TIME: Almanac 1993/TIME Almanac 1993.iso/time/101491/1014350.000

Text File | 1992-08-28 | 3.5 KB | 80 lines

                                                                                MEDICINE, Page 65

The Dark Side of Halcion


Should millions of Americans be popping a sleeping pill banned
in Britain for causing amnesia and depression?


    When Halcion was first approved for sale in the U.S. in 1982,
doctors thought they had found the perfect sleeping pill. Like
its chemical cousins Librium and Valium, it was safer than
barbiturates. As an added bonus, Halcion did not linger in the
body the way most of its predecessors did, and therefore it did
not leave people groggy the next day. Within a few years, the
drug, produced by Upjohn of Kalamazoo, Mich., became the most
prescribed sleeping pill in the world. In 1990 American
pharmacists filled more than 7 million orders. Satisfied
customers include Secretary of State James Baker, who finds
Halcion handy on long plane trips. "Time for a blue bomb," he
sometimes announces before naps, referring to the color of a
0.25-mg Halcion pill.

    Like most drugs, however, Halcion has a dark side after
all. In the mid-1980s, the U.S. Food and Drug Administration
began receiving more and more reports of side effects from the
drug -- everything from amnesia to agitation. The increase
could be explained by the rising number of people taking
Halcion, but the drug got some bad publicity when a Utah woman
killed her mother while on Halcion and sued the manufacturer.
Upjohn settled the case out of court, all the while denying that
the drug was to blame for the murder.

    Now Halcion is facing its most serious challenge yet. Last
week the British Department of Health banned sales of the drug
in Britain, citing new evidence that the pill "is associated
with a much higher frequency of side effects, particularly
memory loss and depression," than similar medications. Soon
afterward, the FDA promised to take a much closer look at the
drug.

    Already the British ban is proving just as controversial
as the drug. Many researchers contend that the media have
exaggerated Halcion's dangers. "This is sensationalism at its
worst," says Dr. James Walsh, president of the American Sleep
Disorders Association. "There is no scientific justification for
this action." But at least a few scientists believe Halcion
should be banned in the U.S. "It's clear that this is a
dangerous drug," says Dr. Anthony Kales of the Pennsylvania
State University College of Medicine.

    Halcion acts on the brain's limbic system, which plays a
major role in the genesis of sleep and the emotions. Because it
lasts in the body only a matter of hours, it can trigger a
boomerang effect, unleashing the very anxiety it was meant to
tame. Adverse reactions become more common the higher the dose.
Doses of as much as 1.0 mg were once prescribed in Europe, but
the recommended dose is now only 0.25 mg. In most cases where
Halcion has allegedly been linked to violent behavior, the
people took more than is deemed safe, had been drinking alcohol,
or had been on the drug for a long period of time.

    Physicians cannot prevent patients from taking more
tablets than instructed. But following all the publicity about
the abuse of Valium in years past, doctors should be more alert
to the dangers of overreliance on tranquilizers and sleeping
pills. Even if the FDA does not find the evidence against
Halcion strong enough to ban the drug, it should be used less
cavalierly.

    By Christine Gorman. Reported by William Mader/London and
Andrew Purvis/New York