When medical treatment brings on disease: iatrogenic disorders

Those who have lasting dysfunctions after taking finasteride or dutasteride are not the only ones whose lives have been altered for the worse because of a medical treatment. This post summarizes diseases and conditions that may arise from medical treatments: five in dermatology, four in psychiatry and one in general medicine.

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Every treatment has been approved by FDA—although some have had warnings and restrictions added after initial approval (e.g., isotretinoin and fluoroquinolones). Many doctors believe they are safe and effective, and some patients have found them effective and tolerable. The safety of some treatments remains a subject of debate among doctors and researchers.

This website does not take an absolutist position against these treatments; rather, it advocates for:

• informed consent of the patient;
• medical advice in the best interest of the patient and free of industry influence;
• respect for the dignity of the patient; and
• research free of industry influence.

Common threads

Although these treatments have different mechanisms and treat different conditions, there are many commonalities in the experience of those harmed by them, including:

Prior to treatment:

• Lack of informed consent: patients were not fully informed of the risks of treatment before it was offered;
• Inflated expectations due to physician advice and marketing;
• Incomplete or unavailable information about harms.

During and after treatment:

• Denial, discounting or deflection of adverse effects when reported. Contributing factors include preference for official medical knowledge over individual experience; physician distaste for ambiguity or the unfamiliar; and fear of liability. Some physicians will readily toss unwelcome complaints into the wastebasket of “psychological problems.”
• Lack of awareness of new regulatory warnings or product recalls;
• Loss of trust in medicine; demoralization; isolation.

Systemic problems:

• Biases in clinical trials and medical literature, including publication bias and investigator bias in detection and characterization of adverse effects;
• Lack of funding for research on treatment-emergent diseases and conditions;
• Gaps in regulation of medical devices (see 2011 IOM report).

Treatment-emergent (iatrogenic) diseases and conditions