Health Tip: Birth Control Pill Side Effects

(HealthDay News) -- Birth control pills contain hormones that prevent the woman's ovaries from releasing eggs -- a process called ovulation.
In many women, the pill causes side effects, which often clear up in two or three months, says Planned Parenthood.

It lists these common side effects of birth control pills:

• Bleeding between periods.
• Sore breasts.
• Nausea and vomiting.
• Changes in libido.
• If you have these side effects for more than three months, consult your doctor, Planned Parenthood advises.

Aspirin Doesn't Prevent First Heart Attack, Stroke

(HealthDay News) -- Contradicting current recommendations, a new trial finds that aspirin does not reduce the risk of heart attack and stroke for people with diabetes or peripheral arterial disease.

Aspirin clearly is effective in secondary prevention, reducing the risk for people who already have had a heart attack or stroke, said study author Dr. Jill Belch, a professor of vascular medicine at the University of Dundee in Scotland. Her report was published in the online issue of the BMJ.

However, in the study of 1,276 people who had not yet suffered a heart attack or stroke but were at high risk because they had diabetes or peripheral arterial disease (partial blockage of leg arteries), "we found that they did not benefit from daily aspirin," Belch said. The study showed that aspirin is ineffective in primary prevention, she noted.

"The number of heart attacks and strokes was exactly the same over eight years for those taking aspirin and those taking placebo," Belch said.

The same was true of the antioxidants given in the trial, she said, which was no surprise. "All the antioxidant studies over the past 10 years have been negative," Belch said.

Both the American Heart Association and the U.S. government recommend aspirin for people who have not had heart attacks or strokes but are at high risk for cardiovascular trouble because of conditions such as diabetes.

Those recommendations probably should be changed, said Dr. William R. Hiatt, a professor of medicine at the University of Colorado, who wrote an accompanying editorial.

The newly reported study "is consistent with six other studies on primary prevention, and all those studies were negative," Hiatt said.

The current recommendations are based on analysis of studies that found some primary prevention benefit in subgroups, he said. "Overall, if you do not have heart disease, the risk of bleeding outweighs any benefit you get from aspirin," Hiatt said.

The U.S. Preventive Services Task Force recommendation for use of aspirin in people at high risk of heart disease cited five studies that included 50,000 people. But its report noted that "no trial showed a significant all-cause mortality difference between aspirin-treated and control groups."

Hiatt said that he served on an advisory committee of the U.S. Food and Drug Administration that reviewed a request in 2003 by Bayer to extending the labeling of aspirin to include primary prevention in heart disease. "We couldn't support that request," he said.

Advertisements urging people to take aspirin to benefit the heart are accurate for those who already have had an event, both Belch and Hiatt said.

"It works if you've already had a heart attack," Belch said. "But there is no proof for primary prevention, no proof at all."

"The evidence is solid that aspirin should be given to people with known heart disease," Hiatt said. "But the evidence for people who have risk factors for heart disease is different."

More information
Risks and possible benefits of aspirin for the heart are reviewed by the U.S. Food and Drug Administration.

New drug for menopause being tested

An experimental menopause treatment was shown to reduced hot flashes, trouble sleeping and other symptoms, while reducing breast tenderness and possibly protecting against breast cancer breast cancer. full story

Salvia Divinorum: Could Hallucinogenic Drugs Have Healing Properties?

By Andrea Useem

In a popular article this week, The New York Times reported on the rash of online videos showing teenagers smoking the hallucinogenic drug derived from leaves of the plant Salvia divinorum. In this video (warning: it has a fair amount of profanity), a girl named Shannon takes one hit from a bong and appears overwhelmed; she’s unable to talk and extremely disoriented. Minutes later, as the effects wear off, she says she feels scared and would not do it again.

Clips like that are hardly an advertisement for the drug, which can be legally bought online. Some states, however, have passed laws ranging from limits on possession to making Salvia illegal. But the video accompanying the Times’s article also shows another kind of user. On camera, a 29-year-old father from Waco, Texas, identified only as Nathan, smokes a pipe of Salvia, then appears to enter a state of meditation while reclining peacefully in a chair. The drug, he says, “awakens something inside you that is greater than yourself.” Read More
Pages: 1 2

Later Use of Clot-Buster After Stroke Possible: Study

(HealthDay News) -- European researchers who showed that the clot-dissolving drug tPA could safely be used within three hours after a stroke now say the limit can be extended to four-and-a-half hours.

"We now have a three-hour limit mandated by authorities," said Dr. Nils Wahlgren, a neurology professor at the Karolinska Institute in Sweden and leader of an international group reporting Sunday in the online version of The Lancet. "Our data indicate that it is safe to extend that from three hours to four-and-a-half hours. The risk of hemorrhagic complications is not significantly different from the earlier time limit."

Tissue plasminogen activator (tPA), also known as the drug alteplase, is the approved treatment for the most common kind of stroke, in which a blood clot blocks a brain artery. The three-hour post-stroke time limit has been set because of fears that use of the clot-dissolving drug beyond that period might cause dangerous bleeding or other complications.

The new report is the latest from a study requested by European authorities after doubts arose about the safety of tPA in stroke treatment, which was approved in 1996 by the U.S. Food and Drug Administration. It was approved in 2002 in Europe.

The study compared the outcomes of 664 people who were given tPA between three and four-and-a-half hours after a stroke against almost 12,000 who received the drug within three hours of an attack.

The study found a death rate of 12.7 percent in the following three months for the three-hour group and 12.2 percent for those getting tPA later. In the early group, 58 percent achieved the ability of independent action, compared to 56.3 percent in the later-administration group.

"We recorded no significant differences between the 3- to 4.5-hour cohort and the within 3-hour cohort for any outcome measure," the researchers reported.

The bottom line, according to Wahlgren: "if patient treatment has been delayed, it is still safe to treat a patient beyond the time limit of three hours."

The results were expected to be presented at an international meeting in Stockholm in November, "when we will recommend a change in the guidelines," Wahlgren said. "I expect it would be accepted by the international community, both in the United States and Europe, and in the rest of the world."

But the new results do not necessarily mean an end to the three-hour limit, cautioned Dr. Larry Goldstein, professor of neurology at Duke University and director of the Duke Stroke Center in Durham, N.C.

"They are consistent with a combined analysis done some time ago that suggested we might be able to treat beyond three hours," Goldstein said. "But those were observational studies, as was this one. Controlled trials done to test that belief have not shown benefit."

It will take a change in the current guidelines to alter the three-hour limit, he said, and the overall benefit of tPA is greater when it is given earlier. "The sooner you get blood to the brain, the better," Goldstein said.

More information
There's more on tPA at the American Heart Association.

Antipsychotic Drugs Boost Stroke Risk

(HealthDay News) -- All antipsychotic drugs can increase the risk of stroke, but the risk is greatest among older patients with dementia, British researchers report.

Concerns about the risk of stroke and antipsychotics were first raised in 2002, especially in people with dementia. In 2004, Britain's Committee on Safety of Medicines recommended that antipsychotics not be used in people with dementia. And, in 2005, the U.S. Food and Drug Administration ordered manufacturers of atypical antipsychotics to add a black box warning to their products about the increased risk for stroke.

"Antipsychotics are effective in treating potentially very distressing psychiatric symptoms, but as with all drugs, their use can be associated with a range of benefits and possible side effects," said study author Dr. Ian Douglas, a research fellow at the London School of Hygiene and Tropical Medicine. "This study has further clarified the potential for antipsychotics to increase the risk of stroke."

Both typical (first generation) and atypical (second generation) antipsychotics are associated with an increased risk of stroke, Douglas said. "This risk is substantially higher in patients with dementia than those without. These findings need to be factored into prescribing decisions made by doctors caring for patients with often-distressing and difficult-to-treat psychiatric symptoms."

For the study, Douglas and his colleague Liam Smeeth, a professor of clinical epidemiology, collected data on 6,790 patients who had suffered a stroke and were taking antipsychotic drugs. Patients taking antipsychotic drugs were 1.7 times more likely to have a stroke, and patients with dementia taking antipsychotics were 3.5 times more likely to have a stroke.

The risk for stroke was slightly higher for people taking the newer atypical antipsychotics, compared with people taking the older typical antipsychotics. Atypical antipsychotics include drugs such as Abilify, Clozaril and Zyprexa. Typical antipsychotics include Thorazine, Haldol and Clopixol.

The study authors did not look at the potential mechanisms associated with antipsychotics that cause stroke, or why the risk appears higher with atypical antipsychotics.

"We believe that the risks associated with antipsychotic use in patients with dementia generally outweigh the potential benefits, and, in this patient group, use of antipsychotic drugs should be avoided wherever possible," Douglas said. "For other patients, careful consideration must be given to the likely individual risks and benefits of any prescribing decision."

The findings were published online Aug. 29 in the British Medical Journal.

Dr. Sam Gandy is associate director of the Alzheimer's Disease Research Center at Mount Sinai Medical Center in New York City, and chairman of the Alzheimer's Association's national medical and scientific advisory council. He said the new study addresses an "important topic and elevates the concern about risks of antipsychotics to a whole new level. The FDA [U.S. Food and Drug Administration] might investigate whether availability limitations or warning labeling should be imposed.

More information
To learn more about antipsychotics, visit the National Institute of Mental Health.

Study: Less talk, more pills from psychiatrists

CHICAGO, Illinois (AP) -- Cartoons about the psychiatrist's couch were recently the subject of a museum exhibition. Now, the couch itself may be headed for a museum.

Psychiatrists who used talk therapy with all their patients prescribed fewer pills, a study found.

A new study finds a significant decline in psychotherapy practiced by U.S. psychiatrists.
The expanded use of pills and insurance policies that favor short office visits are among the reasons, said lead author Dr. Ramin Mojtabai of Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland.

"The 'couch,' or, more generally, long-term psychoanalytic psychotherapy, was for so long a hallmark of the practice of psychiatry. It no longer is," Mojtabai said.

Today's psychiatrists get reimbursed by insurance companies at a lower rate for a 45-minute psychotherapy visit than for three 15-minute medication visits, he explained.

His study found that the percentage of patients' visits to psychiatrists for psychotherapy, or talk therapy, fell from 44 percent in 1996-97 to 29 percent in 2004-05. The percentage of psychiatrists using psychotherapy with all their patients also dropped, from about 19 percent to 11 percent.

A new study finds a significant decline in psychotherapy practiced by U.S. psychiatrists.

The expanded use of pills and insurance policies that favor short office visits are among the reasons, said lead author Dr. Ramin Mojtabai of Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland.

"The 'couch,' or, more generally, long-term psychoanalytic psychotherapy, was for so long a hallmark of the practice of psychiatry. It no longer is," Mojtabai said.

Today's psychiatrists get reimbursed by insurance companies at a lower rate for a 45-minute psychotherapy visit than for three 15-minute medication visits, he explained.

His study found that the percentage of patients' visits to psychiatrists for psychotherapy, or talk therapy, fell from 44 percent in 1996-97 to 29 percent in 2004-05. The percentage of psychiatrists using psychotherapy with all their patients also dropped, from about 19 percent to 11 percent. Continue Reading >>

Is Runner’s High a Religious Experience?

By Andrea Useem

A day after my 35th birthday this spring, I ran my first half-marathon. I expected it to be a grueling physical challenge, and it was. What I didn’t expect was this: Somewhere around mile 10, while listening to a favorite song on my iPod, I experienced a fantastic, expanding sense of joy. I could not restrain myself from reaching my arms up, palms to the sun, to celebrate the sheer pleasure of being alive and propelling myself forward through the humid morning air.

There is a quick diagnosis for my condition: runner’s high, a state that the latest research shows is related to the release of endorphins, the body’s natural opiate. While both runners and researchers have compared the experience of runner’s high to doing street drugs, my own moment in the sun felt more like feelings I have had while praying or meditating. Read More

Kiddie Cholesterol: Would You Put Your Child on a Statin Drug?

By Theresa Tamkins

My daughter, Veronica, is 6. She loves to dance, is a budding gymnast, and hates that she’s the tiniest girl in her class. She also has high cholesterol. A recent test found that her total cholesterol rivals that of a 50-year-old man’s—206 mg/dl.

Apparently, she’s not alone. The American Academy of Pediatrics (AAP) is so concerned about high cholesterol in kids that they issued new guidelines on Monday—the first in more than a decade on kids and cholesterol. The guidelines are in the July issue of the journal Pediatrics. Read More

Viagra for Sports Other Than Sex?

The New York Daily News reported the other day that off-label Viagra use has become “bigger than creatine” among athletes and bodybuilders looking for an extra power boost—one that’s not banned from competitions, at least so far, as steroids are. So I called up Health.com’s Erectile dysfunction (ED) expert, urologist Ridwan Shabsigh, MD, to get his take. Read More

Chemotherapy Has Turned Me Into a Bloodhound

Cancer drugs scramble the signals that the nose and tongue send to the brain, with bizarre results by Jason Carpenter

When one of the doctors offhandedly mentioned that my sense of taste or smell could be affected by the high-dose chemotherapy treatments I was getting in my battle against multiple myeloma, I didn't pay much attention. Not until I found I could detect the slightest whiff of anything from 20 feet. Not until anything I put in my mouth had a taste so intense that I vomited every meal for two weeks.

It was a horrible cycle that I could not break: When a meal came back up, it smelled awful and made me puke more. My mom, who spent some time at the hospital with me and at my house after I was discharged, developed a two-puke-pan routine: She would remove one pan on my command, then slip another one under me so I didn't have to endure the output.

While in the hospital, I developed a vomit association with just about everything the institution stocked for supplies: bathroom soap, hand soap, paper towels, hand sanitizer, toilet paper, and even facial tissue (I could smell tissues rippling in the air across the room). Clearly, some of this was in my head, but a good portion of it was not, according to breastcancer.com.

Thirty-two days after my transplant, I cannot smell hospital supplies without gagging. Because I need to constantly disinfect my hands and face (trying to banish germs that could attack my weakened immune system), I've had to switch to neutral-smelling antibacterial baby wipes. Things are somewhat better: I gag but don’t usually vomit, though I do risk hurling on my laptop just writing this down. I'm told this will slowly ebb over the next weeks or months.

Even my sense of touch has been affected. For the first few post-op visits to the hospital, I nearly jumped out of my skin with pain when the nurse drew blood. I have had my blood drawn hundreds of times, and it's never hurt like this. The nurse noticed and said, "Your nerves are sensitive because of the chemo. It's completely normal."

Normal, my ass. I'm a bloodhound; my food tastes as if someone turned the volume to 11; and I screech like a little girl when I have my blood drawn. But I’ll say it again: I'll take all these wacky side effects over cancer.

As to my progress, I went to the doctor today and my white blood count is back up to 4.1 (close to the low end of normal), my platelets are good, and my red blood cells are charging back. The doctor is so pleased with my recovery that I don't need to see her for three weeks. She even said that I can start to ease the restrictions of being around people. Which means I’m planning to play poker again, tonight, latex gloves and all.

See Jason Carpenter's ongoing video postings about his life with cancer. Warning: Some expletives.

Stem Cell Transplant Update: Advice On Hair Falling Out

The Feel-Good-Enough Drugs

Antidepressants are widely prescribed because they restore balance. But balance isn’t happiness
by Walter Armstrong

I’ve been taking antidepressants since 1994. That may seem like a long time, but since I expect to pop these pills every morning until I die, I’ve stopped keeping count. You could say I’m reconciled to the fact that I was born with bad brain chemistry and need a little extra push to reach that state familiar to everyone but the chronically depressed as well-being. I like it there and have no intention of leaving.

I remember vividly the moment when Prozac first kicked in, like switching from black-and-white to color. I was talking on the phone to a friend who was telling me about her problems, which included taking care of a husband who was dying of AIDS. I heard in the familiar tone of her sad voice how hopeless she felt, but for the first time it failed to find an echo inside me. I proceeded to deliver my first-ever pep talk to her, with all the annoying sincerity of a fresh convert to hope.

The novelty wore off soon enough.
Continue reading "The Feel-Good-Enough Drugs" »

Quit-Smoking Drug May Raise Suicide Risk

(HealthDay News) -- There's increasing evidence that the smoking-cessation drug Chantix is linked to serious "neuropsychiatric" side effects, including agitation, depressed mood and even suicide, U.S. health officials said Friday.

The U.S. Food and Drug Administration has asked Chantix's manufacturer, Pfizer Inc., to make the warning about these potential problems more prominent on prescribing information and on the drug's label. The agency is also working with Pfizer to produce a Medication Guide for patients, officials said.

"We have become increasingly concerned as we have seen a number of compelling cases that truly look as if they are the result of exposure to the drug and not to other causes," Dr. Bob Rappaport, director of the FDA's Division of Anesthesia, Analgesia and Rheumatology Products, said during an afternoon teleconference.

"These cases involve abnormal behaviors, changes in mood, and suicidal ideation and suicide," Rappaport said.

The FDA knows of 491 cases of suicidal behavior associated with Chantix, said Dr. Celia Winchell, a team leader in the FDA's Division of Anesthesia, Analgesia and Rheumatology Products.
"Of these, 420 are from the United States," Winchell said. "There are 39 that involve completed suicides, 34 in the United States."

According to Pfizer, 5 million patients have taken Chantix, whose generic name is varenicline.
Friday's warning follows a Nov. 20 FDA statement that the agency was "evaluating post-marketing adverse event reports on Chantix related to changes in behavior, agitation, depressed mood, suicidal ideation, and actual suicidal behavior."

At that time, Pfizer said there had never been a cause-and-effect relationship shown between Chantix and these symptoms. The company also said that part of the problem may be due to nicotine withdrawal.

Last month, Pfizer agreed, after consulting with the FDA, to update packages of Chantix sold in the United States to more prominently display a warning that users should be monitored for suicidal behavior, depressed mood, and other mental health symptoms.

The FDA approved Chantix in May 2006 as a smoking-cessation drug. It acts in areas of the brain affected by nicotine and may ease withdrawal symptoms and block the effects of nicotine if users resume smoking.

On Friday, FDA officials advised patients to tell their doctor about any history of psychiatric illness before starting Chantix. The drug can cause current psychiatric illness to get worse even if it is under control. Chantix may also cause the recurrence of an old psychiatric illness, the officials warned.

Patients should also report changes in mood and behavior to their doctor. Symptoms to look out for include anxiety, nervousness, tension, depressed mood, unusual behaviors and thinking about or attempting suicide, the FDA officials said.

In most cases, these symptoms developed while taking Chantix, but they can also appear after stopping the drug, the officials noted.
"We are continuing with the review process over the next several months as we try to pin down to what extent these problems are being seen with Chantix," Rappaport said.

Vivid, unusual, or strange dreams may occur while taking the drug. Patients may also experience impaired ability to drive or operate heavy machinery, the officials said.

More information
For more on quitting smoking, visit Smokefree.gov.

New Drug No Substitute for Standard Blood-Clot Therapy

(HealthDay News) -- Three studies on the new anti-clotting medication idraparinux found the drug was effective at treating deep vein thrombosis (DVT) and for the long-term prevention of blood clots. But it was not as effective as the usual treatment for potentially life-threatening pulmonary embolisms.

And, with long-term use, idraparinux appears to have a higher rate of serious bleeding complications than standard therapy.

"This wish to find new anti-coagulants (anti-clotting medications) is urgent," said lead researcher Dr. Harry Buller, chairman of the department of vascular medicine at the Academic Medical Center in Amsterdam, the Netherlands. "Our conclusion in the DVT study was that it was a good alternative. For pulmonary embolism, idraparinux was not as good as standard therapy."

And, Buller said, in the study that compared idraparinux to standard therapy for preventing the formation of new blood clots, the new drug was effective, but "there is a bleeding risk that is too high."

"Clearly, this drug in its present form won't come to the market," said Buller, who added that the drug's manufacturer, Sanofi-Aventis, is working on the medication and adding a biomarker to the drug so it could be quickly removed from the system if a complication such as excessive bleeding occured.

Sanofi-Aventis provided support for all three studies.

Buller said that in western societies, about two to four people per every 1,000 develop either a deep vein thrombosis or pulmonary embolism each year. That means that hundreds of thousands of people in the United States experience these problems each year, he said.

The current treatment regimen includes intravenously delivered or injections of the blood-thinner heparin, followed by six to 12 months of warfarin, an oral anti-coagulant. The currently available treatments are effective but necessitate careful monitoring and require patients to modify their diets and watch what medications they take to prevent complications.

"We wanted to find a medication that was a little safer, more patient-friendly and that could improve the quality of life," Buller said.

Two of the studies, published in the Sept. 13 issue of the New England Journal of Medicine, compared the use of idraparinux to standard therapy (heparin, followed by warfarin) for both DVT and pulmonary embolisms.

The DVT study included 2,904 people, and the pulmonary embolism study had 2,215 participants. In each group, the study volunteers were randomly chosen to receive either once-weekly injections of idraparinux or heparin, followed by three to six months of warfarin therapy.

The incidence of recurrence in the DVT group was 2.9 percent for those on idraparinux compared to 3.0 percent for those on standard therapy. In the pulmonary embolism group, the rates of recurrence were 3.4 percent in the idraparinux group versus just 1.6 percent in the usual treatment group.

Buller said that the frequency of recurrence in the standard therapy group was extremely low -- much lower than would normally be expected -- in the pulmonary embolism study.

"We've never seen this low frequency in studies. It's always around 3 to 4 percent," said Buller, who believes that this is likely a chance finding.

The third study, also published in the Sept. 13 New England Journal of Medicine, compared the use of idraparinux to a placebo in people who had already completed six months of treatment with either warfarin or idraparinux.

Just under half of the 1,215 people recruited for this study were randomly selected to receive six months of idraparinux, and the rest received a placebo. Just 1 percent in the idraparinux group had a recurrent blood clot, compared to almost 4 percent for those on a placebo. However, those who received an additional six months of idraparinux had a higher incidence of bleeding complications -- 3.1 percent versus 0.9 percent for those on a placebo.

"The long duration of action for idraparinux is a benefit, but it's also a hazard, because there's no antidote," said Dr. Edward L. Amorosi, a hematologist at the New York University Medical Center.

"It appears to be a more effective anti-thrombotic for DVT, but it's not safe enough to make it standard treatment," he added.

Buller said that Sanofi-Aventis is conducting research on pulmonary embolism treatment with a newer version of idraparinux, and that results should be available within a year. The new trial should help answer the question of whether or not the findings in the current pulmonary embolism trial were a statistical anomaly or not, he said.

More information
To learn more about blood clots, visit the U.S. National Library of Medicine.

Some UK Drug Trial Victims Recovering

Earlier this week, I told you about six men who were hospitalized in critical condition following a clinical drug trial conducted in the UK by American drugmaker Parexel. The news is good for two patients, who left a London hospital, after making what doctors called "an excellent recovery."

But it's not so great for the rest of them. One patient remains in critical condition and the rest are making progress, albeit more slowly.

You'd think TeGenero, the company that developed the anti-inflammatory TGN1412, would've paid attention to its own animal studies (the glands of two monkeys became swollen after taking the experimental drug).

Just another reason to consider safer, healthy ways to treat your pain without taking a prescription drug or a "tried and true" over-the-counter remedy like aspirin.

BBC News March 28, 2006
more info at: www.dreddyclinic.com