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LIVE FROM THE HEADLINES

Interview With Bruce Rubin

Aired August 4, 2003 - 20:39   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

PAULA ZAHN, CNN ANCHOR: Now we want to get some perspective on what we should know about botox, joined from Miami by Dr. Bruce Rubin. He is a neurologist at the University of Miami. He is not connected with the lawsuits we've been talking about. Dr. Rubin, welcome.
DR. BRUCE RUBIN, NEUROLOGIST: Thank you, Paula.

ZAHN: First of all, your reaction to some of Mrs. Medavoy's claims here.

RUBIN: Well, I feel badly that she is in such dire straits. It's been my experience that none of my patients have had any long- lasting effects from botox. One of the nice things about it is that it is -- its effects are temporary. And the basic science literature supports that. I'm unclear how she would have long-lasting effects, at least from a basic science standpoint.

ZAHN: What about her allegation that sometimes patients don't fully understand that what is being used for isn't approved for by the FDA?

RUBIN: I think those are generally true allegations. Sometimes we, as physicians, have to utilize medications that are not FDA- approved for its use. We often learn by trial and error that certain medications are good for other uses than that which they are approved for.

ZAHN: But you, as a patient, don't want to learn by trial and error, do you?

RUBIN: No, not at all. And I wouldn't advise any physician using medication, unless they were comfortable with its effects and uses. And we -- I think the most guilty part is that we forget to tell patients sometimes that it is not FDA-approved because we're so used to using it and it's so safe. I think you're right, in that it -- we should notify our patients and say, Well, you know, this is not FDA-approved. However, you know, I have a lot of experience using it. There are numerous scientific articles in the literature that support its use, so that you, as a patient, can feel comfortable to choose. I don't -- I don't recommend that any physician use medication they're not comfortable with its effects and know what they're dealing with.

ZAHN: How common do you think it is for doctors to use too much of it, which is what Mrs. Medavoy alleges was -- what happened in her situation? RUBIN: Well, I don't know how common it is. I can tell you it's not uncommon because there is no dosage guideline. I mean, there are guidelines, but every patient responds differently. And I do tell my patients that I've been injecting for over seven years that, Hey, this is a possible side effect. And I tell them, There's good news and bad news. The good news is, is that if you get side effects, they go away. The medication only works transiently. That's my clinical experience and that's what beared out in the literature. The bad news is, however, if you get the benefits, it wears off and you have to come back in for injections again.

So one of the nicest things about botulinum toxin it that the effects are transient. The fact that Ms. Medavoy is having continued complaints is very atypical, and I'm not sure I understand how that could be, from a scientific standpoint.

ZAHN: Dr. Bruce Rubin, thank you for your perspective. Two very different ways of looking at botox this evening.

RUBIN: Sure. You're welcome.

ZAHN: Thanks.

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