UPJOHN'S DRUG XANAX ON TRIAL

Steven B. Harris sbharris at ix.netcom.com
Tue Mar 24 02:19:35 EST 1998


In <351ceba6.5180031 at news.flash.net> etroll at flash.spamnet (Eric O.
Troldahl) writes: 
>
>sbharris at ix.netcom.com(Steven B. Harris) wrote:
>>
>>   Here's a truth: there are no "bad drugs,"  --- instead, what there
>>are, are bad relationships between certain people and certain drugs. 
>>If you need a prime example from your own experience, think of
alcohol.
>>If we made ethyl alcohol only available through physicians, would it
>>then be reasonable for alcoholics to blame doctors?  And would
doctors
>>then be the simple cause of all alcoholism?  Gee, that sounds like a
>>good proposal, then.  Except I hope you understand that there are a
lot
>>of things wrong it.  Premises which need to be examined, and so
forth.
>>
>>                                      Steve Harris, M.D.
>
>If a drug has a higher incidence of major side effects than clinical
positive
>effect, is it still a "good" drug?


    Possibly.  It may be a good drug that nobody knows enough about to
use well, at the moment.  Prednisone and cortisone, when they were
first discovered, were not good drugs.  Now, they are.  Cyclosporin,
when it was first released, was not a good drug.  Now it is. 
Thalidomide is showing signs of one day becoming a good drug.  We
learn, we rehabilitate.  Some horses buck if you mount them wrong.  But
not if you do it right.

    Most drugs go through three phases of clinical development, called
the P, the PP, and the PPP phases.   The Panacea phase is where we
think a new drug is the answer to half of all diseases--- a major
advance.  Later, as side effects come in and we're not sure who's
getting them, the drug goes though the Pandora Plague phase, in which
we think the FDA has made a major *(&^ up, and we have another
Thalidomide on our hands (one thinks of backlash to  AZT, Prozac,
Accutane).   Finally, as we learn to use the new drugs correctly and
with attention to its special dangers, they enter into the Perfectly
Pedestrian Pharmaceutical Phase, and join the ranks of the other drugs.
 Yawn city.

   Thanks to pharmacy prof Louis Goodman (who once taught at my medical
school) for the 3 episodes in the marketing life of the average
pharmaceutical.


                                           Steve Harris, M.D.



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