The apparently positive effects of antidepressants on depression are even smaller than previously thought and "fall far short" of clinical significance, according to a new analysis of the trial data published in Contemporary Clinical Trials. The study was conducted by Irving Kirsch, author of The Emperor’s New Drugs: Exploding the Antidepressant Myth, and MIA Blogger Joanna Moncrieff. More →
Pregnant women taking antidepressant medications, especially during the second trimester, have an increased risk of preeclampsia, a potentially serious or even fatal condition for both mother and child, according to a study by Kaiser Permanente Northern California researchers. More →
Salon looks at old data on depression studies and new data on anxiety disorders, and finds pharmaceutical companies and psychiatric researchers still "aren't telling you the whole truth." More →
A University of Oxford-led randomized controlled study published in The Lancet found that mindfulness-based cognitive therapy was as effective as antidepressants at preventing relapses in depressed people. The press release for the study noted this also meant that MBCT "isn't any more effective" than maintenance antidepressant treatment in preventing relapses. However, the mindfulness group had to deal with another important confounding factor which the study authors only noted in passing. More →
The pilot who deliberately crashed a Germanwings commercial airplane was questioned by the Federal Aviation Administration and denied a license to fly. The Agency reversed course in 2010, however, when his treating psychiatrist wrote letters of support indicating that the pilot's treatment with antidepressants and psychotherapy was a "complete" success, reported CNN and USA Today. More →
On The Mental Elf, forensic psychiatrist Andrew Shepherd reviews in detail a recent study and journal editorial on withdrawal effects from coming off antidepressant drugs. More →
The BMJ article on The Marketing of Serotonin has stirred some interest. There are some highly technical comments on the BMJ site but of course the key point behind the piece is the rather obvious fact that twenty-five years ago many people were saying it was all a myth. The extraordinary Michael Leunig nailed it twenty years ago in the sketch above. (Leunig is wonderful across the board and razor sharp on medicine and mental health).
"The latest prescription figures from the Health and Social Care Information Centre show that the UK is in the midst of a psychiatric drug epidemic," reports the Council for Evidence-based Psychiatry. More →
A recent article on the website i09 titled, ‘The Most popular Antidepressants are Based on an Outdated Theory” has again raised the issue of Chemical Imbalances. It is interesting that the author of the i09 piece cites Dr. Peter Kramer and states, “Some psychiatrists vehemently disagree with the way journalists and other psychiatrists have pushed back against the chemical imbalance theory….” In both cases he cited what he considered the best evidence in support of the theory, but he did not discuss the research in any depth. Back in 2008, we took an in-depth look at the evidence that Dr. Kramer used to support the chemical imbalance theory. When one takes a closer look at that research we do not think it supports the theory. For this reason, we are reposting our 2008 essay about this.
The serotonin reuptake inhibiting (SSRI) group of drugs came on stream in the late 1980s, nearly two decades after first being mooted. The delay centred on finding an indication. They did not have hoped-for lucrative antihypertensive or antiobesity profiles. Even though a 1960s idea that serotonin concentrations might be lowered in depression had been rejected, drug companies marketed SSRIs for depression even though they were weaker than older tricyclic antidepressants. They sold the idea that depression was the deeper illness behind the superficial manifestations of anxiety. The approach was an astonishing success, central to which was the notion that SSRIs restored serotonin levels to normal, a notion that later transmuted into the idea that they remedied a chemical imbalance.
The commonly used antidepressant sertraline hydrochloride (Zoloft) caused up to six-fold increases in build-up of atherosclerosis plaque in the coronary arteries of monkeys, according to a study in Psychosomatic Medicine. More →
Having a high risk of developing post-traumatic stress disorder was associated with almost double the risk of developing type 2 diabetes, according to a study in JAMA Psychiatry. Use of antidepressant medications accounted for nearly half of that increased risk. More →
The impact of long-term SSRIs on memory-related nerve cell receptors does have functional consequences. Research shows that SSRIs impair the acquisition of fear memories. (Perhaps a positive outcome.) But unlearning fear memories involves new learning as well, and according to a study by LeDoux and colleagues, long-term exposure to SSRIs makes it harder to unlearn fear memories.
Most pilots who've used planes to commit suicide had actually been screened for mental health issues, reports the New York Times. Plus a selection of other commentaries that continue to emerge about the Germanwings plane crash... More →
"Pfizer Inc. researchers concluded last year that pregnant women taking Zoloft risked having babies with heart defects, according to evidence made public by a lawyer at the first trial of more than 1,000 lawsuits over the drug," reported Bloomberg. More →
A retrospective study in the Journal of Clinical Psychiatry identified 183 possible cases of people who suffered sexual dysfunction that endured even after stopping taking SSRI antidepressants. Of these, the Israeli researchers identified "23 high-probability cases" of "Post-SSRI Sexual Dysfunction" (PSSD). More →
I thought I would make a small contribution to the discussion about how coverage of the recent airline tragedy focuses so much on the supposed ‘mental illness’ of the pilot and not so much on the possible role of antidepressants. Of course we will never know the answer to these questions but it is important, I think, to combat the simplistic nonsense wheeled out after most such tragedies, the nonsense that says the person had an illness that made them do awful things. So, just to confirm what many recipients of antidepressants, clinicians and researchers have been saying for a long time, here are some findings from our recent New Zealand survey of over 1,800 people taking anti-depressants, which we think is the largest survey to date.
In Forbes, David Kroll asks whether antidepressants are more dangerous for commercial pilots to have than depression. And in Mail Online, Peter Hitchens similarly argues that the public discussion about the Germanwings crash has to start distinguishing between the questions of whether depressed people should be flying commercial planes and whether people taking antidepressants should be. More →
With the current focus on the possible contribution of psychoactive drugs to the crash of GermanWings flight A320 on Tuesday, March 24, it is useful to identify potential links between the effect of the antidepressants and the events. In all 47 cases listed on SSRIstories, the pilots were taking antidepressant medications, mostly SSRIs, often in combination with other medications and sometimes with alcohol.
The crash last week of the Germanwings plane has shocked many. In view of the apparent mental health record of the co-pilot Andreas Lubitz, questions have been asked about the screening policies of airlines. The focus has generally been on the conditions pilots may have or the arguments they might be having with partners or other situational factors that might make them unstable. Even when the issue of the medication a pilot may be taking is raised, it is in the context of policies that permit pilots to continue on drugs like antidepressants to ensure any underlying conditions are effectively treated. But fewer treatments in medicine are effective in this sense than people might think and even when effective they come with effects that need to be balanced against the likely effects of the underlying condition.
Germany's Die Welt has reported that the German pilot who apparently deliberately crashed a commercial passenger plane had antidepressant drugs in his home, according to CNN. The US Federal Aviation Administration has banned US pilots from taking many SSRI antidepressants. More →
The majority of people taking antidepressant medications have never had major depressive disorder, and 38% have never met criteria for having any mental disorder, according to a study in Baltimore published in the Journal of Clinical Psychiatry. More →
The extensive off-label use of antipsychotic medications in nursing homes is causing many adverse effects and providing limited benefits, according to a review of the literature in Health Policy. More →
Pneumonia cases in the elderly are strongly associated with use of anticholinergic medications, according to research in the Journal of the American Geriatrics Society. Some anticholinergics are used for treating psychiatric conditions, including benzodiazepines and tricyclic antidepressants. More →
In 2010, Acta Psychiatrica Scandinavica published a study by Göran Isacsson et al. The paper was titled Antidepressant medication prevents suicide in depression. It’s a complicated article, with some tenuous logic, but, in any event, it’s all moot, because the article was retracted by the authors and by Acta Psychiatrica Scandinavica about sixteen months after publication. The retraction had been requested by the authors because of “… unintentional errors in the analysis of the data …”
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