No one knows drug side effects like the person who is taking a pill.
RxISK.org is the website for patients, doctors, and pharmacists to research and report drug side effects.
Search. Report. Contribute.
All prescription drugs have side effects. The key to good medicine is being able to weigh the tradeoffs between a drug’s side effects and its benefits.
There are a number of steps we take you through at Rxisk.org to establish whether your drug is causing your problem — whether you are suffering from Pharmacosis (see Pharmacosis blogs) or not. This will work for problems known to be caused by the drug but also for problems not yet linked to treatment. These are the steps that any expert would take you through before deciding there was a linkage. These are the steps pharmaceutical companies routinely work through, based on which they often decide their drug has caused a problem, while still denying in public that it does so.
These are the kinds of questions that need to be asked even when it is known that a drug does cause suicide, gambling, heart attacks, or some other problem. Just because someone has begun to gamble or been violent and is on a drug that can cause violence or gambling does not mean the drug has caused the problem. A judgment is still needed as to whether the drug is likely to have played a part or not. Ideally this will be a team judgment — involving the person affected and as many others as possible.
Some of the steps outlined here can be found in other algorithms of which the most famous is the Naranjo algorithm but we ask more questions and score things differently.
Pharmacosis Trigger Algorithm
|points strongly to a link – bring to your doctor/pharmacist|
|points to a likely link – bring to your doctor/pharmacist|
|needs information or input from your doctor/pharmacist (Qs 13, 14, & 15 in particular)|
No simple score can tell whether a drug has caused a problem. It needs a team and research and judgment. The person on the drug is critical — no one knows what is going on quite the way the person on the drug does (see Unbearable lightness of being), and as history shows people on the drugs often get it decades before the experts. But there are many side effects that need judgment calls from doctors or pharmacists or increasingly anyone armed with Google and prepared to research things (see Out of my mind).
Birth defects in general like the phocomelia caused by thalidomide cannot be tested by challenge, de-challenge, or re-challenge. Babies had been born limbless and deformed like this before thalidomide but it suddenly became a lot more frequent.
Just like phocomelia on thalidomide, conditions that looked like tardive dyskinesia happened before the antipsychotics, but were a lot more common after the antipsychotics were introduced. In this case though the tardive dyskinesia that appeared on the drug cleared up if the dose of the drug was increased — could this be caused by the drug? Scoring on the RxISK Trigger algorithm might not point to a link but scoring on the RxISK Terminator algorithm might have helped to bring out the link.
Ultimately the more reports shared among the greatest number of people the more likely we all are to find an answer (see Unbearable lightness of being).
RxISK.org is going live as 1 October 2012.