I'm all for a shake-up for a more simplistic approach to drug safety drug guidelines for pregnant mothers, so a recent article filled me with hope with the headline 'New Pregnancy Drug Guidelines A Mixed Bag For Consumers'.
Alas, it's not all it's cracked up to be.
The FDA have, for many years, categorized a number of prescription drugs, particularly for use in expectant mothers.
Here's how it currently stands.
Category A
Adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters).
Category B
Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women.
Category C
Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
Category D
There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
Category X
Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits.
Simple enough but, in my opinion, very vague. Let's take a look at Category C.
Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.In essence the FDA are telling pregnant mothers that the drug they have in their possession has had an adverse effect on the fetus of animals...they go on to say that there have been "no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks."
It's more or less telling the mother that they should take the drug at their own peril.
So, a shake-up to make these guidelines more crystal clear is welcoming.
Are the FDA going to consolidate all the cases of birth defects that have been settled by pharmaceutical companies throughout US courts and then apply them to the new guidelines?
Nope.
Are the FDA going to read the countless stories on the internet and in the media about mothers giving birth to children with defects after taking a specific prescription drug?
Nope.
Are the FDA going to contact pediatricians to ask if they have ever come across instances where children [fetuses] have had to be aborted due to prescription drug medication causing birth defects?
Nope.
Here's what they plan to do.
They are, it seems, going to ask the drug companies to write the warnings.
So, the likes of Paxil, a drug marketed and manufactured by GlaxoSmithKline, a drug that has, on countless occasions, been implicated in hundreds, possibly thousands of birth defects, will now get a new lease of life. Glaxo, who have settled many of these birth defect cases out of court, will now be asked by the FDA to come up with a warning for pregnant mothers to read.
Are we expected to believe that Glaxo are going to have the consumer in mind when writing a warning about ingesting Paxil while you are pregnant?
To my knowledge GlaxoSmithKline have defended the majority of Paxil birth defect lawsuits. Those they win are usually down to absurd state laws [see Ryan, Glaxo's Non-Viable Fetus - Part I and Ryan, Glaxo's Non-Viable Fetus - Part II - The Twists.]
Do we really believe that the likes of Wyeth are going to be anything but truthful when they write a warning for Effexor? [see - Two Hours With Matthew - The Story of "Effexor Baby", Matthew Schultz and Effexor Baby's Grieving Mother Protests Potential MOTHERS Act, Warns Others]
Perhaps Lundbeck will cease the opportunity to cover their drug, citalopram [Celexa] in garlands when there are cases suggesting that it can cause all sorts of problems to the fetus. [see Citalopram Birth Defects and The Lundbeck Emails [Citalopram Birth Defects]
The FDA plan to remove the pregnancy categories A, B, C, D, and X from all human prescription drug and biological product labeling, they are recommending that the labeling include a summary of the risks of using a drug during pregnancy and lactation.. and they are leaving this to the manufacturers of the said drugs, the same manufacturers who have suppressed information surrounding their drugs and birth defects.
On one hand the FDA are looking as if they really do care about the dangers of these drugs in pregnant mothers, on the other hand they are passing the buck back to the pharmaceutical industry whose main priority is to make bucket loads of money out of the supply of these drugs.
It's just like allowing the cannibalistic witch to provide information on candy and food to Hansel and Gretel.
Don't get me started on the British drug regulator, the MHRA, they still insist that Paxil is not a teratogen...despite the fact that it has been proven to be one in US Courts.
There will be many who read this who will claim that they took antidepressants during pregnancy and their babies turned out just fine. To those I ask just one simple thing...please spare a thought for those mothers who, through no fault of their own, don't have the luxury of holding their babies or ever having the chance to hold their babies babies.
Bob Fiddaman.
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