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Similitude and Rebound Effect of Drugs

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Similitude and Rebound Effect of Drugs son, that its exact opposite, when, as has been observed, there is actually such a thing, is produced in the secondary action Similitude and Rebound by our vital force”. Effect of Drugs (Organon of Medicine, paragraph 65) Based on this postulate or “natural law”, homeopathy makes use of the secondary Scientific Evidence and action of the organism as a therapeutic reaction, and prescribes to ill individuals Therapeutic Application medicines that cause symptoms similar to the disorders they themselves cause (prin- ciple of therapeutic similitude), thus stimu- Marcus Zulian Teixeira, Brazil lating the organism to react against its own disease. In Ancient Greece, Hippocrates classically moted alterations in the different systems taught that there were two approaches to of the human body, and the following sec- Although little was divulged by modern PHILOSOPHY AND DISCUSSION the treatment of disease, namely the princi- ondary action of the organism (vital reaction pharmacology, since it opposes convention- ple of contraries and the principle of simi- or conservation force). The latter acts by al treatment, this same secondary action or lars. Treatment according to the principle neutralising the primary disorders caused homeostatic reaction of the organism has of contraries employs drugs that act con- by drugs, in an attempt to maintain the bal- been observed with the use of several types trary to or by palliating (“anti-”)thesymp- ance of the internal milieu or homeostasis: of modern palliative (antipathic or enantio- toms of the disease (e.g., anti-inflammato- pathic) drugs as a rebound effect or para- ries, antacids, antidepressants, etc.). This is “[…] Excessive vivacity follows the use of doxical reaction of the organism.Wehave the main approach to treatment applied by strong coffee (primary action), but slug- been systematically studying for the last fif- conventional medicine, also known as “al- gishness and drowsiness remain for a long teen years the rebound effect of modern lopathy”. Treatment according to the prin- time afterwards (reaction, secondary ac- drugs, and thus we were able to confirm by ciple of similars is used by homeopathy, tion), if this be not always again removed means of scientific evidence both Hahne- and it employs medicines that cause symp- for a short time by imbibing fresh supplies mannʼs postulate (a drug primary action is toms similars (“homeo”)tothesymptoms of coffee (palliative). After the profound followed by the secondary and opposite re- of the disease (e.g., coffee causes insomnia, stupefied sleep caused by opium (primary action of the organism) and the homeo- and is homeopathically used to treat in- action), the following night will be all the pathic principle of healing [1–11]. somnia; chamomile causes colic, and is ho- more sleepless (reaction, secondary ac- meopathically used to treat colic; belladon- tion). After the constipation produced by To illustrate: drugs classically used in the na causes fever, and is homeopathically opium (primary action), diarrhoea ensues treatment of angina pectoris (β-blockers, used to treat fever, etc.). (secondary action); and after purgation calcium channel blockers, nitrates, etc.) with medicines that irritate the bowels, with beneficial effects in their primary ef- Upon founding homeopathy in 1796, Sa- constipation of several daysʼ duration en- fect (anti-angina), might awaken a para- muel Hahnemann grounded this homeo- sues (secondary action). And in like manner doxical increase of the frequency and inten- pathic therapeutic principle on the careful it always happens, after the primary action sity of chest pain after discontinuation or observation of the drugs used in his time of a medicine that produces in large doses a irregular use of doses, which sometimes on the human body, and postulated a uni- great change in the health of a healthy per- does not respond to any therapeutic means. versal “mechanism of action of drugs”: SUMMARY “Every agent that acts upon the vitality, every medicine, deranges more or less the vital force, and causes a certain alteration Samuel Hahnemann systematised the homeopathic model and the effects This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited. in the health of the individual for a longer of drugs on the state of human health, describing a primary action of the or a shorter period. This is termed primary drugs followed by a secondary and opposite action of the organism. In action.[…]. To its action our vital force en- modern pharmacology, this secondary action is known as the rebound ef- deavours to oppose its own energy. This re- fect or paradoxical reaction of the organism, being described after the dis- sistant action is a property, is indeed an au- continuation of several classes of palliative (enantiopathic) drugs, i.e., those tomatic action of our life-preserving power, that act according to the principle of contrary (contraria contrariis curentur). which goes by the name of secondary ac- Besides being able to cause severe and fatal iatrogenic events when appear- tion or counteraction”. ing after the palliative use of modern drugs, the rebound effect might awaken a healing reaction if the very same drugs involved were employed (Organon of Medicine, paragraph 63) according to the principle of similitude (similia similibus curentur). To illustrate this natural phenomenon, Hah- KEYWORDS Homeopathy, Pharmacology, Adverse effect, Secondary nemann listed the primary actions of the effect, Rebound effect, Paradoxical reaction, Law of similarity medicines employed in his time that pro- Marcus Zulian Teixeira, Similitude and Rebound – Homœopathic Links Summer 2014, Vol. 27: 105–107 © Thieme Medical and Scientific Publishers Private Ltd. 105 Drugs used for the control of arterial hyper- of gastritis and gastroduodenal ulcers caemia/diabetes. Drugs that cause immu- tension (α‑2 agonists, β-blockers, ACE in- might promote, after the primary decrease nosuppression (cyclosporine, corticoids, hibitors, MAO inhibitors, nitrates, sodium of acidity, a rebound increase of the produc- immunosuppressants, etc.) might be used nitroprusside, hydralazine, etc.) might pro- tion of hydrochloric acid by the stomach, to stimulate the immune system in immu- duce rebound arterial hypertension as a eventually causing perforation of chronic nosuppressed patients. Drugs causing at- paradoxical reaction of the organism to the gastroduodenal ulcers. Bronchodilators (ad- tention/concentration disorders (amanta- primary stimulus; antiarrhythmic drugs renergic drugs, sodium chromoglycate, epi- dine, interferons, topiramate, etc.) might (adenosine, amiodarone, β-blockers, calci- nephrine, ipratropium, nedocromil, salme- be used to improve attention disorder in um channel blockers, disopyramide, flecai- terol, formoterol, etc.) used in the treatment children, and so forth. nide, lidocaine, mexiletine, moricizine, pro- of bronchial asthma may worsen bronchial cainamide, quinidine, digital, etc.) may constriction as a paradoxical response of Grounded in Hahnemannʼs premise, since awaken rebound exacerbation of basal ven- the organism to the interruption or discon- 2003 we systematically propose to employ tricular arrhythmias when treatment is in- tinuation of treatment. Drugs indicated for modern drugs according to the homeopath- terrupted. Anticoagulant drugs (argatroban, the treatment of osteoporosis (bisphospho- ic healing principle [12–16]. To allow for bezafibrate, heparin, salicylates, warfarin, nates, denosumab, odanacatib, among actual application of this proposal, a “Ho- clopidogrel, etc.), employed due to their others) can cause paradoxical atypical frac- meopathic Materia Medica of Modern primary effect in the prophylaxis of throm- tures after the biological effect (half-life) as Drugs” was compiled including all the pri- bosis, can promote thrombotic complica- a result of an increased rebound of the mary (therapeutic, adverse and side) effects PHILOSOPHY AND DISCUSSION tions as paradoxical reaction of the orga- osteoclastic activity. Immunomodulatory of 1250 “allopathic” drugs as described in nism. Drugs that have a vasculoprotector drugs (natalizumab, fingolimod, among The United States Pharmacopeia Dispensing (pleiotropic) primary effect (statins, for ex- others), used in the treatment of multiple Information (USP DI, 2004), following the ample) can wake up stroke paradoxically. sclerosis, can cause paradoxical worsening chapter structure of the traditional works of the disease when treatment is inter- on homeopathic materia medica. In the use of psychiatric drugs such as anxi- rupted. And others [1–11]. olytics (barbiturates, benzodiazepines, car- To facilitate the selection of an individual- bamates, etc.), sedative-hypnotics (barbitu- Although a rebound effect or paradoxical ised homeopathic medicine (similar to rates, benzodiazepines, morphine, prome- reaction of the organism usually occurs the totality of symptoms of the patient), thazine, zopiclone, etc.), stimulants of the in a small number of individuals as a func- which is the essential requirement for central nervous system (amphetamines, caf- tion of idiosyncrasy, its effects can be dra- safety and therapeutic success of homeo- feine, cocaine, mazindol, methylfenidate, matic (both in intensity and duration), thus pathic treatment, the next step was to elab- etc.), antidepressants (tricyclic, MAO inhib- strengthening the rationale for their use in orate a “Homeopathic Repertory of Mod- itors, serotonin reuptake inhibitors,
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