Drugging in the Dark
https://jamanetwork.com/journals/jama/fullarticle/2847334
Such is the practice complained of by a correspondent of a contemporary, who finds that many physicians administer medicines in what seems to be a reckless and unscientific manner,—“Strychnine, arsenic, digitalis and aconite, are favorite remedies in all sorts of diseases.” Used in this connection, we may very well object to the word remedies; in other respects we must agree with the complainant, adding that in America quinine seems to hold a high place in the list of drugs that are prescribed when there is some little doubt as to the diagnosis. “Pills and mixtures containing many poisonous drugs are commonly prescribed, even when the practitioner is quite in the dark as to what the cause of the disease may be. With some, the rule is, when the cause is unknown, to mix a great many poisonous stuffs, in the hope that one of them may hit the enemy. A wiser and safer course would be, when the diagnosis is uncertain, to give, in the name of remedy, something that cannot possibly injure the patient.”
https://jamanetwork.com/journals/jama/fullarticle/2847334
Such is the practice complained of by a correspondent of a contemporary, who finds that many physicians administer medicines in what seems to be a reckless and unscientific manner,—“Strychnine, arsenic, digitalis and aconite, are favorite remedies in all sorts of diseases.” Used in this connection, we may very well object to the word remedies; in other respects we must agree with the complainant, adding that in America quinine seems to hold a high place in the list of drugs that are prescribed when there is some little doubt as to the diagnosis. “Pills and mixtures containing many poisonous drugs are commonly prescribed, even when the practitioner is quite in the dark as to what the cause of the disease may be. With some, the rule is, when the cause is unknown, to mix a great many poisonous stuffs, in the hope that one of them may hit the enemy. A wiser and safer course would be, when the diagnosis is uncertain, to give, in the name of remedy, something that cannot possibly injure the patient.”
Audio Highlights April 3, 2026
https://jamanetwork.com/journals/jama/fullarticle/2847562
Listen to the JAMA Editor’s Summary for an overview and discussion of the important articles appearing in JAMA.
https://jamanetwork.com/journals/jama/fullarticle/2847562
Listen to the JAMA Editor’s Summary for an overview and discussion of the important articles appearing in JAMA.
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FDA Approves Higher Dose Injectable Semaglutide
https://jamanetwork.com/journals/jama/fullarticle/2847412
The US Food and Drug Administration (FDA) approved a higher-dose version of weekly injectable semaglutide, marketed as Wegovy HD, for adults with obesity or overweight with at least 1 weight-related condition.
https://jamanetwork.com/journals/jama/fullarticle/2847412
The US Food and Drug Administration (FDA) approved a higher-dose version of weekly injectable semaglutide, marketed as Wegovy HD, for adults with obesity or overweight with at least 1 weight-related condition.
Premature Menopause Linked With Higher Heart Attack Risk
https://jamanetwork.com/journals/jama/fullarticle/2847411
Premature menopause was associated with a 40% higher lifetime risk of coronary heart disease, according to a study published in JAMA Cardiology.
https://jamanetwork.com/journals/jama/fullarticle/2847411
Premature menopause was associated with a 40% higher lifetime risk of coronary heart disease, according to a study published in JAMA Cardiology.
US COVID-19 Deaths May Have Been Underreported, Study Finds
https://jamanetwork.com/journals/jama/fullarticle/2847410
COVID-19 may have caused about 19% more deaths in the US from March 2020 to December 2021 than officially recorded, a new study suggests.
https://jamanetwork.com/journals/jama/fullarticle/2847410
COVID-19 may have caused about 19% more deaths in the US from March 2020 to December 2021 than officially recorded, a new study suggests.
Interstitial Lung Disease as a Late Occurrence in Ocrelizumab-Treated Patients With Multiple Sclerosis
https://jamanetwork.com/journals/jamaneurology/fullarticle/2847194
This case series describes 6 cases of interstitial lung disease among patients with multiple sclerosis receiving long-term treatment with ocrelizumab.
https://jamanetwork.com/journals/jamaneurology/fullarticle/2847194
This case series describes 6 cases of interstitial lung disease among patients with multiple sclerosis receiving long-term treatment with ocrelizumab.
Teleneurology vs On-Site Neurology Consultation for Postadmission Hospital Care of Stroke
https://jamanetwork.com/journals/jamaneurology/fullarticle/2847193
This study assesses the noninferiority of teleneurological ward rounds compared with conventional on-site ward rounds during subacute inpatient stroke care, focusing on adherence to guideline-based quality indicators.
https://jamanetwork.com/journals/jamaneurology/fullarticle/2847193
This study assesses the noninferiority of teleneurological ward rounds compared with conventional on-site ward rounds during subacute inpatient stroke care, focusing on adherence to guideline-based quality indicators.
Advancing Precision Dementia Care With Genetic-Exposome Risk Assessment
https://jamanetwork.com/journals/jamaneurology/fullarticle/2847192
This Viewpoint advocates for an integrated genetic-exposome risk assessment framework for early identification and targeted treatment of Alzheimer disease.
https://jamanetwork.com/journals/jamaneurology/fullarticle/2847192
This Viewpoint advocates for an integrated genetic-exposome risk assessment framework for early identification and targeted treatment of Alzheimer disease.
Navigating Thyroid Hormone Deprescribing in Older Adults
https://jamanetwork.com/journals/jama/fullarticle/2847287
Thyroid hormone medication use is common, with levothyroxine ranking among the 3 most commonly dispensed medications in the US and Europe. Older age is an independent predictor of thyroid hormone initiation. Up to 60% of adults are prescribed levothyroxine for subclinical hypothyroidism (defined as having an elevated thyrotropin [TSH] level and a free thyroxine level within the reference range) or for non–evidence-based indications and generally continue treatment lifelong. Widespread prescribing of levothyroxine and levothyroxine use occur despite 61% of patients with subclinical hypothyroidism spontaneously reverting to euthyroidism and high-certainty evidence failing to demonstrate a benefit from subclinical hypothyroidism treatment. Furthermore, thyroid hormone therapy is associated with increased patient burden and health care expenditures and places patients at risk for iatrogenic thyrotoxicosis (increases the risk for cardiovascular, skeletal, and cognitive adverse effects). Although initiatives exist to prevent the initiation of potentially inappropriate medications in older adults, few have targeted deprescribing, which is the systematic and supervised process of safely reducing or discontinuing a medication.
https://jamanetwork.com/journals/jama/fullarticle/2847287
Thyroid hormone medication use is common, with levothyroxine ranking among the 3 most commonly dispensed medications in the US and Europe. Older age is an independent predictor of thyroid hormone initiation. Up to 60% of adults are prescribed levothyroxine for subclinical hypothyroidism (defined as having an elevated thyrotropin [TSH] level and a free thyroxine level within the reference range) or for non–evidence-based indications and generally continue treatment lifelong. Widespread prescribing of levothyroxine and levothyroxine use occur despite 61% of patients with subclinical hypothyroidism spontaneously reverting to euthyroidism and high-certainty evidence failing to demonstrate a benefit from subclinical hypothyroidism treatment. Furthermore, thyroid hormone therapy is associated with increased patient burden and health care expenditures and places patients at risk for iatrogenic thyrotoxicosis (increases the risk for cardiovascular, skeletal, and cognitive adverse effects). Although initiatives exist to prevent the initiation of potentially inappropriate medications in older adults, few have targeted deprescribing, which is the systematic and supervised process of safely reducing or discontinuing a medication.
Manufacturer-Sponsored Coupon Use and Brand-Name Drug Costs Among Patients With Insurance
https://jamanetwork.com/journals/jama/fullarticle/2847286
This descriptive analysis study examines trends in manufacturer-sponsored coupon use, coupon amounts, and patient out-of-pocket spending among patients with commercial insurance.
https://jamanetwork.com/journals/jama/fullarticle/2847286
This descriptive analysis study examines trends in manufacturer-sponsored coupon use, coupon amounts, and patient out-of-pocket spending among patients with commercial insurance.
Insulin Copay Caps—Impacts Beyond Costs
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2847538
Health Care Policy
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2847538
Health Care Policy
Self-Selection for Medication Abortion Using a Prototype Drug Facts Label
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2847536
This diagnostic study examines whether patients seeking an abortion could accurately self-select their eligibility to use over-the-counter (OTC) medication abortion by using a prototype OTC package and drug facts label.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2847536
This diagnostic study examines whether patients seeking an abortion could accurately self-select their eligibility to use over-the-counter (OTC) medication abortion by using a prototype OTC package and drug facts label.
Optimizing Food-Is-Medicine Programs for High Blood Pressure
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2847535
To the Editor We read with interest the Healthy Food First randomized trial by Berkowitz et al examining the comparative effectiveness of food-is-medicine interventions to address food insecurity and improve blood pressure. The authors implemented 2 pragmatic interventions, a home-delivered food box and a restricted groceries stipend, with a view to practical implementation through payer support. Both demonstrated improved blood pressure, but, contrary to the authors’ expectations, the stipend lowered systolic blood pressure more than the food box, and blood pressure change was modest despite striking improvements in food security. These findings highlight 2 lessons for future food-is-medicine initiatives targeting food insecurity beyond inadequate calorie intake: the quality and precision of the groceries provided and the importance of choice to promote uptake.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2847535
To the Editor We read with interest the Healthy Food First randomized trial by Berkowitz et al examining the comparative effectiveness of food-is-medicine interventions to address food insecurity and improve blood pressure. The authors implemented 2 pragmatic interventions, a home-delivered food box and a restricted groceries stipend, with a view to practical implementation through payer support. Both demonstrated improved blood pressure, but, contrary to the authors’ expectations, the stipend lowered systolic blood pressure more than the food box, and blood pressure change was modest despite striking improvements in food security. These findings highlight 2 lessons for future food-is-medicine initiatives targeting food insecurity beyond inadequate calorie intake: the quality and precision of the groceries provided and the importance of choice to promote uptake.
Optimizing Food-Is-Medicine Programs for High Blood Pressure—Reply
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2847534
In Reply We appreciate the thoughtful Letter from Gao et al regarding the Healthy Food First randomized trial. Moreover, we appreciate the important contributions the Letter authors have made to the field of food-is-medicine research, exemplified by their own recent randomized trial. Overall, we completely agree that food-is-medicine studies should (1) provide food resources with a clear biological mechanism for improving health outcomes, (2) incorporate behavioral science knowledge to promote high engagement, (3) maximally incorporate individual preferences regarding diet selection, and (4) be carefully attuned to potential indignities in intervention approaches.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2847534
In Reply We appreciate the thoughtful Letter from Gao et al regarding the Healthy Food First randomized trial. Moreover, we appreciate the important contributions the Letter authors have made to the field of food-is-medicine research, exemplified by their own recent randomized trial. Overall, we completely agree that food-is-medicine studies should (1) provide food resources with a clear biological mechanism for improving health outcomes, (2) incorporate behavioral science knowledge to promote high engagement, (3) maximally incorporate individual preferences regarding diet selection, and (4) be carefully attuned to potential indignities in intervention approaches.