Abstract

Much media attention and public interest has been recently expressed with respect to major recalls of popular medications worldwide, the most pertinent being the rofecoxib withdrawal in 2004.1,2 Situations such as this have heightened both academic and clinical interest in the areas of medication safety and pharmacovigilance. Fortunately, not all adverse reactions warrant the removal of medications from the arsenal of therapeutic agents at our disposal – however, our increased awareness of adverse reactions allows for the identification of unique and potentially devastating effects that have not been identified in clinical trials before the medication's availability on the general market. Reports of this nature are essential to ensuring the health and wellbeing of patients, not just with respect to adverse reactions implicated with particular medications, but also for the potential of drug-drug interactions and the possible influence of pre-existing comorbidities (two very important factors with respect to complicated medical fields such as neurology). The potential impact of alcohol consumption and complimentary medicines such as St John's Wort also add new dimensions to the situation at hand.3 Unfortunately, these complicating factors may not be incredibly evident at that particular time and may only become significant as the number of case reports increases and a pattern emerges.