The Canadian Task Force on Preventive Health Care has reversed its 2005 recommendations, finding methodological flaws, possible bias, and uncertain generalizability in a review of the literature. “In the absence of a demonstrated benefit of screening, and in consideration of the potential harms, we recommend not routinely screening for depression in primary care settings, either in adults at average risk or in those with characteristics that may increase their risk of depression,” the task force writes in a forthcoming edition of the Canadian Medical Association Journal.
The New York Times reports that the “baffling” rise in suicide rates in the U.S. military is not correlated to deployment, as is often assumed. “Perhaps the biggest challenge facing the Pentagon is simply getting suicidal service members into treatment,” the article states, adding that “despite campaigns to reduce stigma, many service members continue to believe that treatment will be ineffective or hurt their careers.” However, nearly every example given in the article mentions that the person was taking antidepressants – evidence that the person was “not in a good place.”
A study of 530,000 patients who underwent surgery at 375 U.S. hospitals found a 10% increased risk of post-operative complications including bleeding, transfusion, hospital readmission and death. However, the authors note that patients on SSRIs are also more likely to have conditions that increase surgical risk such as obesity, chronic pulmonary disease and depression. Results appear in JAMA Internal Medicine.
The norm in science is that there is free access to the data underpinning experiments. If free access is denied; it’s not science. In the case of branded pharmaceuticals, we do not even know what trials have been done. What is put in the public domain is not data. The selected highlights of a football game and the comments of the pundits afterwards don’t change the score. The selected highlights of pharma studies and the comments of pundits routinely change the score. Full Article →
At the 50th American Psychosomatic Society meeting in New York, Michael Shepherd was speaking. His topic – The Placebo. When the lecture finished, Lou Lasagna said “this paper is now open for questions.” Nothing happened. Nobody said anything at all. Lasagna couldn’t refrain from commenting: “There are 3 possible explanations. First, you were all asleep and therefore you heard nothing. Secondly, it was so bad that since this speaker has come 3,000 miles you didn’t want to embarrass him. Third, it is genuinely so original and new that you don’t quite know what to make of it. I’ll leave you to decide which it was”.
Based on a psychiatrist’s recommendation that the effects of citalopram (Celexa) had contributed to a 61 year-old grandmother’s lethal bludgeoning of her friend of over 20 years as they had tea, the High Court in Edinburgh accepted a reduced plea of ‘culpable homicide.’ The psychiatrist indicated that she had been prescribed a dosage “far in excess of what she should have been prescribed.”
The U.K.’s Mail reports of an effect of SSRIs that, though rare, has shown up in significant numbers of people according to David Healy’s RxISK website; unusual aggressiveness and recklessness associated with relatively minor drinking. “Once I started drinking I found it hard to stop. I also found I was becoming confused after drinking alcohol… I got banned from restaurants and bars in my local town and became an embarrassment to my friends. Once I climbed onto my roof. I was not trying to kill myself. I felt as if I was in a dream.”
A study of the Swedish medical birth registry, conducted by researchers from Sweden, the U.K., and the U.S.A., found a 3.3X greater risk of autism in the offspring of women reporting antidepressant use during pregnancy. The researchers, however, urge caution as the results explain only a small percentage of the prevalence of autism.
Eli Lilly & Co. will pay an undisclosed amount to settle the lawsuit of the parents of a South Dakota boy who committed suicide four weeks after starting the antidepressant Cymbalta. The lawsuit, which was to go to trial next month, that Lilly failed to adequately warn patients that the drug was known to cause suicidal inclinations, and that a 19-year-old student had committed suicide by hanging while participating in a trial of the drug for urinary incontinence.
Dr. Oz looks at the research on antidepressants today, finding that they are over-prescribed, may be counter-productive or harmful, may not work at all, and that advertising them is only allowed in the USA and New Zealand.
Autism rates are on the rise, with the latest report from the US Centers for Disease Control showing 1 in 50 children to be affected. Prozac, the first of the SSRI antidepressants, was launched in 1987 and sales have risen since then. Estimates are that up to 13% of US pregnancies are exposed (or around 500,000 US pregnancies per year). Available scientific data from animal and human studies raise serious concerns that exposure to SSRIs during pregnancy damages the developing brain and may cause neurodevelopmental abnormalities, including autism. Full Article →
Yesterday I attended psychiatry grand rounds, where Andy Miller presented his latest research. Andy has been a pioneer in the field of psychoneuroimmunology and an exponent for the view that major depression reflects systemic inflammation. (I have published a review of this literature recently in Frontiers in Psychology which is available for download). Full Article →
In a study of 6,767 reports of antidepressant trials in juveniles treated for depressive and anxiety disorders, the risk of psychopathological behavioral or mood elevation was 3.5x greater with antidepressants than with placebo. The authors (which include Giovanni Fava of the University of Bologna and Ross Baldessarini of Harvard Medical School) urge “particular caution and monitoring for potential risk of future bipolar disorder.”
A review of research on antipsychotic medications as an adjunctive treatment for depression published this week in PLoS Medicine finds that the widespread practice produces either no benefit or a very small to moderate benefit on quality of life, while also being linked to adverse events such as akathisia, sedation, metabolic effects and weight gain. The authors urge that although clinicians may observe very small to moderate improvement of symptoms, “the lack of benefit with regards to quality of life or functional impairment, and the abundant evidence of potential treatment-related harm” suggest caution.
AntiDepAware promotes awareness of the dangers of antidepressants, in particular to the problem of antidepressants “being prescribed to those who are not depressed, to whom they are likely to do more harm than good.” The the site offers a link to inquest reports in England and Wales over the past 10 years, found mostly in the online archives of local newspapers.
A Colorado based company, Sundance Diagnostics, contacted me a few months ago to tell me about work they are doing to develop a genetic test to predict suicide risk when patients are prescribed antidepressant drugs. Their plan is to sequence the entire human genome of about 360 patients and controls to see if antidepressant drug risk can definitively be predicted. Full Article →
Scientists at Microsoft, Stanford and Columbia University, using automated software to mine data from 82 million internet searches for information related to, found a side effect related to interaction between an antidepressant (paroxetine) and a cholesterol drug (prevastatin) that had as yet gone undetected by the FDA’s Adverse Event Reporting System. The study, published online yesterday by the Journal of the American Medical Informatics Association, found that people who searched for information on both drugs were more likely to do a search for information on hyperglycemia as well.
The humor newspaper The Onion satirizes the conversion of transient human emotions into lifelong illnesses, reporting that “Shortly after losing grip of a helium-filled balloon and watching it float into the air above the San Diego Zoo Tuesday, local child Caleb Tremont, 3, reportedly began a battle with chronic depression that will last for the rest of his life.”
An issue that we think deserves more media attention than it is currently receiving is the idea of Preventive Intervention in Psychiatry. The goal of Preventive Intervention is to reduce the rate of psychiatric diagnoses in an at-risk group of people by pretreating all the group members with a medication. For instance, could the rate of PTSD in the military be reduced by pretreating everybody in the military with an SSRI? Full Article →
In August 2010, my friend and fellow ‘suicide mum’ Deb Williams and I established CASPER – Community Action on Suicide Prevention Education & Research. CASPER’s goals are to provide peer support to families bereaved by suicide, to educate politicians and opinion leaders on suicide and its prevention and to support families and communities to reclaim suicide prevention from medical professionals and governments. Full Article →
A large-scale study of depression-related brain activity may also reveal whether a connection exists between the high rates of both psychotropic medication and suicide in the military, according to Senator Ben Cardin (D-Md).
Japanese engineers have devised a robotic rat that bullies laboratory rats into a state of depression, creating a model of human depression they deem suitable for testing antidepressants. The research, published this month in Advanced Robotics, reports that continuous attacks in young and intermittent attacks (in response to movement) in older rats is most effective.