Monthly Archives: June 2016

Singulair: Doctors, Pharmacists, Regulators Shift Blame Over Asthma Drug Side Effects Warning

Last week 7.30 reported the Therapeutic Goods Administration (TGA) had received almost 90 reports of psychiatric events, including suicidal thoughts, in children and adolescents treated with Singulair’s active ingredient, a drug called montelukast.

Since then more parents have contacted the ABC saying their children became suicidal, depressed, or violently angry while taking Singulair. John, who did want his last name used, said his seven-year-old daughter had been taking Singulair for about a year when he noticed she started having irrational tantrums.

“They’d end up with her biting us and kicking us and screaming on the floor, and then after she’d calm down, which might be like an hour, she’d say things like ‘I can’t be good, it’s impossible, I’m not good enough, why was I ever born, I don’t like myself, why am I so weird, I hate myself,'” he said.

John said she started making comments like that every day. More families tell of asthma drug’s psychiatric effects ( AM ) “There is nothing in the world quite like hearing your seven-year-old full of self-loathing,” he said.

After searching online John and his wife learned Singulair could have behavioural side effects. They took their daughter off the drug and she was better within weeks.

Suicidal thoughts and actions, depression, aggression and hostility are listed side effects on the Consumer Medicines Information for Singulair, but like many parents John said he and his wife never got verbal or written warnings from their doctor or pharmacists, or information leaflets in boxes of Singulair.

The Australian Medical Association (AMA) said parents might have been warned but not realised it.

“Most prescribers do warn, but it might not be in a way that the family have recognised it,” Richard Kidd, the chair of the AMA’s Council of General Practice, said.

“The doctor may have had said something to the effect that this medication could affect the way the child is thinking and, you know, if you’ve got any concerns come back at talk to me — which is not the same thing as saying your child could become suicidal, which is a really scary, confronting thing to say.”

He said it was pharmacists’ responsibility to give patients the Consumer Medicines Information.

Multivitamins

Our bodies need many different vitamins and minerals to function properly. Vitamins and minerals also offer us protection against a host of ailments, including heart disease and some cancers, such as colon and cervical cancer.

The good news is that we can get most of the vitamins and minerals our bodies need daily by choosing the right foods and eating a wide variety of them. Still, many people take a multivitamin daily as an insurance policy — just to be sure they are getting all the vitamins and minerals that their bodies require.

“A multivitamin is a good idea for the trace elements,” says Donald Novey, MD, an integrative medicine physician with the Advocate Medical Group in Park Ridge, Ill.

“You want a multivitamin for all those little things at the bottom of the ingredients list. The ones at the top of the list are familiar and the ones we can’t avoid if we’re eating enriched foods. It’s the trace elements at the bottom that are the ones often missing.”

Trace elements include chromium, folic acid, potassium, iron, manganese, selenium, and zinc.

Daily Vitamin: Our Needs Change With Age

Vitamin supplements can be particularly important during certain stages of our lives, Dr. Novey says. For example, women in their childbearing years can benefit from folic acid, which decreases the risk of some birth defects. A pregnant woman needs a multivitamin, starting in the first trimester, to ensure that the baby receives proper nutrition. Active and older women can benefit from increased calcium, which can help prevent bone loss and fractures. Vegetarians also can benefit from taking extra calcium, iron, zinc, and vitamins B12 and D.

 

Does it matter what time of day you take a multivitamin? Not really, says Stephen Bickston, MD, AGAF, professor of internal medicine and director of the Inflammatory Bowel Disease Center at Virginia Commonwealth University Health Center in Richmond. However, he says, some people find it helpful to take vitamins at the same time every day. If it becomes part of their routine, they are less likely to forget. Also, he says, some people feel that if they take their vitamin with food, it is less likely to cause stomach upset. “I often recommend that people take a chewable vitamin,” Dr. Bickston says, “because they seem to be well tolerated, even in people who have serious digestive conditions, which is what I deal with in my practice.”

 

Daily Vitamin: Tips for Shopping for the Right Multivitamin

Do you need to buy brand name vitamins? Novey says vitamins are like any other consumer product: “You get what you pay for.” He suggests shopping for vitamins in health food or natural food stores. Read the label and make sure its expiration date is at least a few months away. The U.S. Food and Drug Administration’s advice on how much to take — or the Recommended Daily Allowance (RDA) — is often written as “% DV” for percentage of daily value on the label. However, be careful because the DVs on the label may not take into consideration the different requirements for age and gender as RDAs do.

Multivitamins can be beneficial, but doctors warn not to be suckered by “mega” vitamins. The amount of vitamins in a standard multi is generally what you need for health benefits. Rarely do people need more than the RDA of any vitamin. When it comes to vitamins, the too-much-of-a-good-thing rule can apply, Bickston says.

Daily Vitamin: Ensuring Good Health

Clearly, eating a variety of fresh fruits and vegetables, whole grains, fish, lean meats and poultry, and low-fat dairy products is the best way to get your daily dose of vitamins and nutrients to keep your body functioning properly and to ward off illnesses. But taking a multivitamin daily is a good backup plan, and an easy way to fill in any gaps in your diet.

Reduce Overeating After Mentally Taxing Work

The University of Alabama study asked students to complete a challenging exam, then either exercise or rest for 15 minutes. Researchers then treated the students to an all-you-can-eat pizza lunch.

In a separate session, the students also rested and then ate pizza to allow the researchers to get a baseline for the students’ appetite.

You might have thought the exercisers would be hungrier, but the opposite was true: those who had relaxed after the exam ate about 400 kilojoules more than their baseline.

In contrast, those who exercised ate about 100 kilojoules less than their baseline, plus they burned kilojoules during their 15 minutes of high-intensity interval training, reducing their overall energy intake even further.

Researchers say the lactate — one of the brain’s energy sources — that is produced during strenuous activity might have been enough to replenish the students’ brain energy needs after the exam, reducing their need to overeat.

The study has clear implications for the workforce and students, lead author William Neumeier said.

“The modern work environment is highly sedentary and cognitively demanding,” he said.

“Previous studies have shown that mentally demanding tasks, such as a big test, deadlines or other mentally strenuous tasks we perform every day, affect the brain’s energy demands, and increases in food intake were observed following such tasks.”

He said further research was needed to fully understand the observed effect exercise had on participants’ energy intake following mental work.