Product Details

• Amazon Sales Rank: #670585 in Books
• Published on: 2001-10-18
• Released on: 2001-10-18
• Original language: English
• Binding: Hardcover
• 318 pages

From Publishers Weekly
Replete with information supported by recognized and reliable sources, this expos‚-cum-health guide should be read by anyone taking prescription medication. Cohen, an associate professor of medicine and psychiatry at the University of California at San Diego, focuses on the practice of "standard dosing," i.e., the same number of milligrams prescribed for all patients; his articles about dosage have appeared in the New York Times and Newsweek. Asserting that different ages and conditions can affect how a drug is metabolized, and thus its effectiveness, Cohen advises to "Start Low, Go Slow." Lower doses often prove just as effective, and higher doses in the wrong person can be deadly. The chapters proceed logically, divided by families of drugs and, later, by FDA regulations, kickbacks to doctors from pharmaceutical companies, ghostwritten articles commissioned by pharmaceutical companies and attributed to independent doctors in trusted medical journals. Most importantly, Cohen discusses at length deadly and other irreversible side effects of new drugs, suggesting that warnings on drug packages are incomplete. He describes the pharmaceutical companies' practice of luring doctors to exotic weekend-long retreats for a two-hour symposium about a new product. Finally, Cohen gives insight into the doctor's Bible: The Physician's Desk Reference. Clear, easy narrative and anecdotal evidence makes this an accessible, albeit disturbing, read. This medical-biz gadfly delivers an invaluable resource for doctors and patients alike. (Oct. 15)Forecast: Given its nearly limitless potential audience, and with a national author tour kicked off by an appearance on the radio talk show People's Pharmacy, prominent display in stores could make sales take off.

Copyright 2001 Cahners Business Information, Inc.

From Library Journal
Medications don't cause side effects their dosages do. That is the message sent by Cohen, a psychiatrist and professor of family medicine, in this repetitive but necessary expos of drug companies' marketing practices, physicians' prescribing behavior, and the inadequacy of dosing information in the Physicians' Desk Reference. Cohen argues that most adverse effects could be eliminated if doctors tailored a drug's dosage to an individual, but because manufacturers want to obtain approval for new drugs as quickly as possible, they do not perform adequate testing to determine the lowest effective amount. This can cause doctors to use a "one size fits all" mentality and prescribe like dosages for all patients. Cohen presents a plethora of practical information, including lower effective dosage recommendations for 53 top-selling drugs and a questionnaire for patients to determine how sensitive they are to medication. Numerous case studies, quotations from prominent researchers, and references support his premise that doctors should usually "start slow, go slow," and always individualize the dosage for each patient. Highly recommended for public and medical libraries. Natalie Kupferberg, Biological Sciences/ Pharmacy Lib., Ohio State Univ., Columbus
Copyright 2001 Reed Business Information, Inc.

From Booklist
Only about 1 in 20 drug side effects are reported, Cohen says, and drug companies, the FDA, and most physicians pay little attention to them. When a new drug is approved, its manufacturer usually suggests a high dosage to obtain desired results quickly and maximize the company's profits. Drug package inserts, which give scientific and regulatory information, generally don't discuss lower doses, which often bring the same results without risking as many side effects, and The Physician's Desk Reference, often seen as a reliable information source, is a drug-industry product that pretty much reprints the inserts. Cohen's aim isn't to encourage avoiding popular drugs but to draw attention to effective lower doses and avoid side effects. Arguing that drug companies control much of the medical literature and slant research reports and accounts of side effects, he makes a convincing case for establishing a neutral drug safety board to prevent harmful situations fostered by industry disingenuousness. A thorough, solidly based book that deserves to be widely read by medical professionals and the lay public. William Beatty
Copyright © American Library Association. All rights reserved

Customer Reviews

A Pharmacist has an "Aha Moment!"
I began working in pharmacy in the late 1960's. I helped dispense drugs at a retail drugstore in my home town and I did the same in the largest hospital in Chicago. I kept it up at another hospital and then started "doing" it on my own when I opened my retail store in 1983. I read the manufacturers' package inserts and I followed the prescriptions as they were ordered - and I noticed that many people had problems with the "recommended" dose. Sometimes they got used to the dose and sometimes it had to be changed. In any event, the recommended dose was not always accurate accurate - it was often dangerously WRONG.

I don't know what I thought about all the problems with prescription drugs. I guess I just presumed the patients were overly sensitive, or just unlucky. I didn't often think too much about it - until I became aware of Dr. Jay Cohen and his "Case Against the Drug Companies." His shocking book is called "OVER DOSE" and it describes in good detail the dangers of relying on the manufacturers' package inserts to prescribe drugs.

This is an "eye opener" book and it angers me. How is it that we have this overriding desire to place the bottom line above decent care for health? There are some great things happening in medicine - all around the world. But I think that all the good can be quickly undone by hanging on to a misguided philosophy that insists that profits trump everything else. Its time for a change and Dr. Cohen is part of the changing process. I promise to do my part for change. One thing is to expose potential problems (like Dr. Cohen has done) and another is to encourage people to think about the issues (that's my goal). Please get a copy of this book. Read it and then think about what it really means. When we reach a critical mass changes will happen. You can bank on it! (pun intended)

Everyone should read this book!
Finally, someone has put into print an accurate and factual picture of what the drug manufacturing industry does to place profits way ahead of patient benefit and safety. Anyone who takes prescription medications should read this book. Maybe it gets a little too technical in spots for people not in the health professions, but there is plenty of excellent information and suggestions to make this a very valuable reference for consumer-oriented patients.
I am a doctoral-level clinical pharmacist, and I found myself in agreement with most all of what Dr. Cohen has written and recommended in this book. This should be required reading for every practicing physician, medical student, pharmacist, and nurse in the country. Medical schools should add this to their curriculum for all of our doctors-to-be to read before they take their pharmacology course and start their clinical training.

FDA and PMA Foibles Exposed
A valuable theme disclosing inadequate testing by the drug companies and woeful evaluations by the FDA of prescription drugs. The main thesis is well-taken: lower doses of many drugs could minimize side-effects, including death. Actually does not go far enough in exposing all the major drug classes that do not increase lifespan at all!
Also available from Amazon: Prescription for Disaster by Thomas Moore and The Nutritional Cost of Prescription Drugs by Ross Pelton and James LaValle.