Tuesday, August 23, 2016

The Adverse Drug Reaction Nobody Talks About

The Drug Rebound Effect

In our New Patient Orientation Class, one of the topics of discussion is the facts about medication use that are rarely put into proper context.  Acknowledgment of the flaws in the mindset of reactively treating symptoms and disease primarily through pharmaceuticals segues into the prevalence of adverse reactions.  Side effects should not be deemphasized in an “oh, by the way” side bar to the dialogue about whether or not to take recommended drugs.  The dangers are very real, with adverse reactions to medications the third leading cause of death in the United States.  When the last resort is treated as the first option, bad things are prone to happen.

Given that the class is just an hour in length, only specific details of the medication discussion are highlighted, but the conversation could last for several hours.  An interesting question to ask about drugs, building on the information provided in the Orientation, is how they work inside of your body to create their desired results.  An understanding of the mechanism of action for medication may help you better comprehend the mechanism of adverse reactions.

Simply put, drugs are designed to do one of two primary things: speed up or slow down.  For constipation, as an example, medications are taken that stimulate the digestive system to shift from first to third gear, speeding up the process of elimination.  For pain, conversely, medications are taken to downshift the central nervous system’s activity, slowing if not outright blocking the transmission of the alert signal from the painful area to the brain.

All medications, regardless of type, have chemical reactions internally that affect your nervous system – a fact that is important to contextualizing why side effects are so common.  Since the nerves supply the power that makes your internal assembly line run, any substance that seeks to interfere with the activity of your nerves (regardless of intent) runs the risk of throwing a wrench into that system.  Sometimes, the wrench causes a minor problem and sometimes the wrench causes a catastrophic problem; the spectrum of adverse reactions is variable and vast.

One of the most common side effects to medication use is actually one that very few people know much about; it’s called “the rebound,” which occurs when the body reacts symptomatically to the introduction of a drug taken to reduce certain symptoms.  Your body is constantly seeking an adequate-to-optimal level of stability internally, a harmony if you will among its 75 trillion cells while they each perform their 200,000 chemical reactions every split second.  Medication disrupts that inner desire for homeostasis, forcing your body to adapt and sometimes the mere consumption of a drug prompts a more pronounced adaptation that can trigger the very symptom that medication was taken to eliminate.

There is a pattern to normal nerve activity; an EKG measures it specifically in relation to the heart, to give you a frame of reference.  Like the waves gently breaking against the sea shore on a beautiful day, that normal pattern accounts for typical movements (walking, talking, use of your hands, etc.) and basic functions (digestion, blinking, hearing, heartbeat, etc.).  Part of the problem with the misalignment in the upper neck is that, by compromising the brainstem, it throws off that normal nerve pattern, similar to what you might see with waves crashing into the beach on a stormy day.  Harkening back to the assembly line analogy, symptoms often arise from little more than that disrupted pattern, which in and of itself unfavorably affects the system.  Again, though, medication is like throwing a wrench into the system, prompting a more impactful change in nerve activity akin to the ocean massively swelling when a hurricane strikes.

Temporarily, the symptom may dull as the drug takes effect, but once the body tries to reestablish the normal pattern in an effort to resume internal harmony, there is a spike in nerve activity that often brings the symptom back with a vengeance.  It can become a vicious cycle because, when symptoms return, the first reaction is often to take more medication, even when in actuality it may be the drug itself that is proliferating the symptom.  Long-term drug use sets the nerve activity into an abnormal pattern that can be difficult to break regardless of the original cause of the symptom being dealt with – like correcting the upper neck misalignment’s negative effect on the brainstem and its foundational shifting of the body’s structural balance – or medication use being curtailed up to several weeks prior.  

Rebound effects are happening at an alarming rate despite a distinct lack of awareness on the part of those prescribing medications.  According to Dr. Stephen D. Silberstein, a professor of neurology and director of the Jefferson Headache Center at Thomas Jefferson University, at any given time, 3 million Americans suffer headaches brought on just by taking pain relievers.  Dr. Silberstein states that “some doctors may not be aware that drugs they recommend are causing a problem, not solving it” and that, actually, they may inadvertently reinforce the idea that taking more medication or increasing the drug dosage will improve the situation.  

Common medications for everything from pain to respiratory congestion to skin conditions to eye irritation have been known to cause rebound effects.  So, please be aware of this phenomenon.

Sources: Harvard Medical School; Thoms Jefferson University

Thinking good things for as always,

Dr. Chad

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