Category: Pharmaceuticals

Pictured: The accepted theory of how cholesterol forms arterial plaques.

Cholesterol Skeptics Strike Again

I’m really tired of arguing about cholesterol, but I feel obliged to stand up once more to defend science-based medicine from unfair calumny. Lewis Jones’s article “Cholesterol-shmesterol” in Skeptical Briefs (December 2007) included errors and misconceptions about cholesterol. It was a re-hash of the same kind of misinformation that is being spread by The International Network of Cholesterol Skeptics (THINCS) and that...

/ October 9, 2008

Polypharmacy – Is It Evidence-Based?

Polypharmacy essentially means taking too many pills. It’s a real problem, especially in the elderly. A family doctor gives an elderly patient one pill for diabetes, another for high blood pressure, and another to lower cholesterol. The patient sees a rheumatologist for his arthritis and gets arthritis pills. Then he sees a psychiatrist for depression and gets an antidepressant. He takes a...

/ August 12, 2008

Can Psychosis be Prevented?

I recently read an article in Discover magazine entitled “Stop the Madness.” It was about a new treatment program that allegedly can prevent schizophrenia and other forms of psychosis. I found it very disturbing. The PIER (Portland Identification and Early Referral) program was founded by a psychiatrist, Dr. William McFarlane, in Portland, Maine. It has recently expanded to 4 other US sites...

/ July 22, 2008

Forks in the road

It’s been decades since the onslaught of organized quackery began against science and reason. Although most physicians are still capable of reasoning, the percentage of medical graduates whose brains have been cleansed of that ability seems to have increased. Either the brains have been cleansed or they have learned to coexist with unreason and to use both functions simultaneously. The latter is...

/ June 12, 2008

Reading Medical Literature with a Critical Eye

A long time ago I read a study about what makes a good doctor. Some things you might think were important, like grades in medical school, were irrelevant. What correlated the best was the number of medical journals a doctor read. I don’t know whether that means good doctors read more journals or reading more journals makes a better doctor. One thing...

/ May 20, 2008
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Hormone Replacement Therapy

The Women's Health Initiative revealed new risks about hormone replacement therapy, and now the media (and doctors) are scrambling to understand what it means. Of course, because this is medicine, it's complicated.

/ April 1, 2008

Do Antidepressants Work? The Effect of Publication Bias

A recent meta-analysis of the most commonly prescribed antidepressant drugs raises some very important questions for science-based medicine. The study: Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration, was conducted by Irving Kirsch and colleagues, who reviewed clinical trials of six antidepressants (fluoxetine, venlafaxine, nefazodone, paroxetine, sertraline, and citalopram). They looked at all studies...

/ March 12, 2008

A Foolish Consistency

A foolish consistency is the hobgoblin of little minds, adored by little statesmen and philosophers and divines. — Ralph Waldo Emerson (1803–1882) It is odd isn’t it? Large numbers of quality studies published in the best peer review journals consistently showing the same or similar effect and no contradictory studies. Despite the emphasis on evidence-based medicine, the entire literature is dismissed as...

/ February 28, 2008

Proposed Changes to FDA Regulation Present a Dilemma

The Food and Drug Administration (FDA) is proposing a very interesting loosening of their regulations of pharmaceutical company marketing. The pros and cons of the proposed changes present an interesting dilemma, with legitimate points on both sides. When the FDA approves a drug it is approved for a very specific medical indication. I have long thought that FDA approved indications for drugs...

/ February 20, 2008