Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

We need to pay better attention to medication side effects

Marlene Beggelman, MD
Meds
February 22, 2017
Share
Tweet
Share

Years ago, after I suffered a deep personal loss, my doctor prescribed Prozac, and I joined the millions of Americans who have taken an antidepressant. A few weeks later, I had my first panic attack — heart racing, sweating profusely, gasping for breath — sensations of terror normally reserved for life-threatening events. Attacks continued every half-hour and were so incapacitating that I could not even leave my house. My doctors were confounded. Perhaps the attacks were related to grieving, they thought.

It wasn’t until weeks later when a friend, a mental health nurse, showed me a study about Prozac that the situation became clear. The study described high rates of suicide in Prozac-takers who developed severe panic attacks on the drug, and it noted that it would take months for the drug to fully clear from the bloodstream for any side effects to resolve. Predictably, three months after stopping the drug, I never had another attack.

As both a patient and physician, the experience left me with questions. Why didn’t my clinicians recognize the side effect? Why did they choose a long-acting drug with common side effects when there were other, safer choices? Why didn’t I do my homework before agreeing to this medication?

Clinicians often misdiagnose problems caused by medications, especially when patients take multi-drug combinations. In a study a few years ago, when patients told their doctors they had symptoms that are widely known reactions to the drugs they were taking, almost half the doctors told them there was no connection. A typical report: the “doctor suggested it was (my) imagination” or that “it’s all in my head.”

There are various reasons that drug side effects might go unrecognized: the shrinking time physicians have to spend with patients; the fact that doctors receive lots of information about the benefits of drugs but not much on their dangers; and cognitive dissonance or denial about the negative effects that drugs can have.

Cognitive dissonance, a universal human phenomenon, is based on the assumption that people want consistency between their expectations and reality, and twist their thinking into knots to make that happen. In the case of drug reactions, to preserve the notion that our efforts help rather than hurt, our impulse is to attribute the harm to something other than our intervention.

But when doctors fail to connect symptoms to medications, not only do they fail to help their patients, but they also fail to report the side effects to the Food and Drug Administration. As a result, the FDA is likely underestimating the reactions, leading other doctors and patients to believe some drugs are safer than they are.

We could all benefit from more efforts to correct widespread misperceptions that impede the recognition of side effects — beginning with the assumption that the safety profile of most medications is well understood.

In fact, a high percentage of serious reactions have never even been investigated. Since drug reactions are often the cause of even the most frequent symptoms (such as fatigue, achiness, depression and cognitive dysfunction), medications should always be considered as a potential cause.

Patients may be the most reliable sources to report side effects. In fact, they are often the only information source about reactions to medications. Their observations deserve serious consideration.

Federal money for drug research and safety has declined to the point that pharmaceutical companies now fund over 85 percent of all research, medical journal publications and medical conferences, where physicians receive much of their educational information –- a clear case of the fox guarding the chicken coop.

Restoring federal funding to the National Institutes of Health to support more research on medications would go a long way to assure that accurate and unbiased information is available. If we want to change how doctors respond when patients with possible drug reactions walk through their doors, we also need to emphasize misdiagnosed side effects more in formal education and accreditation programs, such as continuing medical education, board certification, and grand rounds.

For their part, pharmaceutical companies could support impartial research creatively — for example, by pooling and distributing funds through independent third parties.

ADVERTISEMENT

A large-scale educational campaign such as the one that targeted smoking would increase public awareness and encourage direct patient reporting to the FDA when a side effect is suspected.

Pharmacists have an important role to play here too, and could be the point of contact where FDA reporting is initiated. It’s easy to imagine a sign at the pharmacy counter that says, “Ask me about side effects.”

It may also be time to expand our vision about how drug-safety research can be conducted. Social media provides a rich source of data, with hundreds of thousands of internet users communicating with each other monthly about their medication-related experiences. This “big data” source offers the massive number of data points required to understand the safety of multi-drug combinations — something that we currently know very little about.

Recently, my friends’ 13-year-old developed the same problem I had experienced with Prozac, and missed school for several months as a result. The parents had not been informed about this relatively common side effect and, as in my case, months passed before the correct diagnosis was made.

Almost three-fifths of Americans take a prescription medication, and nearly 15 percent take five or more, while children are the fastest growing market for drug companies. With drug reactions already the third-leading cause of hospital deaths in the U.S., we desperately need more focused, sustained and unbiased research and education to put the brakes on what is already an epidemic of medication-driven catastrophes.

Marlene Beggelman is an internal medicine physician and a member, Right Care Boston. This article originally appeared in WBUR’s CommonHealth.

Image credit: Shutterstock.com

Prev

Every doctor needs a moment like this

February 22, 2017 Kevin 4
…
Next

How to publish as a medical trainee

February 22, 2017 Kevin 1
…

Tagged as: Medications

Post navigation

< Previous Post
Every doctor needs a moment like this
Next Post >
How to publish as a medical trainee

ADVERTISEMENT

Related Posts

  • The life cycle of medication consumption

    Fery Pashang, PharmD
  • If we don’t pay now to vaccinate our children, they will pay later

    Peter Ubel, MD
  • Stop stigmatizing medication-assisted treatment

    Brandon Jacobi
  • Prescribing medication from a patient’s and physician’s perspective

    Michael Kirsch, MD
  • Close the gender pay gap in medicine

    Linda Girgis, MD
  • The crippling health effects of another government shutdown

    Alani Gregory, MD

More in Meds

  • How medicine repurposing enables value-based pain management and insomnia therapy

    Olumuyiwa Bamgbade, MD
  • Forced voicemail and diagnosis codes are endangering patient access to medications

    Arthur Lazarus, MD, MBA
  • From stigma to science: Rethinking the U.S. drug scheduling system

    Artin Asadipooya
  • How drugmakers manipulate your health from diagnosis to prescription

    Martha Rosenberg
  • The food-drug interaction risks your doctor may be missing

    Frank Jumbe
  • Why retail pharmacies are the future of diverse clinical trials

    Shelli Pavone
  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • Why point-of-care ultrasound belongs in every emergency department triage [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why PSA levels alone shouldn’t define your prostate cancer risk

      Martina Ambardjieva, MD, PhD | Conditions
    • How to handle chronically late patients in your medical practice

      Neil Baum, MD | Physician
    • Reframing chronic pain and dignity: What a pain clinic teaches us about MAiD and chronic suffering

      Olumuyiwa Bamgbade, MD | Conditions
    • How early meetings and after-hours events penalize physician-mothers

      Samira Jeimy, MD, PhD and Menaka Pai, MD | Physician
    • Why medicine must evolve to support modern physicians

      Ryan Nadelson, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 29 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • Why point-of-care ultrasound belongs in every emergency department triage [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why PSA levels alone shouldn’t define your prostate cancer risk

      Martina Ambardjieva, MD, PhD | Conditions
    • How to handle chronically late patients in your medical practice

      Neil Baum, MD | Physician
    • Reframing chronic pain and dignity: What a pain clinic teaches us about MAiD and chronic suffering

      Olumuyiwa Bamgbade, MD | Conditions
    • How early meetings and after-hours events penalize physician-mothers

      Samira Jeimy, MD, PhD and Menaka Pai, MD | Physician
    • Why medicine must evolve to support modern physicians

      Ryan Nadelson, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

We need to pay better attention to medication side effects
29 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...