mental health
Should antidepressants be available OTC?
Adobe
Anyone can now walk into a pharmacy in the United States and buy oral contraceptives over the counter without a prescription, thanks to the recent FDA approval of norgestrel. But there's another safe class of medicine that people should have similarly easy access to: the antidepressants known as selective serotonin reuptake inhibitors (SSRIs), argues psychiatrist Roy Perlis in a First Opinion essay. More than 1 in 10 adults in a U.S. Census survey reported needing therapy for mental health, and being unable to get it — including 1 in 4 who reported current depression or anxiety.
"Allowing over-the-counter access is not a panacea, but could open the door to a safe, effective, and inexpensive treatment for many who need it," writes Perlis.
FDA policy states that non-prescription medications must meet three criteria: they can be used for self-diagnosed conditions; there's no need for a clinician's involvement to be used safely; and they have a low potential for misuse and abuse. Read more from Perlis on how and why he believes that SSRIs fit the bill.
bacteria
New long-term data on alternative to antibiotics for UTIs
Antibiotics have long been the go-to treatment for urinary tract infections. But amid increasing concern about drug-resistant bacteria, researchers are trying to better understand the mechanisms behind UTI pain and find more potential treatments. At the European Association of Urology Congress in Paris this weekend, one team presented initial results from a study on one such alternative: an oral vaccine for UTIs.
Starting in 2014, 89 patients with a history of recurrent UTIs received the vaccine, which is made from inactive bacteria and sprayed under the tongue daily for three months. Researchers followed the participants for up to nine years, and found that over half remained UTI-free with no major side effects for the entire period. Overall, the average time that somebody remained infection-free was about four and a half years. The team is working on a paper and hopes to publish full results by the end of this year, a representative told STAT.
The paper provides the first long-term follow-up data on the vaccine, called Uromune. The treatment is already available in many European countries. It was previously available in the U.S. through the FDA's expanded access program, but that ended last year.
cardiology
New data on beta blockers and Wegovy at ACC
Over the weekend in Atlanta, STAT's Elaine Chen attended the American College of Cardiology conference. Two clinical trials in particular caught her attention:
- Beta blockers are a mainstay in cardiovascular treatment, frequently given to patients after heart attacks. But one new large trial turns that convention on its head, suggesting that the drugs may not in fact help many of these patients. The researchers enrolled about 5,000 patients who specifically had preserved ejection fraction after a heart attack, finding that long-term treatment with beta blockers did not significantly reduce the combined risk of death or new heart attack. Read more about the "potentially practice changing" research, as one doctor put it.
- And of course there's GLP-1 news: Novo Nordisk's Wegovy improved symptoms and physical function in patients who had obesity, diabetes, and a common type of heart failure, boosting Novo's attempt to get the popular drug approved for yet another usage beyond weight loss. The results come from the company's second large trial on the drug in heart failure with preserved ejection fraction, or HFpEF. Read more on how the drug may intervene.
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