Ugh… Kids These Days!

While cocaine was once the drug of choice, bankers are now reportedly turning to the ADHD medication for work days that can last as long as 22 hours, along with nicotine patches and energy drinks. 90-hour-a-week Wall Street bankers snorting lines of Adderall at their deskshttps://www.telegraph.co.uk/world-news/2024/12/15/90-hour-a-week-wall-street-bankers-snorting-adderall-desks/

It never ceases to amaze this Old Underwriter how people manage to find creative ways to kill themselves.

GLP-1 – Compounded or Brand-Name?

Caroline Apovian, MD, co-director of the Center for Weight Management and Wellness at Brigham and Women’s Hospital and professor of medicine at Harvard Medical School, Boston.

“Doctors who are obesity medicine specialists like myself in academic centers do not prescribe compounded semaglutide or tirzepatide,” she said.

Many of the compounded prescriptions, she said, come from telehealth virtual–only companies interested in profits.

GLP-1 Prescribing Decisions: Compounded or Brand-Name? – Medscape – November 14, 2024https://www.medscape.com/viewarticle/glp-1-prescribing-decisions-compounded-or-brand-name-2024a1000krd?

To be clear, all of my GLP-1 posts are not anti-pharma. If you can afford these medications and they work for you on your weight loss journey that’s great. Just be aware of the possible side effects and the fact these medications are for life. You will regain all that you’ve lost if you stop taking the drug.

Here’s the link to Complications? What Complications? (just another GLP-1 receptor agonist post)

Telehealth Company Cerebral Agrees to pay $3.7M fine (and found guilty of nothing)

Telehealth company Cerebral has agreed to pay a fine of more than $3.6 million for allegedly attempting to boost prescriptions of Adderall and other controlled substances, the Department of Justice and Drug Enforcement Administration said Monday. 

Regulators allege Cerebral’s initial visit metric didn’t consider medical literature or whether prescriptions would be clinically appropriate for patients. The company also used financial incentives to spur providers to meet prescribing metrics — and even considered disciplinary measures for those who hadn’t prescribed enough stimulants for ADHD patients, according to a press release.

https://www.healthcaredive.com/news/cerebral-controlled-substance-prescribing-fine-doj-dea/732108/

This company agreed to a fine it was unable to pay so the regulators deferred payment.

Huh?

Mind The Gaps

The Food and Drug Administration is warning consumers not to use any drugs made by a compounding pharmacy in California after regulators realized the pharmacy was making drugs that need to be sterile—particularly injectable drugs—without using sterile ingredients or any sterilization steps.

The products made by the pharmacy, Fullerton Wellness LLC, in Ontario, California, include semaglutide, which is intended to mimic brand-name weight-loss and diabetes drugs Wegovy and Ozempic. Fullerton also made tirzepatide, which is intended to mimic weight-loss and diabetes drugs Zepbound and Mounjaro. Drugmaker shut down after black schmutz found in injectable weight-loss drug https://arstechnica.com/health/2024/11/drugmaker-shut-down-after-black-schmutz-found-in-injectable-weight-loss-drug/

I’ve read the FDA advisory. The FDA warns patients and health care professionals not to use compounded drugs from Fullerton Wellness — https://www.fda.gov/drugs/drug-safety-and-availability/fda-warns-patients-and-health-care-professionals-not-use-compounded-drugs-fullerton-wellness

  1. If you’re injecting what you believe is a weight loss medication do you pay any attention to who the manufacturer is?
  2. Do you read any of the FDA drug alerts and statements?
  3. The FDA names the compounding facility but does not name of any clinics or online purveyors who may be selling you tainted and non-sterile drugs.
  4. If you ask your online provider questions will you get honest answers?
  5. Is losing a few pounds worth the risk?
  6. Have you considered the possibility that the side effects you’re having are not just normal side effects from a GLP-1 type compounded drug and may be from an impure product?

Yikes.

FDA Announces Recall for Duloxetine

Nitrosamine impurities have prompted a number of drug recalls in recent years, including oral anticoagulants, metformin, and skeletal muscle relaxants.FDA Announces Recall of More than 7000 Bottles of Duloxetine – Medscape – October 28, 2024. – https://www.medscape.com/viewarticle/fda-announces-recall-more-than-7000-bottles-duloxetine

Depressing. But will be very depressing for people on this medication.

The More Drugs You Take…(fill in the blank)

This was a retrospective longitudinal cohort study of adults aged 60 years and older.

An increase in polypharmacy severity was significantly associated with a higher likelihood of all-cause hospitalization within 1 year, but not a hospitalization related to IBD. Use of a PIM (potentially inappropriate medication) was also associated with a higher probability of all-cause hospitalization compared with patients without. Hospitalization Risk in Older Adults With IBD Associated With Severe Polypharmacyhttps://www.gastroenterologyadvisor.com/news/hospitalization-risk-in-older-adults-with-ibd-associated-with-severe-polypharmacy/

Photo by Anna Shvets on Pexels.com

Statins Raise Diabetes Risk (but CV Benefit Outweighs the Risk)

Statins raise the risks for increased glucose levels and the development of type 2 diabetes among people who don’t have it at baseline, but those risks are outweighed by the cardiovascular benefit, new data suggested.

The meta-analysis of trials in the CTT Collaboration included individual participant data from 19 double-blind randomized, controlled trials with a median follow-up of 4.3 years comparing statins with placebo in a total of 123,940 participants, including 18% who had known type 2 diabetes at randomization. Also analyzed were another four double-blind trials of lower- vs higher-intensity statins involving a total of 30,724 participants followed for a median of 4.9 years, with 15% having diabetes at baseline.

In the 19 trials of low- or moderate-intensity statins vs placebo, statins resulted in a significant 10% increase in new-onset diabetes compared with placebo (rate ratio, 1.10), while high-intensity statins raised the risk by an also significant 36% (1.36). This translated to a mean absolute excess of 0.12% per year of treatment.

Compared with less intensive statin therapy, more intensive statin therapy resulted in a significant 10% proportional increase in new-onset diabetes (1.10), giving an absolute annual excess of 0.22%

In an accompanying editorial, Hertzel C. Gerstein, MD, and Marie Pigeyre, MD, PhD, both of McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada, noted that the decreased absolute annual incidence of life-threatening cardiovascular outcomes with statins in people at high risk for type 2 diabetes “clearly exceeds the 0.1%-1.3% per year increased absolute incidence of type 2 diabetes.”

Statins Raise Diabetes Risk, but CV Benefit Outweighs It – Medscape – April 09, 2024. — https://www.medscape.com/viewarticle/statins-raise-diabetes-risk-cv-benefit-outweighs-it

ATTENTION PARENTS – Social Media and Self-Diagnosis (scary charts too)

Image source – Technology and Student Well-Being: 10 Charts https://www.edweek.org/research-center/reports/technology-and-student-well-being-10-charts

In The Anxious Generation: How the Great Rewiring of Childhood Is Causing an Epidemic of Mental Illness, social psychologist and author Jonathan Haidt lays out his argument that smartphones and social media are the key driver of the decline in youth mental health seen in many countries since the early 2010s.

The early 2010s were crucial, Haidt argues, because that was when smartphones really began to transform childhood into something unrecognizable. In June 2010, Apple introduced its first front-facing camera, and a few months later Instagram launched on the App Store. For Haidt, this was a fateful combination. Children were suddenly always online, always on display, and connected in ways that were often detrimental to their well-being. The result was a “tidal wave” of anxiety, depression, and self-harm, mostly affecting young girls.In Haidt’s telling, though, smartphones are only part of the problem. He thinks that children in the West are prevented from developing healthily thanks to a culture of “safetyism” that keeps children indoors, shelters them from risks, and replaces rough-and-tumble free play with adult-directed organized sports or—even worse—video games. For evidence of safetyism in action, Haidt contrasts a picture of a 1970s playground merry-go-round, (“the greatest piece of playground equipment ever invented”) with a modern set of play equipment designed with safety in mind and, thus, giving children less opportunity to learn from risky play.

Screen Time for Kids Is Fine! Unless It’s Not — https://www.wired.com/story/pete-etchells-jonathan-haidt-smartphones/?utm_source=pocket_saves

Next steps? Go back online, find a venture capital backed mental health provider, take a quiz, get a diagnosis that confirms your self-diagnosis, have drugs sent to you in the mail.

The scourge of self-diagnosis.