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Dateline has a show about Neurontin...on at 8:00

Posted by marie on 7/11/03 at 19:38 (124159)

My sis the nurse just called to let me know dateline has a segment on neurontin...just passing it on.

Re: Dateline has a show about Neurontin...on at 8:00

Sharon W on 7/11/03 at 20:23 (124167)

Or, if you already missed it (like I did), check it out at this site:

http://www.msnbc.com/news/937302.asp

It's titled:

'Drug giant accused of false claims'

'Whistleblower alleges illegal encouragement of off-label use'

------------------------------------

Marie,

Thanks for pointing this out to us!

Sharon
.

Re: Dateline has a show about Neurontin...on at 8:00

Kathy G on 7/12/03 at 08:54 (124192)

Thank you, Marie, and thank you, Sharon, for the link because I missed it, too. It was very interesting.

I still believe that prescribing drugs for off-label uses can be effective. In one such case, I had some experience. A non-steroidal nosespray called Nasalcrom came out for allergies and was very effective. The same ingredients could be beneficial to someone with chronic allergic conjunctivitis (eyes) which I had. My opthamologist told me that he could write me a prescription for the nosespray and the directions would be for nasal administration when in fact, he wanted me to put a couple of drops in my eyes. I tried it and it worked. Within a six months, a drug came out that was specifically for eye use. It was exactly the same as the nosespray. Had I waited for that drug's release, I would have spent six more miserable months.

I don't understand why so many people on this Board, as well as my own brother-in-law, get such relief with Neurontin if it's not appropriate for pain relief. There's always the placebo effect to consider but it seems to me that those who are prescribed Neurontin have tried everything else and they would be particularly skeptical about the addition of a new drug and less likely to experience that phenomenon. I need to go back and read the article again, though, because everyone I know who takes it for pain takes it in combination with an analgesic of some kind. I don't remember if that's what they said on the show.

As for bipolar disorder, my sister suffers from it and was on Depakote and Lithium and was still having problems. The addition of Neurontin seemed to help her a great deal. When it was prescribed for her, I read up on it and everything I read said that it was given in conjunction with Depakote for the disorder.

Weight gain seems to be a side effects of the drugs used for bipolar disorder and compliance is a huge problem. Some Bipolars even stop taking their meds because of the added weight, even if they are feeling better. I wonder if we're getting the whole story. Did the woman refuse to take the Depakote and did the doctor, in ignorance, give her the the Neurontin only for bipolar?

There are some very reputable doctors who say that Neurontin does nothing for bipolar disorder but it would seem that if the patients see improvement, something must be going on.

The whole discussion brings us back to the fact that in the US, it takes our FDA far more time to approve drugs than it takes other countries. It can be argued for eternity whether our system is better or worse. Controversy over the merits of our exhaustive study system will continue, I believe, as the fear of lawsuits continues to be the determining factor in release of a drug.

Re: Dateline has a show about Neurontin...on at 8:00

marie on 7/12/03 at 09:21 (124196)

Kathy,

At the end of the Dateline segment they did anounce that Neurontin had been approved for pain caused by nerve damage. I thought PHEW. Of course they had some fancier name that I couldn't even begin to pronounce much less spell.

However I know several people who had been perscribed neurontin for dpression and anxiety. They told me it didn't do a thing for them.

marie

Re: Dateline has a show about Neurontin...on at 8:00

Sharon W on 7/12/03 at 10:20 (124205)

Marie,

That's GOOD news!! I know Neurontin works for pain, because it works for ME... So, I'm very glad to hear that they finally got it approved for nerve pain. I did know that they'd been doing a large research study, on the subject...

Hey, this should mean that Dr. Ed and other doctors whose practice sees nerve pain patients but NOT seizure disorders, should finally be able to get samples of Neurontin... and considering the PRICE of that stuff, maybe doctors will be able to provide it for a few of their patients who really need it but are hard pressed for money.

Sharon
:D

Re: John Hockenberry is an idiot

Ed Davis, DPM on 7/12/03 at 11:56 (124219)

Sorry everyone. But I have followed a number of Hockenberry's stories throughout the years. Perhaps he is not an idiot but he is an asshole.

I have, throughout the years, badgered the manufacturer of Neurontin to give me information on the off label use of the drug for nerve pain. They steadfastly refused to do so, instructing me that they could not and even refused to send a salesman/rep to my office to speak to me about it. Perhaps Hockenberry would like to join those sho would like to muzzle any attempt at free speech in the medical field.

Ed

Re: Dateline has a show about Neurontin...on at 8:00

Sharon W on 7/13/03 at 10:44 (124303)

Kathy,

You commented: 'As for bipolar disorder, my sister suffers from it and was on Depakote and Lithium and was still having problems. The addition of Neurontin seemed to help her a great deal. When it was prescribed for her, I read up on it and everything I read said that it was given in conjunction with Depakote for the disorder.'

The manic/depressive lady mentioned in that Neurontin article was wanting to stop Depakote because it was causing her to gain weight. Ironically, the Dateline reporter does NOT mention the fact that using Depekote to be used to treat manic/depression began as an off-label (NOT FDA-approved) use! Depakote was developed as an anti-seizure medication, like Neurontin, and then doctors began to realize it seemed to help people with bipolar disorder so it was prescribed for that purpose more and more...!

By the way, the lady in the article was RIGHT to be worried about the health effects of her 100 lb weight gain after starting Depekote... because being overweight causes insulin resistance, which will lead to (type 2) diabetes unless it is stopped.

Referring to one of the anti-psychotic drugs that have weight gain as a side effect, just like Depekote, James R. Gavin III, M.D, Ph.D, wrote:

'We can't tell ahead of time who's going to be gaining a lot of weight and become a problem. It is not just the underweight patients who gain weight. The risk of gaining weight cuts across underweight, normal weight, and overweight patients. The mechanism of action is not well understood. It is almost surely related to appetite, not metabolism. These patients will eat out the kitchen.'

'An important clinical message is that weight gain is not a dose-related side effect... so don't lower the dose because of weight gain. You either need to deal with it or switch the medicine. But it is not a dose-sensitive side effect.'

Here's a link (followed by excerpts) that supports my remarks about the dangers of obesity and insulin resistance:

The following excerpts are from an article/slide presentation on Medscape (membership required), at the following link:

http://www.medscape.com/viewprogram/2049

FFAs: A Link Between Obesity and Insulin Resistance

It turns out that fat is not a passive tissue. This adipose tissue is metabolically active. It is resistant to insulin and, therefore, it is undergoing accelerated lipolysis, generating free fatty acids. And those free fatty acids do exactly the opposite of what insulin would do at the tissue level.

So instead of muscle tissue being stimulated to take up glucose, it is inhibited. Instead of glucose production being inhibited by insulin in the liver, free fatty acids stimulate it. And what happens is that you now have this contribution to insulin resistance by this active fat tissue.

When we look at the metabolism of muscle in people with type 2 diabetes, what we see is that under insulin-stimulated conditions, not the basal rates, there is a significant decrease in glucose metabolism. That is where the insulin resistance manifests itself.

This excessive lipolysis from this rich fat store that we see under conditions of obesity certainly has a significant deleterious effect in muscle

The liver isn't spared. The increased free fatty acid oxidation, the augmentation of gluconeogenesis as a result of exposure of the liver to those increased free fatty acid levels, results in hepatic glucose output being augmented, and this is precisely what drives up fasting plasma glucose levels.

--------------------------

Sharon
.

Re: MY POST, ABOVE, IS FOR KATHY G

Sharon W on 7/13/03 at 10:50 (124304)

:)

Re: MY POST, ABOVE, IS FOR KATHY G

Kathy G on 7/13/03 at 11:17 (124305)

Sharon,

It is a huge concern, of course, but a one-hundred-pound weight gain is unusual. The majority of patients don't experience such a huge increase in their weight. I worry because my sister practically starves herself because of her increased weight. Part of her weight-gain is due to her age, too, but she won't accept that. (She's 46.) What bothers me is that she's actually too skinny and she could afford to gain another twenty pounds! Since some bipolars either go on eating binges or nearly starve during a manic episode, it's a trade off for doctors. Sometimes, they just have to weigh risk vs. benefit of the side effects of a drug that allows these people to go about living a somewhat normal life. It's a difficult situation.

Re: John Hockenberry is an idiot

Kathy G on 7/13/03 at 11:39 (124311)

There's nothing worse than someone who has no medical background who takes a stand on something he really doesn't understand. I remember years ago when a senator took on Valium. He didn't have the slightest idea about the value of Valium; he just made the demonizing of it his personal crusade. He was well-intentioned by misinformed.

I never watch 20/20 but I suspect Hockenberry may be doing something similar.

Re: John Hockenberry is an idiot

Sharon W on 7/13/03 at 18:48 (124333)

If you pay attention to what Hockenberry was saying, it appears that he (and his whistle-blower) have a VERY low opinion of doctors... I would believe that there are probably SOME doctors out there who would keep on prescribing Neurontin for someone gaining huge amounts of weight, and increasing the dosage more and more because it wasn't working. But, I really can't believe that MOST doctors would just keep on doing that, with patient after patient, unless it DID seem to help many of their bipolar patients. Besides, MDs and other doctors are well aware that Ph.D's exist, and that THEY too are entitled to use 'Dr.' in front of their names!

And how many DOCTORS do you know of who actually go around from office to office, promoting prescription drugs for their manufacturers? The drug reps I've talked to, anyway, had remarkably LITTLE medical training... in fact, the primary job requirement appears to be skill at SALESMANSHIP, not knowledge of pharmacology or chemistry!

By the way, my family doctor commented to me once that the drug reps won't give HER neurontin samples; she said they only give them to neurologists. So I really don't see how there could be many drug reps out there promoting Neurontin for off-label use. I can't help but wonder if maybe their 'whistle-blower' was just a bad apple, to begin with...

Sharon
.

Re: John Hockenberry is an idiot

Ed Davis, DPM on 7/14/03 at 09:08 (124375)

Sharon:

I too, wonder about that 'whistle blower.' I wish I could have talked the company into getting detailed or getting some samples -- they scrupulously followed FDA rules in my experience. It is a large company, owned by Pfizer, and perhaps one can find a few people who said something they should not have said.

Ed