Antidepressants and Overall Wellbeing

Philip Hickey, PhD
27
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There was an interesting article published on April 12, 2014 in Psychotherapy and Psychosomatics.  It’s called The Efficacy of Antidepressants on Overall Well-Being and Self-Reported Depression Symptom Severity in Youth: A Meta-Analysis, by Gary Spielmans and Katherine Gerwig, both of the Psychology Department, Metropolitan State University, St. Paul, Minnesota.

The authors conducted a word-search in Medline, PsychINFO, and the Cochrane Central Register, and identified 8 studies that met their criteria.  They combined the data from these studies and concluded:

“Though limited by a small number of trials, our analyses suggest that antidepressants offer little to no benefit in improving overall well-being among depressed children and adolescents.”

In the Discussion section of the paper, they stated:

“We found no evidence that antidepressants offer any sort of clinically meaningful benefit for youth on self-report measures of depression, quality of life, global mental health, or parent reports of autonomy.”

The authors acknowledge that their study has limitations,  “…the most obvious being the small sample of included trials.”

“A larger sample of relevant trials may lead to differing conclusions.  However, even the strongest signal of efficacy in our results (a pooled statistically nonsignificant effect of g = 0.16 across measures of autonomous functioning, self-esteem, global mental health, and quality of life among adolescents) provides little reason to suspect any robust treatment effects.”

The article goes on to discuss the relative merits of self-report vs. practitioner ratings as measures of efficacy in antidepressant trials:

“Given the high emphasis on clinician-rated depression measures in the reporting of clinical trial outcomes and subsequent reviews…it seems that even the modest efficacy found in prior antidepressant meta-analyses is inflated.  Perhaps this is best illustrated by fluoxetine [Prozac].  The discord between small to moderate effect sizes on clinician-rated measures in three trials (0.52, 0.60, and 0.40)…and negligible to quite modest effects on self-reports (-0.07, 0.22, and 0.15) is notable.  Further, the only fluoxetine trial to report quality of life and global mental health outcomes found no treatment benefit.”

and

“It is unclear exactly how different outcome measures should be weighed, but our findings suggest that the overall benefits of antidepressants in youth have been overstated and that their overall benefit over placebo may be vanishingly small.”

And more disturbingly:

“…a recent systematic review found a much elevated risk of excessive arousal/agitation among youth taking antidepressants versus placebo…Data from a Food and Drug Administration systematic review also found that antidepressants were linked to a statistically significantly higher rate of hostility or agitation relative to placebo…Clearly, a more expansive examination of the risk-benefit ratio of antidepressants in youth, extending beyond clinician-rated depression measures and suicidality, is needed.”

. . . . . . . . 

The first review mentioned in the above quote is Offidani E. et al, 2013.  Here’s their conclusion:

“Risks of excessive mood elevation during antidepressant treatment, including mania-hypomania, were much greater than with placebo, and similar in juvenile anxiety and depressive disorders. Excessive arousal-activation in children or adolescents treated with antidepressants for anxiety as well as depressive disorders calls for particular caution and monitoring for potential risk of future bipolar disorder.”

The FDA review mentioned is the 131 page review by Tarak Hammad, MD, PhD on the link between suicidal behavior and antidepressants’ in youth.  On the link to hostility/agitation, Dr. Hammad stated:

“Although none of the individual trials had a statistically significant result, the overall RR [risk ratio] for Paxil and the overall RRs for all drugs and for all SSRIs were statistically significant showing an increase in the risk of developing these symptoms in the drug group as compared to the placebo group.” 

Perhaps it’s Time to Stop
Calling These Drugs Antidepressants

And, Incidentally

I found no links to the Spielmans, Gerwig article in the mainstream media.  In fact, I found only two outlets that picked it up:  MinnPost, where I found it, and MDLinx.  MinnPost is  ” . . . a non-profit, nonpartisan enterprise whose mission is to provide high-quality journalism for news-intense people who care about Minnesota.”  MDLinx is an online newsletter that  ” . . . aggregates medical articles and research from more than 1,200 peer-reviewed journals and leading news media on a daily basis.”

* * * * *

This article first appeared on Philip Hickey’s website,
Behaviorism and Mental Health

27 COMMENTS

  1. “Perhaps it’s Time to Stop Calling These Drugs Antidepressants.” Absolutely, true. It’s also time to stop calling them “safe smoking cessation meds.” But calling them bipolar inducing drugs or suicide and violence inducing drugs would be accurate.

    I’m quite certain the psychiatric industry has spent the last 60 years confusing the ADRs and withdrawal effects of their drugs, with “symptoms” of their voted into existence disorders. The antipsychotics cause the short and long run “symptoms” of schizophrenia, too.

      • According to my medical records, psychiatric practitioners mandated drugs based upon their denial of the existence of the Holy Spirit, and God; thus, their “desecration” of what is “holy” to me.

        As a Christian, I believe people should treat others as they’d like to be treated. And, as a Christian, it is not my right to forgive those who committed the “only unforgivable sin” in the Holy Bible (denial of the Holy Spirit).

        So, I really do not have a big problem treating the psychiatric practitioners as they treated me, and desecrating their “sacred objects – pills and ECT machines.” Especially since the actual medical evidence has come in showing their “sacred objects” do more long run harm, than good.

        Thanks for speaking the truth, again, Dr. Hickey.

  2. Sigh…Once again Phil Hickey publishes yet another great article with a crystal clear argument about psych drugs. I love what he writes. He and others like Bob Whitaker and Peter Breggin have given us great ammunition for the fight.

    But how do we carry on this fight? I would like to see more articles in Mad In America about strategy and tactics, about what we can actually DO about the abuses of psychiatry like pressuring or forcing people to take these dangerous chemicals. We need to go beyond talking to one another and go out into the world and take our message to the general public.

    If you agree, you can contact me at [email protected].

    • I agree, Ted. I would like to see more articles of the sort you describe.

      If you get some activism going, please report back on the site! My own efforts are currently limited to trying to put an alternative view to family, friends and acquaintances, but this is pretty fruitless because of the pervasive voice of so-called experts and of patients who have bought into the whole box and dice.

    • ” take our message to the general public”

      Links links and more links on the Google index . Sucks that sites like NAMI and Web Md snag first page google for most drug names and mental health keywords but that’s alright the message is getting out.

      “pressuring or forcing people to take these dangerous chemicals”

      I think a survivor run review site for rating hospitals , doctors and medications would be cool. How about like the political forum was added , add a rate that hospital forum or something like that. Every post topix is a google link.

      I don’t know, pharma owns mainstream media, ask your doctor…

    • “But how do we carry on this fight?”

      Might I suggest by starting one?

      At the moment it’s a bit of a mismatch. A 5 year old kid verses Mike Tyson at his prime. Keep playing by the Queensbury rules and the blows will be ineffective.

      Sure it will take time to ‘muscle up’ by getting the public to see what a bully looks like, but in the meantime? I’m for taking the gloves off and a good swift kick to the genitals. A couple of slaps aren’t going to take Tyson down.

      • Exactly! A good swift kick to the genitals is exactly what is needed. It’s time to quit trying to deal with the system by being nice and by fighting fair. There is absolutely nothing nice or fair about the war that the system has carried on against us with impunity. It’s time to turn the tables and use their tactics on them that they’ve used on us for so long.

    • I do agree. But different tactics have been discussed on MIA, from creating peer run alternative treatment groups and facilities, through protests, educational campaigns, civil disobedience and class action law suits. There are two main hindrances to that: time and money. As most psych survivors struggle with both issues (and often with medical problems stemming from psych “treatment”) it’s not easy :(.

      • I totally agree. There has to be a lot more activism and making people aware and getting involved. We need to do WHATEVER it takes, if that means class action lawsuits, etc. and I agree that what makes is difficult is that a lot of people treated with these drugs may be in a compromised state(which is what they want) and difficult to take action. I would love to see someone being held accountable for this criminal behavior and the senseless lives being lost and ruined by these TOXIC drugs.

  3. How about this,

    If anti depressants actually worked they would destroy humanity, why ? Cause if people could be happy for no reason all activity would cease and people would just be happy. This and that bad thing are going to happen but so what , I won’t feel sad… Think about it.

    Sad and bad feelings are motivators.

  4. How about this,

    It’s possible that the “magic mushrooms” can teach people how to be happy again, me and some buddies were talking about our experiences back in the day and ya that was unbelievable fun. My face hurt from laughing for the next 2 days once after a trip my checks were sore the same way my chest would get from bench pressing.

    Then we were busting on mainstream pharmaceuticals and I asked the question, has any one really had a good time parting on Xanax or some pain pills, the consensus was no. That crap can and often will wreck your life.

    This whole anti depressant thing is a joke, One in 10 Americans now takes an antidepressant medication; among women in their 40s and 50s, the figure is one in four. WTF ???

    I am convinced these SSRI drugs are causing divorces and more depression cause they create sexual dysfunction and sex is a big part of the attachment process that keeps couples together.

    • Prozac has given me a major case of anxiety – I’d wake up in the morning practically shaking from fear with no reason. Same with some muscle relaxants – when they worked I was high but as soon as they were cleared from my system I’d start shaking uncontrollably.

    • I totally agree. I blame a big part of the huge increase in divorce rates to these drugs and there are several websites to confirm that. Beyond Meds has some very good information supporting this ~ these drugs can cause people to sort of disconnect and not be able to feel emotions they normally would feel, therefore not knowing how to really feel what “love” is anymore. It’s so sad and alarming to me and the world needs a wakeup call to see what’s really happening.

      • Oh, it can get better: I was actually told that what I felt for my ex was not “love” because the psychiatrist of course had the only right definition of it. Not that it changed anything in the end (our relationship was toxic from the onset) but the same guy was trying to make me believe I was abused by my parents and that all my friends are not really my friends. Fortunately my bs detector went off before I even went into his office but have I been more gullible I might have ended all alone with no one in the world.