Intended for healthcare professionals

Editorials

Judging the benefits and harms of medicines

BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j3129 (Published 30 June 2017) Cite this as: BMJ 2017;357:j3129

Evidence of harms of medicines being hidden in plain sight?

Fiona French's rapid response (1) to 'Judging the benefits and harms of medicines' makes for sobering reading.

Is the real 'E' evidence of the harms of very commonly prescribed neurotoxic medicines (in Fiona's case long-term benzodiazepines and antidepressants) being conveniently and systematically hidden in plain sight?

There is a recent debate article in BMC Family Practice entitled ' "Medically unexplained" symptoms and symptom disorders in primary care: prognosis-based recognition and classification' (2). This article makes for deeply troubling reading. It includes this telling quote :
"Taking a prognostic approach, while remaining agnostic about aetiology, is likely to be acceptable to both doctors and patients".
That is an astonishing statement.

The same article goes to describe major disabling neurological 'symptoms' including Bodily Distress Syndrome (BDS): 'central sensitisation', 'arousal'/'exhaustion') in the following systems: cardiopulmonary/ANS, gastrointenstinal, musculoskeletal, and 'general' (everything else).

Is being 'AGNOSTIC ABOUT AETIOLOGY' of such alarming (and ever growing) evidence - of harm being experienced and reported by patients - trustworthy, honest or even scientific?

(1) http://www.bmj.com/content/357/bmj.j3129/rr-3
(2) https://bmcfampract.biomedcentral.com/articles/10.1186/s12875-017-0592-6

Competing interests: No competing interests

08 July 2017
Marion Brown
Psychotherapist and Mediator (Independent)
none
Helensburgh