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  "documentTitle": "Harmony Biosciences (HRMY)",
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  "notes": "Uses anecdotal evidence from Facebook patient support groups to highlight a safety gap.",
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      "text": "Moreover, numerous posts indicate that doctors as well as Harmony’s specialty pharmacy are telling patients the opposite: that a CYP2D6 inhibitor like an antihistamine DECREASES pitolisant levels, when in fact the opposite is true.",
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      "text": "The FDA’s suggestion on the label to halve the dose to 17.8mg when pitolisant is taken with “strong CYP2D6 inhibitors” does little to mitigate the danger – we again emphasize that this assumes that patients know their CYP2D6 phenotype, which they generally do not.",
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      "text": "Moreover, numerous posts indicate that doctors as well as Harmony’s specialty pharmacy are telling patients the opposite: that a CYP2D6 inhibitor like an antihistamine DECREASES pitolisant levels, when in fact the opposite is true. Some representative examples:",
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      "text": "Our search of every major pitolisant/narcolepsy patient support group on Facebook, with thousands of members and posts, didn’t result in a single post where a patient mentioned being tested for their CYP2D6 phenotype. However, posts frequently indicate that patients are on pitolisant PLUS multiple SSRI’s or antidepressants PLUS other CYP2D6 inhibitors like OTC antihistamines – a recipe for potential tragedy.",
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      "text": "Source: Facebook patient support groups",
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