Sunday, October 21, 2007

Medication Nation

Medication Nation by Mark White Too fat, too thin, too sad, too happy...Whatever the problem Biotech is developing a vaccine or a pill to cure us. Mark White examines the consequences of a world where all our worries can be medicated away. Here is just some of a really interesting article:

Swiss biotech company Cytos has 25 research programs underway, including its ImmunodrugTM nicotine vaccine CYT002-NicQb, along with vaccines for chronic diseases including obesity, hypertension, allergy, psoriasis and rheumatoid arthritis. The company was granted a US patent in early 2005 for vaccines against different drugs of abuse, and hopes to release its nicotine vaccine in 2010. The vaccine antibodies prevent dopamine, the chemical that leads to a feeling of pleasure, from flooding the brain. They have a half-life of 50 to 100 days, meaning the response could be a boosted by a further injection. The rewards are huge: Decision Resources estimated the 'stop smoking' market in America alone will be $1.5bn by 2007, and as China and India become richer, with more people smoking, eventually more people will want to stop smoking too.

Cystos' obesity vaccine works on a similar principle with an antibody against ghrelin, a small protein that regulates appetite. If you inject extra ghrelin into people it makes them hungrier. Fat people who lose weight develop extra ghrelin, leading to yo-yo dieting. The theory is that by stopping the uptake of ghrelin it will be easier to stick to a diet. Cytos is to be running trials with 112 obese volunteers on a six month treatment of the vaccine or a placebo, and at the same time counselling them about healthy eating and encouraging exercise. While obesity is a leading cause of preventable death in rich countries, it is also, in every sense, a growing problem, with rich nations becoming fatter and fatter, and less and less happy about it. A successful vaccine would be worth billions.

The military are in on the act, naturally, sponsoring research into drugs that will keep their soldiers awake without the jittery, glittery rush of adrenaline that follows amphetamine use. And then there are mood-enhancing drugs to combat the rise of depression, a disorder that the World Health Organisation estimates will be the biggest health problem in the industrialised world by 2020.

'Tomorrow's biotechnology offers us the chance to enrich our emotional, intellectual and, yes, spiritual capacities,' says David Pearce, a leading transhumanist philosopher (transhumanists favour using science and technology to overcome human limitations). I think there's an overriding moral urgency to eradicating suffering. This ethical goal eclipses everything else.'

There is an alternative view, explored by philosopher Carl Elliott in his essay Pursued by happiness and beaten senseless: Prozac and the American Dream, that looks at alienation in societies - the 'mismatch between the way you are living a life and the structure of meaning that tells you how to live a life... it makes some sense (though one could contest this) to say that sometimes a person should be alienated - that given certain circumstances, alienation is the proper response. Some external circumstances call for alienation.' He gives the example of Sisyphus pushing the boulder up the mountain. He may be happier on Prozac and his psychic well-being would be improved. But his predicament is not just a matter of the wellbeing of his mental health, but how he is living his life. If someone's life is making them sick, then you can make them well by cither changing how they live their life or by making them fit in with what made them sick in the first place.

The real kicker is the class of experimental drugs developed by Cortex Pharmaceuticals, known as ampakines, that boost the levels of glutamate in the brain - a neurotransmitter implicated in the consolidation of memory. The drug's obvious therapeutic use is to treat people with Alzheimer's or dementia, but why stop there? A report in New Scientist earlier this year described the effects of the Cortex Pharmaceuticals ampakine CX717 on 16 healthy male volunteers at the University of Surrrey who were kept awake all night and then put through tests. Even the smallest doses of the drug improved their performance, and the more they took the more alert they became and the better their cognitive performance. The ampakine users remained alert and with none of the jitters associated with caffeine or amphetamines.

All technologies have mission creep and unintended consequences. Chatterjee dismisses concern about drug safety with the blithe phrase 'in general, newer medications will continue to be safer', despite little evidence to that end - and recent evidence with fen-phen, Vioxx and' the hiding of negative SSRI drug data by Big Pharma pointing in the other direction. The debate is framed in such a way as to make cosmetic neurology sound like an extension of evolution, when it's about as natural as a GM tomato containing a fish gene. This kind of technological arrogance is what's dooming the ecosphere, not saving it. 'I'm not prepared to say they can't be a good thing,' wrote Elliott, by email. 'They may well be. But I guess my feeling is that while the benefits are obvious, the possible drawbacks are not, and need to be thought about more carefully. There are also a lot of people out there with a financial interest in hyping the benefits and downplaying the risks.'

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