This is a good find. I don't see why because it's from 1986 makes it a bad study . The year doesn't matter. i think it's a good study / experiment and it confirms what i myself theorized why not more than 30 mg meto.
i guess i can always test it myself and see how i tolerate 30 mg Meto first and than if that goes good i could try to test 40mg and see how it goes of course i won't try SN then just maybe a half teaspoon of regular salt. i already take a half teaspoon of regular salt as that is a needed electrolyte and also good practice for me for SN.
Also what you say about meto is also true that it empties the stomach quicker so it speeds up helps the absorption of SN.
The year doesn't matter: Watson and Crick's research in 1953 discovered the Structure of DNA "they found the secret of life" . so do we say that's old research because it's from 1953 ? No that's one of the greatest discoveries in the history of the world.
Medical historian Dr. Howard Markel revisits moments that changed the course of modern medicine. The place: The Eagle, a genial pub and favorite luncheon spot for the staff, students and researchers working at the University of Cambridge's old Cavendish laboratory on nearby Free School Lane. The...
www.pbs.org
Likewise imo Charles Darvwin discovered the theory of evolution in 1859 in the book the origin of species. That's not old but the greatest discovery imo . It tells me what a human is ,where did i originate, what am i, what is life and how did life originate. Both of these studies/experiments/conclusions have stood the test of time and are the truth and are imo the 2 greatest discoveries of all time.
en.wikipedia.org
i guess i can always test it myself and see how i tolerate 30 mg first and than if that goes good i could try to test 40mg and see how it goes of course i won't try SN then just maybe a half teaspoon of regular salt. i already take a half teaspoon of regular salt as that is a needed electrolyte and also good practice for me for SN.
manoa.hawaii.edu
Many popular restaurant foods are high in sodium, along with grocery items you might not expect, like bread and canned vegetables.
www.getroman.com
We can keep going back in time, Newton's Principia in 1687 and so on . the year doesn't matter.
Respectfully, I disagree.
The year
does matter when it comes to drug studies. The discovery of DNA, antibiotics, gravity, the theory of evolution, etc., are far different than what appears to be a very small dose-finding study for an antiemetic regimen in cancer patients conducted 30+ years ago.
This study may well have been a building block for future research in antiemetic regimens for nausea and vomiting in cancer patients
at the time it was conducted and with the medications they had available at the time; however, in the 30+ years since this study was conducted much more research has been done and new medications have become available to ameliorate nausea and vomiting in cancer patients. One such medication is Zofran (ondansetron), which was approved in 1991.
In my original post I only discussed the main issues I had with the study, the most important of which was that there is no way to tell if a 50 mg dose of meto will or will not be more beneficial than other dose regimens discussed to date, because the results of the study are actually based on a total staggered dose of 150 mg meto (not 50 mg), with 100 mg administered hours after the chemotherapy - which, with SN would not be possible.
Some other potential issues I had with the study aside from those already described:
~The sample size was relatively small in the B arm of the study (25 patients), which would preclude drawing any definitive conclusions based on this study.
~Some may or may not have received prednisone in addition to meto, which may also aid in amelioration of nausea/vomiting so results of this study may have been confonded by concomitant prednisone use.
~They did not describe the patient population well enough -eg, what type and stage of cancer, age, concomitant medication use, BMI, etc.
~I am not sure how they measured nausea as this is a totally subjective experience and has the potential to bias the results based solely on this subjectivity.
~They did not describe the timing around how they measured the incidence of vomiting which would be a more objective measure of efficacy - for example, was it measured immediately during or after administration of chemotherapy, 24-hours post dose, 1-week post dose, etc.
~There were no specific lists of serious or severe adverse events in order to actually see what was reported by these patients. Tardive dyskinesia, a late-onset extrapyramidal reaction, is a potential severe side effect of meto use so it might be a good idea to see if there are increased reports of this adverse effect with an increased dose of meto. In cancer patients who have no other recourse to ameliorate nausea and vomiting, this may have been considered an acceptable risk
at that time. A study conducted 3 years later concluded that: "the combination of dexamethasone and lorazepam can give major control of emesis in 25% of patients receiving very emetogenic chemotherapy. The addition of metoclopramide increases this to 67% on first exposure to chemotherapy, but at the expense of extrapyramidal reactions in 11.5%."
Br J Cancer. 1989 Nov; 60(5): 759–763. doi:
10.1038/bjc.1989.354. And please do not use this study as a valid source, as I have some of the same concerns with this study as with the one the OP posted.
~There were no reports of other concomitant medications that may have contributed to anti-nausea effects.
All in all, this study has many potentially confounding factors, which is why I wrote that
"Personally, I" would be very careful extropolating information from this study.
Also, on edit, I do not think it is accurate to say it poses no adverse effects. Meto at regular doses is know to cause adverse effects when used for any indication. So it is very unlikely that there were no adverse effects.