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Hello,

I have questions about the collection and meaning of drug side effects data.

The prescribing information that accompanies a drug normally contains a
table of data on adverse events observed while the drug was tested.  The
table lists numerous adverse events, the percent of patients experiencing
each effect who were taking the drug, and the percent of patients
experiencing each event who were taking the placebo.

Regarding the adverse events:  Do the researchers use in every drug trial a
common master list of all possible adverse events that may occur, or is a
list developed for each trial based on complaints that patients volunteer, or
is the list a combination of both?

Regarding the percents:  Are the patients asked about adverse events
which occured prior to taking part in the trial?  That is, do the data show
new events which the patients experienced as a result of taking the drug or
the placebo?  I would guess that most lay people would interpret the data
in this manner.

Or do the percents merely show a comparison of adverse events among
patients taking the drug vs. the placebo regardless of whether the patients
ever experienced these events previously?

If the latter is what the data really show (can anyone confirm this?), that
would explain why dystonia was observed for the placebo when Permax
was tested, as noted by Joe Bruman below.  That would also mean that
many (perhaps most?) people are misinterpreting side effects data.

J. R. Bruman wrote:

> The Physicians' Desk Reference (PDR) description of each approved
> drug is supposed to include *all* reports of adverse effects. In
> controlled trials for the FDA of Permax, 11.6% of recipients
> reported dystonia (4th highest among the neurological effects)- but
> then 8% of those getting placebo also reported it, an insignificant
> difference. Go figure.

Phil Tompkins
Hoboken NJ
age 61/dx 1990