Years ago I had a girlfriend who began to act strangely. On the slightest pretext she’d collapse in a sobbing heap on the floor. At times the wailing became so loud I’d have to flee the apartment.
During one of my escape attempts, Jane (not her real name) blocked the front door so in desperation I slid out the patio door and leapt over a fence. After another of her episodes, I was literally running down the street with her behind, wailing like a banshee.
I felt like I was stuck in some absurdist opera with a psychotic soprano, which went on for months.
At the time, Jane was horrified to discover she was losing her hair in small clumps in the shower. That’s when I began to investigate the meds in the bathroom cabinet. It didn’t take much detective work, as she was only using two medications at the time: birth control and Accutane, an oral treatment prescribed for acne.
When I looked through the Accutane product monograph, I discovered the possible side effects included aggressive behaviour and crying spells. I pointed this out to Jane, saying we couldn’t continue to live together if she took this medication. She stopped and the soprano act tailed off. Unfortunately, the ancillary damage was already done and the curtain came down on our connection.
Canadarxdrugstore warns of the following:
Side effects
Do not ignore any side effect, even a minor one after you BUY ACCUTANE and use it, stop using Accutane and call your doctor at once if you have any of these minor/serious side effects:
Depressed mood, trouble concentrating, sleep problems, crying spells, aggression or agitation, changes in behavior, hallucinations, thoughts of suicide or hurting yourself;
Sudden numbness or weakness, especially on one side of the body;
Blurred vision, sudden and severe headache or pain behind your eyes, sometimes with vomiting;
Hearing problems, hearing loss, or ringing in your ears;
Seizure (convulsions);
Severe pain in your upper stomach spreading to your back, nausea and vomiting, fast heart rate;
Loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
Severe diarrhea, rectal bleeding, black, bloody, or tarry stools;
Fever, chills, body aches, flu symptoms, purple spots under your skin, easy bruising or bleeding;
Severe blistering, peeling, and red skin rash; or
Joint stiffness, bone pain or fracture.
Joint pain, back pain;
Feeling dizzy, drowsy, or nervous;
Dryness of the lips, mouth, nose, or skin; or
Cracking or peeling skin, itching, rash, changes in your fingernails or toenails.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.
The irony is that Jane didn’t have severe acne - which Accutane is intended for - just some minor blemishing. As in the case of my uncle, it seemed like another case of doctor prescribing a hydrogen bomb to swat a housefly.
Adverse effects
Isotretinoin, marketed under the names Accutane and Roaccutane, is a form of Vitamin A that’s been part of dermatologists’ armoury for over 30 years. A 2003 report in the Canadian Medical Association Journal ranked the medication in the “top 10 of the US Food and Drug Administration's (FDA's) database of drugs associated with reports of depression and suicide attempts.”.
In Canada, of the 222 cases of adverse events reported to Health Canada since the drug was first marketed in 1983, 56 (25%) involved psychiatric adverse events, including depression and suicidal ideation…. A warning of a possible link with depression and suicide was issued in 2001. Recently, the FDA warned that people taking Accutane may also experience aggressive and violent behaviours.”
The problem is amplified by patients with unwavering faith in doctors - doctors who sometimes fail to exercise caution and fully inform their patients of possible risks from pharmaceutical medicines.
“I took Accutane too,” writes Amanda (not her real name) in a private communication. “Got pretty much everything on the list. I wanted to throw my head against the wall, the headaches were so bad.“
When I took it was still experimental--the dermatologist said there would be long term changes to the structure of the skin, but the impact would be unknown for some time. I'd already tried several other medications and the scarring acne was spreading from my back to my face, so I was desperate. He said to watch for symptoms, but it didn't occur to me that it could cause mental symptoms.
The doctor aggressively argued that Accutane is a great product when I finally understood and reported my symptoms many years later.
Totally threw me off my career path as I was just at that critical last year of my BA when I should have applied for graduate school, instead of spending so much time trying to deal with the daily nose bleeds, severe headaches, and suicidal ideation. The reduction in acne scarring is nice, but wasn't worth it. I talked my sister out of taking it.”
Amanda believed Accutane was causing her nosebleeds at the time, which was likely correct. (The American Academy Dermatology Association notes that it’s “common” to experience nosebleeds “while taking isotretinoin.”)
She also thought the severe headaches were due to her “infamous statistics professor,” and that the suicidal ideation was due to childhood trauma.
In an attempt to recover from the suicidal ideation I embarked on a series of confrontations that led to death threats and even more traumatic experiences that distracted me from building a career.
Challenges
The maker of Accutane have had plenty of legal challenges, notes a report on drugwatch.com:
Most Accutane lawsuits claim the drug caused Crohn’s disease and other inflammatory bowel disorders. A court dismissed the majority of the more than 7,000 lawsuits filed against Swiss manufacturer Roche in 2014. The New Jersey Supreme Court dismissed another 500 lawsuits in 2018.
…U.S. District Judge James Moody ultimately dismissed all the federal Accutane cases. He ruled that the warning label on the drug was adequate.
Drug makers certainly do warn of side effects, often in unintentionally comic ways, as in the television advertisement below - which might as well be a Saturday Night Live lampoon. When it comes to prescription drugs, the tortoise of reality overtook the hare of satire years ago.
The failed legal challenges to Roche from Accutane plaintiffs might lead you to believe Big Pharma is impervious to the law. Not quite. From 2009 to 2016, billions of dollars in civil and criminal fines went to pharmaceutical firms for false claims, kickbacks to physicians, off-label promotion, Medicare fraud, poor manufacturing processes, monopolistic practices and other offenses.
GlaxoSmithKline paid out $3 billion in a 2012 global settlement, which included $1.5 billion in US federal civil recoveries under the False Claims Act, $478 million in state Medicaid recoveries, and $1 billion in criminal fines and forfeitures.
For its part, Pfizer paid $2.3 billion in a 2009 global settlement:
The settlement resolved allegations that the company illegally promoted the drugs Bextra, Geodon, Zyvox, and Lyrica for uses not approved by the FDA and paid kickbacks in connection with its marketing of these and nine other drugs: Aricept, Celebrex, Lipitor, Norvasc, Relpax, Viagra, Zithromax, Zoloft and Zyrtec.
(I noted with interest that among the listed drugs is one that permanently injured my father in his final years. )
Not far behind, global health care giant Johnson & Johnson and its subsidiaries, Janssen Pharmaceuticals and Scios (J&J), paid $2.2 billion in a 2013 global settlement. Abbot Laboratories paid $1.5 billion in a 2012 global settlement. Merck Sharp and Dohme paid $963 million in a 2012 global settlement.
On it goes, with 13 other pharmaceutical firms shelling out megabucks over the same time period. A number of these fines briefly made the news, but overall they were off the media radar. (Roche, the maker of Accutane, was not on the federal list of offenders.)
For these multibillion dollar firms, a few billion here and there in fines are not disincentives. If say, you deceptively market a risky drug that rakes in $10 billion in one year, a fine of $2 billion for fraud is just a cost of doing business, and no more.
If they’re truly invested in their personal health, every patient should question and investigate any drug recommended by any physician. Or at the very least read the damn product monograph, which is the drug manufacturers’ ‘get out of jail free’ card. As the marvelously-monikered “Chesterfield Davenport” wrote in the comments here recently:
Years ago, I had lunch with my cousin, who is a pharmaceutical sales rep. In an unguarded moment she blamed the doctors’ patients themselves for the horrendous side effects often brought about by her drug portfolio. She explained that since pharmaceuticals were regularly advertised on TV, where it was mandatory that the ads themselves disclose an almost endless list of the known and often horrendous side effects, the patients, if they had common sense, should have figured out that she and the doctors were peddling poison. So she figured the patients often got exactly what they had bargained for. Kind of evil but she also had a point.
A sales rep with a busted moral compass is one thing, but a physician who underplays or fails to warn of potential risks of a prescribed medicine is another. And that’s assuming he or she has accurate information to begin with. Ironically, during our time together Jane worked as a local sales rep for one of the Big Pharma outfits (not Roche), but she quit her job after discovering that the product sheets she was supplying to doctors contained what she believed was misleading information.
As I mentioned in part one,
We hold the people inspecting our bodies - doctors - to a higher standard than the mechanic at the garage working on our car. Or at least, we should. The trouble is, physicians are the priest-class of The Science™. We enter their sacred spaces of healing in postures of suppliance, our critical faculties strangely numb. Yet if any place calls for skepticism, it’s a GP's office, where tunnel vision training combined with overbooking can turn medical consultation into a zero-sum game of pat answers and educated guesswork.
…Yet no matter how well intentioned they are, general practitioners aren’t scientists. They’re technicians. And their profession is embedded in a pharmaceutical-industrial-media complex that traffics in poorly tested, heavily lobbied, and highly profitable pharmaceutical drugs.
Unless you come staggering into the hospital with a coronary infarction, or are carried into a trauma unit with a cap in your ass, the idea of doctors as dispassionate, objective guardians of life and limb seems as mythical as rainbow-riding unicorns. Many general practitioners are just glorified pimps for Big Pharma, blithely participating in the mining of social and personal capital.
“Western allopathic medicine has become a giant deadly machine for stealing all personal wealth throughout the developed world,” notes Dr. Toby Rogers. Precisely what you’d expect from what’s been called the ‘cancer stage of capitalism.’
Unsafe and Ineffective
Three years ago we all became involuntary patients - if not hostages - of a multinational snake oil scam. Ironically, the drug company previously hit with a $2.3 billion fine was the one that profited the most in the rushed rollout of the pandemic era’s “Emergency Authorization Use Countermeasure”- the Covid vaccine.
We now know the jabs were neither safe nor effective. They were never developed to stop infection or transmission. Worse yet, the rollout also correlates with the mysterious excess all-cause deaths from 2021-2023. Yet three years into this pseudoscientific shitshow, don’t expect to hear any of this from a bought and sold legacy press, or hear a peep from your family doctor.
Physician, heal thyself.
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Ask your doctor if death and destruction is right for you.