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Teixeira MZ
100 Rev Assoc Med BRA s 2017; 63(2):100-108
POINT OF VIEW
Therapeutic use of the rebound effect of modern drugs:
“New homeopathic medicines”
Marcus Zulian Teixeira1*
1MD, PhD, Postdoctoral Student of the Department of Obstetrics and Gynecology, Faculdade de Medicina da Universidade de São Paulo (FMUSP). Coordinator of the Elective Discipline Fundamentals of Homeopathy
(MCM0773), FMUSP, São Paulo, SP, Brazil
Summary
Study conducted at the Department of
Obstetrics and Gynecology, Faculdade de
Medicina da Universidade de São Paulo
(FMUSP), São Paulo, SP, Brazil
Article received: 7/4/2016
Accepted for publication: 7/9/2016
*Correspondence:
Departamento de Ginecologia e
Obstetrícia, HC-FMUSP
Address: Av. Dr. Enéas de Carvalho Aguiar,
255, 10º andar, sala 10.166
São Paulo, SP – Brazil
Postal code: 05403-000
marcus@homeozulian.med.br
mzulian@usp.br
http://dx.doi.org/10.1590/1806-9282.63.02.100
The homeopathic treatment is based on the principle of therapeutic similitude,
employing medicines that cause certain disorders to treat similar manifestations,
stimulating a reaction of the organism against its own ailments. The occurrence
of this secondary reaction of the organism, opposite in nature to the primary
action of the medicines, is evidenced in the study of the rebound (paradoxical)
effect of several classes of modern drugs. In this work, in addition to substantiate
the principle of similitude before the experimental and clinical pharmacology,
we suggest a proposal to employ hundreds of conventional drugs according to
homeopathic method, applying the therapeutic similitude between the adverse
events of medicines and the clinical manifestations of patients. Describing existing
lines of research and a specic method for the therapeutic use of the rebound
effect of modern drugs (http://www.newhomeopathicmedicines.com), we hope
to minimize prejudices related to the homeopathy and contribute to a broadening
of the healing art.
Keywords: homeopathy, pharmacology, pharmacodynamic action of homeopathic
remedy, law of similars, rebound effect, new homeopathic remedy.
IntroductIon
The homeopathic model for the treatment of disease is
based on four assumptions: (i) the principle of healing by
similars; (ii) pathogenetic experimentation of medicines in
health humans; (iii) use of ultra-diluted (dynamized) med-
icines; and (iv) prescription of individualized medicines.
Although great importance is attributed to dynamized
medication (produced through the dilution and serial agi-
tations of the substances), incorporated secondarily to the
therapy in order to minimize possible initial symptomatic
aggravations derived from the application of the principle
of healing by similars, the rst two assumptions are the
foundation of the homeopathic episteme, with individual-
ized homeopathic medicine (chosen according to the total-
ity of characteristic signs and symptoms) holding the inher-
ent condition for awakening the organism’s healing reaction.1
In Ancient Greece, Hippocrates taught that diseases
could be treated by the principles of “contraries” (con-
traria contrariis curantur) or “similars” (similia similibus cu-
rantur), recommendations which were followed by sev-
eral exponents of subsequent medical schools.2
At present, the “principle of contraries” is applied to
a large part of conventional therapy, which uses medicines
with primary action against (anti-) the signs and symptoms
of diseases (palliative or antipathic drugs) in order to min-
imize or neutralize their manifestations. On the other hand,
the “principle of similars” is used by homeopathic therapy,
which uses medicines that cause similar signs and symp-
toms (homeo) to diseases in order to stimulate a secondary
action or reaction by the organism against its own disorders.
Since 1998, we have been scientically grounding the
principle of therapeutic similarity through the systematic
study of the “rebound effect” of modern drugs (“paradoxical
reaction” of the organism),
2-12
showing the manifestation of
this secondary and opposite reaction of the organism
after the primary action of numerous classes of drugs. At
the end of 2013, we published a review on the rebound effect
of drugs in this journal,
13
showing the extent of the phe-
nomenon and alerting health professionals about the serious
consequences that this unknown adverse event can cause.
In the last decade, exponents of modern pharmacol-
ogy have suggested a therapeutic strategy entitled “para-
TherapeuTic use of The rebound ef fecT of modern drugs: “new hom eopaThic medicines”
Rev Assoc Med BRAs 2017; 63(2):100-108 101
doxical pharmacology,” similar to the one propagated by
homeopathy for over two centuries, proposing the use of
conventional drugs that cause an exacerbation of the
disease in the short term in order to treat the same disease
in the long term.
14-26
Similarly, since the beginning of our
studies, we have been suggesting the use of modern drugs
in accordance with the principle of therapeutic similar-
ity, proposing the use of drugs that cause adverse events
similar to the manifestations of diseases in order to treat
them homeopathically, using the rebound effect (para-
doxical reaction) in a curative manner. 2,3,9,10,11,13,27-33
In this study, we elaborate on this proposal in accor-
dance with the assumptions of the homeopathic model
and the fundamentals of modern pharmacology, describ-
ing existing research and a specic methodology for the
therapeutic application of the rebound effect of modern
drugs, suggesting the use of this practice in a complemen-
tary and adjuvant manner
34
in a myriad of diseases and
syndromes. As such, we hope to contribute to medical
knowledge, minimizing prejudice related to homeopathy
and encouraging an expansion of the art of healing.
the prIncIple of SImIlarIty accordIng to the
homeopathIc model
In the development of the homeopathic model, Samuel
Hahnemann (1755-1843) used the phenomenological meth-
od of qualitative research to describe the effects of drugs on
human physiology and substantiate the principle of similar-
ity. Based on the study of the pharmacological properties of
dozens of medicinal substances of his time, in which a “sec-
ondary action or reaction of the organism after primary drug
action” was observed,35 Hahnemann enunciated an aphorism
to explain the possible effects of drugs on human health:
Every agent that acts upon the vitality, every medicine, de-
ranges more or less the vital force, and causes a certain al-
teration in the health of the individual for a longer or a
shorter period. This is termed primary action. [...] To its action
our vital force endeavors to oppose its own energy. This re-
sistant action is a property, is indeed an automatic action of
our life-preserving power, which goes by the name of second-
ary action or counteraction. (Organon of medicine, § 63)36
He exemplies this principle describing the primary actions
of medicines on various physiological systems and the con-
sequent secondary actions or counteractions of the organ-
ism, with opposite effects to the primary physiological
changes, which induce the organism to return to the state
prior to the intervention (conservation force or vital reaction
or life-preserving power):
(...) Excessive vivacity follows the use of strong coffee (pri-
mary action), but sluggishness and drowsiness remain for
a long time afterwards (reaction, secondary action), if this
be not always again removed for a short time by imbibing
fresh supplies of coffee (palliative, short duration). After
the profound stupeed sleep caused by opium (primary
action), the following night will be all the more sleepless
(reaction, secondary action). After the constipation produced
by opium (primary action), diarrhea ensues (secondary
action); and after purgation with medicines that irritate
the bowels, constipation of several days’ duration ensues
(secondary action). And in like manner it always happens,
after the primary action of a medicine that produces in
large doses a great change in the health of a healthy person,
that its exact opposite, when, as has been observed, there
is actually such a thing, is produced in the secondary action
by our vital force. (Organon of medicine, § 65)36
In order to provide clarication to readers not familiar with
the homeopathic terminology, the primary actions (direct
effects) of the medicines correspond to the therapeutic and
adverse effects of modern pharmacology, and the secondary
actions (indirect effects) of the medicines or reactions of the
organism correspond to the rebound effect of drugs or par-
adoxical reaction of the organism, which we will describe in
detail below. Similarly, the terms conservation force or vital
reaction or life-preserving power correspond to the homeo-
static mechanisms described by modern physiology, that is,
the property of living organisms to maintain the constancy
of the internal environment through automatic self-adjust-
ments to physiological processes, ranging from simple cel-
lular mechanisms to complex psychological functions.
Whereas this reaction of the organism (secondary and
opposite reaction to the primary action of the medicine)
may manifest with all types of drugs, regardless of the
dose, and in any individual, Hahnemann raises the prin-
ciple of similarity to the category of “natural phenomenon”
(Organon of medicine, § 58, 61, 110-112).36
Proposing to administer substances to patients which
arouse similar symptoms in individuals submitted to “ho-
meopathic pathogenetic experimentation” (“pathogenetic
homeopathic trials,” similar to phase I pharmacological
clinical trials),
37,38
the principle of therapeutic similarity
aims to stimulate a curative homeostatic reaction, inducing
the organism to react against its own disorders.
t
he
prIncIple
of
SImIlarIty
In
the
lIght
of
modern pharmacology2-13
Building a bridge between the principle of similarity and
modern scientic rationality, hundreds of studies de-
Teixeira MZ
102 Rev Assoc Med BRA s 2017; 63(2):100-108
scribed, in recent medical literature, the occurrence of
secondary and opposite reactions of the organism after
the primary actions of different drugs, conrming the
homeopathic postulate. As mentioned previously, this
secondary action or organism’s reaction, which manifests
itself automatically and instinctively in order to maintain
the homeostasis of the system, is described by contem-
porary pharmacology and physiology as the rebound
effect of the drugs, or paradoxical reaction of the organ-
ism, respectively. Analogously, the primary action of the
drugs cited by Hahnemann corresponds to the therapeu
-
tic, adverse and collateral effects of modern drugs.
According to evidence from experimental and clinical
pharmacology,
2-13
the rebound effect of modern drugs
presents similar characteristics to the secondary action or
the reaction of the organism described by the homeo-
pathic model (Organon of medicine, § 59, 64, 69):36 (i) it
causes an opposite reaction of the organism with greater
intensity than the primary action of the drug; (ii) it occurs
after the primary action of the drug as an automatic man-
ifestation of the organism; (iii) it is independent of the
drug, dose, duration of treatment or the type of symptom
(illness); (iv) its magnitude is proportional to the primary
action of the drug; and (v) it only manifests in susceptible
individuals (idiosyncratic character).
According to the extensive literature,
2-13
several studies
illustrate the universality of the rebound phenomenon in
relation to the distinct classes of palliative drugs (antiangi-
nal, antihypertensive, antiarrhythmic, antithrombotic, and
antihyperlipidemic agents, anxiolytics, sedative-hypnotics,
neurostimulants, antidepressants, antipsychotics, anti-
-inammatory drugs, analgesics, diuretics, bronchodilators,
anti-dyspeptics, bone antiresorptive agents, and immuno-
modulators, among others), showing aggravation of the
signs and symptoms initially suppressed by the primary
and direct action of the drug, after its discontinuation.
By denition, the rebound effect presents an inten-
sity and/or frequency a few times higher than the corre-
sponding baseline symptoms suppressed by the primary
action of the antipathic drug, a characteristic that distin-
guishes the rebound phenomenon from the natural reap-
pearance of chronic symptoms after the end of treatment.
Epidemiological studies show that this magnitude can
cause severe and fatal events after the suspension of cer
-
tain classes of drugs (antithrombotics, antidepressants,
bronchodilators, anti-dyspeptics and immunomodulators,
among others).4-13
The rebound effect manifests itself at different intervals
(hours to weeks) after the exhaustion of the biological effect
(half-life) of the drug, and its duration is also variable. De-
spite the suspension or discontinuation of the drug being
a prerequisite for the manifestation of the rebound effect,
given that the primary action of the drug persists while the
receptors are being stimulated (biological half-life), studies
show that the rebound effect may also occur in the course
of treatment due to therapeutic failure or the development
of tolerance, tachyphylaxis or desensitization. On the
other hand, a slow and gradual reduction of doses (taper-
ing) to prevent abrupt discontinuation can minimize the
occurrence of the rebound effect.2-13
In analogy to the proposal to be detailed below, reports
in the literature describe the use of conventional drugs
according to therapeutic similarity. Among these, we can
cite the use of biphasic oral contraceptives to promote
ovulation and rebound pregnancy in women with func-
tional sterility and the use of central nervous system
stimulants (methylphenidate) to treat attention decit
hyperactivity disorder (ADHD).39,40
paradoxIcal pharmacology14-26
A strategy suggested by Richard A. Bond in 2001,
14
para-
doxical pharmacology proposes the therapeutic use of the
paradoxical effects of drugs (secondary reactions of the
organism with the opposite nature to the primary effects
of the drugs). Universal in nature, such paradoxical, bidi-
rectional or compensatory effects appear in several class-
es of drugs, regardless of the dose, and affect various per-
centages of individuals. Although not fully elucidated, this
paradoxical effect is manifested at different levels of the
biological self-regulation systems, increasing the func-
tional complexity of the entire organism, from subcellular
components (channels, enzymes, receptors, transporters,
organelles, etc.) to cells, tissues and organs.15-19
Present in any physiological system, these paradoxical
and bidirectional effects occur due to varying mechanisms:
different actions on the same receptor, due to temporal
effects (for example, beta-blockers with intrinsic sympa-
thomimetic activity); stereochemical effects (for example,
salbutamol); multiple receptor targets, with or without
associated temporal effects (for example, procainamide);
antibody-mediated reactions (for example, heparin-in-
duced thromboembolism); pharmacokinetic effects of
competing compartments (for example, bicarbonate);
interruption and non-linear effects on systems (for ex-
ample, dopaminergic agents); systemic overcompensation
(for example, antiretroviral therapy and immune recon-
stitution inammatory syndrome); other higher level
feedback mechanisms (for example, digoxin) and multi-
level feedback cycles (for example, isotretinoin-associated
acne fulminant), and more.19
TherapeuTic use of The rebound ef fecT of modern drugs: “new hom eopaThic medicines”
Rev Assoc Med BRAs 2017; 63(2):100-108 103
As described for the rebound effect,
2-13
the authors cite
several examples of paradoxical and bidirectional effects
of drugs in different pharmaceutical classes and physio-
logical systems: immunomodulators (systemic corticoids
and TNF-a inhibitors), anticancer drugs (chemotherapy,
radiotherapy and arsenic), antiarrhythmics (procainamide
and isoproterenol), antihypertensives (methyldopa, cloni-
dine, guanabenz, moxonidine and thiazides), vasodilators
(nitrates), drugs for heart failure (beta-blockers, ACE in-
hibitors, angiotensin II receptor blockers and hydralazine),
lipid modifying drugs (brates and ezetimibe), inotropic
and chronotropic drugs (isoproterenol, epinephrine, beta-
-blockers and calcium channel blockers), vasoconstrictors
(ergot alkaloids and vasopressin), anesthetics (sevourane,
ketamine and propofol), antiepileptic drugs (benzodiaze-
pines, barbiturates and hydantoin), sedative-hypnotics
(anticholinergics, antihistamines, antispasmodics, barbi-
turates, benzodiazepines, bromides, chloral hydrate, etha-
nol and opioids), psychotropic drugs (antidepressants and
antipsychotics), peripheral nervous system drugs (acetyl-
cholinesterase and capsaicin inhibitors), antidyskinetic
drugs (dopaminergic agents), acid-base agents (sodium
lactate and bicarbonate), bone metabolism agents (para-
thyroid hormone and bisphosphonates), electrolytes (hy-
pertonic saline and magnesium hydroxide), glycemic agents
(insulin and hypoglycemic agents), steroid hormones (dexa-
methasone), thyroid agents (iodine and lithium), antihy-
peruricemic agents (xanthine oxidase and urate oxidase
inhibitors), gastrointestinal agents (opiates, cholecystoki-
nin and ceruletide), hematological agents (erythropoietin,
vitamin K antagonists and adenosine diphosphate receptor
inhibitors), bronchodilators (short- and long-acting beta-
adrenergic bronchodilators), dermatological agents (his-
tamine receptor inhibitors, high-intensity long-wave ultra
-
violet light and 8-methoxypsoralen), and more.19
For Bond,14 a possible hypothesis to explain the func-
tioning of paradoxical pharmacology is the “difference
between acute and chronic effects of drugs.” Reiterating
that the acute and chronic responses to drugs may differ
substantially, often being of opposite natures, he pro-
poses that “the exacerbation of a disease can make the
compensatory and redundant mechanisms of the organ-
ism achieve a benecial long-term response.” This is par-
ticularly evident in events mediated by receptors: acute
exposure to inhibitors can produce receptor activation
and increased signaling, while chronic exposure can pro-
duce receptor desensitization and decreased signaling.
The same phenomenon occurs with receptor inhibitors.
Similar to the homeopathic method of treatment,
which uses ultra-diluted doses of medicines with the aim
of avoiding possible aggravation of the illness after ap-
plication of therapeutic similarity, as a general rule, pro-
ponents of paradoxical pharmacology suggest starting
with “very small doses, increasing them gradually over
the following weeks.”14
Exemplifying the therapeutic use of the paradoxical
reactions of the organism, the authors describe clinical
conditions which can be treated using this proposal. Con-
gestive heart failure (CHF) is a disease related to impaired
cardiac contractility, in which the acute use of beta-ad-
renergic receptor inhibitors increases cardiac contractil-
ity, improves hemodynamics and reduces related symp-
toms. However, chronic use results in increased
mortality. On the other hand, while the short-term use
of beta-adrenergic antagonists (beta-blockers: carvedilol,
metoprolol, bisoprolol, among others) decreases contrac-
tility and exacerbates the CHF, causing the worsening of
the illness, long-term use results in increased cardiac con-
tractility and decreased mortality.
14,18-20
The same is ob-
served with calcium channel blockers.21
Similarly, beta-adrenergic agonists are the most potent
bronchodilators and play an important role in all stages
of asthma management. However, as mentioned in the
study of the rebound effect, chronic use is associated with
irreversible and fatal paradoxical bronchospasms. On the
other hand, while short-term use of beta-adrenergic an-
tagonists leads to bronchoconstriction and worsening of
asthma, long-term use leads to bronchodilation and in-
creased asthma management.14,18,22,23
Additional examples include the use of methylphe-
nidate (a central nervous system stimulant) in the treat-
ment of ADHD and the use of 5-HT1A serotonin receptor
agonists (mediators of hyperalgesia) to produce analgesia.18
Of ancient knowledge, the use of thiazide class diuretics
provides a paradoxical antidiuretic benet in the treat-
ment of diabetes insipidus, reducing polyuria and increas-
ing urine osmolality.24
Arsenic trioxide (As2O3), an important carcinogen,
has been used by homeopathy for more than two centuries
as an adjuvant drug in the treatment of several types of
cancer, and is being used by paradoxical pharmacology
as a promising anticancer drug,
25,26
mainly in the relapse
of acute promyelocytic leukemia,
41,42
including in Bra
-
zil,43,44 among other applications.19
therapeutIc uSe of the rebound effect
of modern drugS: “new homeopathIc
medIcIneS”27-33
Reiterating that homeopathic treatment has the pre-
rogative of using drugs that cause pathogenetic manifes-
Teixeira MZ
104 Rev Assoc Med BRA s 2017; 63(2):100-108
tations (signs, symptoms, physiological or pathological
changes, etc.) similar to disorders requiring treatment, it
can be applied with any substance (natural or synthetic)
and at any dose (by massive or innitesimal), provided
this principle of similarity is observed. Thus, conven-
tional drugs can be employed according to the homeo-
pathic premises provided they cause primary effects
(therapeutic, adverse or collateral effects) similar to the
totality of individual characteristic manifestations.
In this proposal,
27-33
we are suggesting the use of the
rebound effect of modern drugs in a curative manner,
administering ultra-diluted doses (dynamized medicines)
to patients of the drugs that cause a set of similar adverse
events in phases I-IV pharmacological clinical trials, pro-
posing to stimulate a homeostatic response of the organ-
ism against its own disorders.
To make this project possible, a Homeopathic Materia
Medica of Modern Drugs
29
was elaborated, systematizing
all of the primary or pathogenic effects (therapeutic,
adverse and collateral effects) to 1,250 modern drugs
described in The United States Pharmacopeia Dispensing In-
formation (USPDI),
45
according to an anatomical and
functional distribution (systems or tracts) and in ac-
cordance with the dynamics used in the chapters of the
classic Homeopathic Materia Medica.46
In order to facilitate the selection of the individual-
ized medicines according to the totality of manifestations
similar to the patient-disease binomial, an essential prem-
ise for the success of homeopathic treatment, the second
stage of the project involved the elaboration of a Homeo-
pathic Repertory of Modern Drugs,29 where the pathogenetic
effects and their corresponding medicines are organized
in the same anatomical/functional distribution, following
the arrangement of the classic homeopathic repertories.
47
Titled New Homeopathic Medicines: Use of Modern Drugs
According to the Principle of Similitude,
29
this project is described
and systematized in three digital compendia (Scientic
Basis of the Principle of Similitude in Modern Pharmacology, Ho-
meopathic Materia Medica of Modern Drugs and Homeopathic
Repertory of Modern Drugs) provided on a bilingual site with
free access (http://www.newhomeopathicmedicines.com),
allowing the proposal to be known and applied by all in-
terested colleagues.
Exemplifying this possible ‘off label’ use of numerous
classes of modern drugs according to the principle of
therapeutic similarity, dozens of therapeutic drugs that
show increased blood pressure as primary effect (adalim-
umab, cyclosporine, dopamine and anti-inammatory
drugs, among others) could be used homeopathically to
treat hypertension, provided that other primary or patho-
genetic effects of the drug present similarity with the set
of signs and symptoms of the individual patient. Respect-
ing this individualization of medicine, drugs that increase
blood glucose (amprenavir, corticotropin, diazoxide and
estrogens, and more) could be employed homeopathi-
cally to treat diabetes; drugs that cause inammation of
the gastric mucosa (abacavir, anti-inammatory drugs,
carbidopa and cilostazol, among others) could be employed
homeopathically to treat gastritis and gastric ulcers; med-
icines that cause immunosuppression (cyclosporins, cor-
ticoids and immunosuppressants, and more) could be
employed to stimulate the immune system of immunosup-
pressed patients; among others. Table 1 describes some
examples of possible applications of therapeutic similar-
ity with modern drugs in disorders, diseases and syndromes,
in accordance with the adverse events caused by such on
the various systems or tracts of individuals and described
in phase I-IV pharmacological clinical trials.29,45
uSe of dynamIzed eStrogen In the
treatment of chronIc pelvIc paIn
aSSocIated wIth endometrIoSIS
Endometriosis is a chronic inammatory disease character-
ized by the implantation and proliferation of endometrial
tissue in extrauterine locations, causing chronic pelvic pain
that is difcult to control. As the main pathophysiological
aspect, it is worth mentioning that endometriosis is an
estrogen-dependent disease. Putting into practice the pro-
posal described above, we developed a clinical research
protocol to assess the effect of dynamized estrogen in the
treatment of endometriosis-associated pelvic pain (dys-
menorrhea, deep dyspareunia, non-cyclic pelvic pain, cyclic
bowel pain and/or cyclic urinary pain).
In the study of modern drugs according to the USPDI
45
and, consequently, in the Homeopathic Repertory of Modern
Drugs (Chapter “Female Genitalia”),29 we nd a description
of the specic pathological sign of endometriosis (“endo-
metrial proliferation or hyperplasia”) as an adverse event
in four classes of conventional drugs (systemic and vaginal
estrogens, tamoxifen and toremifene) (Table 2).
One of those drugs, “systemic estrogen,” presents a set
of adverse events (pathogenetic effects) that are quite sim-
ilar to the main manifestations of endometriosis syndrome
(endometrial proliferation, dysmenorrhea, dyspareunia,
abdominal pain, depression, anxiety, insomnia and migraine,
among others) (Table 3), and was selected for the study
due to this particularity (individualization of the medicine).
In this randomized, double-blind and placebo con-
trolled trial (RCT), 50 patients with endometriosis, chron
-
ic pelvic pain refractory to conventional hormone thera-
TherapeuTic use of The rebound ef fecT of modern drugs: “new hom eopaThic medicines”
Rev Assoc Med BRAs 2017; 63(2):100-108 105
TABLE 1 Possible applications of therapeutic similitude with modern drugs.
Anatomical and
functional distribution
Possible applications of therapeutic similitude (Adverse events or pathogenetic effects
caused in individuals)
Mind/Psyche
agitation, amnesia, anxiety, coma, delirium, dementia, depression, disorientation, memory lapses, hyperactivity,
irritability, lethargy, mania, nervousness, panic, schizophrenia, suicidal disposition, and more
Head
cerebral aneurysm, stroke, encephalitis, intracranial hypertension, meningitis, headache/migraine, dizziness/vertigo,
gait disorders, orthostatic hypotension, syncope, instability, and more
Eyes
astigmatism, atrophies, bleeding, cataract, chemosis, corneal diseases, dryness, glaucoma, inammation, keratopathy,
necrosis, neuritis, nystagmus, papilledema, paralysis, pupil disorders, retinal disorders, and more
Vision amblyopia, blindness, diplopia, hyperopia, myopia, presbyopia, scotoma, and more
Hearing tinnitus, deafness, hyperacusis, hearing loss, and more
Nose congestion, coryza, dryness, epistaxis, rhinitis, sinusitis, sneezing, and more
Face motor tics, heat waves, hirsutism, neuritis, paralysis, swelling, trismus, and more
Mouth severe bleeding, discoloration, dryness, gingivitis, glossitis, mucositis, sialorrhea, speech disorders, stomatitis, taste
disorders, ulcers, and more
Throat angioedema, dryness, dysphagia, esophagitis, pharyngitis, ulcers, and more
Outer throat goiter, heat waves, thyroid disorders, lymphadenopathy, parotitis, pain/stiff neck, and more
Stomach
anorexia, dyspepsia, eructation, gastritis, gastroenteritis, hemorrhage, hiccups, nausea, polydipsia, reux, ulcer,
vomiting, and more
Abdomen ascites, appendicitis, cholecystitis, cholestasis, cirrhosis, colitis, gastroenteritis, hemorrhage, liver disorders (failure,
necrosis, steatosis, hepatitis, hepatomegaly), paralytic ileus, inammatory bowel disease, intestinal obstruction or
perforation, malabsorption syndrome, pancreatitis, peritonitis, splenomegaly, tumors, and more
Rectum constipation, diarrhea, hemorrhage, hemorrhoid, mucositis, tenesmus, and more
Bladder hemorrhage, inammation, urination disorders, and more
Kidneys
calculi, edema, inammation (interstitial, glomerulonephritis, pyelonephritis), renal failure, tubular disorders, and more
Urine ketonuria, albuminuria, glycosuria, hematuria, proteinuria, pyuria, sediments, and more
Male genitalia
testicular atrophy, sexual desire disorders, edema, sexual dysfunction (ejaculation, erection, infertility, orgasm),
inammation, and more
Female genitalia
abortion, cancer, contraception, sexual desire disorders, sexual dysfunction, hemorrhage, hormonal dysfunction,
endometriosis, inammation, menstrual disorders, ovarian disorders, uterine disorders, tumors, and more
Larynx and trachea inammation, laryngism, edema (glottis, larynx), and more
Breathing
types (fast, trapped, interrupted, irregular, slow), asthma, bronchitis, dyspnea, respiratory failure, wheezing, rattles, and more
Chest/thorax
acute myocardial infarction, angina pectoris, arrhythmias (atrial brillation, heart block, ventricular tachycardia),
heart failure, pericardial or pleural effusion, inammation (alveolitis, endocarditis, pneumonitis, pericarditis, pleuritis),
pulmonary disorders (edema, embolism, brosis), adult respiratory distress syndrome, and more
Extremities
arthrosis, ataxia, edema, exostosis, fracture, gout, incoordination, inammation (arthritis, myositis, neuritis, phlebitis,
tendinitis), myopathy, neuropathies, osteoporosis, paralysis, rigidity, weakness, and more
Skin
acne, allergies, alopecia, inammation (cellulitis, dermatitis, eczema), necrosis, pemphigus, psoriasis, purpura,
seborrhea, and more
General
anaphylaxis, anemia, anesthesia, seizures, demyelinating diseases, diabetes, edema, encephalopathy, fatigue,
hypertension, hyperthermia, hypotension, hypothermia, inuenza, lymphadenopathy, neuropathy, thromboembolism,
weight (gain/loss), tumors or cancer, and more
TABLE 2 Endometriosis in the Homeopathic Repertory of Modern Drugs (Chapter “Female Genitalia”)29
Endometrium
Endometriosis; disorder, endometrial; proliferation, endometrial; hyperplasia: DrosE-syst., Estro-syst., Estro-vag., Tamo-syst., Tore-syst.
DrosE-syst.: drospirenone and estradiol (systemic); Estro-syst.: estrogens (systemic); Estro-vag.: estrogens (vaginal); Tamo-syst.: tamoxifen (systemic); Tore-syst.: toremifene (systemic).
Teixeira MZ
106 Rev Assoc Med BRA s 2017; 63(2):100-108
TABLE 3 Adverse events or pathogenetic effects of estrogen (systemic).
Anatomical
and functional
distribution
Adverse events or pathogenetic effects of estrogen
(The United States Pharmacopeia Dispensing Information)45
(Homeopathic Materia Medica of Modern Drugs)29
Mind/Psyche anxiety; depression; emotional lability; dementia; irritability; nervousness
Head headache; migraine; dizziness; embolic stroke; chorea; worsening of epilepsy; hair loss
Eyes Herpes simplex; contact lens intolerance; increased corneal curvature (changes in vision); optic neuritis; retinal vein occlusion (thrombosis)
Vision visual disturbances
Nose sinusitis; nasopharyngitis; rhinitis; nasal congestion; herpes simplex
Face acne; hirsutism; herpes simplex; neuritis; chorea
Tongue chorea
Teeth abscesses
Throat nasopharyngitis; pharyngitis
Outer throat neck pain
Stomach anorexia; dyspepsia; nausea; gastroenteritis; vomit; changes in appetite
Abdomen bloating, atulence and abdominal cramps; gastroenteritis; biliary obstruction; pancreatitis; liver changes (hemangioma; enzymes)
Rectum constipation; diarrhea
Bladder urinary tract infection
Kidneys urinary tract infection
Female genitalia
amenorrhea; dysmenorrhea; vaginitis; fungal vaginosis; metrorrhagia; dyspareunia; vaginal hemorrhage; candidiasis; herpes simplex;
increased libido; menorrhagia; stains; endometrial atrophy; endometrial or ovarian cancer; cervical ectropion; endometrial hyperplasia; uterine
leiomyoma; changes in cervical mucus
Breathing bronchitis; asthma exacerbation
Coughing increase in coughing
Chest/Thorax
bronchitis; increased breast size, sensibility or pain; gynecomastia; pleural infection; chest pain; breast cancer; broadenomas;
pulmonary embolism; galactorrhea; myocardial infarction; palpitation; arrhythmias; coronary artery diseases
Back pain
Extremities peripheral edema; cramps; muscle spasms; osteoarthritis; neuritis; chorea; worsening of varicose veins
Sleep insomnia
Skin
irritation; pruritus; rashes; redness; acne; hirsutism; chloasma; hemorrhagic rash; erythema multiforme; erythema nodosum; melasma
General
asthenia; u syndrome; hypersensitivity reactions; infections; pain; weight gain; fatigue; hepatitis; hypertension; hypoesthesia;
thromboembolism; hypocalcemia; cholestatic jaundice; worsening of systemic lupus erythematosus; worsening of porphyria; sodium retention;
diabetes or reduced glucose tolerance; thrombophlebitis; increased triglycerides
Markdown text (font/letter style) to describe adverse events corresponds to their incidence frequency (%) within the population (USPDI, phase I-IV clinical trials): score 4/bold (≥ 4%); score 3/italic
and underlined (1-4%); score 2/italic (< 1%); score 1 / normal (overdose).
py and a set of signs and symptoms similar to the adverse
events or pathogenetic effects of estrogen (Table 3) were
recruited at the Endometriosis Sector of the Clinical Gy-
necology Division of the University of São Paulo Medical
School’s Hospital das Clínicas (HC-FMUSP). The selection
process was carried out through an analysis of patient
records and responses to structured questionnaires. After
meeting the inclusion criteria, the patients were distrib-
uted randomly to receive dynamized estrogen or placebo,
while maintaining conventional hormone therapy. The
primary clinical outcome was the severity of the chronic
pelvic pain after 24 weeks of intervention.
48,49
The results
of this recently published RCT showed that dynamized
estrogen was signicantly more effective than placebo for
reducing endometriosis-associated pelvic pain (dysmen-
orrhea, non-cyclic pelvic pain and cyclic bowel pain), im-
proving quality of life (bodily pain, vitality and mental
health) and reducing depressive symptoms.50
In a similar proposal described in another recently
published paper
51
that demonstrated worsening of pso-
riasis (rebound psoriasis) after discontinuation of im-
munomodulatory drugs (T-cell modulators and TNF
inhibitors), we suggest the treatment of psoriasis with
drugs that cause psoriasis as an adverse event (beta-ad-
TherapeuTic use of The rebound ef fecT of modern drugs: “new hom eopaThic medicines”
Rev Assoc Med BRAs 2017; 63(2):100-108 107
renergic blocking agents, lithium and antimalarial agents,
among others) corresponding with the use of dynamized
estrogen to treat endometriosis.
concluSIon
Describing the undesirable effects of the indiscriminate
use of drugs that act according to the principle of contrar-
ies, opposite to the principle of similars, Hahnemann
warned of the risks of secondary action (rebound effect
or paradoxical reaction) of the organism, validating the
principle of similarity through the Aristotelian syllogism
(modus tollens, denying the consequent or indirect proof):
If these ill-effects are produced, as may very naturally be
expected from the antipathetic employment of medicines,
the ordinary physician imagines he can get over the dif-
culty by giving, at each renewed aggravation, a stronger dose
of the remedy, whereby an equally transient suppression is
effected; and as there then is a still greater necessity for giv-
ing ever-increasing quantities of the palliative there ensues
either another more serious disease or frequently even dan
-
ger to life and death itself, but never a cure of a disease of
considerable or of long standing. (Organon of medicine, § 60)
36
With modern drugs, a large number of iatrogenic events
could be avoided if health professionals paid attention
to the possible occurrence of the rebound effect or par-
adoxical reaction of the organism,13 minimizing the
aggravation of clinical conditions with the slow and
gradual decrease of doses. Although not included in
conventional adverse events of drug, “effects from the
discontinuation of drugs are part of the pharmacology
of the drug”
52
and should be incorporated into the teach-
ing of modern pharmacology.
On the other hand, by employing the rebound effect
of conventional drugs in a curative manner, we can ex-
pand the spectrum of therapeutic similarity with hun-
dreds of “new homeopathic medicines,” including signs
and symptoms that are absent in classic homeopathic
pathogenetic trials and allowing the application of ho-
meopathic treatment for a multitude of diseases, disor-
ders and syndromes.
As has been suggested by the propagators of homeo-
pathic therapy for more than two centuries,
28,33
Bond and
Giles
18
encourage researchers to examine the paradoxical
phenomenon (rebound effect) without prejudice and to
challenge the dogma of current treatment paradigms with
new therapeutic approaches, despite the difculty in ac-
cepting new ideas by our peers.
reSumo
Uso terapêutico do efeito rebote dos fármacos modernos:
“Novos medicamentos homeopáticos”
O tratamento homeopático está fundamentado no prin-
cípio da similitude terapêutica, empregando medicamen-
tos que causam determinados distúrbios para tratar ma-
nifestações semelhantes, estimulando uma reação do
organismo contra seus próprios transtornos. A ocorrên-
cia dessa reação secundária do organismo, de natureza
oposta à ação primária dos medicamentos, está eviden-
ciada no estudo do efeito rebote (paradoxal) de inúmeras
classes de fármacos modernos. Neste trabalho, além de
fundamentar o princípio da similitude perante a farma-
cologia clínica e experimental, sugerimos uma proposta
para empregar centenas de drogas convencionais segundo
o método homeopático, aplicando a similitude terapêu-
tica entre os eventos adversos dos medicamentos e as
manifestações clínicas dos pacientes. Descrevendo linhas
de pesquisa existentes e um método especíco para o uso
terapêutico do efeito rebote dos fármacos modernos
(http://www.novosmedicamentoshomeopaticos.com),
esperamos minimizar preconceitos relativos à homeopa-
tia e contribuir para uma ampliação da arte de curar.
Palavras-chave: homeopatia, farmacologia, ação farma-
codinâmica do medicamento homeopático, lei dos seme-
lhantes, efeito rebote, medicamentos homeopáticos novos.
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