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Acetaminophen use in pregnancy linked to child's behavioral problems

latimes.com

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Re: Acetaminophen use in pregnancy linked to child's behavioral problems

#71

Post by douche »

pjc50 wrote: post #62
rand_r wrote: post #55

Earlier quoted context omitted.

Given how taxing these types of drugs are, why are opiates not an option for most people? They don't cause any long or short-term damage to organs.

Fears about addiction, and a huge dispute over how well-founded those fears are.

Which is slightly odd, considering we had something like 100 years during which codeine, cocaine, heroin, morphine, and a whole bevy of other currently-scheduled drugs were sold essentially unregulated, over the counter and at every county fair in patent medicines. Surely there must be some data there that some conclusions could be drawn from.

Re: Acetaminophen use in pregnancy linked to child's behavioral problems

#72

Post by fifteenforty »

erdevs wrote: post #68
fifteenforty wrote: post #34

Anaesthesia trainee here (doctor, similar to an anesthesiology resident in US vocabulary) I've read the actual referenced paper and not the LA times piece. This type of research is hypothesis generating. As they acknowledge, this shows a correlation, not causation. The big question here is why were these women taking paracetamol/acetaminophen? Was it the drug or the cause of their pain/fever/discomfort that is more r…

Supposing this study is further replicated and one wished to avoid paracetamol during pregnancy, what alternatives for pain relief would be recommended?

Well, that depends on your individual attitude to the relative risks of each drug. I realise that answer sounds unhelpful, but the alternatives all have risks. Opioids (and tramadol, a opioid that also has other effects) have been variably associated with birth defects, but the evidence is not conclusive[1].

[1] http://www.ajog.org/article/S0002-9378(10)02524-X/abstract

Re: Acetaminophen use in pregnancy linked to child's behavioral problems

#73

Post by douche »

contingencies wrote: post #8

OK well I'm not pregnant but I've been downing tonnes of these things for a sprained ankle recently. I don't like doing it as they are hepatoxic to some extent, and would prefer codeine, but the authorities make it too hard to get your hands on in most countries. Grr.

Any particular reason not to take aspirin instead? I've pretty much never taken anything else. Probably I'm wrong, but it seemed less dangerous than ibuprofen or Tylenol.

Re: Acetaminophen use in pregnancy linked to child's behavioral problems

#75

Post by DHMO »

paulajohnson wrote: post #57
fifteenforty wrote: post #34

Anaesthesia trainee here (doctor, similar to an anesthesiology resident in US vocabulary) I've read the actual referenced paper and not the LA times piece. This type of research is hypothesis generating. As they acknowledge, this shows a correlation, not causation. The big question here is why were these women taking paracetamol/acetaminophen? Was it the drug or the cause of their pain/fever/discomfort that is more r…

fifteenforty buries one of the biggest potential issues in his 4th para, so I'm going to highlight it: its not clear if this correlation was found post-hoc or not. If you measure 10 factors and 10 outcomes then you have a potential 100 different correlations. If you assume that any correlation where p<0.05 is significant then you are going to get 5 "significant" correlations just by chance. The summary talks about ho…

> they didn't find correlations with acetaminophen before and after pregnancy, so that's 3 distinct factors just there

No, it's perfectly valid for a drug to only have affect on the growing fetus but where there were not studies proving harm to the child or adult, e.g. Thalidomide.

Re: Acetaminophen use in pregnancy linked to child's behavioral problems

#76

Post by jrowley »

kirrent wrote: post #53
jrowley wrote: post #22

Earlier quoted context omitted.

I'm a big fan of naproxen with a large glass of water.

Add a meal and a PPI and I couldn't agree more.

Hmm, I didn't know about adding a PPI. Anything you recommend? My dad takes naproxen daily for joint pains, and sometimes I take it daily when I'm running a lot ( > 30 miles / week ).

Re: Acetaminophen use in pregnancy linked to child's behavioral problems

#77

Post by rabboRubble »

Broken_Hippo wrote: post #61
MichaelGG wrote: post #52

Earlier quoted context omitted.

Why are you medicating with anything without looking at what it is? Read label. If not understood, quickly look up the medications involved. Unless they are marketed very misleadingly (possible - opiates get tons of bad press, Tylenol doesn't), seems like you have zero reason to complain. You voluntarily consumed medications without even reading through the basic info that's on the box! Splitting into two pills? Why…

I worked in a pharmacy (not a pharmacist), and this sort of thing is extremely common. I helped a nicely dressed fellow one night, who asked where the Advil was. I showed him, and pointed out the store brand (Much cheaper). The guy told me that ibuprofin doesn't work for him, only Advil. This happens with the cough and cold medicines as well - most are the same combination of drugs, sometimes with or without one, and…

Exactly... you hear that "Tylenol" causes liver damage if taken incorrectly. What I didn't realize that Tylenol = Acetaminophen = Paracetamol, in a long list of stuff.

I had a mix of stuff purchased from a couple of different countries and in 2-3 languages. So yeah label reading was a bit of a challenge.

Re: Acetaminophen use in pregnancy linked to child's behavioral problems

#78

Post by dragonwriter »

marpstar wrote: post #36
rabboRubble wrote: post #33

Acetaminophen is one of the more dangerous over the counter drugs available. It is right up there with alcohol for causing liver failure. http://www.mayoclinic.org/diseases-conditions/liver-failure/... The tricky thing with acetaminophen is that it is included in products without adequate warning. If I'm sick, I have a headache and take 2 tylenol, plus cold medicine, plus whatever, and BAM I've killed my liver becaus…

I never take acetaminophen anymore and generally only take ibuprofen, and only a few times a year. Serious question: Why do people even take acetaminophen anymore?

> I never take acetaminophen anymore and generally only take ibuprofen, and only a few times a year. Serious question: Why do people even take acetaminophen anymore?

Because taken properly, its often the safest drug for pain and/or fever reduction there is? NSAIDs aren't exactly without risks, either, after all.

(The dangers are mostly from people either deliberately taking more than the recommended dose, or doing so accidentally by combining different multi-drug products without realizing that they all contain acetaminophen.)

Re: Acetaminophen use in pregnancy linked to child's behavioral problems

#79

Post by rabboRubble »

MichaelGG wrote: post #52
rabboRubble wrote: post #46

Earlier quoted context omitted.

The reason I am freaked about acetaminophen is that I suffer from migraines. The most effective OTC medicine for me is Excedrin Migraine (a combo of acetaminophen, aspirin, and caffeine). I didn’t realize that this med contained acetaminophen. I also didn’t realize that the product name Tylenol equaled acetaminophen. Only put things together when I heard about people overdosing and examined my medicine cabinet and ch…

Why are you medicating with anything without looking at what it is? Read label. If not understood, quickly look up the medications involved. Unless they are marketed very misleadingly (possible - opiates get tons of bad press, Tylenol doesn't), seems like you have zero reason to complain. You voluntarily consumed medications without even reading through the basic info that's on the box! Splitting into two pills? Why…

You are quite right about reading the labels. The issue for me was 1) recognition that a particular OTC chemical is risky beyond expectation, 2) knowledge about all the product names that chemical is called (Tylenol = paracetamol = acetaminophen = APAP), and 3) having the knowledge that product A plus product B over period Y is harmful. I am not a pharmacist, so #3 is really beyond my knowledge base and ability even now.

Migraine sufferers are sort of known for desperate self medicating. Not an excuse but it happen.

Re: Acetaminophen use in pregnancy linked to child's behavioral problems

#80

Post by jbandela1 »

douche wrote: post #73
contingencies wrote: post #8

OK well I'm not pregnant but I've been downing tonnes of these things for a sprained ankle recently. I don't like doing it as they are hepatoxic to some extent, and would prefer codeine, but the authorities make it too hard to get your hands on in most countries. Grr.

Any particular reason not to take aspirin instead? I've pretty much never taken anything else. Probably I'm wrong, but it seemed less dangerous than ibuprofen or Tylenol.

Basically, you can't take aspirin at anti-inflammatory doses without getting a lot of side effects. Ibuprofen is a much better anti-inflammatory.
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