Pfizer's popular pill Neurontin has side effects
A UBC drug-research group has issued a “therapeutics letter” concluding that a widely used pain reliever has very little effect. The Therapeutics Initiative, which is funded by the B.C. Ministry of Health through a grant to UBC, states in its public letter that gabapentin has a “minor role in pain control”. The letter also claims that misleading promotion pushed this drug to “blockbuster status”.
Gabapentin was originally sold under the name Neurontin, which is a Pfizer medication licensed in Canada in 1993 as an add-on therapy for epilepsy. According to the Therapeutics Initiative letter, U.S. sales reached $2.7 billion per year by 2003 after being marketed “for everything”. Last year, B.C. consumers and the PharmaCare program spent more than $30 million on the drug, with 63 percent coming from public funds.
In a phone interview with the Georgia Straight, Dr. Tom Perry said that after Pfizer’s patent expired in Canada and the United States earlier this decade, generic drug manufacturers began producing their own gabapentin.
Perry, a pharmacologist and chair of the Therapeutics Initiative education working group, noted that brand-name Neurontin still exists, but he doubts many people are buying it, because the generic drug is less expensive.
“The message of the letter is that patients who are taking the drug and doctors who are prescribing it should reassess what they’re doing,” Perry said. “If the patient is getting clear benefit, it’s a relatively safe drug—gabapentin. If they’re not getting benefit, they never will because it doesn’t get better over time.”
According to the letter, about 15 percent of patients receive benefits in reducing neuropathic pain by less than one on a scale of zero to 10. A similar percentage of people suffer harm, the letter adds, noting that opioids “afford greater relief in chronic neuropathic pain, with qualitatively different adverse effects”.
Pfizer has a newer drug called pregabalin. The Therapeutics Initiative says its benefits and harms are similar to gabapentin, but at a higher cost.
Perry noted that most people who take gabapentin for pain relief are probably not receiving any benefit. In addition, Perry said, they are likely to be experiencing some brain toxicity, which often takes the form of somnolence, a mild balance disturbance, mild nausea, or generally impaired thinking.
“It can be surprisingly subtle [in] that people feel they have trouble coming up with the right word,” he said. “They attribute their impaired thinking to something else that happened to them, like a motor-vehicle accident or an underlying condition, like MS [multiple sclerosis].”
However, Perry noted that some people suffer a “very, very profound toxicity” from the drug, which can lead to nausea or major speech disturbances that could be similar to those of stroke victims. In rare cases, he said, people develop psychotic hallucinations. “But usually, it’s more subtle,” he said. “The other thing it tends to do is it causes swelling of the feet, or edema, which patients and doctors never seem to attribute to the drug. That could be risky because people may be diagnosed as having heart failure. They end up being put on a diuretic.”
Perry said he was paid to testify for the plaintiff in a class-action lawsuit against Pfizer in Boston. The Therapeutics Initiative conducted its review of gabapentin by examining unreleased company-financed studies, which were disclosed in the court case.
“Another important lesson from this and similar stories [is] if we really want to protect the public, we need universal access within a reasonable amount of time to all data from clinical trials,” Perry said.
Pfizer Canada did not provide a spokesperson to be interviewed by the Straight. In an e-mailed statement, the company described Neurontin is an “important” Health Canada– and Food and Drug Administration–approved medicine that physicians have prescribed to millions of patients safely and effectively. In addition, the company claimed that this drug has “been widely studied for more than two decades and there is an extensive body of publicly available literature on its safety and its use”.
Perry said that Health Canada will approve a drug if a manufacturer can demonstrate that it’s better than a placebo for a certain condition, and if it’s not horrendously dangerous over the short term. “We have no long-term safety-data requirements for anything, really,” he noted. “Until we get reform of drug licensing and supervision of drugs and other technologies globally, we’re going to continue wasting billions of dollars per year in a country like Canada, and causing a lot of harm to people that could be avoided.”
Related article: The pill pushers
Follow Charlie Smith on Twitter at twitter.com/csmithstraight.
Comments
8 Comments
Bryan B. West Van
Mar 25, 2010 at 4:31am
It is good to see the media paying attention to the problem of our society being flooded with drugs that have marginal value, and come with the distinct possibility of serious and troubling side effects.
This article talks about cognitive impairment being one result of this drug. Many, many drugs have these and other "unintended" side effects. <b>Check out Ralph Nader's Citizen Watch organization's website on pharmaceutical drug safety for the most comprehensive info on individual drugs -- www.worstpills.org </b>
Here's another "side effect" of many pharmaceutical medications: if you exhibit any side effects from medication, it's quite likely that your doctor won't connect the dots. Especially for elderly people. It doesn't take much research to determine this, and to hear that most doctors "don't have the time to continually educate themselves on new drug developments." If you try to tell the doctor this, they'll likely just dismiss you (they did that to me). The doctor quoted in this article has a refreshing attitude, but I'm afraid too many doctors simply believe they know everything and won't believe the patient (or family members).
One last, important fact that many people won't be aware of -- that a doctor can (easily, quicky and without any meaningful evidence) declare a person to be incapable of managing their affairs. If/when ths happens, anyone who wishes to apply to the courts to have that person declared legally incapable will be successful.
This happens in BC frequently, especially to the elderly. Often the people applying to have a loved one declared incapable are doing so for the right reasons, and are unaware that the impaired functioning of their loved one may just be a temporary side effect which would stop if they stopped taking the drug(s). Far too often though, unscrupulous "loved ones" take advantage of the opportunity to cease control of the person and their assets.
Sad, but this is not rare, especially in BC where seniors, especially those in care facilities, are routinely given many drugs to keep them sedated (docile), even when there is no medical reason to do so, the drugs are not approved for those purposes, and/or the regulators have imposed strong warnings that the drug is not to be given to the elderly.
Borden
Mar 26, 2010 at 7:30am
I guess that I am one of the very few that is receiving a great benefit from gabapentin. I suffer from diabetes with neuropathic pain of the toes and finger tips. This is a very painful condition especially in my toes where I feel ice-cold pain as well as severe burning (?) This almpst all disapears when I take Gabapentin at night and a much lower dose during the day. It does have the sideeffects of drowsiness that I have experienced. I do sleep well with this medication even though I have never had problems sleeping.
It's been a godsent medication for me.
Nelsonpa1
Apr 1, 2010 at 9:04am
I have been taking Nuerontin for over ten years. I developed epileptic symptons from a Brain tumor in the fall of 1993. The tumor was successfully treated with a combination of radiation and chemo but, I continued to have siezures. Initially, I was having a siezure about once a week. I was reffered to UCLA. By careful administration of my dilanton, my siezures were reduct to one in every three monthes. After they added the Neurontin, I have have had no more seizures. (After several years, I got cocky and, stopped taking my medication. I had another sezure within 4 weeks. I'm not doing that again.)
After reading the article, do have some of the milder symptons (trouble coming up with words, some loss of balance) but, these pale in cotrast to having a grand maul seizure. (Flopping around on the floor like a fish out of water!) They will have to pry these pills out of my dead hands.
Michelle P
Apr 5, 2010 at 7:21pm
I am so glad they have found this conclusion to Neurontin as I am one of the 15% that got very little pain relief and alot of side effects from the drug. I was using it for nerve pain caused by my MS. The neurologist then put me on Lyrica (Pregabalin), which has worked somewhat better. They mention in the article that it too has even more potential for harm, but they don't mention any more than that, so what are those of us to make of that information??? Any suggestions out there?
BaxDoc
Apr 6, 2010 at 2:30pm
The neurontin piece - it is so rife with misinformation I don't know where to begin. First off, ALL drugs have effects. That's why we take them. The ones we like, we call therapeutic. The ones we don't like, we call side effects. With gaba pentin/neurontin, side effects are almost always dose related. so if you are drowsy and confused, lower the damn dose. It's not rocket science. They come in 100mg tabs, lowering dose is easy to do. This is an old, safe drug that's a godsend (as Borden says) for people with neuropath pain; it works for seizures and is more benign than many over the counter meds. I am not sure how Smith can write an entire article based on a single source, Tom Parry, who neither deals with pain nor knows anything about it. I could refer Smith to several pain experts if he is interested. As for the drug not working for 15% of people - this means that it works for 85% of people who take it. That's higher than most drugs. Finally, the TI has been known to get bees in its bonnet - why this time it is for an old, cheap, generic drug is beyond me. Why not turn its gaze to the statins, the single biggest selling drugs in the world for which there is NO evidence (for primary prevention?) Or expensive blood pressure meds where old, cheap diuretics work just as well? The list goes on. Neurontin is a really good drug for people with nerve-related pain. Get over it.
Linda S.
Apr 14, 2010 at 10:12am
I've been taking Gabapentin for 5 years. I take one pill a day, but can take as many as three per prescription. I find that it helps with my nerve damage. I had a back operation but unfortunately I got drop foot before I had the operation and that led to the nerve damage. But I am concerned about side effects from taking prescription medication. I find if I don't take the pill that the pain is quite uncomfortable.
julie
Jul 6, 2014 at 3:13am
i have nueropathy down both legs and both feet due to degenerative disc disease- nuerontin is something ive used on occasion but now my feet are on fire so im a loyal taker and im oddly finding it to be a diuretic which for me is actually good bc my pain meds make me hold water! ive had 2 back surgeries but went numb before they got to mr point being they made me wait 7 weeks to be seen by doctor and too late by then! most people so brain washed by friends and media so allow me o set the record straight...if you or loved one are considering back surgery go get shots of steroid injections bc when you need back surgery you don't think abt it- you beg for it and no you nimble-heads lol just kidding but si sick of being asked or it is assumed that the surgery itself made me this way- no the darn disc which ruptured and fully blew out made me this way! back surgery has allowed me to walk! back surgery just doesn't make you perfect again all the time! but without it i would not even walk!!! so neurontin makes your head fuzzy and you forget words- you can decrease dose- it iss great for burning neuro-pathy pain but not general pain which calls for also pain medicine...neurontin is good though when needed and get off if you can after you are better if you are ever better as i usually am after shots or surgery bc i have ongoing disc degeneration which my mother had also...it is what it is and shots i still get bc i'm avoiding 3rd surgery until the day i beg for it again!!! they have knees and hips down but backs are tricky!!!!! hope this helps and my Q is has anyone else had diuretic effects???
LaIna
Aug 10, 2014 at 12:35pm
This article must have been penned by someone with nothing else to do or write about. And they pieced it together from things that fall into the 'anything is possible' file cabinet, hoping no one who is an actual sufferer of something this treats does read it.
Sorry to break the truth to he or she, but we are here. And of all of the many things this does treat, on and off label, it is miraculous for LOTS of us.
I've taken 1800 mg a day for 16+ years and am a 122 lb. female. I am not losing words or dozing off except in blissful sleep from no pain or muscle spasms and pulling from dystonia.
What that fine and lawsuit years back against Pfizer did, was make we that take it have to PAY more and worst of all, cause doctors to hesitate or refuse to even suggest to patients to try it. HEY.... I was suffering for months and many do for years. I was better starting with the first 300 mg capsule. Within 30 minutes.
So, go witch at some other medication. Not at gabapentin.