50 Shades of Blue

A few months back I poked fun at Fycompa, a new epilepsy drug with an interesting side effect profile. Little did I realize I'd have the chance to do it again (different drug this time) so soon.


Like neurologists everywhere, I was surprised to hear the news Monday about a newly reported side-effect concerning the epilepsy drug Potiga.

Namely, that it makes people blue.

I'm not talking depression here, either.

Let's look at the official FDA announcement:


"FDA is warning the public that the anti-seizure medication Potiga (Ezogabine) can cause blue skin discoloration... (and) does not currently know if these changes are reversible.

The skin discoloration in the reported cases appeared as blue pigmentation, predominantly on or around the lips or in the nail beds of the fingers or toes, but more widespread involvement of the face and legs has also been reported. Scleral and conjunctival discoloration, on the white of the eye and inside eyelids, has been observed as well."


Now, with that said, I want to remind you that if you look at the side effects of ANY drug, you'll find scary shit on all of them. I'm sure I'll put patients on Potiga, and most will likely do fine. But that doesn't mean we can't have some fun with it.

For one thing, they don't even tell you what shade of blue. There are 45 of them. Some people if given the choice, would like a nice turquoise, while others would prefer royal blue. Hopefully further research will shed light on this important topic.

The interesting part is this: Let's say a patient had a choice between this drug and one with a "YOU COULD DIE FROM THIS!!!" black box warning. Felbatol, for example, while very effective for seizures, has the potential to cause TWO (not one, but TWO) great ways to die: severe liver failure and/or destruction of your bone marrow.

Yet, human nature is such that most people would prefer Felbatol, figuring the risk of death is preferable to that of turning blue. After all, death generally isn't socially embarrassing. We ALL die. But blue skin? That's just not fashionable.

Unfortunately, GSK (the drug's manufacturer) is likely going to see this as a drawback to Potiga. They'll tell their sales reps to minimize it and move on to something else. Or mumble "and they might turn blue" hurriedly under their breath.

The truth is they should turn it around, and make it a strength of their spiel. The best way to do this, as I see it, would be to go after some commercial tie-ins.

I've compiled a few modest examples:


Live theater:

Potiga is a proud sponsor of tonight's appearance by:

Blue Man Group

1960's psychedelic movies:

United Artists

To treat seizures, All You Need is Love. And Potiga.

1970's psychedelic movies:

Paramount Pictures

"Violet Beauregarde has been seizure free on Potiga. Next month she'll be endorsing juicers, too."

2000's movies:

Twentieth Century Fox

Potiga for epilepsy: It's out of this world!

2000's remakes of 1970's psychedelic movies:

Warner Brothers

Potiga is now available as chewing gum for your patients who won't swallow pills. Violet Beauregarde set a world record with it!

Music acts:

Atlantic Records

"We're both proud to be on Potiga. Otherwise we wouldn't be able to drive as safely as we do."

Historical tie-ins:

Bunker Hill: Would history be different if British officers had given their men Potiga beforehand?

Using it as an excuse...

ABC television

"No, officer, he wasn't into that sort of thing. He's that color from taking Potiga."

Currently Potiga is only approved for ages 18 and up. But maybe it will work in kids. If that happens, GSK is fortunate to have a wide range of endorsers to choose from!

Dupuis Cartoons

Shaky Smurf, Seizey Smurf, Ictal Smurf, and Aurette are all doing great on Potiga! If it's right for Papa Smurf, isn't it right for your child?

And, of course, who could forget

Sesame Street

New Potiga powder! You can sprinkle it on all your child's favorite foods! EVEN COOKIES!!!

Thank you, SMOD, for bringing this to my attention!