Playing the Odds, Revisited

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It is hard to believe that a year has gone past since I posted Playing the Odds: Antidepressant Withdrawal and the Problem of Informed Consent. The feedback I received underscored the more controversial aspects of SSRI toxicity.  Common themes concerned the abrupt onset of new symptoms 3 to 12 months after stopping the drug, reinstatement of the drug failing to help withdrawal related symptoms, the possibility that withdrawal-related symptoms can persist indefinitely and concerns about using benzodiazepines to help with tardive akathisia.
bipolar drugs good bad ugly

The Good, the Bad, and the Ugly: An Infographic on Bipolar Drugs

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Bipolar drug therapy is a balancing act of benefits vs. harms. Odds of attributable benefit cluster in a 15-25% band, so 75%-85% don’t see substantial benefit. Stated differently, if five people take a bipolar drug, only one is likely to see substantial improvement due to it, but all five will have side effects.

Chemicals Have Consequences: Antidepressants, Pregnancy, and the New York Times

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Depressed pregnant women need good care.  They should not be made to feel guilty for the choices they make concerning their depression or lectured to by those who don’t understand the area or lack compassion for them.  In that sense, Andrew Solomon does the public a service by turning his attention and writing talents to the topic of depression and pregnancy this week in the New York Times.  However, a crucial part of providing good care to depressed pregnant women is to give them accurate information on the topic.  In this sense, Andrew Solomon falls short.
antidepressants for depression

It’s Unlikely That ‘Antidepressants’ Have a True Effect on Depression

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I submitted a letter to the editor of JAMA pointing out the likely explanation for the lack of effect of sertraline. JAMA rejected my letter, as it has done many times. Explaining why psychiatric drugs don’t work is not a priority for medical journals, it seems.

United Nations Statement Criticizes Medicalization of Depression on World Health Day

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"There is a need of a shift in investments in mental health, from focusing on 'chemical imbalances' to focusing on 'power imbalances' and inequalities"

Outcomes in the Era of Atypical Antipsychotics

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Once second-generation antipsychotic drugs came on the market (which are known as “atypicals”), there were claims by psychiatric researchers that they would lead to...

Researchers Develop New Model for Understanding Depression

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Acknowledging that current depression treatments are failing many people, researchers from Michigan State and MIT have developed a new model for understanding how multiple psychological, biological, social and environmental factors contribute to depression.

Antidepressants and Advertising: Psychopharmaceuticals in Crisis

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An article by written by faculty of the Harvard History of Science Department and the Program in Placebo Studies explores how "drug marketing portrays...

Study of Online Antidepressant Forums Reveals Long Lasting Withdrawal Effects

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Effects of discontinuing SSRIs and SNRIs reported on an online forum indicate significant and long-lasting withdrawal symptoms.

German Psychologists Declare “the Drugs Don’t Work”

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Jürgen Margraf and Silvia Schneider, both well-known psychologists at the University of Bochum in Germany, claim that psychotropic drugs are no solution to mental...

Researcher: Antidepressants Protect Against Brain Shrinkage, Despite Our Findings

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A Molecular Psychiatry study found that people who had recurrent depression developed smaller hippocampi and antidepressants protected against that effect -- except insofar as the study evidence seemed to show the opposite of what the media reported on it.

Interview: Researchers Deconstruct Ghostwritten Industry Trial for Antidepressant

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Researchers, Jon Jureidini, Jay Amsterdam and Leemon McHenry, have taken a closer look at the data from a randomized control trial of citalopram (Celexa) that was ghostwritten and then used by the manufacturers to support claims of the drug’s efficacy and safety in the treatment of child and adolescent depression. To get the background on this story, we connected with Dr. Leemon McHenry, an investigator in this study and a lecturer in philosophy at California State University, Northridge.

NICE Guideline Update Acknowledges Severe Antidepressant Withdrawal

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A new update to the NICE guideline for depression suggests providers discuss long-term, severe antidepressant withdrawal symptoms.

Exploring Psychiatry’s “Black Hole”: The International Institute on Psychiatric Drug Withdrawal

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When Carina Håkansson sent out an invitation for a symposium on "Pharmaceuticals: Risks and Alternatives," some of the world's top scientists, along with experts-by-experience, came from 13 countries to explore better ways to respond to people in crisis.

New Data Show Lack of Efficacy for Antidepressants

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An article published this month in the journal BMC Psychiatry suggests that there is a lack of efficacy for SSRIs and that they significantly increase the risk of serious side effects.

Benzodiazepine & SSRI Addiction and Withdrawal

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The May issue of Addiction includes a review of pharmacological and phenomenological issues around benzodiazepine (BZD) and SSRI discontinuation.  Definitions, perceptions and management of the...

Deprescribing: How to be on Less Medication for Healthier Aging

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In this post for Better Health While Aging, Dr. Leslie Kernisan discusses the importance of making sure that older adults are taking the minimum amount...

How Do Antidepressants Really ‘Work’?

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A recent review, published in Neuroscience & Biobehavioral Reviews, challenges the dominant assumptions about the neurochemical and therapeutic effects of Selective Serotonin Reuptake Inhibitors...

Psychotropic Medications Serve as Powerful Tools for U.S. Military, Imperialism

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Ethnographic research sheds light on extensive psychopharmaceutical use by soldiers in post 9/11 U.S. wars.

Psychiatric Drugs: an Increasing Portion of Prescription Costs

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Rising prescriptions for psychiatric medications are partly a result of longer-term treatment and increasing population, according to an article by Joanna Moncrieff and Stephen...

Pooling Data May Hide Negative Outcomes for Antidepressants

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A new study, published in Psychological Medicine, found evidence for a specific type of publication bias distorting the evidence about antidepressant efficacy.

Researchers Challenge Interpretation of Antidepressant Meta-analysis

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Researchers question the overstated results of a large antidepressant meta-analysis and point to cultural pressures to turn to these drugs for a quick fix.

Violence Caused by Antidepressants: An Update after Munich  

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The media is now reporting details about the 18-year-old who shot and killed nine and wounded many others before killing himself on July 22 in Munich. My clinical and forensic experience leads to a distinction among people who murder under the influence of psychiatric drugs. Those who kill only one or two people, or close family members, often have little or no history of mental disturbance and violent tendencies. The drug itself seems like the sole cause of the violent outburst. On the other hand, most of those who commit mass violence while taking psychiatric drugs often have a long history of mental disturbance and sometimes violence. For these people, the mental health system seems to have provoked increasing violence without recognizing the danger.

Int’l Task Force Doesn’t Endorse Antidepressants for Bipolar

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Noting a "striking incongruity between the wide use of and the weak evidence base for the efficacy and safety of antidepressant drugs in bipolar,"...

Reanalysis of STAR*D Study Suggests Overestimation of Antidepressant Efficacy

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Reanalysis of the original primary outcome measure in the STAR*D study suggests STAR*D findings inflate improvement on antidepressant medication and exclusion criteria in conventional clinical trials results in overestimation of antidepressant efficacy.