Letters to the Editor
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there is nothing refreshing ...
about failing to tell a woman about potential consequences of a drug on potential offspring, whether said woman was planning on getting pregnant or not. I'm as pro-choice as the next pro-choicer, but honestly, that comment was ridiculous.
Given the way the study data was compiled, I tend to agree with the conclusion that the problem may be overstated. Luckily, the one time my doctor thought about putting me on a prescription in this class, she did talk to me about what my reproductive plans were. In the end, I went with a different option. She's had a few babies of her own during the time I've been her patient though, so perhaps she's more personally aware of the issues involved because of that.
One way or the other, I always research any new prescription I've been given before I ingest it, and do the same for my children. (At the very least, read the damn package inserts!) Ultimately we need to start seeing ourselves as the guardians of our own health.
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You're right, nothing refreshing...
which is why I said "perversely." In other words, I meant "refreshing," complete with air quotes. Just to be clear.
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I'm skeptical.
If this were a real problem, where are the deformed babies?
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Unplanned pregnanices the problem
Can't women read? Where is teh responsiblity of the woemn taking these drugs. Every precription comes with a detaliled instrctuction explaining the the potential risks. Most of these risks are mimnimal compared to the consequences of not takng the drugs, or chainging life habits. It seems if women are taking these kinds of drugs maybe they should not be getting pregnant anyway. Unplanned pregnancies is the biggest problem in this nation. With the enviromental crisis upon us we should be encouring women not to have children or limit them to 2.
If women cannot take contraception, the best thing is a tubligation.
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Pre-pregnant anyone?
A few months ago when the CDC suggested all women who have even a small chance of conceiving get on the proper vitamin regiment lots of feminists flipped. It was all about Bush trying to keep us barefoot and in the kitchen by forcing vitamin C on us. In fact I just got done reading NOW’s position on the subject (ok, I skimmed it – it’s really shrill and it started giving me a headache).
I didn’t get then and I don’t get now what the big deal is about being ‘pre-pregnant.’ It seems like a no brainer to get on the proper vitamins and pay close attention to your drug intake if that’s where you are in life. I guess I just expect my doctor to ask those important questions and help me out. But after reading that NOW article I can see why some doctor’s are hesitant to get into the ‘baby maker’ conversation. Sometimes I’m sure we’re our own worst enemies.
And no one really knows what’s up with all the autistic kids out there (one out of every 100 I think) - maybe that’s where all the babies with birth defects are.
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Nobody really knows what's up with all the autistic kids....
But there's a good case to be made that the increase is due mainly to changing and more inclusive diagnostic criteria of autism (and it's spectrum disorders).
Barring the MMR vaccine controversy, no prescription drug has been tied, even correlationally, to autism or its increased diagnosis.
I know Anne in NYC is just idly speculating, but for some reason, speculation on autism tends to induce some of the most alarmist, un-scientifically-founded fear responses in people.
And not to diminish the seriousness of the issue, but there is a faction of autistic people who would strenuously object to the categorization of autism as a birth defect.
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More on autism
And any documented link in the medical and scientific literature between certain drugs/vaccines and autism will have to account for the great gender disparity in diagnoses of autism and its spectrum disorders--boys are much more vulnerable (susceptible?) than are girls.
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Useless study - insurance claim coding versus med records
There is one caveat: The data comes from health plan billing codes, which are not as detailed as medical charts. In other words, a doctor could have said, "By the way, are you on the Pill?" but not coded it in his or her records.
Actually, that's HUGE So huge, that's probably the biggest, most glaring flaw in this study, so much so that it renders all of their "findings" irrelevant.
The billing codes that go on claims refer only to office visits (actually having a patient in your office and performing an exam), procedures (mole removal, etc.), and injections (B-12, Depo, vaccinations). There are other codes for surgery claims, physician time use, anaesthesia, nursing home oversight, etc. but those also don't include all the details that go into a patient history, or what is actually said during an exam.
Patient education is *not a billable service*. It will never show up on an insurance claim. It will only show up in the patient history and on the actual patient visit write-up. In order to obtain an accurate illustration of what physicians are telling their patients, the researchers would have had to go through thousands of de-identified charts to comb through looking for (probably) handwritten text stating something like "informed patient of birth defect risk" or somesuch.
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Focusing on this part of the article:
"It's interesting to note that when it comes to prescribing drugs to women of childbearing age, there seems to be no Accutane effect across the board. Women taking Accutane (isotretinoin, or a generic version of same) for acne are required to use birth control and "pass" a pregnancy test before each refill, as well as enroll in a national registry. Of course, such measures may be extreme for drugs with lower risks -- many women and their doctors, for example, decide that the risks of depression during pregnancy outweigh those of taking antidepressants -- but it's curious to observe the gulf between such stringent precautions and, well, none at all. Especially considering that patients receiving class X statins had the lowest rate of contraceptive counseling."
One of the big problems connected with this is that doctors -- especially some psychiatrists -- treating people for mental health problems often ignore important things about physical health. I was once on the antidepressant Wellbutrin. I had noticed at the GP and when I took my bloodpressure at the pharmacy that my bloodpressure was creeping up. I mentioned this on two occasions of medication monitoring by my psychiatrist. I did not observe him even making a note of this. Nor did he even bother to take my blood pressure, even though raised blood pressure in a side effect of Wellbutrin. As my blood pressure began sky rocketing, I finally had to absolutely demand to be taken off the medication.
Too bad. Wellbutrin is a good medication in many ways with fewer problems for weight gain than many other anti-depressants.
I am not going to rant against antidepressants. Instead, my peeve is that doctors who take care of our bodies often ignore the psychological and that doctors who take care of our minds often ignore our the rest of our body. They could do much better and probably would do much better, if they did not rely so much on pharmaceutical reps to give them reliable information about drugs.