Tuesday, March 20, 2012
The Success Cycle
Within a few hours of reading this book, the novice or veteran sales person will learn how to employ a sales system that will take them to the level of success enjoyed by Top Sales Professionals. The Success Cycle will reveal a proven system for sales success in any and every type of sales marketing. By learning and mastering each of the 10 areas of The Success Cycle, sales success can be literally guaranteed. This system is the key to long term sales success. Absolutely a must read for those who desire a track to run on. Cawiezell reveals how this system put him in the top 1% of sales people within 2 years of mastering it. Cawiezell’s philosophy, “The situation is the boss and the results are the judge”. “In order to win the game you have to be in the game”. The Success Cycle will keep you in the game so you can ultimately win the game! The reader will have a ready resource to refer to over and over again and will understand the 5 areas needed to grow success. These are all of the secrets of proven winners! This system teaches you how to get through the following curves: the knowledge curve, the skills curve, the confidence curve, the experience curve, and ultimately enjoy the success curve. thesuccesscycletoday.com
Tuesday, March 13, 2012
The Success Cycle
thesuccesscycletoday.com The Success Cycle was written to educate, guide and provide a proven track to run on for the novice and the veteran salesperson. Not only a good read for salespeople but also for the teacher, coach, politician, businessman and anyone who wants to be successful and is seeking a resource that is easy to understand and implement. Cawiezell explains The Knowledge Curve, The Skill Curve, The Experience Curve, The Confidence Curve , and ultimately The Success Curve. A must read for the rugged individualists, the person who wants to move mountains and make waves.
Thursday, September 8, 2011
Another example of greed, Doctors are as bad as the lawyers !
Dollars for Doctors
Dollars for Doctors
How Industry Money Reaches Physicians
Piercing the Veil, More Drug Companies Reveal Payments to Doctors
by Charles Ornstein, Tracy Weber and Dan Nguyen
ProPublica, Sep. 7, 2011, 5:31 p.m.
Eight pharmaceutical companies, including the nation's three largest, doled out more than $220 million last year to promotional speakers for their products, according to a ProPublica analysis of company data.
For the first time, all these companies have reported a full year of payments, allowing for head-to-head comparisons of how much they spent on physicians to help push their pills. Some appear to be paring back.
Related Stories
Patients Deserve to Know What Drug Companies Pay Their Doctor
by Tracy Weber and Charles Ornstein, ProPublica, Sept. 7
Doctors Dine on Drug Companies’ Dime
by Charles Ornstein, ProPublica, Sept. 7
With Our Dollars For Docs Update Coming, Drug Companies Defend 'Interactions' With Physicians
by Charles Ornstein and Tracy Weber, ProPublica, Sept. 7
Tracking the Money
Our Dollars for Docs Database
We compiled tens of thousands of records from all the companies that have disclosed their payments to doctors so far. Search for your physician.
How Does the Medical Industry Influence Patient Care?
Firms with the highest U.S. sales last year didn't spend the most on physician marketers. Industry leader Pfizer, with sales of $26.2 billion, spent $34.4 million on speakers, ranking third among the eight companies. By comparison, Eli Lilly and Co. spent the most on speakers, $61.5 million, even though its sales were about half of Pfizer's.
"We continue to believe in the benefits and value that educational programs led by physicians provide to patient care," Lilly spokesman J. Scott MacGregor said in an email.
The data provide a preview of what the public can expect to see in 2013, when all drug and medical-device companies -- potentially hundreds -- must report such figures to the federal government.
Until 2009, pharmaceutical company payments to health professionals were closely held trade secrets. But several companies began reporting the information publicly under pressure from lawmakers or as a condition of settling federal whistle-blower lawsuits.
Company 2010 Speaker Payments 2010 U.S. Sales
Lilly $61,477,547 $14.3 billion
GlaxoSmithKline $52,755,793 $13.6 billion
Pfizer $34,382,574 $26.2 billion
AstraZeneca $31,647,101 $18.3 billion
Merck $20,365,446 $18.8 billion
Johnson & Johnson $11,712,900 $12.9 billion
Cephalon $4,241,080 $2.1 billion
ViiV Healthcare $3,975,102 Unavailable
In October, ProPublica published a database called Dollars for Docs that included information from those companies. It allows the public to search for individual physicians to see whether they've been on pharma's payroll.
Today, ProPublica is updating that tool to include payments made to health professionals by 12 companies. Eight of those published data for all of 2010: Lilly, GlaxoSmithKline, Pfizer, Merck, Cephalon, Johnson & Johnson, ViiV Healthcare and AstraZeneca.
In addition to the payments made to speakers, some of the companies also disclosed how much they've spent on consulting, travel, meals and research.
In all, payments to doctors and other health-care providers in ProPublica's database total more than $760 million and cover reports from drug companies between 2009 and the second quarter of 2011.
Some Docs Pull Out
The new data offer a glimpse of how the firms have adapted their strategies over time, both to changes in the marketplace and to increased scrutiny of their sales techniques.
Many experts predict physicians will back away from working for the companies once their names and pay are publicly revealed.
It's too early to know if this is true, but ProPublica's analysis shows that the payouts to dozens of doctors and other health professionals took a steep dive last year.
Pulmonologist Veena Antony, for example, was paid at least $88,000 to give promotional talks for GlaxoSmithKline in 2009. But last year, the Birmingham, Ala., doctor gave them up out of concern that patients might think her advice was tainted.
"You don't even want the appearance that I might be influenced by anything that a company gave," she said.
Cancer specialist Nam Dang was a regular on Cephalon's speaking circuit, pulling in $131,250 in 2009. But those promotional gigs stopped, he said, after he took a job at the University of Florida in Gainesville, which bans such talks. In 2010, he received $10,000 for consulting for Cephalon and Pfizer.
Nurse practitioner Terri Warren, who runs a Portland, Ore., health clinic, earned at least $113,000 from Glaxo in 2009, mostly talking about its herpes drug Valtrex. In 2010, that dropped to $300 after the drug went off patent and Glaxo no longer had a financial incentive to promote it.
"It's a business decision, clearly," said Warren, who felt her talks helped educate other health professionals about treating a taboo illness. "My money [from Glaxo] went into keeping this little clinic alive, and now we have to figure out some other way to do that."
Another group of physicians has ramped up speaking engagements and consulting.
Buffalo hematologist Zale Bernstein earned $49,250 from Cephalon in 2009. The following year, his pay jumped to $177,800 (plus an additional $35,500 for travel). Bernstein did not return calls for comment.
Pain specialist Gerald M. Sacks spoke and consulted for four companies in the database and was among the highest paid. The Santa Monica, Calif., doctor earned $270,825 from Pfizer, Johnson & Johnson, Lilly and Cephalon in 2010, up from $225,575 in 2009. Those figures do not include travel costs and meals.
Over 18 months, Pfizer alone paid Sacks $318,250 for speaking. He did not return repeated calls for comment.
Pfizer's new disclosure also revealed an unusual recipient. Its top-paid physician consultant last year, Dr. Christiana Goh Bardon, runs a hedge fund in Boston that bets on the rise and fall of health-care companies. She was paid nearly $308,000 to "provide input on our BioTherapeutics business development plan," Pfizer spokeswoman Kristen Neese wrote in an email.
Bardon, who started her hedge fund after her Pfizer contract ended, was required to sign a confidentiality agreement and not allowed to invest in Pfizer or any of the biotech companies that Pfizer was looking at acquiring or partnering with for projects, Neese said.
Bardon said in a voice-mail message that she does not currently practice as a physician and her work was based on her business acumen.
Drug Companies Change Their Strategies
Some companies apparently have used fewer physician speakers and consultants since they began posting their data publicly.
Cephalon, a relatively small Pennsylvania company that specializes in pain, cancer and central nervous system drugs, paid physicians nearly $9.3 million in 2009 for speaking and consulting. That figure dropped to $5 million last year.
"There wasn't one big thing that happened that shifted the focus," said spokeswoman Jenifer Antonacci. Rather, the company's marketing strategies for its brands changed.
AstraZeneca cut its spending on speakers from roughly $22.8 million in the first half of 2010 to about $9.2 million in the second half.
The company's U.S. compliance officer, Marie Martino, said AstraZeneca typically holds most of its speaker events in the beginning of each year. But she acknowledged that the company's spending on promotional talks has been decreasing.
"We're in a period now where we don't have a lot of new indications [approved uses] or new products that have been introduced in recent months, and that really is the fundamental explanation for what you're seeing," Martino said.
AstraZeneca, like other companies, is also replacing some in-person speaking events with teleconferences, webcasts and video conferences.
Glaxo's spending on speakers also slowed in 2010, averaging about $13.2 million per quarter in 2010, down 15 percent from the last three quarters of 2009. (Glaxo did not report data in the first quarter of 2009.)
Company spokeswoman Mary Anne Rhyne said the company is working to reduce its speaker rolls by 50 percent. "We feel it is a better use of resources to use fewer speakers more often. This cuts down on training costs as well as lessens the number of contracts needed," she wrote in an email.
And Lilly's speaker payments dropped 10 percent from 2009 to 2010, which spokesman MacGregor said was likely due to "normal year-to-year fluctuation."
ProPublica's early analysis of the data is limited because so few companies report their spending and even then, disclose different information. Lilly, for example, reports every health professional it pays to speak, while Pfizer includes only those who can prescribe.
"It's really unclear how much money is being spent in any one of these areas," said Vincent DeChellis, a principal at NHHS Healthcare Consulting, which has studied the data. "As you get more and more companies participating and submitting this information, you're going to get an initial look" at what may be a multibillion-dollar practice.
When Massachusetts required drug and device companies to report payments to doctors in that state last year, 286 companies did so.
Scrutiny of speaker programs has prompted changes.
After ProPublica reported last year that some drug-company speakers had been sanctioned by their state medical boards, the firms pledged to toughen their screening procedures and exclude physicians with disciplinary records.
Separately, ProPublica found that universities were not enforcing their own policies barring physicians from giving promotional speeches. In response, a number of schools said they would begin using the payment rosters to check for rule-breakers.
Pharma's trade group said the focus of most companies right now is ensuring the accuracy of data that will be publicly released in 2013. But this transparency also must be put into context for patients, said Diane Bieri, executive vice president and general counsel for the Pharmaceutical Research and Manufacturers of America.
Doctors help develop new medicines, advise companies on marketing and help educate their peers about appropriate uses of new drugs, she said.
"If the only information that's available is that company A paid doctor B $75,000 for a consulting arrangement," she said, "that's typically not enough information to really educate the patient about what was involved in that relationship."
Dollars for Doctors
How Industry Money Reaches Physicians
Piercing the Veil, More Drug Companies Reveal Payments to Doctors
by Charles Ornstein, Tracy Weber and Dan Nguyen
ProPublica, Sep. 7, 2011, 5:31 p.m.
Eight pharmaceutical companies, including the nation's three largest, doled out more than $220 million last year to promotional speakers for their products, according to a ProPublica analysis of company data.
For the first time, all these companies have reported a full year of payments, allowing for head-to-head comparisons of how much they spent on physicians to help push their pills. Some appear to be paring back.
Related Stories
Patients Deserve to Know What Drug Companies Pay Their Doctor
by Tracy Weber and Charles Ornstein, ProPublica, Sept. 7
Doctors Dine on Drug Companies’ Dime
by Charles Ornstein, ProPublica, Sept. 7
With Our Dollars For Docs Update Coming, Drug Companies Defend 'Interactions' With Physicians
by Charles Ornstein and Tracy Weber, ProPublica, Sept. 7
Tracking the Money
Our Dollars for Docs Database
We compiled tens of thousands of records from all the companies that have disclosed their payments to doctors so far. Search for your physician.
How Does the Medical Industry Influence Patient Care?
Firms with the highest U.S. sales last year didn't spend the most on physician marketers. Industry leader Pfizer, with sales of $26.2 billion, spent $34.4 million on speakers, ranking third among the eight companies. By comparison, Eli Lilly and Co. spent the most on speakers, $61.5 million, even though its sales were about half of Pfizer's.
"We continue to believe in the benefits and value that educational programs led by physicians provide to patient care," Lilly spokesman J. Scott MacGregor said in an email.
The data provide a preview of what the public can expect to see in 2013, when all drug and medical-device companies -- potentially hundreds -- must report such figures to the federal government.
Until 2009, pharmaceutical company payments to health professionals were closely held trade secrets. But several companies began reporting the information publicly under pressure from lawmakers or as a condition of settling federal whistle-blower lawsuits.
Company 2010 Speaker Payments 2010 U.S. Sales
Lilly $61,477,547 $14.3 billion
GlaxoSmithKline $52,755,793 $13.6 billion
Pfizer $34,382,574 $26.2 billion
AstraZeneca $31,647,101 $18.3 billion
Merck $20,365,446 $18.8 billion
Johnson & Johnson $11,712,900 $12.9 billion
Cephalon $4,241,080 $2.1 billion
ViiV Healthcare $3,975,102 Unavailable
In October, ProPublica published a database called Dollars for Docs that included information from those companies. It allows the public to search for individual physicians to see whether they've been on pharma's payroll.
Today, ProPublica is updating that tool to include payments made to health professionals by 12 companies. Eight of those published data for all of 2010: Lilly, GlaxoSmithKline, Pfizer, Merck, Cephalon, Johnson & Johnson, ViiV Healthcare and AstraZeneca.
In addition to the payments made to speakers, some of the companies also disclosed how much they've spent on consulting, travel, meals and research.
In all, payments to doctors and other health-care providers in ProPublica's database total more than $760 million and cover reports from drug companies between 2009 and the second quarter of 2011.
Some Docs Pull Out
The new data offer a glimpse of how the firms have adapted their strategies over time, both to changes in the marketplace and to increased scrutiny of their sales techniques.
Many experts predict physicians will back away from working for the companies once their names and pay are publicly revealed.
It's too early to know if this is true, but ProPublica's analysis shows that the payouts to dozens of doctors and other health professionals took a steep dive last year.
Pulmonologist Veena Antony, for example, was paid at least $88,000 to give promotional talks for GlaxoSmithKline in 2009. But last year, the Birmingham, Ala., doctor gave them up out of concern that patients might think her advice was tainted.
"You don't even want the appearance that I might be influenced by anything that a company gave," she said.
Cancer specialist Nam Dang was a regular on Cephalon's speaking circuit, pulling in $131,250 in 2009. But those promotional gigs stopped, he said, after he took a job at the University of Florida in Gainesville, which bans such talks. In 2010, he received $10,000 for consulting for Cephalon and Pfizer.
Nurse practitioner Terri Warren, who runs a Portland, Ore., health clinic, earned at least $113,000 from Glaxo in 2009, mostly talking about its herpes drug Valtrex. In 2010, that dropped to $300 after the drug went off patent and Glaxo no longer had a financial incentive to promote it.
"It's a business decision, clearly," said Warren, who felt her talks helped educate other health professionals about treating a taboo illness. "My money [from Glaxo] went into keeping this little clinic alive, and now we have to figure out some other way to do that."
Another group of physicians has ramped up speaking engagements and consulting.
Buffalo hematologist Zale Bernstein earned $49,250 from Cephalon in 2009. The following year, his pay jumped to $177,800 (plus an additional $35,500 for travel). Bernstein did not return calls for comment.
Pain specialist Gerald M. Sacks spoke and consulted for four companies in the database and was among the highest paid. The Santa Monica, Calif., doctor earned $270,825 from Pfizer, Johnson & Johnson, Lilly and Cephalon in 2010, up from $225,575 in 2009. Those figures do not include travel costs and meals.
Over 18 months, Pfizer alone paid Sacks $318,250 for speaking. He did not return repeated calls for comment.
Pfizer's new disclosure also revealed an unusual recipient. Its top-paid physician consultant last year, Dr. Christiana Goh Bardon, runs a hedge fund in Boston that bets on the rise and fall of health-care companies. She was paid nearly $308,000 to "provide input on our BioTherapeutics business development plan," Pfizer spokeswoman Kristen Neese wrote in an email.
Bardon, who started her hedge fund after her Pfizer contract ended, was required to sign a confidentiality agreement and not allowed to invest in Pfizer or any of the biotech companies that Pfizer was looking at acquiring or partnering with for projects, Neese said.
Bardon said in a voice-mail message that she does not currently practice as a physician and her work was based on her business acumen.
Drug Companies Change Their Strategies
Some companies apparently have used fewer physician speakers and consultants since they began posting their data publicly.
Cephalon, a relatively small Pennsylvania company that specializes in pain, cancer and central nervous system drugs, paid physicians nearly $9.3 million in 2009 for speaking and consulting. That figure dropped to $5 million last year.
"There wasn't one big thing that happened that shifted the focus," said spokeswoman Jenifer Antonacci. Rather, the company's marketing strategies for its brands changed.
AstraZeneca cut its spending on speakers from roughly $22.8 million in the first half of 2010 to about $9.2 million in the second half.
The company's U.S. compliance officer, Marie Martino, said AstraZeneca typically holds most of its speaker events in the beginning of each year. But she acknowledged that the company's spending on promotional talks has been decreasing.
"We're in a period now where we don't have a lot of new indications [approved uses] or new products that have been introduced in recent months, and that really is the fundamental explanation for what you're seeing," Martino said.
AstraZeneca, like other companies, is also replacing some in-person speaking events with teleconferences, webcasts and video conferences.
Glaxo's spending on speakers also slowed in 2010, averaging about $13.2 million per quarter in 2010, down 15 percent from the last three quarters of 2009. (Glaxo did not report data in the first quarter of 2009.)
Company spokeswoman Mary Anne Rhyne said the company is working to reduce its speaker rolls by 50 percent. "We feel it is a better use of resources to use fewer speakers more often. This cuts down on training costs as well as lessens the number of contracts needed," she wrote in an email.
And Lilly's speaker payments dropped 10 percent from 2009 to 2010, which spokesman MacGregor said was likely due to "normal year-to-year fluctuation."
ProPublica's early analysis of the data is limited because so few companies report their spending and even then, disclose different information. Lilly, for example, reports every health professional it pays to speak, while Pfizer includes only those who can prescribe.
"It's really unclear how much money is being spent in any one of these areas," said Vincent DeChellis, a principal at NHHS Healthcare Consulting, which has studied the data. "As you get more and more companies participating and submitting this information, you're going to get an initial look" at what may be a multibillion-dollar practice.
When Massachusetts required drug and device companies to report payments to doctors in that state last year, 286 companies did so.
Scrutiny of speaker programs has prompted changes.
After ProPublica reported last year that some drug-company speakers had been sanctioned by their state medical boards, the firms pledged to toughen their screening procedures and exclude physicians with disciplinary records.
Separately, ProPublica found that universities were not enforcing their own policies barring physicians from giving promotional speeches. In response, a number of schools said they would begin using the payment rosters to check for rule-breakers.
Pharma's trade group said the focus of most companies right now is ensuring the accuracy of data that will be publicly released in 2013. But this transparency also must be put into context for patients, said Diane Bieri, executive vice president and general counsel for the Pharmaceutical Research and Manufacturers of America.
Doctors help develop new medicines, advise companies on marketing and help educate their peers about appropriate uses of new drugs, she said.
"If the only information that's available is that company A paid doctor B $75,000 for a consulting arrangement," she said, "that's typically not enough information to really educate the patient about what was involved in that relationship."
Tuesday, August 30, 2011
Stem Cell News
Life & Style
Advice
Money
Travel
Opinion
Fun & Games
Video
Stem cell trials may spell the end for MS
by Miriam Stoppard, Daily Mirror 30/08/2011
Decrease font size Increase font size
A very important study into the use of stem cells is about to begin in several countries, including the UK.
It will examine using them to treat multiple sclerosis but could have implications for many other conditions, including Parkinson’s, motor neurone disease, type 1 diabetes, heart problems and rheumatoid arthritis.
In fact, this study, which will run over the next three to five years, could be the blueprint for the wider use of stem cells.
Advertisement >>
Click here to find out more!
Scientists are hoping to show that stem cell replacement of diseased tissues can slow, stop or even reverse damage caused by the underlying disease.
There are two reasons why I attach so much importance to this project.
Firstly, this is the first time that researchers from around the world have come together to test stem cell therapies in such a large-scale trial, which would be impossible to run in just one location.
It is essential that researchers work together if they are going to make progress and improve stem cell treatment.
The second reason is that the effectiveness of stem cells will be subject to rigorous testing in patients, which will break new ground.
Two main types of stem cells have been tried. In the early days embryonic cells were used, but these were controversial because of where they came from – namely aborted or miscarried embryos.
Later we learned that we have stem cells in our bodies and this adult type can be used as effectively without controversy.
Stem cells hold so much promise. While they are primitive, if given a little nudge, they can turn into any and all of the tissues in the body that might get injured or become diseased.
In this new study the cells will be harvested from the patient’s bone marrow and then grown in a laboratory before being injected directly into the bloodstream.
The theory is that these stem cells will target the damaged protective covering around nerves, called myelin, which becomes scarred in MS sufferers.
This isn’t the first time stem cells have been used with the condition. In 2009, researchers in the US found they could improve symptoms of MS by using cells from fat.
The encouraging part of this research was the symptoms continued to improve almost a year after the stem cells were injected, giving us the hope of a long-lasting effect.
Read more: http://www.mirror.co.uk/advice/miriam/2011/08/30/stem-cell-trials-may-spell-the-end-for-ms-115875-23381723/#ixzz1WWVlRGe1
Go Camping for 95p! Vouchers collectable in the Daily and Sunday Mirror until 11th August . Click here for more information
Advice
Money
Travel
Opinion
Fun & Games
Video
Stem cell trials may spell the end for MS
by Miriam Stoppard, Daily Mirror 30/08/2011
Decrease font size Increase font size
A very important study into the use of stem cells is about to begin in several countries, including the UK.
It will examine using them to treat multiple sclerosis but could have implications for many other conditions, including Parkinson’s, motor neurone disease, type 1 diabetes, heart problems and rheumatoid arthritis.
In fact, this study, which will run over the next three to five years, could be the blueprint for the wider use of stem cells.
Advertisement >>
Click here to find out more!
Scientists are hoping to show that stem cell replacement of diseased tissues can slow, stop or even reverse damage caused by the underlying disease.
There are two reasons why I attach so much importance to this project.
Firstly, this is the first time that researchers from around the world have come together to test stem cell therapies in such a large-scale trial, which would be impossible to run in just one location.
It is essential that researchers work together if they are going to make progress and improve stem cell treatment.
The second reason is that the effectiveness of stem cells will be subject to rigorous testing in patients, which will break new ground.
Two main types of stem cells have been tried. In the early days embryonic cells were used, but these were controversial because of where they came from – namely aborted or miscarried embryos.
Later we learned that we have stem cells in our bodies and this adult type can be used as effectively without controversy.
Stem cells hold so much promise. While they are primitive, if given a little nudge, they can turn into any and all of the tissues in the body that might get injured or become diseased.
In this new study the cells will be harvested from the patient’s bone marrow and then grown in a laboratory before being injected directly into the bloodstream.
The theory is that these stem cells will target the damaged protective covering around nerves, called myelin, which becomes scarred in MS sufferers.
This isn’t the first time stem cells have been used with the condition. In 2009, researchers in the US found they could improve symptoms of MS by using cells from fat.
The encouraging part of this research was the symptoms continued to improve almost a year after the stem cells were injected, giving us the hope of a long-lasting effect.
Read more: http://www.mirror.co.uk/advice/miriam/2011/08/30/stem-cell-trials-may-spell-the-end-for-ms-115875-23381723/#ixzz1WWVlRGe1
Go Camping for 95p! Vouchers collectable in the Daily and Sunday Mirror until 11th August . Click here for more information
Wednesday, August 3, 2011
CCSVI in MS Toronto
CCSVI in MS Toronto
"Lawsuits revealed that studies that suggested the drugs were safe and effective were often not written by the scientists listed as the authors. Instead, they were ghostwritten by writers working for the drug companies that make the medications. The scientists listed as authors were offered payment in return for attaching their names." - CTV
"Lawsuits revealed that studies that suggested the drugs were safe and effective were often not written by the scientists listed as the authors. Instead, they were ghostwritten by writers working for the drug companies that make the medications. The scientists listed as authors were offered payment in return for attaching their names." - CTV
Tuesday, August 2, 2011
Pain Management
Pain Management Blog « The Patient Experience
www.patient-experience.com
There are a number of different ways of managing pain:-a)Medications. These can vary from aspirin and paracetamol through NSAIDs to various different opioid products.b)Physical approaches. These can include spinal cord stimulation,TENS machines,acupuncture or even low level laser therapy.c)Physiolog
www.patient-experience.com
There are a number of different ways of managing pain:-a)Medications. These can vary from aspirin and paracetamol through NSAIDs to various different opioid products.b)Physical approaches. These can include spinal cord stimulation,TENS machines,acupuncture or even low level laser therapy.c)Physiolog
Thursday, July 14, 2011
More Hope
When mice with moderate multiple sclerosis were given very low dosages of dextromethorphan, a drug found in cough medicine, the loss of myelin and the development of paralysis during acute attacks was significantly reduced. (Credit: iStockphoto)
UC DAVIS (US) — A drug commonly found in over-the-counter cough medicine may pave the way for a new and inexpensive therapy for multiple sclerosis.
23Share
In animal testing, the drug dextromethorphan significantly reduced the loss of the fatty sheath (or myelin) surrounding nerve fibers in the central nervous system and also minimized development of paralysis during multiple sclerosis attacks.
The study is published online in the journal Neurobiology of Disease.
“This finding provides an exciting opportunity to better understand the disease and to pursue a new treatment strategy with a drug that is widely available, inexpensive, and known to be safe,” says Wenbin Deng, assistant professor of cell biology and human anatomy at University of California, Davis.
Currently there are few effective treatment options for multiple sclerosis, which affects about 400,000 people in the United States and most often first appears in young-to-middle-aged women.
The condition, that has no cure, is caused by cells of the immune system attacking myelin, the fatty sheath surrounding nerve fibers in the central nervous system that speeds the transmission of nerve impulses.
Symptoms vary widely and often involve periods of motor problems, including paralysis of a limb or poor coordination, which unpredictably may either go away or become permanent. As the disease progresses, it causes increasing disability. Many treatments are poorly tolerated and produce a wide range of side effects.
For the new study, investigators induced mice to have either a moderate or severe type of multiple sclerosis and then treated them with either very low or high dosages of dextromethorphan. Very low dosages given to mice with moderate disease significantly reduced the loss of myelin and the development of paralysis during acute attacks. The high dosages did not offer any benefit.
“Finding that a chemical like dextromethorphan might be useful for treating multiple sclerosis is especially significant because we already know it is safe,” says David E. Pleasure, director of research at the Institute for Pediatric Regenerative Medicine at Shriners Hospitals for Children Northern California in Sacramento and one of the authors of the study. “Normally, a possible new treatment must first undergo years of clinical trials to prove this.”
The researchers began investigating common, over-the-counter cough medicines as treatments for devastating diseases like multiple sclerosis because their molecular structure is similar to morphine. Morphinans—low dose morphine-like agents—have been used “off label” for individuals. While they’re not cures, they potentially can be helpful for selected patients, and appear to have little or no toxicity at low doses.
Dextromethorphan is one of a few morphinan drugs similar in structure to morphine, but without the addictive properties. Deng and Pleasure would like to see clinical trials conducted soon to find out if dextromethorphan is effective in humans with multiple sclerosis. Such a trial would likely involve testing in combination with current standard treatment of the disease.
“Dextromethorphan has a different mode of action than current drugs for multiple sclerosis,” Deng says. “While current treatment targets inflammation and the immune system, dextromethorphan appears to be more directly neuroprotective. Combining the different strategies could offer a real breakthrough in fighting the disease.”
The study was supported in part by grants from the National Institutes of Health, National Multiple Sclerosis Society, and Shriners Hospitals for Children.
UC DAVIS (US) — A drug commonly found in over-the-counter cough medicine may pave the way for a new and inexpensive therapy for multiple sclerosis.
23Share
In animal testing, the drug dextromethorphan significantly reduced the loss of the fatty sheath (or myelin) surrounding nerve fibers in the central nervous system and also minimized development of paralysis during multiple sclerosis attacks.
The study is published online in the journal Neurobiology of Disease.
“This finding provides an exciting opportunity to better understand the disease and to pursue a new treatment strategy with a drug that is widely available, inexpensive, and known to be safe,” says Wenbin Deng, assistant professor of cell biology and human anatomy at University of California, Davis.
Currently there are few effective treatment options for multiple sclerosis, which affects about 400,000 people in the United States and most often first appears in young-to-middle-aged women.
The condition, that has no cure, is caused by cells of the immune system attacking myelin, the fatty sheath surrounding nerve fibers in the central nervous system that speeds the transmission of nerve impulses.
Symptoms vary widely and often involve periods of motor problems, including paralysis of a limb or poor coordination, which unpredictably may either go away or become permanent. As the disease progresses, it causes increasing disability. Many treatments are poorly tolerated and produce a wide range of side effects.
For the new study, investigators induced mice to have either a moderate or severe type of multiple sclerosis and then treated them with either very low or high dosages of dextromethorphan. Very low dosages given to mice with moderate disease significantly reduced the loss of myelin and the development of paralysis during acute attacks. The high dosages did not offer any benefit.
“Finding that a chemical like dextromethorphan might be useful for treating multiple sclerosis is especially significant because we already know it is safe,” says David E. Pleasure, director of research at the Institute for Pediatric Regenerative Medicine at Shriners Hospitals for Children Northern California in Sacramento and one of the authors of the study. “Normally, a possible new treatment must first undergo years of clinical trials to prove this.”
The researchers began investigating common, over-the-counter cough medicines as treatments for devastating diseases like multiple sclerosis because their molecular structure is similar to morphine. Morphinans—low dose morphine-like agents—have been used “off label” for individuals. While they’re not cures, they potentially can be helpful for selected patients, and appear to have little or no toxicity at low doses.
Dextromethorphan is one of a few morphinan drugs similar in structure to morphine, but without the addictive properties. Deng and Pleasure would like to see clinical trials conducted soon to find out if dextromethorphan is effective in humans with multiple sclerosis. Such a trial would likely involve testing in combination with current standard treatment of the disease.
“Dextromethorphan has a different mode of action than current drugs for multiple sclerosis,” Deng says. “While current treatment targets inflammation and the immune system, dextromethorphan appears to be more directly neuroprotective. Combining the different strategies could offer a real breakthrough in fighting the disease.”
The study was supported in part by grants from the National Institutes of Health, National Multiple Sclerosis Society, and Shriners Hospitals for Children.
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