Monday, June 23, 2008

Who needs the PDR?

Only a few lines in this piece are about acupuncture, but I thought it was worth posting for the subject matter alone.  The thing they do not mention is that the PDR does not include drugs that are off patent, so it is basically a sales rep disguised as an important looking book.

8 drugs doctors wouldn't take
If your physician would skip these medicines, maybe you should, too
By Morgan Lord

With 3,480 pages of fine print, the Physicians' Desk Reference (a.k.a. PDR) is not a quick read. That's because it contains every iota of information on more than 4,000 prescription medications. Heck, the PDR is medication — a humongous sleeping pill. 

Doctors count on this compendium to help them make smart prescribing decisions — in other words, to choose drugs that will solve their patients' medical problems without creating new ones. Unfortunately, it seems some doctors rarely pull the PDR off the shelf. Or if they do crack it open, they don't stay versed on emerging research that may suddenly make a once-trusted treatment one to avoid. Worst case: You swallow something that has no business being inside your body. 

Of course, plenty of M.D.'s do know which prescription and over-the-counter drugs are duds, dangers, or both. So we asked them, "Which medications would you skip?" Their list is your second opinion. If you're on any of these meds, talk to your doctor. Maybe he or she will finally open that big red book with all the dust on it.

Once nicknamed "super aspirin," Celebrex is now better known for its side effects than for its pain-relieving prowess. The drug has been linked to increased risks of stomach bleeding, kidney trouble, and liver damage. But according to a 2005 New England Journal of Medicine study, the biggest threat is to your heart: People taking 200 mg of Celebrex twice a day more than doubled their risk of dying of cardiovascular disease. Those on 400 mg twice a day more than tripled their risk, compared with people taking a placebo.

Your new strategy: What you don't want to do is stop swallowing Celebrex and begin knocking back ibuprofen, because regular use of high doses of nonsteroidal anti-inflammatory drugs (NSAIDs) can lead to gastrointestinal bleeding. A safer swap is acupuncture. A German study found that for people suffering from chronic lower-back pain, twice-weekly acupuncture sessions were twice as effective as conventional treatments with drugs, physical therapy, and exercise. The strategic needling may stimulate central-nervous-system pathways to release the body's own painkillers, including endorphins and enkephalins, says Duke University anesthesiologist Tong-Joo Gan, M.D.

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