OTCs in Action Episode 6: Beyond Pain Relief


This week, systemic analgesics and anti-inflammatories are the OTCs in Action, helping fight drug abuse, heart attacks, depression and schizophrenia. While treatment of the first two conditions are optimised in an OTC setting now, the early-stage research on (Rx and OTC) NSAIDs for depression and schizophrenia is showing much promise.

OTCs vs Drug Abuse

On a personal note, a recent dental surgery appointment concluded with the offer of a prescription for painkillers, accompanied by the suggestion that OTC ibuprofen might be enough. Knowing that the OTC would work for me, I declined the Rx drug, but how many people would have just accepted the Rx as the best form of treatment, bringing a potentially risky substance into their homes unnecessarily?

This month, the US National Safety Council is teaching more people that OTCs can be as effective as an Rx painkiller. Evidence for the efficacy of pain medications is a white paper showing the combination of OTC pain medications, ibuprofen and acetaminophen (paracetamol), is more effective at treating acute pain than opioid painkillers. Rx hydrocodone combination products, such as Vicodin, have just been reclassified to make the drugs more difficult for doctors to prescribe, and for patients to refill. The NSC white paper validates the efficacy of OTC treatment for acute pain as an alternative to opioid therapy.

OTCs vs Heart Attacks

Bayer’s Aspirin 81mg has just been approved in Canada for emergency use during heart attacks. According to Bayer, “The message is simple: Canadians should always keep Aspirin 81mg on hand. Be prepared and if you think you or someone around you is having a heart attack, call 911, then crush or chew two Aspirin 81mg tablets.”

NSAIDs vs Depression

The World Health Organisation estimates that depression is one of the top five reasons for loss of quality of life, and NSAIDs are being touted as an important concomitant therapy for some patients, under a doctor’s supervision. Research published by a team at Aarhus University in Denmark “supports a proof-of-concept concerning the use of anti-inflammatory treatment in depression.” Author Ole Köhler, MD, comments, “The biggest problem with depression is that we do not know the causes that trigger the condition in the individual patient. Some studies suggest that the choice of antidepressant medication can be guided by a blood sample that measures whether there is an inflammatory condition in the body. Other studies show that the same blood samples could be used as a guideline on whether a depressive patient can be treated with anti-inflammatory drugs that work better when there is inflammation present simultaneously with the depression. These findings must, however, be verified before they can be implemented in clinical practice.” (JAMA Psychiatry, 15 Oct, 2014)

NSAIDs vs Schizophrenia

Some anti-inflammatory medicines, such as aspirin, oestrogen and acetylcysteine (in cough remedy Fluimucil), can improve the efficacy of existing schizophrenia treatments, according to a study presented at the European College of Neuropsychopharmacology. This research, led by Professor Iris Sommer, University Medical Centre, Utrecht, Netherlands, has shown that the immune system is linked to certain psychiatric disorders, such as schizophrenia and bipolar disorder. Research has shown that “antioxidants and anti-inflammatory drugs could not only reduce symptoms associated with the disorders, but also prevent the appearance of neurobiological abnormalities and transition to psychosis if given early during brain development.” (Science Daily, 20 Oct, 2014)

See Nicholas Hall’s OTC.NewDirections for scientific & regulatory developments in all categories, every week.