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Could Long-Term PPI Use Lead to Dependency?

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Proton Pump Inhibitors (PPIs), a class of stomach acid-reducing drugs that includes Prilosec, Prevacid, Nexium and Protonix, could lead to dependency if taken at prescription strength over an extended period of time, according to a new study conducted by researchers at Copenhagen University.

According to Medicinenet.com, the researchers theorized that this “rebound”  effect was likely a response to the acid suppression caused by Nexium that  resulted in an overproduction of the stomach acid-stimulating hormone gastrin.    The effect  likely lasts between four weeks and three months, they said.  

Despite this effect, the researchers said that the benefits of PPIs outweigh the risks for those who need them.  However, according to Medicinenet.com, they expressed concern that the drugs are being overprescribed, and said doctors need to be more selective about how PPIs are prescribed.

According to a report on Medicinenet.com, the Copenhagen University found that healthy adults without symptoms of acid reflux who took PPIs developed symptoms of the disorder when they stopped taking them after 8 weeks.  Their study, which was published in the journal Gastroenterology, involved 120 healthy adults.  According to Medicinenet.com, half of the subjects took 40 milligram doses of Nexium for 8 weeks, and a placebo for the final four weeks of the trial.  The other half took a placebo for the entire 12 weeks.

At the beginning of the trial, participants in both groups reported similar gastrointestinal  symptoms.  But in weeks 9 through 12, 44% of those who had been taking Nexium reported increased symptoms, while in the placebo-only group, only 15% reported increased symptoms. By the end of the 12 week trial, despite being off Nexium for four weeks, 22% of those in that group still reported symptoms, while less than 2% in the placebo only group were reporting similar symptoms.

According to the researchers, all study participants did report that symptoms had stopped three months after Nexium treatment had ended.

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