Map of life expectancy at birth from Global Education Project.

Friday, March 17, 2006

This time it's personal . . .

Unlike Rexroth's Daughter's mother (who, scandalously, is not married to Rexroth), my mother does not consult me about the medications prescribed for her, or my father. (See comments on "Don't be Afraid to Ask Questions, below.) She goes along with what the doctors want, no matter what I say.

My father has been diagnosed with vascular dementia. Although his neurologist insists that he does not have Alzheimer's disease, she prescribed Aricept for him, which is approved only for treatment of Alzheimer's. This has never sat well with me because a) there is no evidence that Aricept is of any use in vascular dementia; b) a study of another drug in the same class, Reminyl, found that it increases the risk of cardiac death; and c) oh yeah, there actually is no evidence that Aricept is of any real use in Alzheimer's disease either, or does any real good for anybody.

Aricept is approved on the basis of slightly improved scores on certain mental tests in people with Alzheimer's. However, those "improvements" did not translate into any improvement at all in actual functioning, or any delay in disability or the need for custodial care. So why spend the money and accept any risk whatever?

Now the Japanese manufacturer of Aricept, Eisai Corporation (it's made in the U.S. by Pfizer) decided to do a study of Aricept in people with vascular dementia, so they could market it openly for people like my father, as opposed to whatever covert and possibly illegal marketing Pfizer did to convince my father's neurologist to prescribe it. Whoops -- 11 of 648 patients taking Aricept died after 24 weeks, compared to 0 (zero) out of 326 on placebo. That's quite a lot of dead people in quite a short time -- and all for the biologically implausible hope that they might show marginal improvement on formal tests of cognitive functioning, even if it didn't actually make any difference in their lives.

Guess what the company says? It's just a fluke, nothing to see here, move along, keep taking Aricept. The medical doctors on their payroll say the same thing. I say you'd have to be nuts.

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