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Reconsidering Thalidomide

by Alison Hudson

October 10, 2013

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Donate Last week I made a throwaway comment about thalidomide as part of a statement about dangerous drugs, and how"I wouldn’t touch [it] even on a doctor’s recommendation." Because, I mean, thalidomide, right? Deformed babies and lawsuits and the poster child for irresponsible science and stronger FDA regulations -- who could argue with that?

Only, people did. And in doing so they taught me a lesson in challenging assumptions and thinking skeptically.

First, a quick history for those who want to skip the Wikipedia article. Thalidomide was an anti-nausea medication that became popular in parts of Europe in the 1950s as an effective treatment for morning sickness in pregnant women. Unfortunately, thalidomide interfered with fetal development, and an epidemic of so-called "thalidomide babies" were born with significant physical disabilities such as deformed or missing limbs. The drug was eventually pulled off of the shelves, doctors the world over stopped prescribing it, and thalidomide became the poster drug for anyone pushing a pro-naturalistic, anti-Big Pharma health agenda.

One assumption I had made about thalidomide was that after the tragedy they had destroyed all the existing thalidomide, burned every copy of the recipe, and permanently blacklisted the stuff from ever being taken again. So when one commenter said that "thalidomide is back as a cancer treatment," my first thought was,They still prescribe thalidomide?!

Yes, they do. In fact, the United States FDA, which during the thalidomide scandal was heralded for their refusal to grant approval to the drug and saving thousands of American babies from deformity and death, has since given approval for thalidomide to be used in treating bothmultiple myeloma and leprosy. It is tightly controlled, and usage of the drug is governed by a a process of screening that protects pregnant women from being exposed to it; but there it is, legal in the U.S. in 2013 (and in other countries as well).

How could this be? How could thalidomide gain FDA approval after what it had done?

Because science is a rational and progressive philosophy. While thalidomide became a bogeyman in the popular culture, it remained a drug open to further study by pharmacists and doctors. The initial development and marketing of thalidomide may have been tragically marred, but that doesn't mean the drug itself is inherently bad. And so science studied it; and science learned a lot more about how it worked and why it did what it did; and science started finding ways to use it.

Even thalidomide's origin as an anti-nausea medication hasn't been forgotten. In recent years it has been studied as, amongst other things, a drug to combat the nausea caused by chemotherapy. One study called it "highly effective in controlling delayed nausea and vomiting episodes in patients induced by moderately emetogenic chemotherapy" and another declared it "a safe, effective antiemetic."

Skepticism means being willing to challenge all notions, even our own. I was wrong about thalidomide.The thalidomide tragedy was something that no sane human would ever want to see repeated, but even such a horrible history needs to be considered in a reasoned, scientific way. With modern safety procedures, plus advances in understanding the drug itself, there is still a place for thalidomide in the lexicon of modern medicine.

by Alison Hudson

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