Talk:Zolpidem

message: *I think we as editors would be negligent and doing a disservice and could cause real life harm to our readers if we were to withhold potentially lethal side effects from this article. I do not support the vague summary of the source as ‘zolpidem can cause death’ that Declan supports. Instead, I think we should summarise the Kripke source as follows: Zolpidem can increase the risk of depression, infection, poor driving, suppressed respiration which can be serious and potentially lethal side effects.[ref Kripke 2016]
*This will have the effect that our readers will have information of life threatening side effects that they can identify and discuss with their family physician. Depression, infection in immune compromised people, poor driving are serious shit side effects, which nobody disputes can result in death. Of course most people do not experience such problems and take the medication without incident but there will always be that small sensitive percentage.
*I don’t care that he has a website warning the public of certain side effects, all that says to me is he has a conscience, compassion, empathy and basically wants to be a doctor - improve people’s well-being. Our articles are full of references to papers written by people receiving financial rewards from pharmaceutical companies, which is a real COI issue but if we were to ban such papers we would lose valuable information.--Literaturegeek | T@1k? 00:45, 21 August 2018 (UTC)
replies: text: Literaturegeek, I agree with your comment completely. To clarify, I don't think my initial edits adding several secondary sources to the "Adverse" section are the only/best way to mention these articles. I do think they are better than no mention of the articles, which is why I reverted their complete deletion. But your proposal is even better! Declanscottp (talk) 00:50, 21 August 2018 (UTC)

text: A pile of primary sources has no value in WP.  None. Zero. The fact remains that we have nothing but Kripke approaching a MEDRS ref on this (one, precisely one), and Kripke is Kripke. Jytdog (talk) 01:03, 29 August 2018 (UTC)
replies: text: I think the point is that Kripke is not misrepresenting the weight of the available scientific evidence contained in primary research in his review. I accept that causation is not proven, but is strongly suggestive which is why I favour including it in the research section for now.--Literaturegeek | T@1k? 21:45, 29 August 2018 (UTC)
replies: text: LG, I concur with both of your points and your suggestion of research section with a downward link, though as a compromise, not as what I think is best. "Kripke is Kripke"=unwarranted and unsupported ad hominem. Declanscottp (talk) 22:37, 29 August 2018 (UTC)

text: so the question is, given that a) we have precisely one MEDRS-like source about increased mortality; b) that piece is authored by self-disclosed activist against these drugs, how much WEIGHT do we give his paper?  Note his other main headers (after he deals with mortality): "Hypnotics can cause serious and potentially lethal infections", "Hypnotics are associated with increased cancer", "Hypnotics increase incidence of clinical depression", "Automobile crashes, falls, and other accidents are associated with hypnotics", "Safe doses of hypnotics for target populations are unknown", "Contributory factors combined with hypnotics could cause covert deaths" (note the discussion of Scalia'a death, omg), "Hypnotics cause withdrawal insomnia, anxiety, panic, and epilepsy".   This is so far out there compared to the rest of literature, and the drug labels (despite his claims about what "the FDA" says.)  The journal is a ... dicey as well - see Faculty_of_1000#F1000Research. I am very hesitant here. Jytdog (talk) 02:26, 30 August 2018 (UTC)
replies: text: A classic WP:REDFLAG case. Weight given should be zero or very little. Alexbrn (talk) 06:06, 30 August 2018 (UTC)
replies: text: I agree that weight given should be little, which is why I am leaning towards placing the text in the research section.--Literaturegeek | T@1k? 19:57, 30 August 2018 (UTC)
replies: text: I didn't put "little", but "zero or very little". That would be achieved by omitting it entirely, or maybe just having a link under further reading at most. Any sort of body text would probably be a bit much I think. Alexbrn (talk) 20:18, 30 August 2018 (UTC)
replies: text: Ok fair enough. I don’t agree with zero body text because multiple mainstream sources have studied this area and almost all of this primary research by multiple experts agrees that this group of drugs increase mortality. Therefore, there is no evidence that Kripke is misrepresenting the scientific evidence in primary sources in his MEDRS secondary source. REDFLAG is more for POV pushing secondary sources that make wild FRINGE and/or pseudoscientific claims that have little underlying support primary or otherwise.--Literaturegeek | T@1k? 20:30, 30 August 2018 (UTC)
replies: text: FRINGE includes exaggerated claims of efficacy or harm.   Again there is one MEDRSish source that makes this global mortality claim. One. Not "multiple".  It is not our place to evaluate the primary literature. (I will say, that you seem impressed by the big long list. I encourage you to actually review them, if you are, since this seems to be getting important to you on some level outside the boundaries of what we do here.  #40, PMID 1569439, doesn't even mention this drug. I have no idea how many of the others do, nor what they actually say about mortality.  Not my job here, and most importantly, not my place here.)   Jytdog (talk) 23:34, 30 August 2018 (UTC)
replies: text: It is a valid point that we do not know for sure - without another MEDRS source(s) by different authors becoming available - whether Kripke has allowed bias to creep into his review. I have reviewed the long list of sources and my thoughts are: yes, some of the sources are not specific to zolpidem but rather GABAergic hypnotics in general and a couple of the sources find no link to hypnotics increasing mortality. Certainly the evidence is not suffice to include the single MEDRS source in the adverse effects section and I now am opposed to including a downward link to the research section because this mortality issue is an important area of ‘active research’, it is not ‘settled science’ so has no business in the adverse effects section of the article. I should say I have never taken the drug zolpidem and I don’t know anyone in my personal life or otherwise who has had their life shortened by zolpidem, so I do not have an axe to grind on this mortality issue. If we can’t find consensus I will just let the subject drop and move onto other articles. I feel this conversation is coming to an end soon as everybody has heard each other’s points of view. And I feel valid points have been made by everybody which is why finding consensus has been and is difficult for this issue. Is there any carefully worded and WEIGHTed text that you could agree to for the research section, jytdog?--Literaturegeek | T@1k? 01:52, 31 August 2018 (UTC)

text: Yeah, but why not tag in the findings of his MEDRS review? Since your proposed block of text suggests he is a bit of an alarmist that means our readers can see that he might have a degree of bias in his research and look at it in context.--Literaturegeek | T@1k? 08:53, 31 August 2018 (UTC)
replies: text: The reason is, that in the context of the proposed content above, his review paper becomes a primary source, and I avoid using them.Jytdog (talk) 19:56, 9 September 2018 (UTC)
replies: text: Nah, because you can’t use a source dated to 2004 and another to 2012 to debunk a more recent 2016 review article. That would be poor editing. Also, you have not summarised the 2004 source fairly, the New York Times clearly states the person stating that ‘Kripke is about the only person to hold these views’ is a consultant for the pharmaceutical company who manufactures the drugs, but like I say it is too old of a source to discredit a 2016 review paper. The 2012 article, an expert is quoted as saying that Kripke’s research ‘certainly raises a red flag (about possible increased mortality) but it does not prove sleeping pills are the cause,’ but your summary of the source paints Kripke to be a crank with no mainstream support. The reality of course is that many experts have published primary research and the majority reach similar findings as Kripke (that hypnotics are associated with increased mortality, cancer, etc). Really I can’t see consensus forming on this Kripke and mortality issue and wonder should we all just leave this as ‘no concensus’ and wait for another MEDRS source to be published?--Literaturegeek | T@1k? 20:24, 9 September 2018 (UTC)
thread_title: Mortality

message: In 2018, comedian Roseanne Barr faced controversy for tweets that were criticized as being racist. Barr defended her actions by saying that she had made her statement under the influence of Zolpidem. Zolpidem responded by claiming that racism is not a known side effect of this medication. Is this claim notable enough to be included in this article, and if so, is it a medical claim that requires further research? To my knowledge, there is not a clinical study disproving a link between Zolpidem and racism. The FDA approved label of Zolpidem states that patients may suffer "impaired inhibition" (page 3).  --Xwedodah (talk) 04:32, 9 November 2021 (UTC)
thread_title:  Racism as a side effect