When are over-the-counter (OTC) drugs more effective than prescription drugs? When is doing nothing better than taking a medicine?
Prescription drugs are stronger than over-the-counter (OTC) drugs, but sometimes too much is a problem. For example, after a car accident, opioids are sometimes offered as relief from the pain of having been knocked around pretty badly. However, a study just published in November shows that opioids are no more effective than boring old OTC meds for injuries sustained during a car accident. Even worse, those who were given opioids stayed on the drugs longer than those who take Tylenol (acetaminophen) or Advil (ibuprofen).
Sometimes using no medicine at all is the better choice. For example, a recent study on migraines in children and teens (aged 8-17) showed that a placebo was more effective than Topamax or Elavil, commonly prescribed migraine drugs. Also, the medicines had adverse side effects like fatigue, dry mouth, mood alterations, weight loss and more. Why would this be? It may be that migraine drugs work differently in younger bodies. Research on adults with the same drugs indicate they are effective which is a good reminder that a drug that works with one population might not for other people.
Just because a drug is approved doesn’t always mean it’s effective.
Nexavar (sorafenib), the only drug on the market for a type of liver cancer (hepatocellular cancer), was approved based on clinical trials, but a follow-up study found that when used in the real world it did not extend life. This drug, as with many others, was approved based on a “surrogate endpoint,” blood level or other indicators that the drug is working. Follow-up studies to confirm that the drug really does work (extends life) are crucial so that we don’t depend on ineffective drugs.
Alternatives last longer and many have good side effects. Turning to insomnia drugs often causes a “rebound” effect, meaning after just a few uses, many can’t sleep without them. Another study shows that cognitive behavioral therapy for insomnia (CBT-I) gets better results than prescription drugs like Ambien. And there’s a bonus: You learn skills to use for a lifetime and no morning-after drowsiness.
Whether you’re sick or sleepless or in pain, ask questions before you reach for a pill. Sometimes the answer is to take a little time and let your body heal itself.
