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Bitter Pills: Inside the Hazardous World of Legal Drugs Hardcover – April 1, 1998

24 customer reviews

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Editorial Reviews Review

Bitter Pills started as a magazine story, inspired by Stephen Fried's wife's frightening reaction to an antibiotic. After he won a National Magazine Award for that article, he expanded his investigation into this book. What he has uncovered is astounding, starting with the fact that, in the U.S. alone, between 45,000 and 200,000 people die annually of reactions to legal drugs (2 to 9 percent of the 2.3 million Americans who die each year) versus the 5,000 to 10,000 who die of illegal drug use. As Fried compulsively investigates what happened to his wife and how reactions like hers were considered statistically insignificant by drug companies and the FDA, he learns things most of us don't want to know about the mechanisms that cause pills to land on pharmacy shelves. Chances are, after reading Bitter Pills, you'll be much more careful about accepting prescriptions for new medications.

From Publishers Weekly

Five years ago, Fried's wife, after taking an antibiotic for a minor urinary tract infection, developed such side effects as delirium, visual distortions and insomnia, followed by a debilitating manic-depressive illness that the prescription drug apparently triggered. This report on the often lethal hazards of over-the-counter and prescription medications intertwines Fried's personal story of coping with his wife's condition and an informal, scattershot probe into the drug development and approval process, based on interviews with doctors, FDA officials, consumer advocates, neuroscientists, pharmaceutical executives and sales reps, lawyers and pharmacologists. By turns tedious and revealing, his labyrinthine investigation is sprinkled with useful suggestions for revamping U.S. drug testing and regulatory procedures. Freelance writer Fried includes cases involving adverse reactions to heart medicines, anti-inflammatory and psychiatric drugs, skin creams, anti-asthmatics and AIDS medications. He highlights the laxity of safety standards regarding the prescribing of drugs for children and pregnant women. An appendix offers guidelines for consumers on assessing potential drug dangers, and dealing with doctors and pharmacists.
Copyright 1998 Reed Business Information, Inc.

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Product Details

  • Hardcover: 432 pages
  • Publisher: Bantam; 1 edition (April 1, 1998)
  • Language: English
  • ISBN-10: 0553103830
  • ISBN-13: 978-0553103830
  • Product Dimensions: 1.2 x 6.2 x 9.5 inches
  • Shipping Weight: 1.3 pounds
  • Average Customer Review: 4.7 out of 5 stars  See all reviews (24 customer reviews)
  • Amazon Best Sellers Rank: #406,312 in Books (See Top 100 in Books)

More About the Author

Stephen Fried is an award-winning journalist and best-selling author who teaches at Columbia University Graduate School of Journalism and the University of Pennsylvania. He has written five widely praised books: THING OF BEAUTY: THE TRAGEDY OF SUPERMODEL GIA (which inspired the Emmy-winning HBO film Gia and introduced the word "fashionista" into the English language); BITTER PILLS; THE NEW RABBI; HUSBANDRY; and APPETITE FOR AMERICA: FRED HARVEY AND THE BUSINESS OF CIVILIZING THE WILD WEST--ONE MEAL AT A TIME (a New York Times best seller that was also named one of the ten best books of the year by the Wall Street Journal.)

His sixth book, co-authored with former Congressman Patrick Kennedy, A COMMON STRUGGLE: A PERSONAL JOURNEY THROUGH THE PAST AND FUTURE OF MENTAL ILLNESS AND ADDICTION (Blue Rider), will be published in October 2015.

He is currently writing DR. RUSH: BLOOD, REVOLUTION, FRIENDSHIP, MADNESS AND THE SECRET HISTORY OF THE AMERICAN HIPPOCRATES for Crown, and also lectures widely on the subjects of his books.

A two-time winner of the National Magazine Award, he has written for Vanity Fair, Glamour, The Washington Post Magazine, GQ, Rolling Stone, Ladies Home Journal, Parade, and Philadelphia magazine (where he got his start.) Fried lives in Philadelphia with his wife, author Diane Ayres.

Customer Reviews

Most Helpful Customer Reviews

41 of 41 people found the following review helpful By Mary VINE VOICE on February 5, 2002
Format: Paperback Verified Purchase
I didn't know about Stephen Fried and "Bitter Pills," much less quinolone antibiotics, until I myself was, like Mr. Fried's wife, "Floxed," just a few weeks ago. I began my search for information on reactions to quinolones after four days of gatifloxacin (brandname Tequin) left me with tingling and weak arms and legs, difficulty swallowing and breathing, visual disturbances, headaches, dizziness, and more. I seriously thought I had a stroke or Guillain Barre syndrome or rapid onset multiple sclerosis, I was so sick.
Let me say that first, Stephen Fried's book is an excellent overview of the circumstances of adverse drug reactions to quinolone antibiotics. And with the increased visibility and use of Cipro, and the ease with which doctors dispense heavy-hitting antibiotics like Levaquin and Tequin, I'm sure I'm not going to be the last person to suffer a reaction and end up being "Floxed" and needing the information and reassurance provided by this book.
But it is also much much more. It's an expose of the pharmaceutical industry's fast and loose way of dealing with drugs, drug safety and the American public. This is not a rant -- it's an impeccably researched and detailed presentation of the intricacies involved in drug approvals and tracking of adverse reactions that exposes the limitations of the system, and the dangers those limitations present to us as patients and consumers.
As a patient advocate and spokesperson for thyroid and autoimmune disease patients, I know all too well the feeling of being held hostage to big pharmaceutical companies at the expense of my health and wellness.
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24 of 24 people found the following review helpful By Mark Wylie on January 12, 2001
Format: Paperback Verified Purchase
This book begins as a personal story. One day journalist Stephen Fried was forced to rush his wife, novelist Diane Ayres, to an emergency room, when she suffered a severe seizure. She turned out to be suffering an adverse reaction to an antibiotic, Floxin, which she had been instructed to take for a minor urinary infection. "Bitter Pills" grew out of Fried's attempts to understand what had happened to his wife.
Fried, and his readers, soon discover that Diane Ayres' case was not unique, or even rare. Floxin is only one of legions of prescription drugs which can cause severe adverse reactions, which cause at least 45,000 deaths per year in the US (some estimates go as high as 200,000). It is a tribute to Fried's excellence as a reporter that he is able go beyond his dramatic personal story to give a comprehensive picture of what he calls " the hazardous world of legal drugs."
Fried reviews the history of drug regulation in the US, and ably documents the shortcomings of the current regulatory system, as well as the inordinate influence drug companies have on the process. Two of the many specific "hazards" he identifies are the desperate need for doctors to have an independent, reliable source of information on the drugs they prescribe (almost all the informatin they currently have comes from drug manufacturers), and the equally crying need for an effective system for reporting and cataloging adverse drug reactions.
I put this book down very impressed with Fried as both a reporter and a writer. He has clearly immersed himself in an important issue long enough, and deeply enough, that he has mastered it. He has then turned around to convey the complex issues involved to readers very effectively and without losing their interest. I look forward to work of similar excellence from Fried in the future.
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21 of 22 people found the following review helpful By Joel M. Kauffman on September 9, 2001
Format: Paperback
"Bitter Pills" is the real-life version of "Strong Medicine" by Arthur Hailey. With a very personal beginning resulting from his wife's near death and slow recovery from taking ONE PILL (Floxin), author Fried went on to find whether there were other victims (many), and why the drug was approved in the first place. Interviews in profusion show why the FDA has its problems. Examples are given of the tendency of drug companies to defend their drugs at any cost regardless of evidence. The end of the book contains addresses of many drug companies, organizations to whom to report adverse drug reactions, and a sample form to send to the FDA. Well thought-out advice for patients (or their helpmates) to investigate drugs are given. A number of other good books on the subject are listed.
Fried is to be congratulated for doing a very accurate job with a minimum number of accusations. I did not find a single technical error in the entire book, and I have about 12 years exploratory drug development and teaching about it as a professor of medicinal chemistry.
Even Fried may not have realized how many drugs not discussed in his book shorten life, because they are tested and accepted based on surrogate endpoints for short periods. This may not be so bad for antibiotics that are taken for two weeks, but can be very destructive for drugs intended to be taken for 20-40 years.
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14 of 14 people found the following review helpful By A Customer on November 12, 2000
Format: Paperback
I read this book at least a year ago but am still impressed by the story and the thoroughness of the author. I found it especially chilling because it is something I can imagine happening to me. Like Fried's wife, Diane, I too suffered a mild closed-head injury from an automobile accident as a child. Also like Diane, this injury has never given me problems and so I have never had reason to worry the subject - never considering it might have repercussions, certainly not when it comes time to fill a prescription. The most chilling part is that I can easily imagine a physician doing exactly what Diane's physician did - reading (or glancing at) the bland official Floxin contraindications as Fried has presented them, and deciding the antibiotic will be just fine!
Fried's investigation into the drug-approval process was fascinating reading. By looking at one antibiotic in depth, he captured a lot of specific information that can no doubt be applied to the general case of pharmaceutical approval.
The appendix to the book suggests how to read a drug insert and is a wonderful bonus - practical information you can use any time you deal with your MD or go to the pharmacy.
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