Canadian Family Physician Journal Withdraws Recommendation Of Morning Sickness Pill

The medical journal no longer recommends Diclectin as the go-to drug for expectant mothers, after the guidelines put in place by Motherisk were called into question

Recommendation for the morning sickness drug Diclectin has been withdrawn by the Canadian Family Physician medical journal.

In the paper, it emphatically renounces the popular medication as the first-line treatment for pregnant women and cites the work of the Toronto doctor who called into question the efficacy of the drug earlier in the month. 

Diclectin is the only prescription drug authorized by Health Canada to treat nausea and vomiting in pregnant women—but this January, Dr. Nav Persaud, a family physician at St. Michael’s hospital in Toronto, published a paper claiming that the popular medication is not backed by good evidence

The Canadian Family Physician also stated in the paper that the journal's previous clinical guidelines, which advocated the use of Diclectin, were developed by Motherisk—Sick Kids' much beleaguered clinical research program—which had financial ties to the drug company that makes the medication. 

"In 2015 the guidelines for the management of nausea and vomiting in pregnancy (NVP) developed by Motherisk and endorsed and published by the Society of Obstetricians and Gynaecologists of Canada, recommendations from which were published previously in the pages of Canadian Family Physician (CFP), came under critical scrutiny," the journal read.

It went on to say that despite consistently endorsing the use of Diclectin, the work by Persaud and colleagues has revealed that the drug is no more effective than Vitamin B alone. 

Although recent studies find no connection between Diclectin and malformations and suggest that the risk of childhood malignancies still remains small, the original analysis has been reported as flawed and its conclusions wrong.

So what does this mean for the popular morning sickness drug?

Given the lack of evidence that Diclectin is more effective than commonly available vitamins, the journal suggests that Pyridoxine (Vitamin B) could now be considered as first-line therapy for patients.

But the second conclusion the CFP draws is perhaps more troubling. The Canadian Family Physician ended its long-standing relationship with Motherisk back in 2015 on the basis of their questionable reputation. The journal claimed that going forward, it will only work with institutions or organizations that serve the needs of family physicians and their patients. 

"This episode is a clear lesson that we must do so with greater scrutiny, with more formal agreements, and only with those that do not have any ties to industry or other entities that would create, or even appear to create, information or guidelines that have a purpose other than clear and science-based benefit to patients in our care."

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