Meds

How the opioid superagonist DFNZ challenges pain medicine

Meds

April 5, 2026

A publication in Nature in April 2026 reports that N-desethyl-fluornitrazene (DFNZ), a modified nitazene and µ-opioid receptor (MOR) superagonist, produced potent analgesia in rodents with less respiratory depression, weaker dopamine-linked reward signaling, lower withdrawal burden, and no clear tolerance or MOR downregulation. The study challenges the usual assumption that very high MOR efficacy must inevitably produce the full adverse-effect profile seen with conventional opioids. Opioid pharmacology has long been …

The clinical evidence and reality of peptide therapy

Shiv K. Goel, MD

Meds

April 5, 2026

There is a sentence I have been practicing for two years. I believe peptide therapy works. It sounds simple. It is not simple. In the culture of evidence-based medicine, a culture I was trained in, believe in, and have practiced inside for over two decades, saying you believe something that the evidence has not yet fully validated carries consequences. Raised eyebrows at conferences. The careful distance of colleagues. The quiet …

The risks of direct-to-consumer pharmaceutical advertising and Big Pharma

Ronald L. Lindsay, MD

Meds

March 29, 2026

In 2002, prescribing risperidone meant fighting through layers of resistance. I had to argue with formulary doctors, armed with a special copy of the New England Journal of Medicine article where my own name was highlighted, just to gain permission. That was the level of scrutiny these drugs once demanded. The article itself was not obscure, it was a landmark trial demonstrating risperidone’s efficacy in children with autism spectrum disorders.

Yet …

Statin safety and efficacy: What recent studies reveal

Cliff Dominy, PhD

Meds

March 28, 2026

Are you concerned about statins? In the past two weeks, cold hard statistics have cut through the fog of misinformation surrounding these best-selling drugs, focusing instead on the safety and efficacy of lowering your blood cholesterol level. No emotions or bias, just numbers. Welcome information for anyone who has enjoyed numerous trips around the sun and is looking forward to many more.

Middle age, that point in life when your invincibility …

Huntington’s disease gene therapy: FDA reversal delays AMT-130

Meghan Johnston, MPH

Meds

March 17, 2026

At the end of September 2025, a gene therapy company released results from a clinical trial showing that a breakthrough procedure reduced the progression of Huntington’s symptoms by 75 percent over three years. Researchers collected data from 12 participants who received the therapy and compared the data with two types of control groups.

The company’s drug, AMT-130, shows unprecedented outcomes, so why is the FDA slowing …

The truth about psychiatric supplements and mental health

Muhamad Aly Rifai, MD

Meds

March 15, 2026

Patients ask me about supplements every week. They bring bottles from Amazon, health food stores, podcasts, and social media. They want something natural. They want something gentler. They want something they can buy without asking permission. I understand the instinct. Psychiatric medications have side effects, cost, stigma, and disappointment. But the supplement aisle is not a sanctuary. It is a marketplace that could turn dangerous.

That matters because supplements in the …

Ketamine therapy for chronic pain and substance misuse

Olumuyiwa Bamgbade, MD

Meds

March 13, 2026

Health care works best when it solves real problems in real lives. That is why recent research on ketamine therapy for chronic pain deserves attention. The peer-reviewed study looked at 20 adults living with chronic pain who also struggled with substance misuse. The results suggest that carefully designed pain treatment may help more than pain alone. It may also improve mood and support recovery from substance misuse. In a …

Kratom vs. 7-OH: Understanding the potency gap and risks

Emma Fenske and Bradley M. Buchheit

Meds

March 13, 2026

The clink of ice in the glass had been an evening “wind down” routine ever since the pandemic. It had served as a way to drown remnants of stress that bubbled up throughout the course of the day. This “routine” developed over weeks, but eventually evolved into dependence, addiction even, he worried. I need to do something about this before I lose it all, he thought one morning upon waking …

Why the FDA regulations on peptide therapy matter

Vikas Patel, MD

Meds

March 10, 2026

Everyone wants peptides, do you not? That includes Health and Human Services Secretary Robert F. Kennedy Jr. Last week, he announced on the Joe Rogan Experience that the FDA would reverse its restrictions on roughly 14 peptides that were banned from compounding pharmacies in 2023. “My hope is that they’re going to get moved to a place where people have access from ethical suppliers,” he told Rogan, while acknowledging, in …

GLP-1 weight regain: Why stopping medication leads to weight return

Jessica Duncan, MD

Meds

March 4, 2026

Stopping a GLP-1 abruptly and expecting maintenance of weight loss is not realistic. Even replacing it with a standard “eat less, move more” plan is not sufficient as it ignores what we know about hunger regulation and metabolic adaptation. A reduced-calorie diet and 30 minutes of daily walking, while helpful, are rarely sufficient to overcome the physiological forces defending prior weight.

Weight maintenance after significant loss requires managing cravings, psychological hunger …

Marijuana rescheduling: Why the medical community’s silence is dangerous

Farid Sabet-Sharghi, MD

Meds

February 22, 2026

By presidential order, marijuana has been rescheduled from Schedule I to Schedule III. This is not a subtle bureaucratic shift. It is a historic decision with major medical, regulatory, and cultural implications. Yet, astonishingly, much of the medical community has responded with near silence. There has been little serious discussion, no broad professional debate, and minimal effort to educate clinicians or the public about what this change does, and does …

Peptides for chronic pain: Navigating safety and regulations

Stephanie Phillips, DO

Meds

February 21, 2026

I have so many patients struggling with horrible arthritis pain! All the treatments we have either really don’t work well or have side effects, and many times cause more harm than good. I found myself having a risk-benefit discussion with every single patient with chronic pain, and at times, feeling like I was doing more harm than good when trying to help treat the pain.

Patients are taking NSAIDs, and I …

Mifepristone safety: Comparing the data to Viagra and penicillin

Theresa Rohr-Kirchgraber, MD and Sophia Yen, MD, MPH

Meds

February 21, 2026

As physicians, we pride ourselves on following the evidence. We weigh risks and benefits, assess data, and trust science to guide decisions about patient care. Yet, when it comes to reproductive health, lawmakers and courts too often override scientific consensus. Nowhere is that clearer than in the debate over mifepristone.

Patients deserve care rooted in evidence and science, not ideology. To provide safe and best-practice medical care, physicians need the ability …

Deprescribing in health care: Why less medication can be more

American Medical Association & John Whyte, MD, MPH

Meds

February 17, 2026

Every day, millions of Americans take medications to manage chronic conditions or prevent disease. Prescription drugs are vital tools in modern medicine, but in some circumstances, they can also lead to serious adverse drug interactions, diminished quality of life, and even life-threatening complications.

This is a complex issue with high stakes for patients. Older adults, in particular, are often prescribed multiple drugs by different doctors for different reasons. The Centers for …

Beyond weight loss: the expanding benefits of GLP-1 receptor agonists

Zehra Haider, MD

Meds

February 9, 2026

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) were introduced to help manage type 2 diabetes. They improve glycemic control and promote weight loss, which we all know are essential for long-term outcomes. In practice, I’ve seen that their impact goes beyond these traditional targets. Patients often benefit from cardiovascular protection and kidney improvements, and emerging data show advantages in areas we did not initially anticipate, such as sleep apnea, joint health, …

Oral Wegovy: the miracle and the mess of the new GLP-1 pill

Shiv K. Goel, MD

Meds

February 2, 2026

A patient stopped me in the hallway recently, not in an exam room, not seated, not “ready” for a clinical conversation. Just a human being catching me between visits and asking a question that felt heavier than any lab result:

“Doc, is this finally the thing that will work? Or is it just another trap?”

That question is the GLP-1 era in one sentence. And with the launch of oral Wegovy, it …

U.S. opioid policy history: How politics replaced science in pain care

Richard A. Lawhern, PhD & Stephen E. Nadeau, MD

Meds

January 31, 2026

Based on our combined experience of over 70 years in patient advocacy, pain management, and behavioral neurology, we are convinced that U.S. public perception and public policy on treatment of pain have been driven almost entirely by sociopolitical and legal factors. Seldom in recent years has policy been significantly influenced by science.

The U.S. enjoyed a brief period of scientifically enlightened policy in the late 1990s through 2008. A large number …

How CAR-NK cancer therapy could be safer than CAR-T

Cliff Dominy, PhD

Meds

January 9, 2026

Imagine a cancer therapy that bypasses the immune system and strikes tumors with greater precision. The advantages of a blindfolded immune system could mean reduced therapeutic side effects and delivering more of the drug to where it is needed the most. Now imagine that this potentially safer and highly effective therapy was available on demand. Thanks to a new generation of genetically modified biologics, it may be closer than we …

Psychedelic-assisted therapy: science, safety, and regulation

Muhamad Aly Rifai, MD

Meds

January 4, 2026

We are hearing stories about mushrooms and MDMA and see clinics advertise ketamine. We hear of friends chasing a spiritual reset. Many in America feel the weight of depression, trauma, and addiction inside families. Psychedelics sit at the center of this pressure, with hope on one side and hype on the other.

KevinMD already published multiple essays on psychedelic medicine since 2022, including pieces on what physicians need to know, prudence …

The anticoagulant evidence controversy: a whistleblower’s perspective

David K. Cundiff, MD

Meds

December 29, 2025

My partner broke her femur in a Zumba class just before Christmas 2025 and had successful surgery. Following successful surgery, physicians prescribed Lovenox (an anticoagulant) and Plavix (an antiplatelet drug), the standard regimen for preventing or treating venous thromboembolism (VTE). However, the intervention proved very risky: She lost three pints of blood into her leg and required a two-pint blood transfusion, direct complications of the Lovenox and Plavix.

Physicians adopted anticoagulants …

Meds

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