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Thursday
Jun172010

Mornidine: Now She Can Cook Breakfast Again

By Jill Arnold

 

This advertisement appeared in Volume 81 of the Canadian Medical Association Journal on July 1, 1959.

 

The text reads:

NOW SHE CAN COOK BREAKFAST AGAIN… WHEN YOU PRESCRIBE NEW MORNIDINE ™ (BRAND OF PIPAMAZINE)

A new drug with specific effectiveness in nausea and vomiting of pregnancy, Mornidine eliminates the ordeal of morning sickness.

With its selective action on the vomiting center, or the medullary chemoreceptor “trigger zone,” Mornidine possess the advantages of the phenothiazine drugs without unwanted tranquilizing activity.

Doses of 5 to 10 mg., repeated at intervals of six to eight hours,, provide excellent relief all day. In patients who are unable to retain oral medication when first seen Mornidine may be administered intramuscularly in doses of 5 mg. (1 cc.).

Mornidine is supplied as tablets of 5 mg. and as ampuls of 5 mg (1 cc.).

G.D. Searle & Co., Chicago 80, Illinois- Research in the Service of Medicine.

 

According to the Pharmaceutical Manufacturing Encyclopedia, pipamazine was introduced in the United States in 1959 under the trade name “Mornidine” by G.D. Searle & Co. Mornidine had post-surgical applications as well.

 

The drug was ultimately withdrawn from the market for causing hepatic lesions in patients. From the Food and Drug Administration [Docket No. 98N-0655]:

Pipamazine: All drug products containing pipamazine. Pipamazine, formerly marketed as Mornidine tablets and injection, was associated with hepatic lesions. Approval of the NDA for Mornidine tablets andinjection was withdrawn on July 17, 1969 (see the Federal Register of July 17, 1969 (34 FR 12051)).

 

The marketing of Mornidine as a morning sickness drug overlapped with the widespread prescription of thalidomide in Europe as a safe morning sickness drug for pregnant women.

Doctors in Europe first prescribed thalidomide in the late 1950s to treat anxiety, insomnia and, in pregnant women, morning sickness. It was marketed in Europe as well as in Japan, Australia and Canada. It was withdrawn from the market in the early 1960s when doctors learned that it caused devastating birth defects. About 10,000 children around the world were born with major malformations because their mothers had taken the drug during early pregnancy (3).

[…]

In 1961, doctors in Germany, Australia and Great Britain noted a significant increase in the number of babies born with severely malformed or missing arms and legs. These birth defects were traced to the use of thalidomide during early pregnancy, when a baby’s arms and legs begin to form.

The most well-known defect, a severe shortening of the arms or legs with flipper-like hands or feet, is called phocomelia. Affected babies almost always have defects on both sides and often have both the arms and legs malformed. In especially severe cases, the babies have complete absence of limbs. The drug also causes malformations of the eyes and ears, heart, genitals, kidneys and digestive tract (including the lips and mouth) (3, 5). About 40 percent of babies exposed to the drug die before or soon after delivery (5).

Thalidomide is one of the most powerful human teratogens (drugs or other agents that cause abnormal development in the embryo or fetus). Taking even a single dose of thalidomide during early pregnancy may cause major birth defects (1). Women should never take thalidomide if they could become pregnant or if they are pregnant.

 

But at least Mother could wake up and cook everyone bacon. Heaven knows that Father can’t figure out the percolator.

 

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Reader Comments (18)

God, it just makes me sick to my stomach. No pun intended. :(

June 17, 2010 | Unregistered CommenterStassja

That's unsurprising, but super scary. I had hyperemisis with my pregnancy and was on medication, which was the only thing that helped me to keep ANYTHING down. Although everyone assured me the medication was perfectly safe, I never felt completely comfortable taking it and tried to go off it several times. If the above is any indication, I had good reason to feel uneasy about the medical community's reassurances of "safety".

June 17, 2010 | Unregistered CommenterDana

To be fair, Thalidomide WAS perfectly safe. . . for the mother. *eyeroll*

It actually raises a really interesting quandary. How do you medicate pregnant women? You can try not to, but women in pregnancy will frequently have conditions that require medication, and even more frequently will have conditions where it would be a lot easier if you could take a frickin pill like you would if you weren't pregnant. (Migraine, common cold, etc.) Ex post thalidomide, it is impossible to do drug research on pregnant women, and for damn good reason; a fetus is not capable of informed consent. You can do animal studies, but animals aren't people; animal studies were done with thalidomide, and the problems weren't found. (It turns out that thalidomide's birth defects are unusually species-specific; there are two separate optical isomers of the drug, only one of them causes phocomelia, and only a couple of species, humans among them, convert the good one to the bad one.) You can do computer modeling, which is exactly as accurate as your computer model is, for good or for ill. You can, in theory, do utterly ghoulish things like identifying women whose unborn children have 100% fatal defects and persuading them do let you do placental transfer tests before they terminate the pregnancy, but that's ethically abhorrent in about a thousand different ways. So, we run drug trials on animals and on non-pregnant humans, cross our fingers, and hope for the best, and then we watch reeeeeally carefully when we prescribe it in real life.

It's a bad system. But try as I might I can't figure out how to do it better.

June 17, 2010 | Unregistered CommenterKathryn T.

<<It's a bad system. But try as I might I can't figure out how to do it better.>>

I have to agree with you in regards to testing of drugs.

And while I acknowledge that in some cases medications may be necessary, in many cases (like in birth), just knowing it's normal and this too shall pass and having a good support network can help a woman get through that phase. I realize, there are extreme cases where that doesn't apply...but in many cases, chewing a little peppermint gum, for example, will calm the stomach.

Too often, when we are just trying to make things better, we end up making them worse.

I'm with Jill on this one though...can't dad figure out the percolator?

Thank goodness I live now...my dh is the morning person and believe me he percolates, or there would be no percolation in our house :-)

June 17, 2010 | Unregistered CommenterAnne

Since I started working with midwives and talking to women about what and how much they ate, I've had only a few women whose nausea/vomiting was severe enough to consider medications. Acupuncture helped more than a few as well. Drugs have only been around for 60 years or so, interesting how quickly we've come to believe they are necessary.

I'm not saying that drugs are never helpful or that taking them is bad. I just know that some experience in handling things without drugs, beginning in childhood, leads to important wisdom that can guide decisions like how to treat nausea in pregnancy.

I am offended by the sexist imagery in the advertisement, but, honestly, it was pretty typical of the times. Today, we'd see an ad showing a woman headed off to the office, cause, heaven forbid a woman (or a man) take time for hers/hiself or her/his children! No matter if it's in a marriage, the workplace, or the community, we all seem to feel like we are indispensable. And we gotta keep the man happy. From the moment of conception, there's just nothing convenient about children. But thank the stars that people keep havin' em.

June 17, 2010 | Unregistered CommenterElizabeth Allemann

While I agree with comments that medication should be a last resort in pregnant women, especially for "normal" first trimester nausea and vomiting, I want to say that I too suffered from hyperemesis, which is a dangerous and sometimes life threatening condition. But because it presents like morning sickness and doctors are often reluctant to prescribe medicine to pregnant women, many many women are undertreated for this condition (and treated badly by other mothers who assume that some crackers and a cup of tea will cure their condition). So I just wanted to say to pregnant women who have uncontrollable vomiting - take your condition seriously and don't be afraid to take medication if it's necessary. I didn't like taking medication either while pregnant, but it was necessary in my case, and I like other hg mothers had two very healthy babies (consult the hyperemesis website helpher.org for more information on the condition and its treatments).

June 17, 2010 | Unregistered CommenterErin

But it's way more political than this right? Because one thing that works very consistently on problems like hyperemisis with relatively few risks and no known side-effects is... marijuana. But nobody is going to recommend that, and if you even suggested that you self-medicated with it while pregnant in order to keep you and the baby from starving to death you may well have your parental rights terminated at birth. Why? Because no pharmaceutical company stands to make any money off it so there are no powerful lobbying groups supporting it. The thing is, there are no documented birth defects associated with pot. As far as I know tests on other mammals resulted in no birth defects, and studies on humans resulted in the same kinds of risks as smoking tobacco, but they didn't control for tobacco use, so many of the moms in the study were also smoking tobacco while pregnant. Based on even these flawed studies the worst risk seems to be low birth weight. Of course if you have severe morning sickness, that ship has already sailed, and everyone knows there are other ways to ingest pot than smoking it. So it's far more complicated than just "we want to find something that will help you with your morning sickness and be safe for you and the baby." It's more like "we want to find something that will help you with your morning sickness that feeds the pharmaceutical-industrial-complex in the right sort of way."

Which is not to say that I'm recommending everyone go out and smoke pot while pregnant ... and I didn't, but mostly because I didn't experience much nausea and didn't have access to pot that I could be sure was grown in a chemical-free environment. But it does seem like if the motive of helping pregnant moms and their babies was as pure as it's made out to be, there would be considerably more R&D going on in this area as well as a moratorium on all the punitive public health activities surrounding marijuana use and pregnancy.

June 17, 2010 | Unregistered CommenterRachel_in_WY

Yes, currently it's usually better to either just deal, or use natural remedies to treat common pregnancy ailments like morning sickness. But, let's be honest, the *reason* it's better that way is because we can be sure it's safe for both mother and baby. If there was a pill to eliminate morning sickness that was as safe and effective as taking a Tylenol for a headache, I'd take it! I'm glad that the medical community at least tries to find or develop safe medications to make pregnancy more comfortable. (I just wish they'd be quicker about discontinuing treatments that turn out to be more trouble than they're worth, or limiting treatments to situations when they *are* worth the trouble.)

I also think Dana makes a great point that it's very difficult to determine what is and isn't safe for pregnant women and their babies. We can't just stop advancing medical science in the area of obstetrics -- the advances are often good! But we can't test on unborn babies, either.

As for the dated tone of the advertisement, I think it's worthwhile to realize that, for a lot of women in the 50s, taking care of home and hearth (including breakfast) was their main job. It was the way they contributed to the family (and, IMO, it's an important contribution). I don't know about you, but I don't like it when illness makes it hard for me to do my job. I value pregnancy, and my role as the only person in our family who can create new members, but I don't like feeling like I can't do basic tasks that I feel are also valuable and important ways that I contribute to my family. I don't like it when my husband has to do those things for me, even when he does so happily. Sort of the way my husband happens to feel right now, after his big plans to do some work around the house and give me a little time off during his vacation this week were derailed when he threw his back out. If a pill could make him feel well enough to install the new faucet in the bathroom, he'd be happy!

June 17, 2010 | Unregistered CommenterMichelle Potter

I don't understand why abortion is legal, but a pregnant woman can't consent to medical testing in drug trials. It seems inconsistent.

June 17, 2010 | Unregistered Commentermari

"But it's way more political than this right? Because one thing that works very consistently on problems like hyperemisis with relatively few risks and no known side-effects is... marijuana. "

A while back I read this book "The panic-free pregnancy : [an OB/GYN separates fact from fiction on food, exercise, travel, pets, coffee, medications, and other concerns you have when you are expecting]" by Michael S. Broder.
I was looking for a book to counter all the comments I was getting about my eating habits while pregnant. Egads, pregnant woman drinking coffee, eating brie and *yikes* a glass of wine!!! I thought having a book to back me up would be helpful. This book would do as such in regards to food,wine and pot. It would not be helpful in regards to labor, very medical model of care. So I didn't point any family to it.
My point in mentioning this book is that he writes about alcohol and recreational drugs. I don't have it in front of me, but I remember showing my husband what the author writes about the safety of pot and saying "if I have bad morning sickness, spark me up". I didn't have any nausea that ginger couldn't cure, so no pot for me.
You have a great point in the politics of meds in our country.

June 18, 2010 | Unregistered CommenterMyssie
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