💊 Safe and Effective … Or Perhaps Not

As I work, between other tasks, to clear out the news chum, here’s a collection of articles related to health, medicine, and drugs:

  • Co-Pay Accumulators. One of the big problems with our medical system in the US today is how we pay for drugs, and a large part of that are the games insurers make us play. Consider co-pay accumulators. These impact use of those coupons drug manufacturer’s provide to make their drugs affordable. Copay accumulators mean that coupons no longer will be counted toward patients’ deductibles. When you use the coupons, you pay a fixed amount. The drugs manufacturer takes care of the difference between that fixed amount and what the drug company charges (or what insurance would pay). More importantly, the coupons are often applied to the insurance deductible (especially for injectable drugs ), speeding up the point where your out-of-pocket max is met. Co-pay accumulators, on the other hand, allow insurers to double dip: They get their full co-pays and they get to extend the duration of patients’ deductibles. The article is an interesting read for the exploration of the pros and cons.
  • Anticholinergic drugs and Depression. Recent studies are showing that some classes of anticholinergic drugs — particularly those used to treat depression, Parkinson’s and urinary incontinence — carry a higher risk of cognition problems or dementia. The concern is those anticholinergics used for depression (e.g. amitriptyline), urinary incontinence (e.g. oxybutynin) and Parkinson’s disease (e.g. procyclidine) were associated with around a 30% increased risk of developing dementia. Amitryiptyline is of interest to me, as it is a common drug used for migraines as well.
  • Depression Drugs and SuicideMore than a third of American adults use medications that list depression as a risk, and a quarter use drugs that increase the risk of suicide. The 203 drugs researchers identified aren’t obscure; they include some of the most commonly prescribed medications around — like birth control, beta blockers for high blood pressure, and proton pump inhibitors for acid reflux. Many are drugs used for migraines. The researchers from the University of Illinois and Columbia University discovered people using these drugs had an elevated risk of depression compared to the general population. And the more medications with depression as a side effect people took, the more their risk of the disease increased. It is certainly something to be aware of. [And while I’m ending a sentence with a preposition, here’s why that is considered bad.]
  • Yogurt and Chronic Inflammation. A recent study provides new evidence that yogurt may help dampen chronic inflammation. The study explored the hypothesis that yogurt may help reduce inflammation by improving the integrity of the intestinal lining, thus preventing endotoxins — pro-inflammatory molecules produced by gut microbes — from crossing into the blood stream. While anti-inflammatory medications like aspirin, naproxen, hydrocortisone and prednisone can help mitigate the effects of chronic inflammation, each comes with its own risks and side effects. There is a need for additional options — particularly safe, gentle, long-term treatments. Researchers have been exploring dairy products as a potential dietary treatment for more than two decades. Findings have been mixed, setting up a scientific debate about whether dairy products are pro-inflammatory or anti-inflammatory.
  • Baking Soda and Auto-Immune Disease. Here’s another interesting study, this time concerning baking soda (the most effective antacid, in my book). It appears that a daily dose of baking soda may help reduce the destructive inflammation of autoimmune diseases like rheumatoid arthritis. The study is some of the first evidence of how the cheap, over-the-counter antacid can encourage our spleen to promote instead an anti-inflammatory environment that could be therapeutic in the face of inflammatory disease, Medical College of Georgia scientists report in The Journal of Immunology.
  • Dealing with Chronic Pain. We’re all hearing about the opiod epidemic. Yet for those with chronic pain, they are often the only choice. What if they weren’t, and I’m not talking CBD as an alternative. Pain often has a psychological cause or at least a psychological component. There are 100 million Americans who suffer from chronic pain, and an unknown number of them with back pain, neck pain, fibromyalgia symptoms, or other forms of pain that have no diagnosed physical cause. There have been numerous studies showing the benefit of placebos — in other words, belief that something will work — and belief is a large component of why prayer works for some. The problem is  the psychological component is often dismissed or never acknowledged. Cognitive behavioral therapy, meanwhile, shows meaningful benefits on chronic pain — both for psychogenic pain, and for pain with a physical cause — according to systematic reviewsof the research. There’s also promising research around mindfulness-based stress reduction and therapies inspired by it.
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