When medicines cause harm: learning from the DES disaster

The DTB podcast returns with a new format, and a new host: Dr. Hannah Harris, urgent care GP and now Clinical Editor of DTB.   In this episode, Hannah is joined by Professor Barbara Mintzes and Carol Devine, a patient and second-generation victim of Diethylstilbestrol (DES), to examine the long-term, multigenerational impacts of this synthetic oestrogen prescribed in pregnancy to prevent miscarriage from the 1940s to 1980s. They discuss why DES continued to be prescribed despite early proof of inefficacy and harm, Carol’s personal health struggle as a "DES Daughter," and the ongoing fight for government recognition and patient care.     This episode also highlights key clinical updates from the September issue of the Drug and Therapeutics Bulletin, including a commentary by the new Editor-in-Chief, Dr. Gordon Mallarkey, on precision medicine in COPD, non-hormonal treatments for polyendocrine metabolic ovarian syndrome, diagnosis of spasticity, and continuous glucose monitoring in type 2 diabetes.   Read the issue on our website: https://dtb.bmj.com/content/64/9.   We would love to hear from you with comments or questions via email ([email protected]), or you can find us on X with the handle @DTB_BMJ, and also LinkedIn and Facebook under “Pharmacy at BMJ Group”.   The DTB Podcast is hosted by Hannah Harris. It is produced by Hannah Harris and Letícia Amorim. It is edited by Letícia Amorim.

In this podcast accompanying the March 2026 issue of the DTB (https://dtb.bmj.com/content/64/3), Syba Sunny (DTB Clinical Editor) is joined by Shivali Fulchand (Editorials and Education editor at The BMJ). Syba and Shivali discuss this month’s editorial on clinically important differences (https://dtb.bmj.com/content/64/3/34) and talk about why this is such an important topic. Then they go on to talk through the DTB’s drug review on the new adrenaline nasal spray that’s been formulated for the treatment of anaphylaxis (https://dtb.bmj.com/content/64/3/36).     Please subscribe to the DTB podcast to get episodes automatically downloaded to your mobile device and computer. Also, please consider leaving us a review or a comment on the DTB Podcast iTunes podcast page. If you want to contact us, please email [email protected]. Thank you for listening.  

In this podcast accompanying the February 2026 issue of the DTB (https://dtb.bmj.com/content/64/2), Syba Sunny (DTB Clinical Editor) is joined by Julian Treadwell (DTB Associate Editor). Syba and Julian start by talking about this month’s ‘thank you’ editorial (https://dtb.bmj.com/content/64/2/18) before delving into the hot topic of GLP-1 drugs for the treatment of obesity, which is the subject of a DTB review article that summarises what is known about their benefits and harms (https://dtb.bmj.com/content/64/2/19). Finally, they discuss an intervention to reduce sedative use in patients who have been taking these drugs for a long time (https://dtb.bmj.com/content/64/2/25).    Please subscribe to the DTB podcast to get episodes automatically downloaded to your mobile device and computer. Also, please consider leaving us a review or a comment on the DTB Podcast iTunes podcast page. If you want to contact us, please email [email protected]. Thank you for listening.

In this podcast accompanying the January 2026 issue of the DTB (https://dtb.bmj.com/content/64/1), Syba Sunny (DTB Clinical Editor) is joined by Tom Nolan, an NHS general practitioner and Clinical Editor at BMJ Medicine. Syba and Tom first talk through this month’s editorial on disinformation and misinformation (https://dtb.bmj.com/content/64/1/2), and discuss ways to combat these in medicine. They then provide an overview of a DTB Forum article, which explains the benefits of taking people off antidepressants using the hyperbolic tapering method (https://dtb.bmj.com/content/64/1/3). The episode ends with Tom sharing his thoughts about the role of artificial intelligence (AI) in primary care.   Please subscribe to the DTB podcast to get episodes automatically downloaded to your mobile device and computer. Also, please consider leaving us a review or a comment on the DTB Podcast iTunes podcast page. If you want to contact us, please email [email protected]. Thank you for listening.

In this podcast accompanying the December issue of the DTB  (https://dtb.bmj.com/content/63/12), David Phizackerley (DTB Editor) is joined by Syba Sunny (Clinical Editor). David and Syba discuss this month’s editorial, written by Julian Treadwell, academic GP and DTB editorial board member, which delves into the challenges of prioritising preventative medicine in primary care (https://dtb.bmj.com/content/63/12/178). They then talk about a review article that provides an overview of the new drug elinzanetant, a non-hormonal treatment for vasomotor symptoms associated with menopause (https://dtb.bmj.com/content/63/12/182). Finally, the journal bids an emotional farewell to David, who is retiring after many good years at the DTB. Please subscribe to the DTB podcast to get episodes automatically downloaded to your mobile device and computer. Also, please consider leaving us a review or a comment on the DTB Podcast iTunes podcast page. If you want to contact us, please email [email protected]. Thank you for listening.

In this podcast accompanying the November issue of DTB (https://dtb.bmj.com/content/63/11) David Phizackerley (DTB Editor) is joined by Syba Sunny (DTB Clinical Editor). David and Syba discuss the editorial that argues that NHS budgets should not be used to ensure that pharmaceutical companies invest in the UK (https://dtb.bmj.com/content/63/11/162). They talk about a DTB Select article that summarises a systematic review and meta-analysis of trials that assessed patients with a reported penicillin or beta-lactam allergy who underwent direct oral penicillin challenge (https://dtb.bmj.com/content/63/11/163). They finish by discussing the main article that explores the intersection of medication errors, prescribing errors, harms resulting from the use of medicines and some legal consequences (https://dtb.bmj.com/content/63/11/168).   Please subscribe to the DTB podcast to get episodes automatically downloaded to your mobile device and computer. Also, please consider leaving us a review or a comment on the DTB Podcast iTunes podcast page. If you want to contact us please email [email protected]. Thank you for listening.

In this podcast accompanying the October issue of DTB (https://dtb.bmj.com/content/63/10) David Phizackerley (DTB Editor) is joined by Julian Treadwell (DTB Associate Editor). David and Julian discuss the editorial that highlights a few of the challenges associated with the introduction of an orphan medicine into clinical practice (https://dtb.bmj.com/content/63/10/146). They talk about a DTB Select article that summarises a randomised clinical trial that assessed the effect of allopurinol on cardiovascular outcomes in people with ischaemic heart disease who did not have gout (https://dtb.bmj.com/content/63/10/147). They finish by discussing the main article that provides an overview of the evidence for mavacamten (▼Camzyos) for the treatment of symptomatic obstructive hypertrophic cardiomyopathy in adults (https://dtb.bmj.com/content/63/10/150).   Links GP Evidence: https://gpevidence.org/ Preventing Overdiagnosis 2025 International Conference: https://www.cebm.ox.ac.uk/preventing-overdiagnosis   Please subscribe to the DTB podcast to get episodes automatically downloaded to your mobile device and computer. Also, please consider leaving us a review or a comment on the DTB Podcast iTunes podcast page. If you want to contact us please email [email protected]. Thank you for listening.

In this podcast accompanying the September issue of DTB (https://dtb.bmj.com/content/63/9), David Phizackerley (DTB Editor) is joined by Syba Sunny (DTB Clinical Editor). David and Syba discuss the editorial that highlights changes to antibiotic susceptibility reports, and in particular, the change to the 'I' classification from 'intermediate' to 'susceptible, increased exposure’ (https://dtb.bmj.com/content/63/9/130). They talk about a DTB Select article that summarises an evidence review of deprescribing interventions in primary care and the importance of collaborative multidisciplinary teams, education and training, and shared-decision making (https://dtb.bmj.com/content/63/9/131). They finish by discussing the main article that provides an overview of pharmacological management of chronic heart failure with reduced ejection fraction and the four main groups of drugs that form the four pillars of treatment (https://dtb.bmj.com/content/63/9/133).   Please subscribe to the DTB podcast to get episodes automatically downloaded to your mobile device and computer. Also, please consider leaving us a review or a comment on the DTB Podcast iTunes podcast page. If you want to contact us please email [email protected]. Thank you for listening.

In this podcast accompanying the August issue of DTB (https://dtb.bmj.com/content/63/8), David Phizackerley (DTB Editor) is joined by James Cave (former DTB Editor-in-Chief). David and James discuss an editorial generated by artificial intelligence (AI) (https://dtb.bmj.com/content/63/8/114) which looks at the role of AI in publishing. They talk about a DTB Forum article (https://dtb.bmj.com/content/63/8/115) that explores some of the practical problems of implementing drug safety alerts.  A DTB Select article (https://dtb.bmj.com/content/63/8/117) provides an overview of a double-blind, randomised, placebo-controlled trial of tirzepatide for weight reduction in people without diabetes. They finish by reviewing the main article (https://dtb.bmj.com/content/63/8/118) that provides an overview of the evidence for lecanemab for the treatment of mild cognitive impairment and mild dementia due to Alzheimer’s disease.   Link BMJ policy on AI use: https://www.bmj.com/content/ai-use    Please subscribe to the DTB podcast to get episodes automatically downloaded to your mobile device and computer. Also, please consider leaving us a review or a comment on the DTB Podcast iTunes podcast page. If you want to contact us please email [email protected]. Thank you for listening.

In this podcast accompanying the July issue of DTB  (https://dtb.bmj.com/content/63/7), David Phizackerley (DTB Editor) is joined by Syba Sunny (Clinical Editor). David and Syba discuss the editorial (https://dtb.bmj.com/content/63/7/98) which focuses on some key changes in the new national asthma guideline and the implications for patients and healthcare professionals. A DTB Select article (https://dtb.bmj.com/content/63/7/99) provides an overview of a double-blind randomised placebo-controlled trial that assessed whether bisoprolol reduced the number of exacerbations in people with COPD. The main article (https://dtb.bmj.com/content/63/7/103) is an overview of abaloparatide, which is licensed for the treatment of osteoporosis in postmenopausal women at increased risk of fracture.   The podcast begins with a discussion about ideas for new articles for DTB and the therapeutic areas currently under consideration. If you have a suggestion for an article that you would like DTB to cover, please email details to [email protected].   Please subscribe to the DTB podcast to get episodes automatically downloaded to your mobile device and computer. Also, please consider leaving us a review or a comment on the DTB Podcast iTunes podcast page. If you want to contact us please email [email protected]. Thank you for listening.