[Michaelangelica]

Zolpidem / Stilnox

Did a sleeping pill end her brilliant life?

Dylan Welch
February 19, 2008

SHE was young, gifted and only weeks away from receiving her doctorate. A young philosophy graduate, she had been offered scholarships at Oxford and Cambridge.
The eminent philosopher Raimond Gaita lauded her as a future leader in the field.

Did a sleeping pill end her brilliant life? - National - smh.com.au

TGA monitors Stilnox following Ledger's death

Posted Thu Jan 24, 2008 12:00pm AEDT
Updated Thu Jan 24, 2008 12:58pm AEDT


Australian regulatory authorities are considering further restrictions on Stilnox, which was reportedly one of the prescription drugs found yesterday in the Manhattan apartment of late actor Heath Ledger.

TGA monitors Stilnox following Ledger's death - ABC News (Australian Broadcasting Corporation)

TGA to consider classifying Stilnox as 'drug of abuse'

Posted Tue Feb 19, 2008 8:37am AEDT

The National Drugs and Poisons Schedule Committee is meeting to decide whether the sleeping pill Stilnox should be classed as a drug of abuse.

TGA to consider classifying Stilnox as 'drug of abuse' - ABC News (Australian Broadcasting Corporation)

The Stilnox dilemma
June 3, 2007
The victims of this medical scandal reveal the full of extent of the apparent reactions and the ongoing psychological damage they've experienced …

The Stilnox dilemma

More warnings for sleeping pill Stilnox

November 28, 2007 - 5:15PM

The controversial sleeping pill Stilnox will be sold in smaller packs, carrying extra warnings of potential "rage reactions".

This follows alarming reports of bizarre sleep time behaviour.

Australia's medicines regulator has announced that extra warnings will be stamped on the product

More warnings for sleeping pill Stilnox - Breaking News - National - Breaking News

Stilnox 'rage reactions' label
November 29, 2007


The controversial sleeping pill Stilnox will be sold in smaller packs and with extra warnings of potential "rage reactions" in the wake of alarming reports of bizarre sleep time behaviour.

Stilnox 'rage reactions' label - National - theage.com.au

STILNOX Safety Reports
Total STILNOX reports: 44.
STILNOX FDA safety alerts: No.
Reported deaths: 3 Reported hospitalizations: 18.
STILNOX problem was reported by a Physician from AUSTRALIA on Nov 02, 2006

Title: Report of TGA regulatory actions related to zolpidem ('Stilnox')
Publisher: Australian Government Department of Health and Ageing
Description: ADRAC has monitored the reported side effects associated with Stilnox use since it was first registered. In June 2006 ADRAC noted that it had received several reports of bizarre sleep related behaviour in patients taking Stilnox.
Date: Jun 2007

Health Warnings

Zolpidem ('Stilnox') - updated information - November 2007
(Publisher: Australian Government Department of Health and Ageing)

http://www.healthinsite.gov.au/conte...0FA0&PID=61946
STILNOX side effects and STILNOX interactions, STILNOX medical symptoms


Look at the dates on these reports.
How long does it take for the message to get though?

[CraigD]

Originally Posted by Michaelangelica

Zolpidem / Stilnox

…
How long does it take for the message to get though?

It’s a complicated message, so not only may it take a while to get through, it’s hard to guess what it will be when it does. It may not be that Stilnox/Zoloft (Zolpidem) should be banned.

From The SMH article, there are a few complicating factors with in the case of Mairead Costigan’s untimely death:

• She didn’t die from drug toxicity or overdose, but from a fall, either accidental or intentional (suicide)
• She wasn’t taking Zoloft when she fell to her death, but another sleep aid, Imovane/ Lunesta (Zopiclone), a drug with a similar effect but significantly different pharmochemistry than Zoloft.
• She appears to have had medical/mental health issues other than the insomnia being treated by the Zoloft and Lunesta.
  Though the article doesn’t provide information such as her height, from looking at it’s photo, I wonder if she suffered from some body self-image disphoria resulting in anorexia, as she appears significantly underweight in this photo, which I’m guessing shows her at 51 kg, vs. her recent low weight of “the low-40s”.
  I don’t think we can speculate meaningfully about the factors contributing to Costigan’s death without a more complete medical/psychiatric history, which it would be inappropriate for people other than her caregivers to have, and inappropriate for them to discuss on the internet.

Hypnotic sleep aid drugs like Zoloft and Lunesta present a complicated situation for the clinician. They’re much lower toxicity than the early drugs they replace (barbituates), so are safer to prescribe, especially for people you suspect of being depressed and possibly suicidal – giving a potentially suicidal person a supply of barbituate adequate for a painless, fatal over dose is, obviously, a very bad idea. However, this increased safety can cause clinicians to neglect therapy and follow up.

Costigan is an atypical case, having (I’m guessing) better than typical financial, medical, and social resources. Psychiatric mistreatment is, in my experience, more common among the less resourced, where physician case loads are higher and quality of care typically lower. Especially strange to me is that a PhD student in a university philosophy department would come to such an end, as I assume she had at least the possibility of access to good conventional psychotherapists through. My experience with such academic settings is that psych faculty put extraordinary effort into helping people in their neighboring departments, affording some of the best psychiatric care I’ve ever seen. Unfortunately, as may be the case with Costigan, sometimes the best efforts of many capable people aren’t enough.

Another thing that concerns me about hypnotic sleep aids is that, despite manufacturer literature and other research indicating that they have a low potential for abuse, I know for a fact that many people are abusing them. Though many people seem able to use them for months on end without any tendency toward overmedication or recreational use, some people seem to find these drugs enticingly nice and fun. Though a “soft” drug compared to the older barbiturates and many illicit drugs, they’re very available on the gray market, and I’ve seen folk, especially young ones, use them recreationally in situation chillingly similar to the article’s description of Costigan’s last moments.

The best result that could come out of this and other attention about limitations and dangers of sleep aid drugs, IMHO, would be a shift toward non-drug treatments of insomnia, particularly sleep studies. Unfortunately, these treatments are more expensive than drugs-based treatments, so such a shift may prove difficult.

[HydrogenBond]

Have there ever been a study to compare the adverse affects and mortality rates between legal and illegal drugs? I would have to assume the legal ones will score lower, but has there even been a study to prove this? Maybe part of the problem is if one legal drug causes harm it can be covered up with another legal drug. One would have to take into consideration drug changes, which may represent the treatment for the affects of another legal drug. With illegal drugs one may not have secondary illegal drugs to treat problems caused by the primary drug. One would have to normalize both types for it to be an unbiased study.

[Michaelangelica]

Thanks craig
no rep sorry
Are you the sanest person at hypography?

My "(?)", was meant to mean that this is an early alert and the drug may or may not be found 'deadly'.

To HB

Have there ever been a study to compare the adverse affects and mortality rates between legal and illegal drugs? I would have to assume the legal ones will score lower,

I would guess the other way HB.-illegal drugs lead to less deaths.
(Alcohol and cigarettes are not 'illegal')
Shall we make a bet on it?

[Michaelangelica]

The Cholesterol Con -- Where Were the Doctors?

By Maggie Mahar, Health Beat. Posted February 29, 2008.

For years, medical studies have challenged the efficacy of cholesterol-lowering drugs. Why are we just hearing about this now?
. . .
This brings me to the question I ask in my headline: During the many years of the Cholesterol Con, where were the doctors? When everyone from the makers of Mazola Corn Oil to the Popes of Cardiology assured us that virtually anyone could ward off heart disease by lowering their cholesterol, why didn't more of our doctors raise an eyebrow and warn us: "Actually, that's not what the research shows"?

No doubt, you've heard about the recent Business Week cover story, "Do Cholesterol Drugs Do Any Good?", which blew the lid off the theory that "statins" -- drugs like Lipitor, Crestor, Mevacor, Zocor and Pravachol -- can cut the odds that you will die of a heart attack by slowing the production of cholesterol in your body and increasing the liver's ability to remove LDL, or "bad cholesterol," from your blood.
. . .
Dr. Ronald M. Krauss, director of atherosclerosis research at the Oakland Research Institute, told Business Week. "When you look at patients with heart disease, their cholesterol levels are not that [much] higher than those without heart disease," he added. "Compare countries, for example. Spaniards have LDL levels similar to Americans', but less than half the rate of heart disease. The Swiss have even higher cholesterol levels, but their rates of heart disease are also lower. Australian aborigines have low cholesterol but high rates of heart disease."
. . .
And if the key to statins is that they reduce inflammation, it's worth keeping in mind that this is what other effective heart treatments like aspirin and the omega-3 fatty acids found in fish oils, garlic and vitamin E do -- at a much lower cost and with far fewer side effects.
. . .
there does seem to be a risk that women on statins develop memory loss so severe that their relatives may begin shopping for a nursing home.

Memory loss that can mimic alzheimers is the second most common side affect for people taking statins, right after muscle pain,

AlterNet: Health and Wellness: The Cholesterol Con -- Where Were the Doctors?

STATIN SIDE EFFECTS: DO DOCTORS TAKE PATIENTS' COMPLAINTS SERIOUSLY? A New Study Reveals What Happens When Patients Complain of Statin Side Effects to Their Doctors.
. . .
The researchers focused on three types of side effects commonly caused by statins. The first type involved muscle pain, tightness, cramping, or weakness. In private consultations, patients described their symptoms to 138 doctors. According to the patients, fifty-three doctors (38%) acknowledged the possibility of statin side effect. Eighty-five doctors (62%) dismissed the possibility.

Patients presented symptoms of cognitive disorders, including impaired memory or thinking, to 56 doctors. Sixteen doctors (29%) acknowledged the possibility of a statin side effect. Forty doctors (71%) dismissed the possibility.

Patients presented symptoms of nerve injuries (neuropathies) including pain, weakness, or loss of function to 49 doctors. Seventeen doctors (35%) acknowledged the possibility of a statin side effect. Thirty-two doctors (65%) dismissed the possibility.

STATIN SIDE EFFECTS: DO DOCTORS TAKE PATIENTS' COMPLAINTS SERIOUSLY?

Risk factors for myopathy and rhabdomyolysis with the statins

Four statins (HMG CoA inhibitors) are available in Australia for the treatment of hypercholesterolaemia: simvastatin, atorvastatin, pravastatin and fluvastatin. Each of the statins may cause myalgia or rhabdomyolysis. Cerivastatin was removed from the market worldwide because of an unacceptably high rate of rhabdomyolysis, including fatal cases, particularly when used with gemfibrozil.1
. . .
ADRAC has received 91 reports of rhabdomyolysis with simvastatin and 26 with atorvastatin, as well as many reports of myalgia, myopathy or creatine kinase (CK) increase.

Australian Adverse Drug Reactions Bulletin, Volume 23, Number 1, February 2004

The Canadian Adverse Drug Reaction Monitoring Program (CADRMP) has received reports of rhabdomyolysis or myopathy with all statins approved for sale in Canada (Table 1). In severe cases, rhabdomyolysis can result in kidney failure.8

Canadian Adverse Reaction Newsletter, Volume 12, Issue 1, January 2002
Rhabdomyolysis is the breakdown of muscle fibers resulting in the release of muscle fiber contents (myoglobin) into the bloodstream. Some of these are harmful to the kidney and frequently result in kidney damage.


Statin Drug Danger

[Michaelangelica]

FDA Issues New Warnings on Harmful Drug Used to Stop Smoking
Tuesday, March 04, 2008 by: Frank Mangano
Chantix, a new prescription drug to help people stop smoking.

The FDA is discovering the more they investigate this prescription drug, the more they are finding different and serious health problems such as a distinct relationship between the drug and serious neuropsychiatric symptoms

FDA Issues New Warnings on Harmful Drug Used to Stop Smoking

Canada Bans Anti-Inflammatory Drug Prexige after Reports of Severe Liver Damage

Canada Bans Anti-Inflammatory Drug Prexige after Reports of Severe Liver Damage

[Michaelangelica]

Health News - New York Times
Bill Crandall for The New York Times
Dr. Howard Heit is a leader in pain management and tightly controls methadone use of patients. Checking pain sensitivity of patient Alexandra Sherman.

Once used mainly in addiction treatment, the drug is now more widely prescribed and is a growing cause of deaths.

* Video: Methadone: The Pain Killer | Graphic Graphic: The Methadone Boom
* F.D.A. Weighs Training to Dispense Narcotics
* Times Topics: Methadone

[dkv]

US is world's largest consumer of illegal drugs. Roughly 4 times its nearest competitor. More than 20% of teenagers get involved with drugs at age less than 13. More than 50% teenagers drink and drive. The situation is alarming.
The doctors cheat .. they prescribe wrong drugs to the patient.
More than 14000 patiets entered the emergency rooms due to drug overdose.
Highly educated Americans are also the most irresponsible.

[dkv]

Youth Risk Behavior Surveillance --- United States, 2007
In the United States, 72% of all deaths among persons aged 10--24 years result from four causes: motor-vehicle crashes, other unintentional injuries, homicide, and suicide.
During the 30 days before the survey, 29.1% of high school students had ridden in a car or other vehicle driven by someone who had been drinking alcohol, 18.0% had carried a weapon, and 5.5% had not gone to school because they felt they would be unsafe at school or on their way to or from school.
During the 12 months before the survey, 6.9% of high school students had attempted suicide.
In addition, 75.0% of high school students had ever drunk alcohol, and 4.4% had ever used methamphetamines.
Results from the 2007 survey indicated that 47.8% of students had ever had sexual intercourse, 35.0% of high school students were currently sexually active, and 38.5% of currently sexually active high school students had not used a condom during last sexual intercourse.
Among U.S. adults aged >25 years, 59% of all deaths result from two causes: cardiovascular disease and cancer.
Among high school students nationwide during 2007, 20.0% had smoked cigarettes during the 30 days before the survey,
35.4% had watched television 3 or more hours per day on an average school day, and 13.0% were obese.
During the 7 days before the survey, 78.6% of high school students had not eaten fruits and vegetables five or more times per day,
33.8% had drunk soda or pop at least one time per day, and 65.3% had not met recommended levels of physical activity.

Forced to Have Sexual Intercourse

Nationwide, 7.8% of students had ever been physically forced to have sexual intercourse when they did not want to (Table 11).
Overall, the prevalence of having been forced to have sexual intercourse was higher among female (11.3%) than male (4.5%) students; higher among white female (11.0%), black female (13.3%), and Hispanic female (11.4%) than white male (3.2%), black male (7.8%), and Hispanic male (6.2%) students, respectively; and higher among 9th-grade female (9.2%), 10th-grade female (13.1%), 11th-grade female (12.0%), and 12th-grade female (10.9%) than 9th-grade male (4.1%), 10th-grade male (3.4%), 11th-grade male (5.0%), and 12th-grade male (5.7%) students, respectively. Overall, the prevalence of having been forced to have sexual intercourse was higher among black (10.5%) and Hispanic (8.8%) than white (7.0%) students and higher among black male (7.8%) and Hispanic male (6.2%) than white male (3.2%) students. Overall, the prevalence of having been forced to have sexual intercourse was higher among 11th-grade (8.5%) and 12th-grade (8.3%) than 9th-grade (6.6%) students; higher among 10th-grade female (13.1%) than 9th-grade female (9.2%) students; and higher among 11th-grade male (5.0%) and 12th-grade male (5.7%) than 10th-grade male (3.4%) students. Prevalence of having been forced to have sexual intercourse ranged from 6.3% to 14.0% across state surveys (median: 9.1%) and from 5.6% to 12.2% across local surveys (median: 8.5%) (Table 12).

Lifetime Cigarette Use

Nationwide, 50.3% of students had ever tried cigarette smoking (even one or two puffs) (i.e., lifetime cigarette use) (Table 25). Overall, the prevalence of lifetime cigarette use was higher among male (51.8%) than female (48.8%) students; higher among white male (51.7%) than white female (48.3%) students; and higher among 9th-grade male (46.0%) than 9th-grade female (39.2%) students. Overall, the prevalence of lifetime cigarette use was higher among 10th-grade (48.8%), 11th-grade (53.4%), and 12th-grade (59.3%) than 9th-grade (42.7%) students; higher among 11th-grade (53.4%) and 12th-grade (59.3%) than 10th-grade (48.8%) students; and higher among 12th-grade (59.3%) than 11th-grade (53.4%) students. Overall, the prevalence of lifetime cigarette use was higher among 10th-grade female (48.7%), 11th-grade female (51.4%), and 12th-grade female (58.5%) students than 9th-grade female (39.2%) students; higher among 12th-grade female (58.5%) than 10th-grade female (48.7%) and 11th-grade female (51.4%) students; and higher among 11th-grade male (55.4%) and 12th-grade male (60.1%) than 9th-grade male (46.0%) and 10th-grade male (48.8%) students. Prevalence of lifetime cigarette use ranged from 24.9% to 62.2% across state surveys (median: 51.9%) and from 36.5% to 57.6% across local surveys (median: 43.6%) (Table 26).
10.7% of students had smoked more than 10 cigarettes per day on the days they

Nationwide, 44.7% of students had had at least one drink of alcohol on at least 1 day during the 30 days before the survey (i.e., current alcohol use)

Marijuana Use
Nationwide, 38.1% of students had used marijuana one or more times during their life (i.e., lifetime marijuana use) (Table 39). Overall, the prevalence of lifetime marijuana use was higher among male (41.6%) than female (34.5%) students; higher among white male (41.8%), black male (44.5%), and Hispanic male (42.0%) than white female (34.1%), black female (35.0%), and Hispanic female (35.9%) students, respectively; and higher among 9th-grade male (33.0%) and 11th-grade male (48.3%) than 9th-grade female (21.7%) and 11th-grade female (36.6%) students, respectively.
Nationwide, 19.7% of students had used marijuana one or more times during the 30 days before the survey (i.e., current marijuana use)

Nationwide, 7.2% of students had used any form of cocaine (e.g., powder, crack,** or freebase††) one or more times during their life
Nationwide, 3.3% of students had used any form of cocaine (e.g., powder, crack, or freebase) one or more times during the 30 days before the survey
Nationwide, 2.0% of students had used a needle to inject any illegal drug into their body one or more times during their life
Nationwide, 13.3% of students had sniffed glue, breathed the contents of aerosol spray cans, or inhaled any paints or sprays to get high one or more times during their life (i.e., lifetime inhalant use)
Nationwide, 5.8% of students had used ecstasy (also called "MDMA") one or more times during their life
Nationwide, 14.2% of students had smoked a whole cigarette for the first time before age 13 years
Nationwide, 23.8% of students had drunk alcohol (other than a few sips) for the first time before age 13 years
Nationwide, 8.3% of students had tried marijuana for the first time before age 13 years
Nationwide, 7.1% of students had had sexual intercourse for the first time before age 13 years
black female (60.9%) and (72.6%) black students had ever had sexual intercourse against the average 45%

[dkv]

Another research on the drug use worldwide
PLoS Medicine - Toward a Global View of Alcohol, Tobacco, Cannabis, and Cocaine Use: Findings from the WHO World Mental Health Surveys

Drug overdose
News and Views: Adverse Reactions to Antibiotics Sends thousands to ER

Drug related deaths
Study: Accidental drug overdose rates hit new high - FierceHealthcare

All the figures are less than the actual. Recently fox news came up with a news which showed that more than 90% of US paper currency notes carry some drug dust against to less than 20% in Europe.