Archive for November, 2006

Beta blockers and dementia

Monday, November 27th, 2006

I was watching 60 minutes last night. They had a segment about the use of a beta blocker propanolol for traumatic stress syndrome lauding its ability to block the formation of traumatic memories. It was pretty interesting.

Many of the elderly I interact with are on beta blockers to control their hypertension. Often, their hypertension remains poorly controlled which fits with the studies that indicate that beta blockers are not a good prescription choice for the elderly hypertensive.  Moreover, “no trial has shown that lowering blood pressure with a beta blocker reduces the risk of a heart attack or cardiovascular event in patients with essential hypertension compared with placebo.” Thus, even where the beta blocker reduces blood pressure it does not accomplish the ultimate goal of preventing heart attack, stroke, and all-cause morbidity and mortality. “This indicates that, at present, millions of elderly hypertensive patients are needlessly exposed to the cost, inconvenience, and adverse effects of beta blockers even though they will never harvest any real benefit.”

The do seem to harvest the side effects, however.  Fatigue and nightmares are fairly common side effects of beta-blockers. Other side effects that are more rare are “confusion (especially in elderly patients)” and hallucinations (seeing, hearing, or feeling things that are not there). My mother was recently put on a beta blocker while in the hospital. When I left her one evening, she was doing fine. When I got back to the hospital the next morning, she informed me that “something was wrong with her mind.” And indeed she was disoriented and seemed to have lost her mind & memory. Both her nurse and her doctor insisted that this mental state was common in people her age subjected to the stress of being in a hospital. At our insistence they discontinued the beta blocker (toprol) and within hours her mind was clear as a bell. Her blood pressure was not affected, that is, it did not go up when the meds were discontinued. I often think that if she had not had family there, she would have deteriorated further and they probably would have diagnosed her with dementia and have started her on a bunch of other drugs.

In many elderly, short term memory is fragile and they are at risk for dementia in all its various forms. Beta blockers appear to work in traumatic stress by interfering with the person’s ability to lay down such a memory. It seems reasonable to me that taking such a drug on a continuous basis may be creating dementia in many of our elderly. There was no discussion of this potential on 60 minutes and I am not aware of any studies on the topic. But, if you know an elderly person who “seems to be losing it,” perhaps you should check and see if they are on a beta blocker. It may be the drugs and not the mind that is at fault.

Right now we are managing mom’s hypertension reasonable well with herbs (Rauwolfia being the main component for that) and she seems to be doing well.

For the study on beta blockers quoted above see:

Messwerli FH. Antihypertensive therapy: beta-blockers and diuretics — why do most physicians not always follow guidelines?

Full text available at http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1312291

Posted in beta-blockers, dementia, elderly, hypertension | No Comments »

Mandatory Flu Vaccinations Planned

Thursday, November 23rd, 2006

I was recently asked to write an article about why I choose not to get a flu shot. I had not given a great deal of thought to my decision so it was interesting to read the research on the effectiveness of flu vaccinations. I learned that the flu shot does not really provide much protection against influenza, even where there is a good match between the circulating flu strain and the strain used for the vaccine. A recent example on point: 49 residents in an Australian nursing home and 7 staff members just came down with the flu, 6 of them died. More than 90% of the residents and about 55% of the staff were vaccinated.

You can read my article on why I do not get a flu shot on page 12 of the Vashon Loop:

http://www.vashonloop.com/PDF/LoopV3_23.pdf

A few days later I read an article a friend sent me about a panel discussion on world affairs held at Stanford University and moderated by Ted Koppel. The panelists concluded that the threat of pandemic influenza was the most troubling crisis facing the world. I was immediately struck by a comment made by the CEO of GlaxoSmithKline, Jean-Pierre Garnier:

“The solution is not to stockpile vaccines. The solution is to nip it in the bud. Our best shot is to draw a circle around the infected area and vaccinate everyone.”

(http://sfgate.com/cgi-bin/article.cgi?f=c/a/2006/10/15/BAGB8LPPO1.DTL)

Is the government planning mandatory vaccination using a vaccine that may be entirely ineffective? Is that part of our preparedness plan? It indeed appears to be. Most state preparedness plans grant the government authority to make flu vaccination mandatory. Those who cannot (or will not) take the shot will be quarantined. I found little information on how the quarantine will be implemented. Will people be forced to stay home or will they be sent to “quarantine camps”? In any case, how many of us can survive being quarantined for an extended period of time? Our bills will continue to pile up even if we are not allowed to work and earn a living.

It would be easier to stomach the thought of mandatory vaccinations if the drug manufacturers had any faith in the safety of their products. Instead, they have convinced Congress to shield them from any and all liability for damage done by their drugs and vaccines during an “emergency.” I believe they know their vaccines will be ineffective — the better planned seasonal flu shots are — and they know they will cause damage to many.

I think it is time for the public to wake up and look at this issue. It is bad enough that tax dollars are being wasted on stockpiles of largely ineffective antiviral drugs and vaccines. There is no reason to guarantee vaccine manufacturers a market for their products as well as freedom from liability for injury caused by their negligence.

Posted in influenza, pandemic preparedness, vaccination | 3 Comments »