May 2018 - The Good Doctor Is In

May152018 by DocNo Comments

Non-24 Sleeping Pill | $15,000 a Month

[caption id="attachment_254" align="alignleft" width="150"] logo created by RKL[/caption] The cash price for a single month of Vanda Pharmaceuticals’ highly advertised “Non-24” sleeping pill averages $15,000. This translates to $500 a night or $180,000 a year for basically a sleeping pill that targets the melatonin receptors in the brain. A four month supply of melatonin readily available without a prescription at any grocery store or pharmacy costs about $6. This drug, more properly known as Hetlioz, gained FDA marketing approval in 2014. That year the cost for one month of Hetlioz was an egregious $7500. By 2017 it rose to in excess of $13,000 and surpassed $15,00 by early 2018. The “Non-24” pill sold as Hetlioz contains a molecule similar to but somewhat different from over-the-counter melatonin preparations. For obvious reasons…

May92018 by DocNo Comments

Chlamydia – Symptoms | Complications

Blogs

[caption id="attachment_254" align="alignleft" width="150"] logo created by RKL[/caption] CHLAMYDIA -SYMPTOMS | COMPLICATIONS Every year a small devilish bacteria, Chlamydia trachomatis, attacks nearly 3 million Americans. It especially targets young, sexually active women. Unfortunately the overwhelming majority of people harboring this organism experience no symptoms warning that something is amiss. Only months, years or even decades later chronic pelvic pain, discomfort during sexual intercourse or infertility appear as sequelae to a long forgotten liaison. Understanding Chlamydia its symptoms and complications focuses attention toward early diagnosis, treatment and avoidance of complications. CHLAMYDIA: A STI Generally considered a sexually transmitted infection or STI, nearly 140 million cases of Chlamydia will occur this year throughout the world compared to nearly 80 million cases of gonorrhea. While impressive, these figures pale in comparison to the…

May82018 by DocNo Comments

Victoza Heart Disease Diabetes and Survival

Video Blogs

[caption id="attachment_254" align="alignleft" width="150"] logo created by RKL[/caption] Can Victoza favorably disrupt the unholy trinity of obesity, type 2 diabetes and heart disease? Since most type 2 diabetics die of cardiovascular disease rather than elevated blood sugar, this question significantly impacts survival. Advertising claims suggest advantages for the injectable anti-diabetic drug Victoza in protecting the heart, stimulating weight loss and reducing the likelihood of death from cardiac events. Are these based in reality or merely commercial entreaties from the drug maker looking to ensnare more customers? Among the results emphasized by the company are a statistically significant fall in death from cardiovascular causes from 1.6 in 100 patient-years down to 1.2. Regarding death from any cause Victoza reduced the toll from 2.5 deaths in 100 patient-years to 2.1. While statistically…

May32018 by DocNo Comments

Prevagen – Save Your Money Instead

Video Blogs

[caption id="attachment_254" align="alignleft" width="150"] logo created by RKL[/caption] Considering Prevagen - save your money instead. Want to think like a jellyfish – take Prevagen. Tiresome repetitious televised commercials somehow link brain health, clearer thinking and a sharper mind to an amino acid present in jellyfish. This moderately expensive supplement at once claims to improve mental clarity while at the same moment noting “this product is not intended to diagnose, treat, cure or prevent any disease.” Studies supposedly demonstrating Prevagen’s benefits must be taken with the proverbial grain of salt. These company sponsored “investigations” appear highly flawed, unscientific, unreliable and not published in any recognized peer review journal. Apparently the company and its principals even played a dominant role in writing the papers. Evidence supporting for Prevagen stems from the Madison…

May22018 by DocNo Comments

Gabapentin Remains an Enigma

Video Blogs

[caption id="attachment_254" align="alignleft" width="150"] logo created by RKL[/caption] Gabapentin remains an enigma: one of the most widely prescribed and abused drugs yet one with relatively little scientific justification for its use. Approved as an add on for partial seizures in adults and children, it gained a certain following for treatment of severe nerve pain following in the aftermath of shingles – post-herpetic neuralgia (PHN). Even for post-herpetic neuralgia, gabapentin fails to live up to expectations. Only moderate quality evidence exists regarding this indication. Unfortunately studies indicate only 15% of individuals benefit by a 50% reduction in pain compared to those receiving a placebo. And typically the investigations lasted only two to three months in PHN where symptoms persist for months to years. Gabapentin finds a certain cache as therapy for…

May12018 by DocNo Comments

Linzess Targets Chronic Constipation

Video Blogs

[caption id="attachment_254" align="alignleft" width="150"] logo created by RKL[/caption] Linzess targets chronic constipation related to long term conditions of undetermined cause such as the Irritable Bowel Syndrome. By definition this requires fewer than 3 bowel movements each week for at least 3 months. Unfortunately this very expensive drug, whose price continues to steadily increase, provides only mild relief. With a cash price in excess of $15 a day, the drug seems as likely to cause harm as benefit. Approximately 1 in 5 individuals receiving Linzess experience diarrhea which at times may be quite serious. Especially among the more fragile this may lead to dehydration, low blood pressure, dizziness and possibly fainting episodes. Advertisements aimed at the general public suggest the drug offers major advances in combating constipation. Studies however suggest Linzess…