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Tuesday, November 27, 2012
Reminder: Progress Doesn't Always Go Forward
Whatever the medical problem, we all like the idea of simply taking a pill over more heavy-handed approaches like surgery, transplantation, chemotherapy, and radiation. It's just so simple, right -- open the mouth, toss the little thing in, and swallow? For treating neurological problems in particular, nothing may seem more logical: sure, an awful lot of wiring comes into play... but it's mostly just chemicals, right? You should be able to just add more of a chemical, or introduce a new one, to fix some inner imbalance?
The US military in particular has been investigating the use of a drug commonly called citicoline (WebMD) for treatment of traumatic brain injuries.
Not that anyone expects a "cure," of course, especially one to be simply gulped down in battlefield emergencies. But citicoline has seemed (in both rats and humans) to halt some of the chemical effects on the brain of various injuries -- not just head trauma, but ischemic stroke, glaucoma, and so on. Best of all: it's a naturally-occurring drug, marketed under various brand names but not subject to patent restrictions... and (at least in the US) requires no prescription. A quick search online confirmed that it's inexpensive and widely available from "regular" sources. You don't have to obtain citicoline from a furtive retailer with an office on the sidewalk at a poorly-lit street corner.
But a recent study in Europe of over two thousand patients (published in the Journal of the American Medical Association, or JAMA) reveals that citicoline is no more effective than placebos in the treatment of TBIs. The study followed the progress of over two thousand patients, including more than 1,200 in the US, over the course of 90 days' treatment. This is disappointing news, for TBI treatment not just here but around the world. (The study's author says citicoline is approved for use as a TBI treatment in almost sixty countries.)
One interesting angle to the report, by the way: although they didn't sponsor the study, a Spanish manufacturer of citicoline supplied the samples used in the testing. Good to be reminded that pharmaceutical testing doesn't always lead to results beneficial to the commercial interests of the parties behind it.
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