The Drug Detectives
Women who make sure your medication is safe
O, The Oprah Magazine, February 2006
wants to take a pill that won't work or—worse—is harmful. But who can
judge good medicine from bad when today's wonder drugs so often become
tomorrow's pharmaceutical mistakes? We spoke to three women who
investigate the tablets and capsules we swallow in the name of health.
Principal investigator, Drug Effectiveness Review Project, Portland, Oregon
spends her days sifting through the available data to see how a new
drug stacks up against others in its class: Is it more effective? Is it
safer in the long run?
When McDonagh is surprised, it's not
usually by something she finds but rather by something she can't
find—like studies showing long-term safety for kids taking ADHD drugs.
Also lacking, she says, is hard evidence that ADHD drugs improve
academic performance. "Do the kids keep up with peers as they advance
through school, so they graduate at the same rate?" she asks. She calls
the data "abysmal."
McDonagh admits she's now a skeptic about
new drugs, which aren't necessarily superior to what's already on the
market. Check reports on science-backed Web sites like
ohsu.edu/drugeffectiveness, www.fda.gov/cder, and cochrane.org to see
if there really is a difference in results between the new drug and
others in the same class. Also note how long the pill has been studied;
if it's less than a year, some side effects may not yet be apparent and
you could be safer with medications that have been on the market awhile.
Director, Cardiovascular Nutrition Laboratory, USDA Nutrition Research Center on Aging, Tufts University, Boston
if you should take that omega-3 supplement? Want to know if soy really
is good for you? Lichtenstein is your woman. Her beat is getting to the
bottom of food and supplement claims.
What excites her is when
science comes up with a clear answer, even if the accepted wisdom turns
out to be wrong—for instance, that beta-carotene supplements protect
against heart disease (they don't, and may do more harm than good) or
that chromium enhances glucose metabolism, reducing body fat (wrong
Her findings have affected her own choices. "I make sure
I include fish in the family's diet," she says, pointing out that the
evidence for omega-3 is pretty good—but in food, she stresses, not
supplements. And that's true across the board: The most proven way to
get your nutrients is through healthy eating. "If you take fiber and
you sprinkle it over a hot fudge sundae," she says, "the benefits won't
negate what's in the sundae."
Formulary pharmacist, Drug Information Services, Kaiser Permanente, California
with ten other investigators, Kubota-Sako gathers evidence to help the
HMO giant decide which drugs should be on its list of preferred
medications. By scrutinizing the scientific studies, Kaiser has
frequently been ahead of the curve in recognizing problems with drugs,
she says. For instance, they picked up on the dangers of COX-2
inhibitors such as Vioxx and Celebrex long before the FDA issued
warnings and decided early on that these drugs should be used only in
very specific types of people. "Often in these studies," Kubota-Sako
warns, "the study population doesn't apply to the population at large."
of the most important lessons she's learned from nine years as a drug
sleuth is that every single medication has risks. When you get a
prescription, aside from doing your own research online (don't depend
solely on Web sites sponsored by the drug company), make sure to grill
the doctor and pharmacist about possible side effects.