Tag: antidepressants

The antidepressant Paxil has been linked to birth defects. "An Ohio federal judge on Wednesday ruled that GlaxoSmithKline must face a product liability suit brought by a woman whose child was born with heart defects after she took the antidepressant Paxil during her pregnancy, ruling that she had successfully pled fraud."

While publication bias has been known to overestimate the efficacy of antidepressant treatments, a new study suggests that research on the use of psychotherapy in depression suffers from a similar bias.

The October edition of the Journal of World Psychiatry, the 3rd ranked journal of Psychiatry, will publish a reanalysis of antidepressant efficacy versus placebo in major depression. When the researchers, Arif Khan and Walter Brown, analyzed the data from the FDA archives for antidepressants approved between 1985 and 1997, “it was evident that the conventional wisdom of 70% response with antidepressants was at best an overestimate.” In fact, “the magnitude of symptom reduction was about 40% with antidepressants,” compared to “about 30% with placebo.”

On Wednesday, JAMA Psychiatry released a meta-analysis comparing the results of cognitive-behavioral therapy and antidepressant medication in severely depressed populations. Currently, many practice guidelines suggest that antidepressants be used over psychotherapy for major depressive disorder. The analysis, however, found that “patients with more severe depression were no more likely to require medications to improve than patients with less severe depression.”

In May 2014, the RIAT team asked GSK what the children who became suicidal in the course of Study 329 have since been told. The consent form says that anyone entering the study would be treated just the way they would be in normal clinical practice. In Study 329, the children taking imipramine were by design force titrated upwards to doses of the order of 300 mg, which is close to double the dose of imipramine given in adult trials by GSK or in normal clinical practice. In normal clinical practice it would be usual to inform somebody who had become suicidal on an SSRI that the treatment had caused their problem.

This past Saturday, I was on my way back from Europe to Boston, and while on a stop in Iceland, I checked my email and was directed to a new blog by Ronald Pies in Psychiatric Times, in which he once again revisited the question of whether American psychiatry, and the American Psychiatric Association (APA), ever promoted the idea that chemical imbalances caused mental disorders. And just like when I read his 2011 writings on this subject, I found myself wondering what to make of his post. Why was he so intent on maintaining psychiatry’s “innocence?” And why did it matter?

Probiotics have certainly become quite the rage across the world for the treatment of all kinds of ailments from irritable bowel syndrome (IBS) to infectious diarrhoea to stress to low mood. Some might say that the enthusiasm has been rather slow to develop. Recently, the popular press has propagated the idea that probiotics are the next antidepressants.

In addition to hosting the Panorama programs and The Famous Grouse history of Study 329, Study329.org has a comprehensive timeline on the origins of concerns about the SSRIs and the risk of suicide, initially with Prozac and subsequently with Paxil/Seroxat. The hope is to provide a comprehensive repository for anyone who wants to study SSRIs, RCTs, and Study 329 in particular.

My prior MIA blog posts have largely addressed the problems that can occur when people try to stop taking serotonin-related antidepressants, particularly  after taking them for a long period of time. I wanted to share a few updated thoughts that I have on the problem.

Seniors are twice as likely to receive psychotropic prescriptions than younger adults but are much less likely to receive mental health care from psychiatrists or to receive psychotherapy, according to a recent study published in the Journal of the American Geriatrics Society. "Our findings suggest that psychotropic medication use is widespread among older adults in outpatient care, at a far higher rate than among younger patients," the study’s lead author Dr. Maust said in a press release. “In many cases, especially for milder depression and anxiety, the safer treatment for older adults who are already taking multiple medications for other conditions might be more therapy-oriented, but very few older adults receive this sort of care."

On The New York Times Opinionator Blog, Diana Spechler has written a series entitled “Going Off,” relating her experience transitioning to a life without...

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.

With 1 in 5 Americans taking a psychiatric medication, most of whom, long term, we should probably start to learn a bit more about them. In fact, it would have been in the service of true informed consent to have investigated long-term risks before the deluge of these meds seized our population over the past thirty years.

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.

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.

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.

A former Duke University psychiatry chair is calling for a retraction of a study suggesting that the FDA's black-box warnings about increased suicidality in youth taking SSRIs led to increases in adolescent suicide attempts.

A British Medical Journal study led by Harvard Medical School's Christine Lu suggested that black box warnings about increased suicidality in youth who take antidepressants actually led to increases in adolescent suicide attempts. However, the latest in a stream of critics of that conclusion are the authors of one of the key studies cited by Lu in support of her team's analysis.

A study that appeared online in the British Medical Journal suggests that the FDA’s warning in 2003 that antidepressants increase the risk of suicidal ideation in youth paradoxically  led to an increase in suicide attempts in this age group. Media reports on the study tell of how the black-box warning “backfired.” But is this conclusion warranted by the study? Or is the study flawed? And how did the media report on this story?

The Atlantic web site has just published a strange piece on the efficacy of the antidepressants. When getting into a discussion with about antidepressants with a...