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Today's
Stories
January 12
/ 13, 2008
Saul Landau
60
Years of Empire
January 11,
2008
Dave Lindorff
Did
Hillary Really Win New Hampshire? More Questions About Diebold
Voting Machines
Paul Craig
Roberts
No
Escape from War and Unemployment
Andy Worthington
Six Years of Guantánamo
Kenneth Couesbouc
Banking on Thin Ice
Jeff Ballinger
Inside the Vienna Consensus
Christopher
Brauchli
Lethal Injection, the Supremes and China
Manuel Garcia, Jr.
Paying No Attention to the Presidential Campaigns
Andrew Silverstein
Bush's Weepy Visit to Jerasulem
Marwan Bishara
Bush in the Middle East
Robert Weissman
The First Amendment Gone Wild
Patrick Irelan
Damn the Small Boats!
Website of
the Day
Hillary and the Superdelegates: Or Why She Wins Even When She
Loses
January 10,
2008
Alexander Cockburn
Now
Nader Claims He Didn't Endorse Edwards
Bob Wing
Marqueece Harris-Dawson
Race Within the Race: Obama, the NH Vote and the Specter of Tom
Bradley
Michael Donnelly
White Women Gone Wild?
David Macaray
Three Big Reasons for the Decline of Labor Unions
China Hand
Bush's Delusional Policy Pushes Pakistan to Brink of Catastrophe
Ayesha Ijaz Khan
Saudi Arabia and Pakistan: Brotherly, Friendly Countries?
Rannie Amiri
Obama, Man of Kansas or Kenya?
Website of the Day
Iranian Video of the Hormuz Incident
January 9,
2008
Cockburn /
St. Clair
The
Empire Strikes Back
Dave Lindorff
The Bad News from New Hampshire: Death By Triangulation
John Chuckman
Pardon My Laughter: Watching the US Primaries from Canada
James Bovard
Stomping Freedom: Inside the Martial Law Act of 2006
Alan Farago
As Florida Sinks: the View from the Titanic
Russell Mokhiber
Why Picket the New York Times in DC on Friday?
William S. Lind
Kicking the Can Down the Road in Iraq
Peter Morici
Beyond the Sophistry: Why the Trade Deficit Matters
Josh Reubner
Sudan vs. Israel: Double Standard on Divestment
Mike Roselle
The Pursuit of Happiness
Website of the Day
Bottles of Tears on the Wall: Steve Perry on NH
January 8,
2008
Paul Craig
Roberts
No
Jobs for the New Economy (or the Old)
Russell Mokhiber
The Black Hillary: Obama is Just Another Political Sedative
Robert Fantina
The Gulf of Tonkin and the Strait of Hormuz
Dave Zirin
Butts on Parade
Shamako Nobel
I Am an Emcee: the Politics of Hip Hop
John Ross
Zapatista Women Encounter Themselves
Brenda Norrell
Apaches Defend Homeland from Homeland Security
Laura Carlsen
Why Bolivia Matters
Patrick Irelan
Remember the Maine!
Evelyn J. Pringle
The Holes in Bush's FDA
Jonathan M.
Feldman
After Iowa and New Hampshire: a Strategy for Rebuilding the Peace
Movement
Michael Dickinson
Playing Soldier
Website of
the Day
Sean Hannity on the Run!
January 7,
2008
Chris Floyd
There
Will Be Blood: But No Justice for Iraq Atrocities
John Blair
Remove That Man! Creeping Fascism in Indiana
Uri Avnery
The Case of the White Bird
Andy Worthington
Who Are the Gitmo Saudis?
Binoy Kampmark
Needling the Convict: Lethal Injection and the Supreme Court
David Macaray
Women on Strike
Ralph Nader
Obamarama: the Politics of the Smooth Mood
Michael Donnelly
It's the War Vote(s), Stupid!
Ron Jacobs
Ron Paul's Run: Is Being Against the War Enough?
Gideon Levy
The Hostile President
Dave Lindorff
A Real 9/11 Cover-Up? Sibel Edmonds, Turkey and the Bomb
Website of
the Day
Plagues and Pleasures on the Salton Sea
January 5 /
6, 2008
Douglas Valentine
Good
Guys in Black Hoods
Kevin Young
The
US Occupation and Popular Opinion in Iraq
Richard Rhames
Saddam
Who?
Saul Landau
Bush Snatches Defeat from Victory
Marc Lynch
Why Bush's Iran Strategy is Failing
Robert Fantina
Iowa, Democrats and the Iraq War
Donna Volatile
Antiwar Soldier: an Interview with Jonathan Hutto, Sr.
Jelle Bruinsma
Norman Finkelstein in The Netherlands
Bob Sutcliffe
Remembering Andrew Glyn, Rebel Economist
Harvey Wasserman
Anti-Nuclear Renaissance
Missy Beattie
Why Obama Can't Save Us
David Swanson
Remembering the Separation of Powers
Jacob Hornberger
The Importance of the Padilla Case
Shepherd Bliss
Survival Tools from Kokopelli Farms
Ron Jacobs
Bleeding Kansas
Poets' Basement
Patti Smith, B.R. Gowani and Peter Buknatski
Website of the Weekend
Jimmy Dean Sausage Call Complaint
January 4,
2008
Cockburn /
St. Clair
A
Good Night in Iowa
Jonathan Cook
War Crimes Airbrushed from History
Paul Craig Roberts
Thinking for Yourself is Now a Crime
Stan Goff
Ron Paul's Monkeywrench
Dave Lindorff
Clinton's Iowa Flop Exposes DLC Myths as Frauds
Niranjan Ramakrishnan
To Pindi Station
Allan Nairn
U.S. Elections Over Before They Began
Joshua Frank
The Failures of Sectarianism
Peter Morici
Economy on the Skids
Mary McInnis
Iowa Cocky-Us: How to be a Caucus Tease
Website of the Day
The Return of Obama Girl
January 3,
2008
Fatima Bhutto
Farewell
to Wadi Bua
Pam Martens
The
Free Market Myth Dissolves into Chaos
Joanne Mariner
The Presidential Candidates and Torture
Zoltan Grossman
Remember the '80s: Social Movements Between Woodstock and the
Web
David Domke
The Echoing Press and Huckabee
Norman Solomon
Edwards Reconsidered
Nikolas Kozloff
Return of the Faux Liberal
Jacob G. Hornberger
The Padilla Case and the Future of Habeas Corpus
Martha Rosenberg
Quit Picking on Huckabee's Son, Michael Vick
Russell Means
This Property is Condemned: a Notice to Those Occupying Lakotah
Lands
Website of the Day
WolfQuest
January 2,
2008
Jeff Taylor
The
Left and Ron Paul
M. Shahid Alam
The Life and Death of Benazir Bhutto: a Pakistani Tragedy
Gary Leupp
Madness Compounding Madness: Calls for Intervention in Pakistan
Paul Craig Roberts
Criminals with Badges
Heather Gray
Georgia's Racist Death Penalty
Fred Gardner
and Shobhit Arora
Dr. Strangelove's Nemesis
David Macaray
Labor Unions and Taft-Hartley
Benjamin Dangl
Fear and Loathing in Bolivia
January 1,
2008
Iain A. Boal
City
of Disappearances
B. R. Gowani
Benazir's Death in Crisistan
Shahid Mahmood
Bhutto and the Press
Linn Washington,
Jr.
Old Injustices Endure: From Crack Sentences to Racial Profiling
Harvey Wasserman
Taking Leonard Peltier to Iowa: the Moral Low Point of the Clinton
Era
John Ross
2008, Already a Year to Forget
Website of the Day
The Thrill is Gone: BB and Gladys
December 31,
2007
Alexander Cockburn
Goodbye
2007 and Good Riddance!
Tariq Ali
Pakistan, the Aftermath
Liaquat Ali Khan
The Perfidy of Pakistan's Rulers
Wajahat Ali
After Bhutto, a Nuclear Pakistan?
Robert Fisk
Who Killed Bhutto?
Ajai Sahni
Myths and Realities About Benazir Bhutto and Pakistan's Dark
Future
Marwan Bishara
You Say Talk, I Say Attack: The Middle East and the US Presidential
Election Campaigns
Uri Avnery
The Beilin Syndrome
Mark T. Harris
Does This Happen in Canada?
Brenda Norrell
Resistance and Censorship
Website of the Day
A People United Will Never Be Defeated
December 29
/ 30, 2007
Alexander Cockburn
Options
in America: Kill Yourself or Have a Baby
Tariq Ali
Indignation and Fear Stalk Pakistan
Fawzia Afzal-Khan
My Encounter with Benazir Bhutto
Gary Leupp
The U.S. and Pakistan After 9/11: Blowback from an Unholy Alliance
China Hand
Pakistan Stares Into the Abyss
Jacob Hornberger
Stop Medddling in Pakistan
John Chuckman
Pakistan and the Failure of Quick-Fix Politics
Missy Beattie
Evaluating Bush with the Bhutto Corruption Standard
Ralph Nader
Who Will Take the Next Step?
Fidel Castro
There Hasn't Been a Day in My Life When I Haven't Learned Something
Robert Fantina
The Sham of Homeland Security
Greg Moses
Beauty from the Heart of Texas
Catherine Lutz
What We Can Not See: Art and Bombing
Kristin Van
Tassel
Seeing in the Dark
Kim Nicolini
Redacted: Brian DePalma's Scream of Outrage
Phyllis Pollack
Keith Richards Runs With Rudolph Once More
Poets' Basement
Landau, Gibbons and Davies
Website of
the Weekend
Driving Karachi in Search of the Perfect Naan
December 28,
2007
Farzana Versey
The
Complex Electra
Wajahat Ali
A
Pakistani Requiem
Binoy Kampmark
Death in Rawalpindi: Bhutto and Her Legacy
Ayesha Ijaz
Khan
Not Dead Yet: The Pakistan People's Party Still Survives
Anthony DiMaggio
Turkey's Bombing of Iraq
Ray McGovern
Creeping
Fascism
Jim Goodman
Biofuels, the Biggest Scam Going
Ron Jacobs
Transcending the Colonizer's History: Iran, a People Interrupted
Russell Hoffman
Mini-Nukes by Toshiba
John Murphy
Greens Gone Wild
Website of the Day
Guiliani Campaign Official: "Only Rudy Can Defeat the Muslims"
December 27,
2007
Dilip Hiro
A
Tragedy Foretold: Will Bhutto's Death be a Boost for Her Party?
Murtaza Shibli
Who Killed Bhutto?
Stephen Soldz
Fallujah,
the Information War and U.S. Propaganda
Bill Quigley
Locked
Outside the Gates
Paul Craig Roberts
The Great American Lock-Up
Omer Subhani
Killing Bhutto: What Happens Next in Pakistan?
Marjorie Cohn
The Torture Tape Cover-Up: How High Does It Go?
Allan Nairn
Cataclysm By Money Whim
Jacob G. Hornberger
Smearing Ron Paul: Shame on the NYT
Norman Solomon
Channeling Suze Orman
Patrick Irelan
Rumsfeld Spills the Ink
Ben Tripp
Pass the Razor Blades
Website of the Day
Quagmire, For What It's Worth
December 26, 2007
Charles Tripp
From
One Saddam to Fifty
Paul Armentano
No-Knock, You're Dead
Rannie Amiri
Lebanon in Search of a Government
Stanley Heller
Brzezinski and Charlie Wilson's War
John Walsh
Two Unreasonable Men
Martha Rosenberg
The Strange Career of Scott Gottlieb
Norman Madarasz
Bolivia Amends New Constitution and Faces Mutiny from Within
Website of
the Day
Cockburn at the Battle of Ideas
December 25,
2007
Patrick Cockburn
Conscience
and Empire
December 24,
2007
Andrea Peacock
A
Dark Ride on the Border
Tariq Ali
Thinking of Edward Said
Uri Avnery
Help! A Ceasefire!
Jill Jameson
Burma is Not Back to Normal: A Trip from Rangoon to Mae Sot
Steve Melendez
Russell Means Goes to Washington
Mike Whitney
The Big Fix
Chuck Munson
Not Getting It About New Orleans
John Walsh
Clueless Crusaders
Farzana Versey
Tony Blair and the Hawking of Religion
Richard Neville
Dreaming of a White House Christmas
Website of the Day
Back in the USSR
December 22 / 23, 2007
Alexander Cockburn
Mike
Huckabee's Ascending Chariot
Ralph Nader
Politics
and Profits: How the Oil Cartel Gets Its Way
Andy Worthington
Intelligence Failures, Battlefield Myths and Unaccountable Prisons
in Afghanistan
Ahmad Faruqui
The Comedian of Pakistan
Bill Moyers
Society on Steroids
Rev. William
E. Alberts
Blessed are the Peacemakers
Timothy J. Freeman
From Kant to Lennon: Can War Really be Over?
Anthony DiMaggio
Democrats Continue to Capitulate on Iraq
Fred Gardner
Molecule of the Year, Cannabiodiol
Paul Krassner
Enhanced Hazing Techniques
Seth Sandronsky
17 Years of Meanness: Repealing California's Three Strikes Law
William Loren
Katz
Christmas Eve Freedom Fighters: Recalling the Battle of Lake
Okeechobee
Michael Dickinson
In the Dungeon of the Zabita
Ron Jacobs
Why Leon Russell Still Matters
David Vest
Doyle Bramhall's "Is It News?"
Poets' Basement
Orloski, Davies and Ford
Website of the Weekend
George W. Hates Santa
December 21,
2007
John Ross
New Massacres Loom in Mexico
Jacob Hornberger
Nothing Can Morally Justify the Invasion of Iraq
Dick J. Reavis
A
Way Out of the Newspaper Abyss
Jeff Cohen
and Norman Solomon
The 2007 P.U.-litzer Prizes
Peter Morici
Business as Usual as Recession Looms
Jack McCarthy
Let Us Now Praise Judith Regan (Even If She Did Sleep with Bernie
Kerik)
Raúl Zibechi
Sex and Revolution
Steve Early
How the Presidential Candidates Made Me an Atheist
David Macaray
Union Aftermath
Patrick Bond
Zuma, the Center-Left and the Left-Left in S. Africa
Lakota Freedom Delegation
A Declaration of Independence from the USA
Website of
the Day
Solomon v. Beck: Tale of the Tape
December 20,
2007
David Rosen
Mitt
Romney's Secret Life as a Pornographer
Alan Farago
The
Huckster and the Wreckage: Jeb Bush and the Subprime Mortgage
Crisis
Laura Carlsen
Standing Up to NAFTA
Ashley Dawson
The Return of the Bread Riot
Wayne Smith
and Jennifer Schuett
Cuba Changes, US Policy Stagnates
Website of
the Day
How to Talk to a FoxNews Reporter
December 19,
2007
Saul Landau
Is
the NIE Bush's Watergate?
Paul W. Lovinger
Hillary the Hawk
Norman Solomon
The Mad Corporate World of Glenn Beck
Dave Zirin
George Mitchell's Drugs of Choice
Marjorie Cohn
Bush Still Spinning Iranian Nukes
Sen. Russell
Feingold
The Iraq War is Exhausting Our Nation
Sonja Karkar
A Christmas Reflection on Palestine
Anthony Papa
Open the Drug Gulags
Christopher Ketcham
Pave the Holy Lands with Good Intentions
Davey D
Britney's Little Sister is Pregnant: Should We Blame Hip Hop?
Website of
the Day
When Republicans Use the F-Word on TV
December 18,
2007
R. F. Blader
The
Politics of Teen Pregnancy
George Wuerthner
Gunning for Wolves in Idaho
Steven Higgs
Can the NAFTA Superhighway be Stopped?
Vijay Prashad
Encounters with Ghadar
David Macaray
The Free Rider Problem
Ralph Nader
Nine Books That Make a Difference: a Reading List for the Holidays
Eva Liddell
Privatizing War Abroad, Invading Privacy at Home
Martha Rosenberg
While the Bodies are Still Warm: Drugs, Shrinks and Shooters
Dave Lindorff
When Impeachment is Out of Print
Peter Morici
The Consequences the Trade Deficit
Website of
the Day
Ron Paul: How Fascism Will Come to America
December 17,
2007
Mike Whitney
Staring
Into the Abyss
Tom Barry
Planning
the War on Immigrants
Uri Avnery
A
Gaza Masada?
Greg Moses
Crossing the Line in Texas
Allan Nairn
Terrorism; Counter-
Terrorism: Excuses for Murder
Patrick Bond
South Africa's Fight Between Hostile Brothers
Stephen Lendman
Police State America
Charles Jonkel
Grizzly Right of Way
Laray Polk
An Inside-Out Crisis in Gaza
Stephen Fleischman
Pawns in Their Game
December 15
/ 16, 2007
Peter Linebaugh
A
People's Penny for the Magna Carta
Howard Zinn
Bomb After Bomb
Standard Schaefer
The Greening of Big Tobacco
Raymond J.
Lawrence
Let's Take Christ Out of Christmas
Alan Farago
Down on Desolation Row: the Vultures and the Growth Machine
Saul Landau
Lord Byron and the Bad Tourists
Jenna Orkin
Lying to "Reassure" the Public: Bush's EPA and the
Post-9/11 Toxic Air Cover-Up
Ahmad Samih
Khalidi
Why a Palestinian "State" is a Punitive Construct
Robert Fantina
Politics By Photo-Op
Missy Comley
Beattie
Resistance Amid the Ruins
Ramzy Baroud
Of Mormons and Muslims
James L. Secor
A Vision for China's Future
Elijah Wald
Ike Turner's Music Won't be Forgotten
Website of
the Weekend
The Alliance for the Wild Rockies Needs (and Deserves) Your Support
December 14,
2007
JoAnn Wypijewski
The
Dirty Cad: What Giuliani's Sex Life Tells Us About Him
John Ross
Iraqi
Refugees Return: One Cruel Hoax
Jacob Hornberger
Terror Suspects Belong in Federal Court
Andy Worthington
Guantánamo and the Supreme Court: What Happened?
Allan Nairn
"Shoot Them on the Spot": Rewarding War Crimes
Dave Zirin
The Mitchell Report: Absolving the Owners
Dave Lindorff
The First Cut is the Deepest
Misty MacDuffee
Toxic Grizzlies
Ben Terrall
What Happened to Lovinsky Pierre-Antoine?
Dr. Mustafa
Barghouthi
Prerequisites for Peace
Website of the Day
Sen. Kit Bond: "Waterboarding is Like Swimming"
December 13,
2007
Paul Craig
Roberts
Shrinking
the Dollar from the Inside-Out
Mike Whitney
Dershowitz for the Defense--of Waterboarding
Ron Jacobs
Blank Check DemocratsL the Great War Funding Conspiracy
Norman Solomon
The USA's Human Rights Daze
Peter Morici
The Dragon and the Toothless Dog: China Doesn't Flinch
Sandy Mayes
Blocking the Strykers: 13 Days of War Resistance at Port Olympia
Franklin Lamb
The UN in Lebanon: Whose Mission Is It Fulfilling?
Jacob Hornberger
Don't Reform the CIA, Abolish It
Nadim Rouhana
An Interloper in My Own Land
Dave Zirin
On Pigskin and Petrol
Website of the Day
Rachel's Needs (and Deserves) Your Support!
December 12, 2007
Allan
Nairn
US Intelligence is Tapping Indonesian
Phones
Alan
Farago
How Sprawl Eats Its Young
Ray
McGovern
Torture, Lies and Videotape
Winslow
T. Wheeler
The Phony Pentagon Budget Cuts
Evan
Jones
The Raid on Great Western: Why an Australian Bank Might Spell
Doom for the US Farm Belt
James
Petras
An Open Letter to Sarkozy on the Exchange of Political Prisonsers
Joel
Hirschorn
The Horserace Fiction: Clinton, Obama and the Democratic Machine
Joshua
Frank
Why Ron Paul Deserves Our Attention
Sherry
Wolf
Why the Left Should Reject Ron Paul
Dan
Bacher
Survey of a Fish Graveyard
Website
of the Day
Men Eating Bugs
|
Weekend
Edition
January 12 / 13, 2008
Don't Take That
Pill!
The
Ignored Risks of Fluoroquinolones
By STAN COX
The case studies are scattered around
in the medical journals: a 62-year-old woman with acute psychosis;
a 73-year-old man with "severe delirious psychotic features";
a woman of 47 suffering from insomnia and barely able to stand
or walk; a 62-year-old woman who ruptures her Achilles tendon;
a man, 75, struck with repeated seizures; a 64-year-old diabetic
woman with life-threatening hypoglycemia.
All of those people had suffered the side effects of a specific
class of antibiotics known as fluoroquinolones. Because they
target bacteria and not our own tissues, antibiotics are often
not scrutinized for side effects by the Federal Drug Administration
(FDA) or manufacturers as carefully as are, say, psychiatric
drugs. But in the bodies of people, cats, rats, and mice, fluoroquinolones
not only kill bacteria but also appear to attach to certain brain
and nerve receptors, kill tendon cells, and cause other kinds
of havoc.
Clinical trials conducted over
three decades in the process of gaining FDA approval for fluoroquinolones
-- which encompass many drugs, among the most familiar of which
are ciprofloxacin (Cipro) and levofloxacin (Levaquin) [1] --
showed that psychiatric and central-nervous-system problems occurred
in more than 10 percent of patients.[2] Such trials, as well
as "adverse drug reaction" (ADR) reports that began
to be filed by US doctors and patients once the drugs were being
marketed, indicated serious reactions in about 1 to 2 percent
of cases in which the drugs are administered.
A study of ADRs in Italy, published
in 2005, found that among more than 50 types of drugs, fluoroquinolones
accounted for 11 percent of all adverse events and were involved
in the largest number of serious problems, edging out antidepressants.[3]
When, near the end of one of
those ask-your-doctor commercials, a fast-talking disembodied
voice reads off a drug's side effects, usually over a scene involving
fields of waving grass and a puppy dog, it tends to sound like
a lot of nasty stuff that's going to happen to someone else.
But in reading and writing about the pharmaceutical industry
for the past couple of years, I started wondering about what
life is like for the real people who do experience those side
effects. Then last fall, when my own father was assaulted with
terrible symptoms apparently caused by a widely prescribed fluoroquinolone,
I didn't have to wonder any longer.
"A
remarkable safety record"
If even only one person in
100 suffers a grave side effect of such a popular class of drug,
that can mean millions of people affected. At their worst, fluoroquinolones
can ruin or, potentially, end lives. On the Internet, people
who have been "floxed" as they call it (because the
generic names of many such drugs contain the letters "flox")
come together in forums and discussion groups to swap graphic
accounts of searing pain, psychosis, blistering skin, kidney
and liver damage, muscle-wasting, tendon rupture, hallucinations,
insomnia, suicidal thoughts, and panic attacks. Award-winning
journalist Stephen Fried was moved to write a book, Bitter
Pills: Inside the Hazardous World of Legal Drugs
(1999) after his wife Diane suffered long-term damage after taking
a single pill of a fluoroquinolone called Floxin.
Dr. Jay Cohen, a medical researcher
and associate professor at the University of California, San
Diego, published a paper on peripheral neuropathy caused by fluoroquinolones
on 2001. Since then, he says, "I have received several
hundred emails, most of which relate terrible, often catastrophic
reactions to Levaquin, and some to Cipro. These reactions are
slow to pass, leaving some people disabled for months or years.
It is an awful problem."
Clinical trials and case studies
published by doctors in leading medical journals also make it
clear that such problems exist, but in the journals, it's common
to see conclusions like this, from a 2002 paper: "Levofloxacin
[Levaquin] has been used in more than 200 million prescriptions,
with a remarkable safety record."[4]
In their practices, doctors
often appear to be attributing fluoroquinolone damage to other
causes. Says Cohen, "Unfortunately, many doctors do not
know that fluoroquinolones can cause such severe, long-lasting
reactions. When a reaction occurs, some doctors deny that it
could have been caused by the drug. Doctors order a battery
of tests to seek other causes, but the tests usually show nothing."
The spoils
of war
People who find themselves
under assault by bacteria (including the 2 million who get infected
each year in hospitals) desperately need antibiotics. And, better
late than never, there is a growing awareness that the use of
antibiotics must be planned much more rigorously, to curtail
the development of resistant bacteria. But the popularity of
some of the drugs has as much to do with historical accident
as with safety and efficacy.
The huge commercial success
of the fluoroquinolones can be traced to 1990 and Operation Desert
Shield, when the US military was concerned that Iraqi forces
with whom they were soon to do battle were planning to use anthrax
as a bacterial weapon. The armed forces ordered 30 million doses
of the fluoroquinolone ciprofloxacin -- Cipro -- to be administered
to troops as a preventative measure. That drug was chosen mainly
because it was new, and the Iraqis would not have been expected
to have selected an anthrax strain resistant to it.[5]
Although no anthrax attack
is known to have been launched in Kuwait or Iraq (and Desert
Storm veterans have blamed the side effects of the antibiotic
for some of the symptoms of Gulf War Syndrome), Cipro got the
reputation as a kind of superdrug, and sales rose through the
90s. The actual anthrax attacks of October 2001 triggered a
wave of panic-buying and pill-swallowing, and Cipro's manufacturer
Bayer responded by producing 200 million additional doses within
two months.
A shocked David Flockhart,
chief of clinical pharmacology at the Indiana University School
of Medicine, told the Los Angeles Times, "Cipro is
basically a big gun whose benefits outweigh its risks in certain
circumstances, but the bigger gun you use, the more damage you
can expect as collateral."[6] Of more than 3000 postal
employees who took Cipro following the anthrax attacks, 26 percent
had problems with their digestive system, and 14 percent reported
neurological problems.[7]
Cipro and its newer fluoroquinolone
cousins have since become the most frequently prescribed class
of antibiotics in the US, accounting for one prescriptions out
of four. By 2003, more than a half-billion prescriptions had
been written for Cipro and Levaquin alone.[8] Under contracts
then in effect, the Defense Department and Veterans Administration
together were dispensing about 9 million doses of fluoroquinolones
per year.[9]
The quinolone family of antibiotics
grew out of research on anti-malarial drugs, which also carry
a heavy load of side effects. One member of that family, a malaria
medication called mefloquine (Larium), has become notorious for
causing problems that include, according to FDA, "psychiatric
symptoms ranging from anxiety, paranoia, and depression to hallucinations
and psychotic behavior. On occasions, these symptoms have been
reported to continue long after mefloquine has been stopped."
In what passes for innovation
in the pharmaceutical industry, companies continue to modify
the chemical structure of fluoroquinolones in search of similar,
effective antibiotics that be patented. One recent study warned
that members of the newest generation of such drugs, judging
from their chemical structures, are even more likely to cause
adverse side-effects than are now-popular ones like Cipro and
Levaquin.[10] Because the truly informative testing of drugs
occurs not during the FDA approval process but through their
use by millions of patients, a lot of people are certain to experience
damage from these drugs first-hand.
One victim's
story
At 77, my father was a specimen
of good health who ate a solid vegetarian diet and would regularly
bike 20 or more miles in a day. So it came as a terrible blow
when, in October, he had to go in for emergency cardiac artery
bypass and valve-replacement surgery. Complications of the surgery
kept him hospitalized longer than expected -- with two more trips
to the operating room -- weak, exhausted, and down to only 125
pounds from his former 155.
A full month after being admitted,
he finally seemed to begin recovering. But at that point, he
plunged once again into a terribly weakened state, sleeping little
or not at all, his arms and legs almost constantly in motion,
unable to walk without falling backward. That went on for almost
two weeks, until he made a quick turnaround, regained his ability
to walk, and was discharged.
When he had been out of the
hospital for five days, feeling wiped out but not ill in any
way, a physician's assistant decided that he needed an antibiotic
prescription in case he might have pneumonia. The drug was Levaquin.
He took the first dose that night, and by the following evening,
he was going downhill fast. He spent almost all of the next
day in bed, too weak to walk or even sit up, spending most of
the time with his eyes closed or in a blank stare, making bizarre
sounds and gestures.
Unable to get any answers from
his doctors, my mother and I, in desperation, stopped giving
him the Levaquin. (As a geneticist, I was as aware as anyone
of the rule that says never to stop an antibiotic in mid-course,
but we were indeed desperate.) Within 36 hours, he had begun
improving remarkably but remains very weak six weeks later.
His doctor has since concluded that he never had pneumonia.
When I went back and looked
at my father's 33-page hospital file of doctors' notes, along
with the 146-page (!) daily file of medications he'd been given,
I saw that his earlier abrupt deterioration, a month into the
hospital stay, had coincided with the start of a course of a
fluoroquinolone called moxifloxacin (Avelox), also given for
suspected (but nonexistent) pneumonia. The just-as-abrupt improvement
that led to his discharge occurred a day and a half after his
last dose of moxifloxacin.
Who's minding
the (drug)store?
The label for Levaquin includes
information that is typical for fluoroquinolones: "Convulsions
and toxic psychoses have been reported in patients receiving
quinolones, including levofloxacin. Quinolones may also cause
... tremors, restlessness, anxiety, lightheadedness, dizziness,
confusion and hallucinations, paranoia, depression, nightmares,
insomnia and, rarely, suicidal thoughts or acts. These reactions
may occur following the first dose."
In, 2004 the FDA issued a new
warning on fluoroquinolones, stating that treatment should be
stopped if patients felt strange neurological symptoms like "pain,
burning, tingling, numbness, and/or weakness ... in order to
prevent the development of an irreversible condition."
In 2005-06, the Illinois Attorney general and the group Public
Citizen petitioned the FDA to add a so-called "black box"
warning to packages, this one regarding the danger of tendon
rupture, a well-documented effect of the drugs. So far, no action
has been taken.
Jay Cohen responded to FDA's
addition of the 2004 statement by asking, "The question
is, will doctors notice these warnings? Doctors do not reread
package inserts or the PDR every time they prescribe the same
drug. Moreover, the package inserts of quinolones are very long,
and the information can easily be overlooked. Perhaps the greatest
usefulness of the new warnings may be for patients who develop
side effects with quinolones and who consult the Physician's
Desk Reference [PDR], or for doctors who consult the PDR after
patients complain about side effects."[11]
In that sense, the warning
does its job, but too late for the patient: Once my father was
in big trouble, I indeed looked up the fine-print warnings.
Among several of his doctors with whom I discussed his experience
with fluoroquinolones afterward, none had known that the drugs
can have serious effects on the central nervous system -- yet
none was surprised that they do.
One of the nurses told us that
the cardiac-surgery patients she sees are "generally sent
home with about 20 prescriptions." Without some of the
drugs he received during surgery and his six-week hospital stay,
my father would not have survived. But as he struggled to regain
his health, he twice had his recovery reversed (and, it seems,
nearly ended altogether) by the side effects of drugs prescribed
for an illness that he never actually had.
Tragically, his overmedication
is not unusual. Studies of outpatients have consistently shown
that more than half the drugs they were taking were unnecessary.
By one estimate, 20 million unnecessary antibiotic prescriptions
are written in the US every year and as many as 100,000 Americans
die annually from reactions to prescription drugs of all kinds.[12]
With a toll like that, the costs of overmedication can't fully
be measured in dollars. (And one study found that only 6 percent
of adverse reactions are accurately reported.)
A survey of patients admitted
to two hospitals' emergency departments found that for half of
those patients who were taking multiple drugs at the time, it
was the pharmaceuticals themselves that had landed them in the
emergency room. Another survey of patient charts found that
three-fourths of the time, the documents did not accurately list
all the drugs being taken.[13]
The risks of drugs in general
are known to be much higher in elderly patients. As what one
letter to the Journal of Clinical Oncology called "the
leading drug consumers", our older friends and relatives
have far too many opportunities for drugs to interact with an
existing medical condition or another drug. At any given time,
says one study, 78 percent of people over 65 years of age are
on medications -- and half of that group are regularly taking
five or more drugs.[14]
Elderly patients not only take
more drugs; they also have more health problems that can magnify
the side effects and often mislead patients and doctors about
what ails them. In the words of one researcher, "It is
easy to ascribe decline in functional status to worsening disease
or old age and not thoroughly investigate the contribution of
inappropriate drug therapy."[15] That's what happened to
my father; until the drug effects became too obvious to ignore,
we all assumed he was still suffering aftershocks of surgery.
Another study put its finger
on the bigger problem, noting that despite having learned in
medical school about systematic approaches to prescribing, "physicians
learn how to prescribe in 'real-world' settings ... and they
are influenced by their peers, pharmaceutical company marketing,
healthcare systems, and patient demands and expectations."[16]
Hazardous interactions among
medications continue to be a big issue in medicine. Through
hard experience, medical administrators have come up with a list
of the ten most dangerous drug interactions, and two of those
involve fluoroquinolones. But as for actually preventing such
problems, there is always more talk than action. Were a proposed
drug to be safety-tested not only on its own, but in combinations
with other drugs, its sponsoring company would have to shell
out many times as much money and spend a lot more development
time.
That won't happen. Drug executives
are already threatening to stop developing antibiotics altogether,
because in the companies' eyes, they don't justify the cost of
research and testing. That's because they are usually prescribed
only for a matter of days at a time, not for many years like
the more profitable lifestyle drugs and treatments for chronic
diseases.[17]
Having in their inventories
a class of antibiotics that's so popular among physicians and
on which so many chemical variations-on-a-theme are possible,
companies are not acknowledging the toll being taken by fluoroquinolones
on vulnerable patients. Jay Cohen says, "As far as I can
tell, the manufacturers have not lifted a finger to try to help
these people, nor have they undertaken research to try to explain
these reactions and to develop measures to help patients avoid
them."
He adds that drugs like Levaquin,
Cipro, or Avelox "should not be used as first line antibiotics.
Other, safer drugs should be tried first. The need for antibiotic
therapy with fluoroquinolones should be gauged carefully, and
unnecessary use should be avoided."
Unfortunately, most people
don't learn about the risks of fluoroquinolones or other drugs
until, like me, they encounter them first hand and look around
for information. Then they find sites like Cohen's www.medicationsense.com
or the most comprehensive fluoroquinolones victims' site, www.fqresearch.org.
That site is urging that the drugs never be used "unless
there is a direct threat to the patient's life or limb."
Stan Cox is a plant breeder and writer in Salina,
Kansas. His book Sick
Planet: Corporate Food and Medicine will be published by
Pluto Press in April. They can be reached at: t.stan@cox.net.
NOTES
1. See the long list of fluoroquinolones
at http://www.fqresearch.org/alphabetical_listings.htm
2. For example, see www.fda.gov/cder/foi/nda/96/020634-1.pdf
3. Galatti et al., Neuropsychiatric
reactions to drugs: an analysis of spontaneous reports from general
practitioners in Italy. Pharmacological Research 3: 211
(2005)
4. Rubinstein and Camm, Carditoxicity
of fluroquinolones. Journal of Antimicrobial Chemotherapy
49: 593 (2002)
5. Enserink, Researchers question
obsession with Cipro. Science 294: 759 (2001)
6. Krucoff, Drug of choice
has a downside. Los Angeles Times, 29 Oct. 2001
7. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5047a2.htm
8. Rubinstein and Camm (2002)
and Houston Chronicle, 1 Nov. 2001
9. http://www.fbodaily.com/
10. Mandell and Tillotson,
Safety of fluoroquinolones: An update. Canadian Journal of
Infectious Diseases 13: 54 (2002)
11. http://www.medicationsense.com/
12. See references in http://www.lef.org/magazine/
13. Both studies referenced
by Delafuente, Understanding and preventing drug interactions
in elderly patients. Clinical Reviews in Oncology/Hematology
48: 133 (2003)
14. Jörgensen et al,
Prescription drug use, diagnoses, and healthcare utilization
among the elderly. Annals of Pharmacotherapy 35: 1004
(2001)
15. Deafuente (2003)
16. Hanlon et al., Suboptimal
prescribing in older inpatients and outpatients. Journal of
the American Geriatrics Society 49: 200209 (2001)
17. Projan, Why is big Pharma
getting out of antibacterial drug discovery? Current Opinion
in Microbiology 6: 427 (2003)
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