Category Archives: Medical

Health, Medical, Research, Science

Homeopathy: ‘Evidence’ that could resolve its legitimacy?

HOMEOPATHIC REMEDIES

THERE were 2,700 prescriptions for homeopathic remedies issued by NHS GP practices between December 2016 and May 2017. Clearly, there are patients – and doctors – who believe there may be something to the therapy.

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And while patients’ stories are far from proof that homeopathy works, it begs the question: is it simply a placebo effect or is it something more?

Proponents argue that key evidence showing a genuine benefit is often left out of major studies that claim to review all the available evidence.

According to Dr Peter Fisher, a rheumatologist and clinical director of research at the Royal London Hospital for Integrated Medicine, there have been 43 summaries of homeopathic trials and 21 showed an effect greater than a placebo.

“This is a proportion very similar to what studies of conventional treatments find,” says Dr Fisher.

He is also critical of the way the trials now used as evidence that homeopathy doesn’t work were run.

One key study published in The Lancet in 2005 found “weak evidence for a specific effect of homoeopathic remedies” and implied they were no more than placebos. However, Dr Fisher describes the research as “failing to meet elementary standards of quality and transparency.”

The study analysed eight out of more than 100 randomised controlled trials – the “gold standard” for proving treatments are better than a placebo, where one group gets the real therapy and the other a “fake”.

“But the rules as to what studies could be included were changed half-way through,” claims Dr Fisher. “This excluded 93 per cent of available trials and skewed the results against homeopathy. When the study was re-analysed using the original rules, good evidence for homeopathy emerged.”

On the other side of the debate, Professor Edzard Ernst has said that the British Homeopathic Association has misrepresented studies that it claimed showed homeopathy differs from a placebo. While the two sides are poles apart on what the evidence shows, all agree the principle behind homeopathy – super dilution – is a problem, flying in the face of science.

Compared with standard drug treatments, once a homeopathic remedy has been diluted thousands of times, there should be nothing left but water. But what if it could be shown that something clearly physical is going on?

Dr Steven Cartwright, a research biochemist formerly of the Sir William Dunn School of Pathology at Oxford University and now employed at Diagnox, a commercial lab, is looking at precisely that. He trained as a homeopath after a single dose “cured” the hayfever he’d had for years – “I was curious to find out more.”

Using a group of dyes that have some unusual properties, he believes he’s discovered a clue as to what is going on. The dyes change colour depending on the liquid they’re put into. In water, one might show up as red, but blue in alcohol.

Exactly why is not clear, but Dr Cartwright believes it could be because they respond to electrical and magnetic fields. When he mixed some regular shop-bought homeopathic remedies with the dyes they produced different colours. “You couldn’t see them with the naked eye but they showed up when looked at through a standard bit of lab equipment, a spectrophotometer,” he says.

He believes something in the remedy was affecting the dye. “I think it was probably picking up an electric or magnetic charge, possibly the result of the vigorous shaking that goes on during dilution,” he says.

What’s more, the effect was stronger the more diluted the remedy, and different remedies produced different colours.

“It’s too early to make any claims,” says Dr Cartwright. “There is a group in Brazil working to replicate it.

“We might have discovered a radical new medical mechanism. But let’s see.”

The NHS view remains as previously stated: that there is no robust evidence to support homeopathy.

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Government, Health, Medical, Science, Society

Cannabis: Drug closely linked to psychosis

CANNABIS DEBATE

As debate in Britain is renewed over the legalising of cannabis, a leading academic has claimed that the drug is linked to psychosis.

THERE has been renewed debate in Britain over the legislation of cannabis. Last week, for the first time ever, the NHS prescribed cannabis oil for 12-year-old Billy Caldwell to treat his epilepsy.

But a psychiatric expert, Professor Robin Murray, an authority on schizophrenia at King’s College London, has claimed that one in six people with psychosis in the UK would never have developed it if they had not smoked the drug. The leading academic said about 50,000 people were now diagnosed as psychotic solely because they used the substance while teenagers. Many had no family history of psychosis and would have had no risk of developing the disease if they had not smoked ‘high-strength cannabis’, he claimed.

The Royal College of Psychiatrists has also spoken out to warn that cannabis use ‘doubles the risk’ of someone becoming psychotic. The warning was given following comments made by former Tory leader William Hague who said the drug should be decriminalised for recreational use.

Professor Murray said: ‘If you smoke heavy, high-potency cannabis, your risk of psychosis increases about five times.

‘A quarter of cases of psychosis we see in south London would not have happened without use of high-potency cannabis. It is more prevalent in that area, but the figure for Britain would be one in six – or approximately 50,000 people.’

Cannabis can make users feel paranoid, experience panic attacks and hallucinations, and it is also linked to depression and anxiety. Many experts claim it is only people who are predisposed to psychosis who develop it after smoking cannabis. However, Professor Murray added: ‘It is true there are some people with a family history of it who are pushed into psychosis more easily by smoking cannabis. But most have no family history, there is no evidence they are predisposed to schizophrenia or psychosis. The problems start only when they are 14 and 15 and start using cannabis.’

It is believed the drug disrupts dopamine, a brain chemical which helps people predict what is going to happen and respond rationally. In developing brains, cannabis can skew this so that people become paranoid and deluded.

Dr Adrian James, Registrar at the Royal College of Psychiatrists, said: ‘As mental health doctors, we can say with absolute certainty that cannabis carries severe risks. The average cannabis user is around twice as likely as a non-user to develop a psychotic disorder.’

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Health, Medical, Society

New medical guidelines for dementia patients

DEMENTIA

DOCTORS have been instructed to recognise the “human value” of patients with dementia as part of a major overhaul of care.

Dementia patients should be treated as individuals, have a say in their care and not face discrimination for their age or the severity of the illness, new guidelines say.

While there is currently no cure for dementia, the guidelines stress the importance of diagnosis so that patients and their families can prepare for the future and start treatments to slow its advance. This includes giving patients a controversial spinal tap when doctors are unsure whether they have dementia.

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Charities have welcomed the care blueprint but warned that substantial investment would be needed to implement the measures, which include appointing dementia “champions” to advise patients and their families on the care available.

A spokesperson from the Alzheimer’s Society, said: “It’s encouraging to see the steps it’s taking to ensure the needs and rights of people with dementia are met. However, the guideline is just a starting point. What we need now is support to implement these recommendations.”

Recent figures suggest a million Britons are living with dementia. This is expected to double by 2051 due to the ageing population and obesity, which raises the risk of the condition.

Health watchdog NICE drew up the new advice – the first changes to healthcare guidance in a decade – to improve the postcode lottery of care on the NHS following concerns that dementia patients were being failed across the UK.

Ofsted-style ratings carried out in 2016 found that 57 per cent of health boards were giving patients with dementia and Alzheimer’s inadequate care.

Officials found some patients were never diagnosed with dementia, while many of those who were did not receive a check-up for 12 months. Last year, a major study found hundreds of thousands of Britons had dementia but did not know because they were never given a formal diagnosis in case it made them anxious.

For the first time, the guidelines urge doctors to carry out a spinal tap – using a needle to extract spinal fluid from patients whose diagnosis is unclear. However, the procedure is uncomfortable, sometimes painful, and can cause side-effects such as severe headaches and infections.

Other changes include a recommendation for more training for staff such as carers at home, in care homes and GPs to better support people living with dementia. The guidance says people with dementia and their carers should be assigned a health or social care professional to co-ordinate treatment, rather than being left to navigate the options themselves.

Initial assessments should include recording a history – including cognitive, behavioural and psychological symptoms – and how it affects daily life.

This should either come from the patient or a spouse, loved one or carer who knows them well, it recommends.

Alzheimer’s Research UK said: “We’re very happy to see the NICE guidelines give additional attention to how health professionals can help people with dementia get involved in research.”

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