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Is the most widely used herbal supplement a real threat?

Kratom, which is a plant-derived supplement, is growing in popularity. A new report provides further evidence of its adverse effects and calls for more research. Historically, manual laborers in Southeast Asia have used the compound — either chewing the leaves or making them into tea — to soothe aches and pains and boost energy levels. It is most commonly available in the form of a green powdered supplement. Although manufacturers market kratom extract as safe and natural, it is far from inert. Scientists have carried out limited studies on its effects, but it appears to act as a stimulant at lower doses and has a sedative effect at higher doses. Over recent years, usage in the U.S. has increased sharply. The researchers took data from between January 1, 2011, and July 31, 2018. In total, they identified 2,312 reports that mentioned kratom exposure. The data describe a worrying trend: In the whole of 2011, there were 18 exposures, but, in just the first 7 months of 2018, there were 357 exposures. More than half of the events (56.5%) involved taking kratom as a powder, capsule, or tablet, with 86.2% of users taking kratom orally. In four cases, the reports listed kratom as either a contributing factor or a cause of death. In two of these cases, the reports identified kratom alone; in the other two cases, additional compounds played a role. Although kratom is less potent than other opioids, it can still have significant negative effects on the body. "In larger doses, it can cause slowed breathing and sedation, meaning that patients can develop the same toxicity they would if using another opioid product. It is also reported to cause seizures and liver toxicity." Says, lead author Prof. William Eggleston. (Source: www.medicalnewstoday.com)

New drug to keep acute migraine at bay

Many people with acute migraine rely on triptans, a class of drugs that have been in use since the 1990s. However, triptans do not help everyone, and some people cannot take them because of their adverse side effects. The drug in the study, rimegepant, belongs to a new generation called gepants, which work in a different way than triptans. Gepants stop head pain by blocking the receptor for calcitonin gene-related peptide (CGRP), a small protein that the body releases during migraine episodes. Studies were conducted on the same. The results showed that 19.6% of those who took rimegepant tablets had no pain after 2 hours compared with only 12.0% of those who took placebo tablets. The investigators note that this difference is statistically significant, meaning that it was highly unlikely to be due to chance.

In addition, 37.6% of the participants in the rimegepant group experienced relief from their "most bothersome symptom" 2 hours after taking their tablet compared with 25.2% of those in the placebo group. The most common side effects were nausea and urinary tract infection. The investigators observed no adverse cardiovascular effects. "These results confirm that rimegepant's mechanism of action — blocking the CGRP pathway — effectively relieves pain and associated symptoms that occur during acute migraine attacks," Dr. Lipton concludes. Biohaven Pharmaceuticals, the developers of rimegepant, sponsored the trial. They are waiting for the Food and Drug Administration (FDA) to approve the drug for the treatment of acute migraine. "As someone who has studied CGRP blockers for more than a decade, I'm gratified to see their benefits confirmed in a large-scale clinical trial.", says Dr. Richard B. Lipton.

(Source: www.medicalnewstoday.com)