From Our Readers
In your article “So You Think You Have an Ulcer?” (September 8, 1982), you recommend the drug “cimetidine,” known by the brand name Tagamet, as being very effective and having very few side effects. I am a pharmacologist and have learned from several gastroenterologists here in Thailand that cimetidine does have many side effects. Since your article might influence people’s thoughts regarding drug treatment, there is a need to be careful when recommending any type of medicine. Many doctors here prefer to use antacids. Sometimes they use cimetidine only for a short period of time and then go over to antacids so as to avoid the side effects of prolonged use of the drug.
L. S., Thailand
We agree that there is no completely safe drug. Our article stated that the first type of effective medication prescribed for peptic ulcers is antacids. But many doctors believe that there are cases that respond better to cimetidine, which in its early use showed few noticeable side effects. However, the circular entitled “The Medical Letter” (December 24, 1982) acknowledges that while cimetidine has a low incidence of toxicity, its wide usage has produced many reports of serious adverse effects and interactions with other drugs. Commenting on cimetidine and a newer drug of a similar type called ranitidine, the circular states: “Ranitidine appears to be as effective as cimetidine for treatment of duodenal ulcers. Preliminary evidence suggests that the newer drug may cause fewer adverse effects and drug interactions.” The magazine “Medical Progress” (January 1983) states concerning cimetidine: “Minor side effects became apparent during clinical trials, but other adverse reactions have emerged only after a period of time.” While acknowledging the value of cimetidine and ranitidine in treating ulcers, “Medical Progress” states: “We must not allow these fashionable agents to obscure our lack of basic knowledge as to the causes of peptic ulcer disease and the need to continue research in this area with the aim of prevention in mind.”—ED.
How to Get a Job
After one and a half years without full-time employment, the practical advice in Awake! (February 8, 1983, “How Do I Handle a Job Interview?”) helped me to get employment at a greenhouse/nursery, although my experience in this field is limited. I especially feel that the suggestion of a follow-up thank-you letter after the interview helped me to secure the job. I’m glad to be working again.
C. C., Washington
Woman’s Changing Years
Thank you very much for the article “A Woman’s Changing Years.” (April 8, 1983) To say the least, it was very enlightening. This change has affected me for more than two years now. But there were still things happening I couldn’t understand before reading the article. Situations are easier to adjust to when you know what’s taking place or, rather, understand why they’re happening.
E. M., New York