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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Mtom on October 18, 2020, at 11:31:15
A study published in June 2020 from researchers at the University of California Berkeley and the University of Chicago found that Women have a nearly 2-fold greater risk than men for
exhibiting ADRs across all drug classes and are significantly more likely to be hospitalized secondary to an Adverse Drug Reaction. This included antidepressant drugs (see list of drugs investigated in article linked below). They discuss that Pharmacokinetics differ between males and females. They also note that most drugs are not administered on a milligram/kilogram basis but as a one size fits all dose, leading to higher exposures in women and optimally dose should be based on mg/kg body weight However corrections for height, weight and body composition eliminates only a minority of gender dependent pharmacokinetic differences.
In the discussion they note their results show a striking sex difference in pharmacokinetics: among patients administered a standard drug dose, females are exposed to higher blood drug concentrations and longer drug elimination times than males. This likely contributes to the near doubling of adverse drug reactions in female patients, raising the possibility that women are routinely overmedicated.Sex differences in pharmacokinetics predict adverse drug reactions in women Irving Zucker1,2* and Brian J. Prendergast https://bsd.biomedcentral.com/track/pdf/10.1186/s13293-020-00308-5
Another interesting 2016 paper on this topic Sex differences in the psychopharmacological treatment of depression can be downloaded through https://www.researchgate.net/publication/313611992_Sex_differences_in_the_psychopharmacological_treatment_of_depression
It would be interesting to hear Dr. Bob's thoughts on this.....
Posted by Mtom on October 18, 2020, at 11:36:23
In reply to New Study:Females have more Adverse Drug Reactions, posted by Mtom on October 18, 2020, at 11:31:15
Gender is generally not revealed in posts, however this study suggests it to be one factor in differences between side effects among patients.
> A study published in June 2020 from researchers at the University of California Berkeley and the University of Chicago found that Women have a nearly 2-fold greater risk than men for
> exhibiting ADRs across all drug classes and are significantly more likely to be hospitalized secondary to an Adverse Drug Reaction. This included antidepressant drugs (see list of drugs investigated in article linked below). They discuss that Pharmacokinetics differ between males and females. They also note that most drugs are not administered on a milligram/kilogram basis but as a one size fits all dose, leading to higher exposures in women and optimally dose should be based on mg/kg body weight However corrections for height, weight and body composition eliminates only a minority of gender dependent pharmacokinetic differences.
> In the discussion they note their results show a striking sex difference in pharmacokinetics: among patients administered a standard drug dose, females are exposed to higher blood drug concentrations and longer drug elimination times than males. This likely contributes to the near doubling of adverse drug reactions in female patients, raising the possibility that women are routinely overmedicated.
>
> Sex differences in pharmacokinetics predict adverse drug reactions in women Irving Zucker1,2* and Brian J. Prendergast https://bsd.biomedcentral.com/track/pdf/10.1186/s13293-020-00308-5
>
> Another interesting 2016 paper on this topic Sex differences in the psychopharmacological treatment of depression can be downloaded through https://www.researchgate.net/publication/313611992_Sex_differences_in_the_psychopharmacological_treatment_of_depression
>
> It would be interesting to hear Dr. Bob's thoughts on this.....
>
Posted by undopaminergic on October 19, 2020, at 3:55:23
In reply to New Study:Females have more Adverse Drug Reactions, posted by Mtom on October 18, 2020, at 11:31:15
Doses need to be individualised, not sexualised. That said, it may make sense to use a lower starting dose for women, as they do for children and the elderly.
-undopaminergic
Posted by Mtom on October 19, 2020, at 9:54:50
In reply to Re: New Study:Females have more Adverse Drug Reactions, posted by undopaminergic on October 19, 2020, at 3:55:23
I am the last person to want to sexualize anything. And I agree that "personalized medicine" is the way of the future although have doubts it will happen anytime soon. There are of course many differences between individuals that include not just weight and the other factors discussed in these papers, but also genetics, comorbidities, taking multiple drugs, diet, etc. that may impact both efficacy and adverse drug reactions (ADRs).
However I'm just reading and commenting on what the researchers found in this particular scientific paper. The researchers state that females have almost 2 x more adverse effects than males. They found differences in the ways females absorb, distribute, metabolize and eliminate drugs etc., (i.e. pharmacokinetics, detailed in the linked paper).
The paper notes - I'm paraphrasing - that females are (on average) smaller than males and generally a lower proportion of muscle mass yet they say that some evidence shows adjusting for weight differences does not always reduce the number of ADRs in females. They do quote both one paper which argues that body weight "is" the factor as well as another which found this "not" to be the case. Their own analysis also finds differences in ADRs remain after correcting for body weight. They also note that more intensive research is needed.
The paper is interesting, discusses in much more detail than I can post all the factors that may play a role, and is really worth a read.
They finish with notes that include the observation that most basic research is conducted in male animals, whether cell lines or in vivo and various recommendations including that drugs when feasible should be dosed on a body weight bases for "both" men and women as well as other recommendations.
> Doses need to be individualised, not sexualised. That said, it may make sense to use a lower starting dose for women, as they do for children and the elderly.
>
> -undopaminergic
>
Posted by undopaminergic on October 19, 2020, at 10:09:36
In reply to Re: New Study:Females have more Adverse Drug Reactions, posted by Mtom on October 19, 2020, at 9:54:50
Sorry if I sounded too critical.
This is the end of the thread.
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