Research

Millions Take Gabapentin for Pain. But There’s Scant Evidence It Works. (click to read full article)

...“There is very little data to justify how these drugs are being used and why they should be in the top 10 in sales. Patients and physicians should understand that the drugs have limited evidence to support their use for many conditions, and there can be some harmful side effects, like somnolence, dizziness and difficulty walking.” Furthermore, for patients prone to substance use disorders, like an opioid addiction, the gabapentinoids, although they are not opioids, are potentially addictive, he said.

The gabapentinoids are symbolic of three currently challenging problems in the practice of medicine: a deadly national epidemic of opioid addiction prompting doctors to seek alternative drugs for pain; the limited training in pain management received by most doctors; and the influence of aggressive and sometimes illegal promotion of prescription drugs, including through direct-to-consumer advertising.

What if the Placebo Effect Isn’t a Trick?
New research is zeroing in on a biochemical basis for the placebo effect — possibly opening a Pandora’s box for Western medicine (click to read full article)

... Not that the researchers are without explanations. But most of these have traditionally been psychological in nature, focusing on mechanisms like expectancy — the set of beliefs that a person brings into treatment — and the kind of conditioning that Ivan Pavlov first described more than a century ago. These theories, which posit that the mind acts upon the body to bring about physical responses, tend to strike doctors and researchers steeped in the scientific tradition as insufficiently scientific to lend credibility to the placebo effect. “What makes our research believable to doctors?” asks Ted Kaptchuk, head of Harvard Medical School’s Program in Placebo Studies and the Therapeutic Encounter. “It’s the molecules. They love that stuff.” As of now, there are no molecules for conditioning or expectancy — or, indeed, for Kaptchuk’s own pet theory, which holds that the placebo effect is a result of the complex conscious and nonconscious processes embedded in the practitioner-patient relationship — and without them, placebo researchers are hard-pressed to gain purchase in mainstream medicine.

Electroacupuncture Promotes Central Nervous System‐Dependent Release of Mesenchymal Stem Cells (click to read full article)

In this study, we show how the use of electroacupuncture (EA) at specific points stimulates mesenchymal stem cell (MSC) release into peripheral blood through the activation of the nervous system. EA could be used to aid tissue repair through increasing the levels of circulating MSC. Moreover, MSC can be harvested directly from the blood of EA‐treated humans and animals and expanded ex vivo. Thus, EA may be a low cost, low risk method for MSC harvest for autologous stem cell therapy.

 


Acupuncture for paroxysmal and persistent atrial fibrillation: An effective non-pharmacological tool? (click to read full article)

In Traditional Chinese Medicine, stimulation of the Neiguan spot has been utilized to treat palpitations and symptoms related to different cardiovascular diseases. We evaluated whether acupuncture might exert an antiarrhythmic effect on patients with paroxysmal or persistent atrial fibrillation (AF). Two sets of data are reviewed. The first included patients with persistent AF who underwent electrical cardioversion to restore sinus rhythm. The second included patients with symptomatic paroxysmal AF. All subjects had normal ventricular function. Acupuncture treatment consisted of 10 acupuncture sessions on a once a week basis with puncturing of the Neiguan, Shenmen and Xinshu spots. In patients with persistent AF, the recurrence rate after acupuncture treatment was similar to that observed in patients on amiodarone, but significantly smaller than that measured after sham acupuncture treatment or in the absence of any antiarrhythmic drugs. In a small group of patients with paroxysmal AF, acupuncture resulted in a significant reduction in the number and duration of symptomatic AF episodes. In conclusion, we observed that acupuncture of the Neiguan spot was associated with an antiarrhythmic effect, which was evident in patients with both persistent and paroxysmal AF. These preliminary data, observed in 2 small groups of AF patients, need to be validated in a larger population but strongly suggest that acupuncture may be an effective non-invasive and safe antiarrhythmic tool in the management of these patients.