I wasn’t talking about non-pharmaceuticals, and neither were you. Non-pharmaceuticals don’t go through clinical trials, and they mostly don’t require any pre-approval. So that’s clearly just trying to pad your list.
Benzodiazepines do not have effects that only suddenly show up after 10-20 years of use. The serious side effects/withdrawal show up with a few months of heavy use, sometimes sooner. They’re also actively prescribed (with some appropriate caution), so a really weird one to lead with.
There are actually quite a few drugs still widely prescribed today that cause similar QT prolongation to terfenadine (e.g. quetiapine). The difference is they are for more serious conditions where the other options have similarly serious side effects, and terfenadine has to compete with Benadryl. No reason to have to get periodic EKGs just to keep your sinuses decongested in allergy season.
> Of the 528 new drugs approved over the period of interest, a total of 22 (4.2%) were eventually withdrawn. Between 3.9% and 4.4% of the drugs approved in each 5-year period were eventually withdrawn (χ2 = 0.04, p = 0.99 for difference among 5-year periods). The median time between approval and withdrawal was 1271 days (interquartile range 706–2876).[0]
I’ll give you the benefit of the doubt, and assume that you just didn’t care to read the paper once you assumed it agreed with you and did not selectively quote on purpose. From the same paper:
> Of the 22 drugs withdrawn, 11 first had a serious safety warning and 11 did not (Table 2). The median time between the Notice of Compliance and withdrawal was 1271 days (interquartile range 706–2876).
So, the percentage you quoted was double what we were actually talking about here. On top of that, I don’t think you finished reading what you did quote; the median time to withdrawal was < 5 years, and if you actually look at the table only two drugs with serious safety issues actually hit the 10-20 year range you mentioned.
> those users could have chosen lifestyle intervention
We’ve been trying all kinds of “lifestyle interventions” for a long time, from doctors telling people to exercise to semi-organized campaigns of body shaming. It hasn’t worked for the vast majority of people in practice. So unless you have some actually novel idea here, you’re essentially trying to get people to switch from a drug that works to the power of positive thinking. Good luck with that.
Benzodiazepines do not have effects that only suddenly show up after 10-20 years of use. The serious side effects/withdrawal show up with a few months of heavy use, sometimes sooner. They’re also actively prescribed (with some appropriate caution), so a really weird one to lead with.
There are actually quite a few drugs still widely prescribed today that cause similar QT prolongation to terfenadine (e.g. quetiapine). The difference is they are for more serious conditions where the other options have similarly serious side effects, and terfenadine has to compete with Benadryl. No reason to have to get periodic EKGs just to keep your sinuses decongested in allergy season.
> Of the 528 new drugs approved over the period of interest, a total of 22 (4.2%) were eventually withdrawn. Between 3.9% and 4.4% of the drugs approved in each 5-year period were eventually withdrawn (χ2 = 0.04, p = 0.99 for difference among 5-year periods). The median time between approval and withdrawal was 1271 days (interquartile range 706–2876).[0]
I’ll give you the benefit of the doubt, and assume that you just didn’t care to read the paper once you assumed it agreed with you and did not selectively quote on purpose. From the same paper:
> Of the 22 drugs withdrawn, 11 first had a serious safety warning and 11 did not (Table 2). The median time between the Notice of Compliance and withdrawal was 1271 days (interquartile range 706–2876).
So, the percentage you quoted was double what we were actually talking about here. On top of that, I don’t think you finished reading what you did quote; the median time to withdrawal was < 5 years, and if you actually look at the table only two drugs with serious safety issues actually hit the 10-20 year range you mentioned.
> those users could have chosen lifestyle intervention
We’ve been trying all kinds of “lifestyle interventions” for a long time, from doctors telling people to exercise to semi-organized campaigns of body shaming. It hasn’t worked for the vast majority of people in practice. So unless you have some actually novel idea here, you’re essentially trying to get people to switch from a drug that works to the power of positive thinking. Good luck with that.