Just when AARP magazine, and so many other well respected and widely read publications, are carrying articles about pandemic flu planning for personal homes, more bad news. This news is not for the publications, nor is it for their readers, but for the authors who have tied their name to poorly researched advice. November 14, 2006 the U.S. Food and Drug Administration (FDA) and Roche Laboratories, Inc., the manufacture of Tamiflu, announced that new labeling would be provided for this highly publicized pandemic flu drug. It turns out that Tamiflu is just one more drug to be added to the long list of medication recently implicated in “self-injury” (suicide) and other psychiatric side effects.
While the data is not completely clear as to how much of the hallucination and confusion associated with Tamiflu administration in the Far East is related to influenza and how much is directly related to the drug, several things are clear.
- Those who received Tamiflu are far more likely to display “abnormal behavior” and “self-injury” than those who have not received the drug.
- The likelihood of having these side effects increases as the dose increases and as the length of time the drug is taken increases.
Tamiflu is one of two drugs available for the treatment of pandemic influenza. Unfortunately, the pandemic strain currently being studied in Asia (H5:N1) is already showing resistance to normal doses of Tamiflu. In fact, in recent cases the dose of Tamiflu has had to be doubled and the length of treatment also doubled. Further complicating this fact is the need in these cases to add the second pandemic flu drug, also at double dose and double length of treatment.
What does this mean for psychiatric side effects? It means that these side effects will increase if not arithmetically then logarithmically. In other words, the side effects may not just double, but quadruple or more.
Common sense and good science are stakes in the heart for those alarmists encouraging the general public to stockpile Tamiflu or any other medication. Stockpiling “just in case” medication is always a bad idea. Most simple infections are now resistant to basic antibiotics because patients have stockpiled “left over” antibiotics from prior infections and started them on their own. For too many decades, physicians have sent patients home with “just in case” antibiotics for the “next time” they get sick. This technique is lazy and it is the medical profession that is responsible for the problems we now see as a result of this lazy approach to healthcare.
What is surprising is that the American public stands for it. If you took your car to your favorite mechanic for an oil change and he sent you home with an extra case of oil “just in case” you would change mechanics. If you went to your favorite hairdresser for a color and style, and she sent you home with an extra pair of scissors “just in case” you would quickly change stylists or at least think her crazy. This style of medical practice was born of the same medical hubris that allowed doctors to think themselves “gods” and should have died with that mindset. The most recent announcements by the U.S. Food and Drug Administration on the risks of psychiatric side effects in Tamiflu only point out the dangers of good medication taken the wrong way or for the wrong indication. Prescribing any medication is a balance of risks and benefits, and when balancing risk and benefits we can all use good advice, both physicians and patients, alike.