New research, published in Psychiatry Research, features personal accounts of antidepressant users and their experiences of negative side effects related to sex, work, socializing, and physical health. John Read and a team of researchers in the U.K. further explored informed consent and the impact of polypharmacy.
“This survey, the second largest to date, confirms that side effects are very common when taking ADs [antidepressants].”
Staggeringly high rates of antidepressant prescriptions continue to climb. In England, prescriptions have doubled since 2005. Similarly, antidepressant use doubled in Australia between 2000 and 2014 becoming the most commonly used medication taken by 1 in 10 Australians each day. By 2005, antidepressants were the most widely prescribed drug in the United States, and by 2012, one in eight adults had incorporated their usage into their daily routine.
The efficacy of antidepressants for mild to moderate major depression, when tested in blinded, non-industry studies, are found to be no different from placebo. The authors cite meta-analytic evidence demonstrating that “the overall effect of new-generation antidepressant medications is below recommended criteria for clinical significance.”
Researchers contend that the harmful costs of taking antidepressants outweigh any potential benefits, only demonstrated to have potentially greater than placebo effects on individuals exhibiting signs of very severe depression.
Negative symptoms that are most commonly reported by antidepressants users include nausea, headaches, dry mouth, insomnia, somnolence, diarrhea, dizziness, and constipation. Other findings from placebo-controlled studies has similarly focused on medically-related symptoms. While acknowledging the significance of these findings, the authors of this study sought to expand upon existing research to examine how antidepressants negatively impact people in terms of their personal and interpersonal lives.
Currently, the largest dataset covering antidepressant usage and its negative effects on one’s personal life identified experiences of sexual difficulties, emotional numbness, feeling not like oneself, agitation, reduction in positive feelings, suicidality, and caring less about others. Very few studies have investigated how prescribers go about informing patients of adverse effects, and almost none have examined the effects of combining other psychiatric medications with antidepressants.
Read and co-researchers surveyed over 1,000 antidepressant users in the U.K. on their experiences of interpersonal and daily-life related symptoms. To address the gaps in the literature, they additionally questioned to what extent participants were informed of negative effects by prescribers and whether participants were simultaneously taking other psychiatric drugs. The online survey was designed and disseminated by Mind, a mental health charity located in England and Wales.
The majority of participants taking only antidepressants (85.9% of 484) reported side effects of antidepressant use. Of those effects reported, adverse symptoms related to sex life (43.7), work or study (27%), physical health (26.8%), and social life (23.5%) were most commonly endorsed, followed by negative effects in their close relationships (20.9%) and independence (10.5%). Additional participant comments about their experiences on antidepressants were included:
“I hate it. It makes me emotionally flat – for example, I had to stop taking them after a recent family bereavement to make sure I was able to cry at the funeral.”
“The drugs make me totally disconnected from everything and lifeless.”
“I think it is causing fatigue, amongst other things so I have had to drop my hours at work from full-time to 3 days a week.”
“It affected my sexual relationship with my partner as I had no desire to have sex and we are still feeling the effects of this now as he is nervous to ask after knowing that I wasn’t interested for such a long time.”
“It is very hard to separate the effects of the meds and the effects of the illness.”
The remaining 524 participants reported taking antidepressants alongside tranquilizers or sleeping pills, antipsychotics, and/or mood stabilizers. This indicates that just over half of the 1,008 survey respondents were taking two or more psychiatric drugs. Furthermore, the more medications being used, the more severe the reported side effects.
Polypharmacy, or the simultaneous use of at least 2 psychiatric drugs, more than doubled the rates of experiencing most of the negative symptoms listed and was found to be more common when drugs were prescribed by a psychiatrist rather than a general practitioner (GP).
“Despite its rapid increase polypharmacy cannot be described as an evidence-based approach,” note the authors who address that almost no study has examined the impact of polypharmacy, much less found evidence to support it.
Approximately 48% of participants taking antidepressants indicated that they had been given enough information about the medication whereas about 40% reported that they had not received enough information.
The remaining percentage noted that they were unsure or could not remember. Interestingly, men (53.5%) were significantly more likely to report being given enough information than were women (46.8%). Age was positively related to not being given adequate information such that the older one was, the less informed they felt about adverse symptoms.
Additional participant comments regarding informed consent were as follows:
“In reality, psychiatrists refuse to answer questions and refuse to accept or discuss side effects.”
“The side-effects weren’t explained very well by the prescribing GP. Anorgasmia is a particularly bad side-effect.”
“Would of liked to hear more about side effects….. I had to find out lots of information myself when I was in a difficult anxious state.”
“I wasn’t told of all the side effects; in fact, when I researched them myself and then told my doctor, she hadn’t got a clue it could affect you in the way it affected me.”
Overall, the results of this underscores how extremely common it is to experience negative symptoms when taking antidepressant drugs, particularly those related to personal and interpersonal functioning.
“In reducing the depression the drugs may also be reducing all feelings and thereby replacing painful feelings with an empty emotional void, both personally and, as a further consequence, interpersonally.”
Interestingly, 85% of participants experienced antidepressant drugs to be at least “fairly effective.” The authors offer the following context for this finding:
“Many people do feel less depressed when taking ADs [antidepressants] but it seems this is primarily because of the expectation raised by the processes involved in prescribing and taking the pills rather than by the chemicals therein.”
They add that in the largest study conducted on antidepressant-related negative personal symptoms, “one of the strongest predictors of perceived efficacy was the perceived quality of the relationship between the prescriber and the patient.”
Finally, the findings underscore the importance of informed consent, exploring symptoms beyond the bio-medical domain, and discouraging the growing rates of polypharmacy found, in this study, to be especially promulgated by psychiatrists.
Read, J., Gee, A., Diggle, J., & Butler, H. (2017). The interpersonal adverse effects reported by 1,008 users of antidepressants; and the incremental impact of polypharmacy. Psychiatry Research. http://dx.doi.org/10.1016/j.psychres.2017.07.003 (Link)
Very surprised that suicide feelings and mania was not a major side effect of the antidepressants. Especially with the statistician at GSK stating 6.7% committing suicides while on Paxil. SSRIs all basically work the same. Mania not even being mentioned. I find that interesting.
I agree. I can only speculate that mania may be harder for the person him/herself to notice, as it doesn’t necessarily feel bad to the person experiencing it at the time it’s occurring. I also wonder what kind of questions they asked – if they were very open ended, a person might report, say, agitation and feelings of restlessness and loss of sleep and suicidal thoughts, but not put them all together and call it “mania.” We know mania is a reasonably common reaction, and it is puzzling that it doesn’t appear in the manuscript.
From A Pathologist.
“…..A former assistant state pathologist has expressed serious concern about the growing link between anti-depressants and suicide.
Dr Declan Gilsenan said in his 30-year experience carrying out postmortems, he had seen “too many suicides” after people had started taking the drugs and questioned whether GPs were over-prescribing them….”
GPs are definitely over prescribing the antidepressants, and they are lying to their patients describing them as “safe … meds.”
Polypharmacy is absolutely a huge problem, and we have the DSM in part to thank for this, given it recommends combining the psychiatric drugs, especially for those defamed as “bipolar.”
As to, “Very few studies have investigated how prescribers go about informing patients of adverse effects, and almost none have examined the effects of combining other psychiatric medications with antidepressants.” A little reminder to the “mental health industry,” combining either the antidepressants and/or the antipsychotics can make people “psychotic,” via anticholinergic toxidrome.
Anticholinergic toxidrome should be included in the DSM, as should neuroleptic induced deficit syndrome.
Although this likely means we can get rid of the “schizophrenia” diagnosis, since the neuroleptics can create what appears to the “mental health professionals” to be both the positive and negative symptoms of “schizophrenia,” via the above mentioned toxidrome/syndrome.
Today’s “mental health professionals” are staggeringly ignorant about the adverse effects of their drugs.
Whenever I told my psychiatrist about new, unusual and upsetting symptoms that the drugs were causing he either dismissed them as minor or perceived them as worsening mental illness. Of all the toxic effects I’ve had from polypharmacy the Akathisia was the very worse and I had no idea at the time what it was. When the Akathisia started the psychiatrist said it was mania and prescribed more drugs. When a client has had their perception and behavior altered from polypharmacy how can they clearly answer any kind of questionnaire? I didn’t have internet at the time which has proved for so people a potential lifesaver.
Effect? The anxiety, agitation, akathisia, worsening depression they caused leads to polypharmacy solutions instead of removal of the drug. And then the worsening and illness this causes leads to a label of “TRD”, which paves the way for some brain damaging ECT. The despair and the trauma and the brain damage from ECT leads to justification for more drugging.
How about this for a headline:
“Research now confirms that repeatedly bashing your head against a brick wall can damage the brain.”
Let’s get real. Articles like this are several decades behind the scientific studies and the historical realities that prove that psychotropic drugs are harmful to the human brain. Consult Peter Breggin. Read Bonnie Burstow. Study Thomas Szasz. One might even consider reading Robert Whitaker’s books, since, if I’m not mistaken, he has some connection to Mad in America.
Look. Terms like “antidepressant” or “antipsychotic” or “medications” are euphemisms for poisonous, brain-altering, noxious chemicals. There is no such thing as a “side-effect.” These drugs do not have “side-effects” because that would mean that they produce some health benefit in the first place. Some people who take psychotropic drugs appear to benefit from a placebo effect, but most of them appear to improve because of what Dr. Peter Breggin describes as “medication spellbinding.” Some people think that they feel better when they drink beer, smoke cigarettes, or snort cocaine. But no one pretends that alcohol, nicotine and street drugs are “medications” that have “side-effects.” It’s time to start telling the truth about psychiatry and psychotropic drugs. It’s time to slay the dragon of psychiatry.
And yet UK GP’s are pleased by the increase in prescribing over the last ten years as they say the drugs are effective. They also say that there are withdrawal effects but these can be managed by coming off them slowly over a couple of months which is completely counter to what many ssri withdrwal support groups report.
Meanwhile, in another land, I see no epidemiology that shows a reduction in days off work for depression as a result of all these extra drugs being prescribed.
Big disconect going on here. I largely blame Time to Change, the UK big funded anti stigma campaign. Disease like any other init? Bound to drive up prescriptions, especially with a depression and austerity policies putting the majority of the population under financial stress.
I love John Read’s work by the way.
In Ireland it’s very difficult to explain away the impacts of widespread SSRI usage.
“Researchers contend that the harmful costs of taking antidepressants outweigh any potential benefits.”
Exactly what are the benefits?
Every single label for SSRIs show us the potential harms, ie; ‘side effects’.
I’ve not come across one single patient information leaflet that actually lists the benefits, it’s also a question I have put to the UK medicines regulator, the MHRA, on countless occasions. To date, not one single person from any global drug regulatory agency has been able to tell me of the benefits of SSRIs.
If SSRIs save lives then the label doesn’t suggest that they do. If SSRIs cure depression or other related “disorders”, the label doesn’t tell us so.
So, without sounding like a stuck record, exactly what are the benefits? There’s plenty of professionals on Mad In America, can any answer this rather simple question?
When people “Act Out” in the community they are often presented as coming from the “Severely Mentally Ill” section. But the reality is often that they are on SSRIs – for no real medical reason.
When it comes to psychiatric drugs, doctors should really not be resorting to polypharmacy so much. I think there is a tendency to see depression as the root cause for all sorts of psychiatric conditions, and this is unfortunate, as well as a spur to the dishing out of drug cocktails. On site at MIA there is another recent news story about research on people taking both benzodiazepines and SSRI antidepressants. Physicians need to learn, you are no closer to a solution when you compound the problem with an additional problem. Co-morbid conditions, more than anything else, tend to be a pharmaceutical marketing device, and should be discouraged. Even if some over eager expert is out to diagnose multiple conditions, it is better if you are going to drug, to restrict your drugging to one diagnosis rather than create multiple side effect and withdrawal problems for the person being drugged. There is also the issue of outcomes, multiple diagnoses and drug cocktails don’t improve outcomes, as a rule, what you get is quite the reverse. Perhaps it would help, when dealing with psychiatric issues, if every physician stocked their shelves with rose colored glasses. Taking a dim view of matters, in terms of self-fulfilling prophesies, can make matters more bleak than they really should be. “Recovery”, so-called, happens, but not within a social and informational vacuum.
Many people who go into a psychiatrist’s office like I did mistakenly think there is a drug to make whatever problematic situation we are in better.
Shit science attacks shit science.
Shit science wins.