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Can You Teach an Old Drug New Tricks?

There’s a new trend in the pharmaceutical industry: repurposing old drugs for new indications and/or combining current drugs to create brand new effects.  Recent studies suggest that two drugs (Lyrica and Neurontin) approved for the treatment of neuropathic (nerve) pain may also be helpful for improving sleep quality.  And since disordered sleep is also at the root of conditions like fibromyalgia, there seems to be reason for enthusiasm.  Another study suggests that Wellbutrin (an anti-depressant often used as a smoking cessation aid) could be useful for enhancing libido.  Again, some cause for celebration – quit smoking AND improve your sex life with one pill?  Not bad.

The New York Times describes the new trend in drug combination research – robots combine random drugs to see if together they have stronger effects on tissue cultures than they do alone.  Sounds like low-brow trial and error, but companies such as CombinatoRx are betting that this approach will turn up potential therapeutic benefits at a faster rate (and at much lower costs) than the old-fashioned process of original drug research and development.

This should be handled with a healthy dose of skepticism – is combining nexium (a stomach acid reducer) and naproxen (pain medicine that can harm the stomach lining) anything more than a commercial gimmick?  What about the chance finding that anticoagulants enhance the effects of inflammation-reducing steroids?  Perhaps that is indeed relevant and helpful?

It’s clear that testing drug combinations has the potential to create a financial windfall for pharmaceutical companies – so the FDA will need to make sure that these new combo drugs offer real benefits over taking them separately.

Still, if you asked me where I’d rather put my research dollars – testing unusual drug combinations in Petri dishes or analyzing whether or not water has memory (a foundational principle of homeopathy), I think you know where I’d place my bet.

Go ahead and shuffle and re-deal, Big Pharma.  Maybe you and the FDA will uncover something useful after all?  We’ll be watching with interest and a critical eye.This post originally appeared on Dr. Val’s blog at

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