The beautiful thing about science is that it is constantly changing, as new facts bump up against old ideas, theories, and received wisdom. So it should come as no surprise to learn that two reports of recent vintage now have to be revised.
One of the reports -- allegedly linking soda drinking and cancer of the esophagus (EC) -- was one I previously pegged as pseudo-scientific claptrap of the worst order. My main gripe was the gullibility of so-called "health reporters" who published this baseless association as though there were some scientific evidence behind it. Now comes a real study, in a real scientific journal, the Journal of the National Cancer Institute (JNCI), whose authors supervised a multi-center study seeking a link between consumption of carbonated beverages and esophageal cancer. The results: not only was there no cause-and-effect relationship, but, au contraire, there was actually a negative correlation between soda consumption and EC!
Of course, no one believes -- yet -- that drinking soda will actually protect you from EC. But the clear lack of association between causation of EC and soda highlights the fact that preliminary reports about this or that causing various cancers should not be passed on by credulous or lazy reporters as fact. To anyone savvy in science the earlier report was clearly groundless, but the public has been inundated with phony cancer scares for so long that many folks just avoid the "deadly" substance attacked or tune out all such reports entirely. Occasionally, cancer scares turn out to be valid -- smoking, of course, comes to mind. But consumers must be able to rely on media science reporters to screen out alarmist releases or they will lose all faith in both journalists and scientists.
Suicide Is More Important Than Soda
Perhaps a more important issue is our confidence in pharmaceutical safety. The federal drug regulators at the FDA are not supposed to be overly cautious or alarmist. But they have recently taken that point of view.
Over 200 million prescriptions were written last year for antidepressants in the U.S. When the FDA issued a warning last October that antidepressants might actually increase "suicidal thinking," particularly in young people, Americans' confidence in these drugs -- relied upon by psychiatrists to relieve suffering in their depressed patients -- took a significant plunge.
Now comes a new, large-scale, federally funded study, which refutes the FDA's position. Researchers evaluated suicidal behavior in over 65,000 patients who filled prescriptions for antidepressants over a ten-year period. The results: the number of suicide attempts fell by 60% in adults during the month after antidepressant treatment began, and it declined further in the subsequent five months. The findings also directly counter the FDA concern with some newer antidepressant drugs: when suicide attempts were compared in patients taking these drugs (some in the SSRI category) and in patients taking older antidepressants (mainly the "tricyclics"), an increase in suicide attempts was seen only for the older drugs. For the newer drugs, the rate dropped dramatically in the first month after antidepressants were prescribed.
What about the legitimate fears parents have over the safety of these drugs for their children? Also not to worry: much as was seen in adults, the rate of suicide attempts by adolescents was highest in the month before treatment and declined by about 60% after treatment began. According to Robert Freedman, M.D., editor in chief of the American Journal of Psychiatry: "This study directly addresses the question of whether newer antidepressants increase or decrease suicide risk for adolescents. The answer is that suicide risk is decreased and that the positive effects exceed those of earlier-generation drugs. The use of the newer drugs had decreased in response to concerns about suicide risk. [This] study provides evidence to the contrary. The newer drugs decrease suicide risk significantly."
How many young people attempted or committed suicide as a direct result of the dire warnings issued by the politically-sensitive FDA? We will likely never know. It has become more and more common of late for press reports, political speeches, and "consumer-advocate" campaigns to focus on the risks of our medications, avoiding consideration of the tremendous benefits which accrue to us from their appropriate use. Of course, every drug has some risk -- but what about the benefits? (See ACSH's new publication on this subject.)
To a great extent, our increasing health and longevity come to us thanks to our generally safe and effective pharmacopeia. It is disappointing that even our FDA seems to be unaware of this fact.
Gilbert L. Ross, M.D., is Executive and Medical Director of the American Council on Science and Health (ACSH.org, HealthFactsAndFears.com).