Announcing: Video Lecture Course on Science-Based Medicine

A couple of years ago, the James Randi Educational Foundation commissioned me to develop a series of 10 video lectures on Science-Based Medicine. After a lot of work and many vicissitudes, it is now available. The lecture titles are: Science-Based Medicine vs. Evidence-Based Medicine What Is CAM? Chiropractic Acupuncture Homeopathy Naturopathy and Herbal Medicine Energy Medicine Miscellaneous

The Debate Is Over: Antidepressants DO Work Better Than Placebo

  Depression can kill. Antidepressants can help. A meme that continues to appear regularly in the media and in the comments section of this blog is “antidepressants are no better than placebo.” It is a false belief based on a faulty interpretation of the evidence. A new study has just come out that should put

The Elephant in the Compounding Pharmacy

Compounding pharmacies create medicines specifically designed for the needs of an individual patient when those needs are not met by products available on the market. They may eliminate an ingredient the patient is allergic to, they may prepare a liquid version of a pill for patients who have difficulty swallowing, they may alter the taste

The Movie “Cholesterol: The Great Bluff” Is an Exercise in Denialism

The movie “Cholesterol: The Great Bluff” claims that we have been lied to: cholesterol doesn’t cause heart disease and statins are harmful. It is biased and misleading. The people interviewed in the movie are denialists who don’t accept the clear evidence for the role of blood cholesterol levels and the benefits of statins. A correspondent

“New vaccine replaces statins?” Not so fast!

News reports suggest new drugs may replace statins. PSCK9 inhibitors are useful, but only along with statins in high risk patients not controlled on statins alone, or for patients who can’t tolerate statins. They’re not about to replace statins. PyMOL rendering of the structure of the PCSK9 protein. Are statins obsolete? Are new drugs more effective and

Most Patients Get No Benefit from Most Drugs

Some people are reluctant to take statins because they don’t benefit the majority of patients who take them. Actually, most drugs don’t benefit most of the patients who take them. Since we have no way of identifying those who will benefit, we are stuck treating the many to benefit the few. Most of these won’t

When Drugs Cost Too Much

Our ability to develop new drugs is fast outstripping our ability to pay for them; some are exorbitantly expensive and not very effective. Funds are limited, and as a society we need to have a serious discussion about how they are to be allocated. How much is it reasonable to pay for a drug? If

Statin Denialism

When Richard Dawkins was asked to justify his belief in the scientific method, he answered, “It works, bitches!”1 When the scientific evidence is compelling, one would have to be willfully perverse to reject it. But some people do; they reject findings that don’t fit with their ideology. We call them denialists. We have climate change

Glucosamine and Chondroitin: Do They Really Work?

Glucosamine and chondroitin are widely used for osteoarthritis pain. My daughter even gives them to her elderly horse. Their popularity is puzzling, since the evidence from scientific studies indicates that they don’t work. Wikipedia has a useful survey of the history, studies, criticisms, and systematic reviews (https://en.wikipedia.org/wiki/Clinical_trials_on_glucosamine_and_chondroitin). It includes a long list of references. I

Testing Testosterone Treatments

Whatever is in this water, it isn’t testosterone Ponce de Leon is said to have been looking for the Fountain of Youth when he explored Florida. That’s only a myth. Now there’s a new myth, that testosterone supplements are a Fountain of Youth for aging men. Men are urged to get their testosterone levels checked if they have