Doctors don’t provide enough information about drug side effects


Several months ago I developed a stomachache after taking an over-the-counter medication for symptoms suggesting acid reflux.

When I told the doctor about my reaction, she said the medication, which she had prescribed, should not have caused my stomachache.

But the Food and Drug Administration lists stomach pain and upset stomach as among the drug’s possible side effects. The episode reminded me that physicians rarely counsel me on side effects when they tell me to take a medication.

Other people feel the same way, I’ve discovered, lamenting drug side effects and looking for answers and moral support on Internet message boards.

So I started to wonder: How much knowledge do doctors have about medications? What can patients do to educate and protect themselves?

For Liz Awbrey of Oklahoma, finding answers meant finding a new doctor.

Awbrey was in her 50s when a doctor suggested she try a sedative that would allow her to get a better night’s sleep and help ease her chronic fatigue syndrome.

She lost 20 pounds and started falling during exercise class. Her doctor said he wouldn’t be worried if the weight loss plateaued, which it did.

When she told her doctor she wanted to stop the drug - because it wasn’t helping her condition - he didn’t warn her about withdrawal. When she developed insomnia, depression and anxiety, the doctor suggested an antidepressant, which she declined.

“I was, like, ‘I was fine before I got on it, so it’s got to be the drug,’ ” Awbrey said.

Awbrey, now 60, turned to an organization that helps people get off addictive drugs with tapering suggestions, nutraceuticals (medicinal food products) and other support. The organization suggested supplements, advising her to ask her doctor about them.

She also found a new doctor who talks to her about side effects and often suggests vitamin and supplement alternatives to drugs. She is now back to her old self.

“The doctor who gave me that, he’s not a bad doctor,” Awbrey said of the physician who prescribed the sedative. “He’s a nice man,” she said, but added that drug companies may not warn doctors sufficiently about side effects.

Doctors learn about drugs in medical school and later during continuing-education programs. But those programs are often funded by drug companies, according to J. Douglas Bremner, a professor of psychiatry and radiology at Emory University School of Medicine in Atlanta.

Bremner said pharmaceutical companies even reach medical students by influencing those who train them.

“They’re not really trained to be scientists, they’re trained to be apprentices,” Bremner said. “That’s what the drug companies know… . If they can get the person who trains them to change what they’re prescribing, they can get them to.”

When Bremner taught continuing-education sessions, the pharmaceutical companies that paid him provided the slides. Because the slides seemed to favor those companies’ drugs, he started using his own.

“When I did that several times, they stopped asking me,” Bremner said.

Adriane Fugh-Berman, a professor in the Department of Pharmacology and Physiology at Georgetown University Medical Center, said doctors often “prescribe irrationally,” pushing branded over generic drugs, new over old, and suggesting medication for diseases invented or exaggerated by drug companies.

“We’re in sort of a bad situation now where the people in control of prescribing drugs know the least about the drugs,” said Fugh-Berman, who directs PharmedOut at Georgetown, which researches drug marketing and educates health-care professionals about its influence.

But Andrew Powaleny, director of public affairs for PhRMA, said the pharmaceuticals trade group’s “Code on Interactions with Healthcare Professionals” says that ethical relationships are needed to provide the latest information about prescription medicines. Information about side effects, Powaleny said, should be included in discussions.

Fugh-Berman said patients need to become their own experts, researching drugs on websites - such as the government database MedlinePlus - that are “free of [the pharmaceutical] industry.”

Doctors have a responsibility to listen to their patients about side effects, too, she said.

“I tell medical students: If a patient develops a symptom after they’ve gone on their drug, it’s always the drug’s fault until proven otherwise,” said Fugh-Berman.

Amy Thompson, a clinical pharmacist and an associate professor at the University of Michigan’s College of Pharmacy, said doctors have plenty of knowledge about drugs, but there are so many available they don’t know the possible side effects of all of them.

“But they have access to look into it,” she said, referring to online databases, continuing education and pharmacists.

“I think it’s important the patient understand what the medication is, what they’re taking it for, what they should expect to see,” Thompson said. “If the medication has some sort of very serious side effect, I would want them to know what to look for.”

Marlene Beggelman, founder and chief executive of Enhanced Medical Decisions, a health information technology company in Cambridge, Mass., said the FDA might be underestimating side effects because doctors often don’t report them. Although the FDA collects reports on its Adverse Event Reporting System, the reporting is voluntary and adverse reactions are considered underreported. Beggelman described her own experience with side effects in a blog post on KevinMD.com.

Beggelman, an internal medicine physician, said doctors mean well even when the care they deliver has negative consequences.

“I think that very often it’s a human quality of not wanting to think that what you’re doing to try to help people is actually causing problems,” she said.

Awbrey, the woman who took the sedative, said doctors need to do better.

“I feel like I was greatly harmed because all I did was take something that a doctor told me would make me better,” she said. “It ruined my life.”



Reader Comments ...


Next Up in Community

Your guide to finding the best lawn care pros this summer
Your guide to finding the best lawn care pros this summer

The “Agony and the Ecstasy” may be a literary classic, but it's also an on-point description of owning a house with a lawn. Yes, it offers a wonderful play space for the kids and a respite from the workaday world for the adults. But when the heat climbs and the brown spots start showing and the lawn guy who signed up in cooler months...
Anthony Bourdain to be honored with ‘food trail’ in home state of New Jersey
Anthony Bourdain to be honored with ‘food trail’ in home state of New Jersey

New Jersey is honoring native son and award-winning celebrity chef Anthony Bourdain with a “food trail” of his favorite New Jersey restaurants. >> Read more trending news  Although the popular writer, storyteller and host of CNN’s Emmy-winning “Parts Unknown” was born in New York, according to his biography...
Here’s how to identify (and get rid of) venomous spiders in your home
Here’s how to identify (and get rid of) venomous spiders in your home

Most people aren't too happy when they encounter a spider, and that's especially true if the creepy-crawly you come across happens to be venomous. Although it's understandable to be anxious about venomous spiders, it’s important to know the difference between a harmless spider and a dangerous one. Here are some important tips from experts on...
New boozy push pops contain more alcohol than a glass of wine
New boozy push pops contain more alcohol than a glass of wine

If you miss the summer days of cooling off with a Push-Pop, never fear! Buzz Pop Cocktails, a Las Vegas-based company, has invented liquor-infused push pops with flavors including Lemon Drop Martini and Moscow Mule. Each Buzz Pop Cocktail is 15 percent alcoholic by volume -- double the amount of alcohol in a glass of beer, or nearly two glasses of...
Rare photo: The best-looking Beatle might not have been John or Paul
Rare photo: The best-looking Beatle might not have been John or Paul

He was The Beatles’  original drummer, the one that got replaced by Ringo Starr and missed the ride to music immortality. Which might also make him the disgruntled Beatle. But was Pete Best the best-looking Beatle? Recently discovered in The Palm Beach Post’s archives is this November 1965 photo by Miami News photographer...
More Stories