Thursday 31 May 2018

My body spake, not I

Roseann Barr just uttered an outrageous racist slur on Twitter and had her back-from-the-dead Gig on ABC cancelled forthwith. Twitter is like an open mouth ready for foot. She blamed her medication: Ambien which is a neurotransmitter-jiggling sleep-inducer. Sanofi, the French MegaPharm which has made billions out of Ambien didn't issue a cease-and-desist because you cannot re-call the spoken word, the sped arrow, the past life, the lost opportunity . . . or the sent tweet. They did, however, point out  “People of all races, religions and nationalities work at Sanofi every day to improve the lives of people around the world. While all pharmaceutical treatments have side effects, racism is not a known side effect of any Sanofi medication,” they should know because the list of side-effects is long. And includes one which is exactly opposite to the effect for which people take Ambien:
  • SUBJECTIVE: trouble sleeping; discouragement; clumsiness or unsteadiness; confusion; depression; sleepiness or unusual drowsiness; daytime drowsiness; confusion about identity, place, and time; seeing, hearing, or feeling things that are not there; burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings; dizziness, lightheadedness, or fainting; loss of interest or pleasure; memory problems; mood swings; nightmares or unusual dreams; sense of detachment from self or body; slowing of mental and physical activity; tiredness; trouble concentrating; double vision; drugged feeling; false or unusual sense of well-being; feeling of unreality; feeling sad or empty; lack of appetite; lack of feeling or emotion; lack or loss of self-control; lack or loss of strength;
  • OBJECTIVE fast heartbeat;  skin rash; swelling of the face; abnormal or decreased touch sensation; abnormal sensation of movement; appetite disorder; chest discomfort; chills; dry mouth; heartburn; hives or welts; itching ears; nausea; redness of the skin; redness or soreness of the throat; sneezing; stuffy or runny nose; vomiting;
  • BEHAVIOUR: binge eating; unusual excitement, nervousness, or irritability; 
  • BOWELS: abdominal or stomach pain; constipation; diarrhea; frequent bowel movements; 
  • PLUMBING: frequent urge to urinate; difficult, burning, or painful urination; bloody or cloudy urine; longer or heavier menstrual periods; bladder pain;  
  • BREATH: difficulty with breathing; wheezing; 
  • MOVEMENT: falling; loss of balance; balance disorder; difficulty with moving; difficulty with swallowing; joint pain; muscle aches, cramping, pain, or stiffness; swollen joints; 
  • VISION: eye redness; blurred vision; vision changes; 
  • HEARING:  earache; headache; hearing loss; continuous ringing, buzzing, or other unexplained noise in the ears; change in hearing; [see also falling / balance / dizziness above]
I put out a list of all the reported side-effects for infliximab two years ago. Totally different disease, totally different drug, totally different mode of action . . . but lots of overlap in the adverse symptoms.
HuffPo has an essay on the particular and peculiar cases where the Ambien Defense has been played by lawyers for people who have killed other people while under the influence. My Da, a sea-captain, never shirked responsibility for his own actions and neither for the actions of everyone under his command.

Zolpidem, sold as Ambien, seems to act as a GABA agonist: locking into the gamma-amino butyric acid GABA receptor to gee-up its potency. As with all oral medications that interfere with normal neurotransmitter-receptor relationships it is impossible to target the drug to only those receptors in the particular subset of neurons that you wish to influence. As you see from the list of side-effects above, GABA affects, at least, the brain, bowels, lungs/trachea, urinary tract . . . I tell ya, it's a wonder any drugs are approved as safe and efficacious.

Once, while he nodded on a chair,
At the moth-hour of eve,
Another poor man sent for him,
And he began to grieve.

'I have no rest, nor joy, nor peace,
For people die and die';
And after cried he, 'God forgive!
My body spake, not I!'

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