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When a doctor prescribes a medicine there is an implicit promise that it will relieve symptoms or cure us when we are ill. The Hippocratic Oath that most physicians take upon graduation is widely understood to prohibit doctors from doing harm. Patients should not have to deal with a drug boomerang, a situation in which the medicine causes causes more harm than good!
What Is A Drug Boomerang?
Boomerang: n.
1. (Australian) a curved piece of wood; when properly thrown will return to thrower.
2. A miscalculation that recoils on its maker.
This definition from Webster’s Online Dictionary describes the unintended consequences of certain medications.
When doctors prescribe a drug to solve a problem, they don’t expect it to make things worse. But sometimes prescriptions lead to a drug boomerang.
Why The Hippocratic Oath Matters!
The precise phrase, “first, do no harm,” is not technically part of the oath. Hippocrates wrote it in a different work titled “Of the Epidemics.” In the actual oath, doctors promise to “do no harm or injustice” to their patients.
Of course, all medications have the potential to cause side effects in some patients. All you have to do is watch a direct to consumer (DTC) drug commercial on television to appreciate that. Health care providers are supposed to balance benefits against risks for every medicine they prescribe.
Most patients understand this. They don’t expect, however, that a medication will cause the very problem it’s being prescribed to treat. That, dear reader, is a drug boomerang!
Was Hormone Replacement Therapy a Drug Boomerang?
During the 1980s and 1990s women were told that they needed to take hormone replacement therapy (HRT) to build strong bones, diminish wrinkling and reduce their risks of having a heart attack or other cardiovascular complication. I recall a conference in which a woman asked the speakers about HRT and breast cancer. She was dismissed on the grounds that the great benefits of estrogen and progestin for preventing heart attacks far outweighed a small increase in cancer.
Then women who had been told they needed hormone replacement therapy after menopause to protect their hearts learned that HRT could increase their chance of a heart attack. This was the conclusion of not one but two clinical trials, the Heart and Estrogen/Progestin Replacement Study and the Women’s Health Initiative (Hypertension, Oct. 11, 2004).
You can read more about the HRT drug boomerang at this link.
The UDGP Drug Boomerang:
Drugs for type 2 diabetes are intended to control blood sugar. But the reason for that is to reduce the risk of developing cardiovascular complications such as heart attacks, strokes and premature death. Heart disease is the reason people with diabetes often die younger.
In 1970, scientists reported the results of a clinical trial that alarmed endocrinologists. In the University Group Diabetes Program (UGDP), a drug widely prescribed to control blood sugar was compared to placebo. The trial lasted for several years and enrolled more than 800 people. To their shock, the investigators found that people taking tolbutamide (Orinase) were twice as likely to develop heart trouble as those on placebo.
The CAST Drug Boomerang:
A decade later, researchers decided to test drugs being prescribed for serious heart rhythm problems. These can be frightening and dangerous. The medications flecainide (Tambocor) and encainide (Enkaid) were compared to placebo in the Cardiac Arrhythmia Suppression Trial (CAST).
Nearly 1500 volunteers participated in the trial. After ten months, 89 people had died. These were disproportionately patients taking the active medications, who died from heart rhythm problems and other cardiac causes. As a result, the investigators stopped the study (New England Journal of Medicine, March 21, 1991).
Antidepressants That Increase the Risk for Suicide:
If you look at the black box warning for antidepressants such as sertraline (Zoloft) you will read something alarming:
“Antidepressants increased the risk of suicidal thoughts and behavior in pediatric and young adult patients in short-term studies. Closely monitor all antidepressant-treated patients for clinical worsening, and for emergence of suicidal thoughts and behaviors.”
If that isn’t a drug boomerang message we don’t know what is. Most people assume that antidepressants reduce the likelihood of suicidal thoughts. You will be surprised to discover that the research does not support that assumption. Here is a link that will blow your mind.
Are New Alzheimer Meds A Drug Boomerang?
Perhaps you have heard about the new “breakthroughs” against Alzheimer’s disease (AD), aducanumab and lecanemab. These drugs are very effective at ridding the brain of beta-amyloid, which was thought to be the underlying cause of AD. But do these drugs restore memory and improve the lives of people with dementia? You can read our recent analysis of these medications at this link.
The media has made a big deal about these new AD drugs. What you have not read much about is a possible side effect: brain atrophy. Brain shrinkage is not good for people who are at risk for dementia.
NSAIDs and Cartilage:
The latest example of an unexpected outcome was recently presented at the Radiological Society of North America. Researchers recruited 277 patients taking NSAIDs such as ibuprofen or naproxen for their knee osteoarthritis. They compared these subjects to 793 individuals not taking these anti-inflammatory drugs.
All the volunteers had MRI scans at the outset and again after four years. At the end of the study, those taking the nonsteroidal anti-inflammatory drugs had more inflammation and less cartilage in their knees than the people in the control group.
Final Words on the Drug Boomerang Effect:
Drug boomerang complications leave patients and doctors as puzzled as the FDA. It is shocking that it often takes decades for scientists to discover when medications may be causing more harm than good. Drug companies and doctors should try harder to follow the Hippocratic oath to “do no harm or injustice.”
What do you think? Please share your thoughts in the comment section below.
TERI
This happened to me with the osteoporosis drug Prolia. Pausing a single injection caused me to have 3 non-traumatic vertebral fractures–while hiking at the bottom of the Grand Canyon. It is now a warning on the box but they speed through it on their TV commercials. I’d been on it for 7 years. None of my doctors or oral surgeon were aware that this could happen. I paused just one shot for oral surgery and have needed back surgery and am still in a back brace. Now I am in a “Prolia trap” where I can’t get off it for fear of more fractures. This one is ripe for your reporting.
Sue
The best are the new migraine drugs wherein the side effects are nausea and vomiting. That’s what I started with! I don’t need a drug to increase it!
Carol
Thank you for this informative article! About 20 years ago, my husband was wrongly given the fluroquinolone antibiotic known as Cipro. Cipro was only supposed to be used for patients close to death, but my husband was only mildly ill. After 3 days, my husband couldn’t sleep, and his life was ruined because the Cipro caused both his achilles tendons to rupture, and many other tendons were hurt (painful tendonitis), and even nerve damage happened! This is sometimes called “getting floxed.” Unfortunately, we didn’t know about this until years later, so my husband has suffered with pain for 20 years. If you know of a cure for getting terribly harmed by taking fluoroquinolones such as Cipro, please let us know.
Charlotte
I was prescribed Metoporal for afib but it has made me extremely tired and my heart rate has gone down! I certainly do not feel well at all!
Joette
I took ropinirole for Parkinson’s disease for 8 years before I realized it was doing more harm than good. The biggest problem is that it disrupts your sleep, which causes a host of problems related to daytime sleepiness, and all the while they tell you that sleep problems are a symptom of Parkinson’s.
Barb
One problem with drugs, OTC and prescription, is the inactive ingredients. One in particular is bothersome to a lot of people – propelyne glycol. I have allergies and have tested positive on a skin test for this. If I take Zyrtec or Benedryl to help deal with an allergic reaction rash, these drugs can actually cause a rash as both have propelyne glycol…………..
Angela
I have been saying for years: The Medical Industry is killing us. The Food Industry is killing us. The Pharmaceutical Industry is killing us.
Bernice
Thank you for the boomerang effect article. I have tried using generic Voltaren lately, before I walk, for arthritis in my knees. I have noticed that my knees feel a little funny or slightly weaker after use. I am suspicious that it might not be so good for me. It is not the walking since I am doing my usual 20-minute, moderately-paced walk. Have you seen any research re: a possible boomerang effect of Volteran or generic Voltaren?
I now use Arnica on my knees as needed. It does not seem to bother me and is reasonably effective. Are there any adverse effects to Arnica?
Joy
Recently had Type A Flu, went to an urgent care (was out of state) because of high fever. Put me on Tamiflu, took two pills, became so sick with diarrhea and vomiting that I stopped the Tamiflu and let the flu run it’s miserable course. Had a double whammy of misery – never again! Have heard from others, as well as a hospital nurse that it happens frequently. Many have been adversely affected by it!
Lisa H
When you block a cell receptor site and/or poison an enzyme…what could possibly go wrong?
Val
Drugs given to me on several occasions for nausea have immediately caused more extreme nausea, not relief.
Lavon
You are right on…I just almost lost it over Jardiance : 5 weeks like zombie …extreme sleepiness brain fog …
& more.
Jane
I bet the drug companies aren’t surprised.
Maria
A few years ago I was prescribed Flagel and Cipro in an urgent care center. I had a reaction to the flagel which landed me in the hospital where they continued the flagel and I became worse. I lost 25 pounds, was hallucinating, and in terrible shape. It wasn’t until my son looked at the black box warning for Flagel and saw that I had all of the dangerous side effect of taking that drug. No one had looked at the black box warning. My liver and right kidney have never fully recovered.
Sharon
I took premarin-provera for a few months and ended up having a stroke. I was in my 50s. Went to my primary care and told him what happened and he immediately told me to get off the drug. Going through menopause was rough but I took Black Cohash Root for a short time and that helped. I am no longer taking any drugs which my new primary care said I need. I went back to supplements since I never had troubles while I was on them. I feel much better and am in my 70s. No more drugs for me. I will do things naturally.
Dee
Oklahoma
I have been on flecainide for 16 years and will turn 60 in a month. When I was originally diagnosed with afib, I weighed about 100 pounds more than I do now. I’ve been able to reduce my dosage from 100mg bid to 50mg bid with minimal breakthrough. I WANT OFF. I would like to take adaptogenic herbs that would help with my adrenal fatigue but they can’t be used with flecainide. I am trying to get some recommendations on alternatives to this drug so that I can take it to my cardiologist. Can you offer any? Neither the physicians nor the pharmacists in our area have a clue. Thank you for your time!
cpmt
To MARY, you are lucky that you only had erythema N., A friend of mine has cancer of her breast because of that, hormone therapy.
To EBM, can you please give the websites were to find this literature and…? or how to look for this information? I am new on this, computer and internet, and I would like to find it. I don’t know what it should be the ‘title’ to find it (I am not from this country and my vocabulary is limited) Thank you.
SNH
ebm: Wake up is right!
It’s appalling to see how many of my same age are on multiple meds… statins, bone pills, reflux, antidepressants, you name it. And every time the see the doc, they get a new pill. Some of their ills have got to be attributable to one or more of their meds or the interactions between them.
It’s sad. Have you seen the waiting rooms in doctors’ offices lately–they’re full! If they went to the gym (or for a walk) half as often as they do the doctor and the fridge, they’d be better off I reckon.
Crummy diets and sedentary lifestyles are health hazards, as is stress I think–people don’t know what to do with their stress either. Pills for that too.
ebm
You spelled out what I’ve been saying for a long time (1975 when I went to a holistic MD in Los Angeles). I have been “studying” reading up on Health and how to stay that way ever since then. We cannot expect all aches and pains to go away by taking prescriptions since for every pill given we need one to two more to counter the side effects
I see so many friends on crummy diets and sedentary lifestyles on BP and statin meds who can barely walk anymore. Crestor caused my dear friend to walk with a cane within one week of taking it because the Dr switched him from Simvastatin to Crestor without an explanation, and he, being a male (ha ha) did not even ask why. He went off the Crestor and only slight muscle weakness is remaining. There is sooo much literature out there about how to stay healthy but most people want it easy and take what the Dr gives them, a pill, some I know take 17 pills 3xday!! Wake up America.
Mary
Hormone replacement therapy can rebound big time. Since I am very fair skinned and quite thin, I was advised to take Premarin-Provera to prevent osteoporosis. Long term on this drug can cause problems. Since other causes for my condition have been ruled out, I believe many years of hormone therapy is the reason I now suffer from erythema nodosum (very painful nodules and red irritated skin on the lower legs). I was immediately taken off hormones when the problem started seven years ago.
It is my belief that we should not mess with God’s plan for the body’s natural changes. I wish this thought had crossed my mind way back when.
Donna
How about the boomerang effect of proton pump inhibitors (drugs like Prilosec, Nexium) that actually can increase heartburn and become addictive in nature? I am suffering from adverse reactions 6 years after discontinuing Nexium. I was on a double dose for three years. It has been a nightmare.
Penny H.
I have taken both Fosamax and Boniva. How long is considered “long term”?
PEOPLE’S PHARMACY RESPONSE: SOMETHING BETWEEN FOUR AND FIVE YEARS MIGHT BE LONG ENOUGH TO GET THE MAJOR BENEFIT WITHOUT EXCESS RISK. NO ONE IS QUITE SURE, BUT HERE IS A RECENT EXPERT REVIEW:
J Clin Endocrinol Metab. 2010 Feb 19. [Epub ahead of print]
Long-Term Use of Bisphosphosphonates in Osteoporosis.
Watts NB, Diab DL.
SNH
Thanks for the article. It is a good reminder that drugs/medications come with a risk and should not be taken lightly. Unfortunately, these days visits to doctors result in prescriptions (and it’s not all the doctors’ fault–people often demand them).
Similarly, in the fray of the current health care debate and discussion about “preventive” care, no one talks about the most effective preventive measures (like weight reduction, healthy diet and other healthy habits) because they involve personal responsibility. Instead, “preventive” has come to mean more tests to detect early disease (which is ok, but not the full story), and then of course, more prescriptions and procedures to follow.
People seem to have adopted the idea that medicine can “fix” anything that’s wrong with a pill. It just isn’t so.