise—there is no brain chemical imbalance to fix.
This is pure propaganda. Antidepressants and antipsychotics have a role in the management of acute disease, and trying to tough it out without them can and does lead to suicide.
Epidemiological analysis shows that SSRIs reduce suicide rates. There is a specific problem with use in children, but it’s uncertain whether this balances out or not – however, this does not undermine the conclusion that:
[T]he strongly positive results of the TADS study indicate that medication treatment is vital for effective treatment of adolescent depression. With the confusing results of studies to date, fluoxetine is a good first choice for antidepressant treatment of adolescents. However, there may be reasons that clinicians choose to start other antidepressants instead. For instance, adolescents with a good prior response to another antidepressant, who are currently on another antidepressant with good response, or who have a history of poor response to fluoxetine, would probably be started or stay on another antidepressant.
In other words, follow the data not the dogma.
73 Tumour necrosis factor (TNF)-blocking drugs
Meant to replace painkilling COX-2 inhibitor drugs, they’ve been linked to tuberculosis and cancer.
Having “been linked to cancer” is a standard WDDTY weasel phrase. Yes, there is a plausible link between TNF inhibitor|TNF inhibitorsW and cancer. This applies to both synthetic drugs and natural TNF inhibitors such as curcuminW, catechins and canabinoids.
As with any effective treatment, it’s a question of risks versus benefits.
74 Atypical antipsychotics
These next-generation drugs, classed as the ‘new’ antipsychotics, include olanzapine (Zyprexa), quetiapine (Seroquel) and risperidone (Risperdal). Studies show they’re no better than the older variety, and may cause Alzheimer’s disease and hasten mental decline in the elderly. They also cause sexual dysfunction and depression, and so make any psychiatric condition worse.44
Reference 44: Clin Neuropharmacol. 2005 May-Jun;28(3):111-4. Use of ziprasidone in parkinsonian patients with psychosis. Gómez-Esteban JC, Zarranz JJ, Velasco F, Lezcano E, Lachen MC, Rouco I, Barcena J, Boyero S, Ciordia R, Allue I.
A source at last! So what does it say?
Twelve patients with Parkinson disease and psychosis were included in an open-label 12-week trial of ziprasidone. Two patients withdrew from the treatment because of adverse effects. The remaining 10 patients reported a significant improvement in psychiatric symptoms. Altogether, there was no deterioration of motor symptoms (UPDRS III score: basal 40.4 +/- 11.1, first month 41.1 +/- 10.8; final visit, 37.7 +/- 13.3). Two patients (20%) suffered a slight deterioration in motor symptoms and another patient suffered deterioration of gait. No analytic alterations or serious adverse effects that could limit the use of ziprasidone were observed. Although controlled trials are needed, the findings suggest that ziprasidone may be effective in parkinsonian patients with psychosis.
Is it just me, or does that say pretty much the opposite of what WDDTY claim? Be in no doubt: ziprasidoneW is an atypical antidepressant, the fifth such to be licensed by the FDA.
This is unusually dishonest even by WDDTY’s standards: the paper supports the use of the drug in Parkinson’s sufferers, but this is spun as a recommendation against it.
75 Anticholinergic drugs
These have a long list of side effects, including dementia.
This is not specific to anticholinergicW drugs, but to anticholinergics generally, including plants of the solanacae family, henbane and mandrake.
They also have a long list of beneficial effects. They suppress muscle spasms, for example, so are often used in gastritis and ulcerative colitis. But the major source of adverse reactions appears to be in recreational drug users, not least because medical use tends not to be long-term. One of the better known anticholinergics is butylscopolamineW, marketed under trade names such as Buscopan, which is used to control stomach cramps. It tends to be used episodically and not chronically.
These osteoporosis drugs can halt bone loss, but they’ve also been linked to high rates of atrial fibrillation, a heart-rhythm disorder that can lead to stroke.45
Reference 45: N Engl J Med, 2007; 356: 1809–22: Once-Yearly Zoledronic Acid for Treatment of Postmenopausal Osteoporosis, Black et. al.
RESULTS: Treatment with zoledronic acid reduced the risk of morphometric vertebral fracture by 70% during a 3-year period, as compared with placebo (3.3% in the zoledronic-acid group vs. 10.9% in the placebo group; relative risk, 0.30; 95% confidence interval [CI], 0.24 to 0.38) and reduced the risk of hip fracture by 41% (1.4% in the zoledronic-acid group vs. 2.5% in the placebo group; hazard ratio, 0.59; 95% CI, 0.42 to 0.83). Nonvertebral fractures, clinical fractures, and clinical vertebral fractures were reduced by 25%, 33%, and 77%, respectively (P<0.001 for all comparisons). Zoledronic acid was also associated with a significant improvement in bone mineral density and bone metabolism markers. Adverse events, including change in renal function, were similar in the two study groups. However, serious atrial fibrillation occurred more frequently in the zoledronic acid group (in 50 vs. 20 patients, P<0.001).
The question then would be: are you better off suffering a hip fracture due to untreated osteoporosis, or atrial fibrillation, which may or may not result in a stroke?
WDDTY claims to be all about informed choice, but by giving only a tiny subset of the information, they actively impede a properly informed choice. It’s about as much use as advising everybody never to leave the house in case they get knocked over crossing the road.
It’s the ultimate just-in-case lifestyle drug, taken to ward off heart disease and stroke, but it actually increases the risk of stroke sevenfold.46 It can also cause serious gastrointestinal bleeding. Other NSAIDs now carry warnings regarding their cardiovascular and gastrointestinal risks—and guess what? They haven’t been proven to reduce inflammation.
Reference 46: Lancet Neurol, 2007; 6: 487–93 Change in incidence and aetiology of intracerebral haemorrhage in Oxfordshire, UK, between 1981 and 2006: a population-based study. Lovelock CE, Molyneux AJ, Rothwell PM; Oxford Vascular Study.
This is a long-term study of stroke risk which finds that in the over-75s long term use of antithrombotics (aspirin) is associated with an increase in stroke incidence. This is most likely to be based on a population with higher dosages, as the prophylactic dose recommendation has reduced over time.
Reliable sources support low dose aspirin as a prophylactic against heart disease and stroke, unreliable sources promote more aspirin (mainly out of date) or none (WDDTY and other natural-woo promoters).
The Mayo Clinic has a useful reference. One interesting point that WDDTY didn’t make is that if you’re already taking aspirin daily, stopping can cause a rebound effect and actually trigger a stroke. Let’s hope nobody suffers a stroke after following WDDTY’s advice and sues them.
The important thing to remember is that a paediatric dose confers most of the benefit, but most of the risk studies refer to an adult dose, two to four times as great. As always discuss it with your doctor, not some anti-medicine crank.
78 HRT and the Pill
Their cancer connections are finally indisputable, even though drug companies keep fighting the evidence.
We already covered HRT. The pill? WDDTY really are becoming more reactionary over time.
- There’s a small increase in risk of breast cancer, which reduces when you stop taking the pill and returns to normal by 10 years after you stop taking it.
- There’s an association with cervical cancer, likely to be down to the fact that cervical cancer is rarely seen in women whoa re not sexually active.
- There’s a reduction in the risk of ovarian cancer, and the longer you take the pill the lower the risk gets.
- There’s a reduction in cancer of the uterus which lasts for around 15 years after you stop taking the pill.
- There may also be a reduction in bowel cancer.
Oh, and you tend not to get pregnant.
Your doctor knows all this, it’s safe to take your doctor’s advice rather than the ideological nonsense form WDDTY.
79 Antiepileptic drugs
These can lead to suicide and also cause potentially fatal liver failure. Many of the newer ones like Keppra (levetiracetam), Topamax (topiramate) and Sabril (vigabatrin) increase the risk of depression and suicide or self-harm threefold.47
Reference 47: Neurology. 2010 Jul 27;75(4):335-40. Use of antiepileptic drugs in epilepsy and the risk of self-harm or suicidal behavior. Andersohn F, Schade R, Willich SN, Garbe E.
Once again, WDDTY misrepresents the source. Here’s what it actually says:
Newer AEDs with a rather high frequency of depressive symptoms in clinical trials may also increase the risk of self-harm or suicidal behavior in clinical practice. For the most commonly used other groups of AEDs, no increase in risk was observed.
So: older AEDs do not increase the risk of suicide. Newer ones might, so doctors should be on the lookout for symptoms of depression. Which may well be partly due to the well documented tendency of practitioners to be more conservative and report more adverse reactions in new drugs than for well understood ones, where they know that symptoms are unlikely to be directly related. Nothing to see here, move along please…
It’s hard to express how inappropriate it is to issue a blanket warning against antiepileptic drugs based on a misrepresentation of early studies on an entirely new class of drug that’s only recently entered clinical practice.
80 Zetia and other second-generation cholesterol-lowering drugs
Not only do these drugs not work, but they’re also hard on the liver.
We totally understand: cholesterol is natural so trying to control it is evil. Heart attacks are natural too, as is dying by the age of 40.
NICE don’t endorse ezetimibeW other than in cases where statins are not well tolerated, or as an adjunct to statins where cholesterol remains stubbornly high. It’s a relatively new class of drug and the evidence base is changing fairly quickly. Your doctor should be reading up on this, so it’s worth discussing the findings of ENHANCE and, when published, IMPROVE-IT with your doctor. As always, the advice form your doctor is likely to be evidence-based not ideology-based like WDDTY.
Cholesterol levels are a proxy marker and the jury is still out on whether reducing cholesterol levels is a valid end in itself; however, the outcome of statin trials does indicate a significant reduction in cardiac events so it does seem likely.
Errata and corrections:
- Thanks to Andrew Crysell for spotting a schoolboy howler in the first section, fixed on 27/12/2013