# New pharmaceuticals: when is the safest time to adopt them **URL:** \ **Category:** In My Humble Opinion\ **Created:** [February 16, 2009, 10:00pm UTC](https://boards.straightdope.com/t/new-pharmaceuticals-when-is-the-safest-time-to-adopt-them/486175 "2009-02-16T22:00:11Z")\ **Posts on this page:** 11\ **Page:** 1
**Author:** ![Athena](https://avatars.discourse-cdn.com/v4/letter/a/35a633/32.png) [@Athena](https://boards.straightdope.com/u/Athena)\ **Post date:** [February 16, 2009, 10:00pm UTC](https://boards.straightdope.com/t/new-pharmaceuticals-when-is-the-safest-time-to-adopt-them/486175/1 "2009-02-16T22:00:11Z")
I think we’ve all seen a new drug show up on the market, only to be pulled a couple years later because of unforeseen complications. As such, I’m a little hesitant to take drugs that haven’t been around for a while. I mentioned this to my primary care doctor, and he agreed with me - the way he put it was “you don’t want to be the first person on the block to try it, but you also don’t want to be the last person.” Given that, is there an optimum time to decide that a drug has been around long enough that most of the potentially dangerous side effects are exposed? If so, what’s that timing? 2 years? 5 years? 10 years? Longer? Are there any studies done on this sort of thing? And on a similar note - what’s the longest a drug has been around, only to be pulled for a really bad side effect that was only figured out late in the game? ---
**Author:** ![Athena](https://avatars.discourse-cdn.com/v4/letter/a/35a633/32.png) [@Athena](https://boards.straightdope.com/u/Athena)\ **Post date:** [February 17, 2009, 3:39pm UTC](https://boards.straightdope.com/t/new-pharmaceuticals-when-is-the-safest-time-to-adopt-them/486175/2 "2009-02-17T15:39:02Z")
Noone? C’mon, someone has to have an opinion! ---
**Author:** ![gonzomax](https://avatars.discourse-cdn.com/v4/letter/g/e8c25b/32.png) [@gonzomax](https://boards.straightdope.com/u/gonzomax)\ **Post date:** [February 17, 2009, 3:52pm UTC](https://boards.straightdope.com/t/new-pharmaceuticals-when-is-the-safest-time-to-adopt-them/486175/3 "2009-02-17T15:52:57Z")
[Cholesterol medications and side effects](http://www.all-about-lowering-cholesterol.com/cholesterol-medications.html) Cholesterol drugs are terrible on the body. They have been around for a while. ---
**Author:** ![Athena](https://avatars.discourse-cdn.com/v4/letter/a/35a633/32.png) [@Athena](https://boards.straightdope.com/u/Athena)\ **Post date:** [February 17, 2009, 4:16pm UTC](https://boards.straightdope.com/t/new-pharmaceuticals-when-is-the-safest-time-to-adopt-them/486175/4 "2009-02-17T16:16:02Z")
> [@gonzomax](#): > > [http://www.all-about-lowering-cholesterol.com/cholesterol-medications.html](http://www.all-about-lowering-cholesterol.com/cholesterol-medications.html) Cholesterol drugs are terrible on the body. They have been around for a while. With all due respect, that page appears to be a shill for something called [Cholest](http://dan.xtend-life.com/product/Cholest-Natural.aspx?id=854647). I’m looking for something a bit more reputable. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [February 17, 2009, 4:40pm UTC](https://boards.straightdope.com/t/new-pharmaceuticals-when-is-the-safest-time-to-adopt-them/486175/5 "2009-02-17T16:40:00Z")
It depends on the drug, what other drugs are available at the time, the severity of the condition, presence of co-morbid conditions, etc. In other words, there’s really no right answer. IMHO. And cholesterol lowering drugs, in the form of statins, are one of the few drugs to have solid evidence of their beneficial and life-prolonging effects. ---
**Author:** ![Athena](https://avatars.discourse-cdn.com/v4/letter/a/35a633/32.png) [@Athena](https://boards.straightdope.com/u/Athena)\ **Post date:** [February 17, 2009, 4:56pm UTC](https://boards.straightdope.com/t/new-pharmaceuticals-when-is-the-safest-time-to-adopt-them/486175/6 "2009-02-17T16:56:52Z")
I know there’s no “right” answer for everything. I guess I was looking for some kind of study or something that said “by the time a drug has been out for X years, research has shown that we generally know most of the potential side effects.” ---
**Author:** ![suranyi](https://avatars.discourse-cdn.com/v4/letter/s/e36b37/32.png) [@suranyi](https://boards.straightdope.com/u/suranyi)\ **Post date:** [February 17, 2009, 5:21pm UTC](https://boards.straightdope.com/t/new-pharmaceuticals-when-is-the-safest-time-to-adopt-them/486175/7 "2009-02-17T17:21:34Z")
A book I once found in the bookstore – I think it was called “Good Drugs, Bad Drugs”, or something like that – suggested you wait five years after a new drug comes on the market before taking it. That is, unless the new drug provides definite benefits beyond any currently existing drugs. Ed ---
**Author:** ![minor7flat5](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/minor7flat5/32/258_2.png) [@minor7flat5](https://boards.straightdope.com/u/minor7flat5)\ **Post date:** [February 17, 2009, 5:52pm UTC](https://boards.straightdope.com/t/new-pharmaceuticals-when-is-the-safest-time-to-adopt-them/486175/8 "2009-02-17T17:52:48Z")
IMHO, if you have a strong need for a particular medication and the doctor has provided the alternatives and explained why a particular one is best, why fret about it? It’s all about balancing risk. If it’s a new migraine medication that will possibly work better than your current one, then maybe it isn’t worth the risk. If it’s a breakthrough cancer drug, then maybe it is. All prescription drugs go through a rigorous process of [clinical trials](http://en.wikipedia.org/wiki/Clinical_trials) that may involve thousands of patients and last years. This is done not only to prove efficacy, but to protect us. Though there is [criticism](http://en.wikipedia.org/wiki/Clinical_trials#Criticism) of the clinical trial process out there, this process weeds out a huge number of potentially dangerous drugs and identifies many of the dangerous side effects of the ones that are eventually approved. Big-pharma shenanigans aside, it is not unheard for a big-publicity lawsuit to involve a side effect that was fully understood and documented right on the product’s label (e.g. the drug label warns that 1 in 10,000 has permanent kidney damage, and someone who eventually did experience kidney damage sues). Of course, it is important that you understand why the drug is prescribed and what other options there are. Some of those big-pharma shenanigans involve encouraging doctors to prescribe drugs for off-label uses among other things. You probably don’t want to be taking the stuff because a smooth sales rep just passed through. ---
**Author:** ![Athena](https://avatars.discourse-cdn.com/v4/letter/a/35a633/32.png) [@Athena](https://boards.straightdope.com/u/Athena)\ **Post date:** [February 17, 2009, 6:08pm UTC](https://boards.straightdope.com/t/new-pharmaceuticals-when-is-the-safest-time-to-adopt-them/486175/9 "2009-02-17T18:08:02Z")
> [@minor7flat5](#): > > IMHO, if you have a strong need for a particular medication and the doctor has provided the alternatives and explained why a particular one is best, why fret about it? If there was a “strong need” for THAT particular medication, sure. But there’s a lot of competing medications that do similar things, and personally, if I have a choice, I tend to choose stuff that’s been out for a while and maybe put up with some side effects while the new cool drug gets tested on other people for a few years. ---
**Author:** ![minor7flat5](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/minor7flat5/32/258_2.png) [@minor7flat5](https://boards.straightdope.com/u/minor7flat5)\ **Post date:** [February 17, 2009, 7:25pm UTC](https://boards.straightdope.com/t/new-pharmaceuticals-when-is-the-safest-time-to-adopt-them/486175/10 "2009-02-17T19:25:16Z")
> [@Athena](#): > > If there was a “strong need” for THAT particular medication, sure. > > But there’s a lot of competing medications that do similar things, and personally, if I have a choice, I tend to choose stuff that’s been out for a while and maybe put up with some side effects while the new cool drug gets tested on other people for a few years. That was my point. If the doc can’t convince you why X should be used instead of Y or Z, then ask for Y or Z instead if you want them, for whatever reason. My other point was that drugs are not “tested on other people for a few years” when they are on the open market. Before a drug reaches the open market, it has been studied for an average of 14 years, with several of those years being clinical trials in humans. They are the true guinea pigs. I totally agree with you that using a new drug can be compared with being an early adopter for a new operating system, but the FDA sets the bar pretty high, so I wouldn’t lose much sleep over it. That’s just my opinion. ---
**Author:** ![Athena](https://avatars.discourse-cdn.com/v4/letter/a/35a633/32.png) [@Athena](https://boards.straightdope.com/u/Athena)\ **Post date:** [February 17, 2009, 7:40pm UTC](https://boards.straightdope.com/t/new-pharmaceuticals-when-is-the-safest-time-to-adopt-them/486175/11 "2009-02-17T19:40:20Z")
> [@minor7flat5](#): > > That was my point. If the doc can’t convince you why X should be used instead of Y or Z, then ask for Y or Z instead if you want them, for whatever reason. > > My other point was that drugs are not “tested on other people for a few years” when they are on the open market. Before a drug reaches the open market, it has been studied for an average of 14 years, with several of those years being clinical trials in humans. They are the true guinea pigs. > > I totally agree with you that using a new drug can be compared with being an early adopter for a new operating system, but the FDA sets the bar pretty high, so I wouldn’t lose much sleep over it. > > That’s just my opinion. I guess I don’t agree that the FDA sets the bar pretty high. Well, maybe they do, but I think we’ve seen enough examples of drugs that have entered the market only to be pulled a couple years later that we know things can slip through. By “tested on other people” I don’t mean formally tested. But it _is_ a test. Clinical trials use a relatively small group of people; once a drug gets on the market, hundreds of thousands of people are on it. My personal feeling is if you take a drug the first year it’s out, you _are_ part of a test group, albeit not a formal one. Heck, we can’t even get software right when it first comes out. Cars often have a few years of trial & error when a new model comes out before everything is “right”. Pharmaceuticals are whole other level of complexity than software or cars, and I’m going to avoid being a test bed if I can.