Saturday, September 1, 2012

Thalidomide - The "Other" Half of Every Medication





50 years later - the makers of Thalidomide have finally apologized. (News article here)

Over 10,000 babies were effected, most of whom died in early childhood.  Those that survived had debilitating defects, like the famous "flipper babies" whose arms were nothing more than little nubs.

Is late really better than never, or does there come a time when it's so late it's just patronizing and pointless to apologize?

There are a small number of victims still alive today.  Their mothers took the drug to treat morning sickness.  They didn't know that only half of the drug treated nausea, the other half caused birth defects. 

That's what this post is about - the "other half" or "mirror image."

Has anyone ever taken Prilosec - and then been switched to Nexium?
How about Celexa switched to Lexapro?
Zyrtec to Xyzal?
Ritalin to Focalin?
Provigil to Nuvigil?
Effexor to Pristiq?

They are the same medication as before - but now you're only getting the half that works.

Have you read the generic names?

All they did was add a prefix to the same drug name. 
They just added "levo," "es," "dex," "ar" or something like it to the beginning of the name.

Citalopram (Celexa) was replaced with Escitalopram (Lexapro).
Venlafaxine (Effexor) replaced with Desvenlafaxine (Pristiq).

Why?

When any chemical compound is made - it's possible and even likely to really make two different molecules - they're just mirror images of each other.  Like your left and right hand.  They're called enantiomers.  The mixture of the two is called a racemic mixture.


When medications are made - they often don't worry about whether they are making one compound or both.  The mirror image usually does nothing anyway, and it's cheaper if you don't have to separate the two.
They test the drug, and if it works they produce it.

That was the problem with Thalidomide.  One molecule treated nausea - it's mirror image caused birth defects.  The drug company gave people the mixture.

Even if they had done the extra work to only make the one molecule that worked - there still would have been birth defects because with thalidomide - one mirror image can mutate and become the other one in our bodies.  We were doomed either way.

So what's happening now?  Are any drug companies making NEW drugs - or are they all just relabeling the half that works - and selling it pure instead of mixed?

Anyone taking (Synthroid) Levothyroxine? 

Why didn't the drug company make Dexthyroxine instead?  - because that's the half that didn't work.

We rarely get NEW drugs anymore.  It costs too much to test a drug when you have no idea if it will actually get FDA approval.  But if you know the drug already works - just produce it pure without the mirror image - and you've got another 7-12 years of profits for the new medication.

Thalidomide showed us the horror of not understanding our own science.  Have we really learned the lesson, or just learned how to profit by it?

3 comments:

Blastkka said...

So does this mean I should stop taking Celexa and switch to the new one? Do you know what's wrong with the other half of that one?

Simple Citizen said...

Blastkka

1 - Thanks for the question!

2 - I would never give personal medical advice to someone on-line. It's not appropriate for many reasons.

3 - As far as all the research has shown - nothing is wrong with the other half, it just doesn't work as well - it's mostly wasted space. The "S" half is a better antidepressant than the "R" half - so they made a purely S version of citalopram and called it "escitalopram"

They have the exact same side effect profile, they are both pregnancy Category C. It's basically a question of who is taking it - if one didn't work, the other may. (even if it's just placebo effect, it happens all the time)

Hope this helps.

Blastkka said...

Thank you. I've been on Citalopram for almost twelve years and it makes a huge difference for me. I was just wondering if there were safety concerns. I guess I'll hope some major problem isn't being apologized for 50 years down the road.