Woman: Antidepressants led to suicides of relatives

--Kaiser-- wrote: »

There are many studies suggesting they don't work as well as pharmaceutical companies say. Like this one
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2253608/?tool=pubmed

"These findings suggest that, compared with placebo, the new-generation antidepressants do not produce clinically significant improvements in depression in patients who initially have moderate or even very severe depression, but show significant effects only in the most severely depressed patients. "

Interestingly they seem to start working in those cases, because placebo stops working. Might be a line of inquiry into the placebo effect itself.

seamus wrote: »

Actually I don't disagree at all that for many people they can work if they're correctly prescribed and monitored.

The problem is the insane levels of prescription of drugs which in reality should only be used on a relatively small number of people, and prescribed by doctors who may lack the necessary clinical knowledge to correctly assess the patient.

They're right up there with antibiotics as doctors' favourite solution for getting rid of annoying patients.

That has been my take for years. Including the comparison with antibiotics. Both are "wonder drugs", but both have the real potential to cause issues within medicine down the line. Of that I'm convinced in the case of some classes of anti depressant medications.

For a start the apparent rise in bipolar disorders. Once bipolar depression was quite the rare illness. It's risen pretty massively in the last 20 years. Now I'm not some Big Pharma nut here, I think there are a myriad of reasons for this. Underdiagnosis in the past for a start. The broadening of definitions for the condition(and others) has increased the apparent numbers too. I'd even throw in medical insurance and it's influence on medicine* as it tends to medicalise more "symptoms". I'd even add medical "fashion" into the mix. Like any area with humans, fashion and memes come into medicine too. Getting ones tonsils out was a rite of passage for one generation with a sider order of adenoid removal for operating table 2, infant circumcision for another, glue ear was dead popular for a while too. In psychiatry firing electricity through your head was dead popular for a while. Even lobotomys were all the rage. Ahh but we know so much more now? Yep and no doubt all of the above said the same thing at one time or another. On top of those reasons I'd also add an environmental change and IMH some anti D's in some people may turn a unipolar one off episodic depression into a rolling up and down long term thing. It's not so long ago(30 years ago) that psychiatric textbooks saw depression(unipolar) as generally an acute condition that would pass in the majority of patients.

Into that mix I'd add the people, the patients themselves. Just like the parent who insisted of an antibiotic for their kids snotty nose or for their own viral headcold(I'm shocked how many still think they work on viruses), some people insist on that "pill for every ill". Plus I'd even say depression itself has become quite the thing to have for some. It's a label with a sense of belonging for some. The label itself may mean people think it's a permanent state for them. Plus for all the talk of it being kept under wraps publicly I've found people are only to happy to tell others of their diagnosis. Self diagnosis another issue, where people may even feel they want to be part of some group, even this one. Doctors may respond to that, especially if the patient in front of them is well versed by Dr Google on the symptoms they claim to have.

Do NOT get me wrong. Depression and mental illnesses are very bloody real conditions. They can rob a person of the most valuable thing they own, themselves. Doctors and especially psychiatrists are dedicated horribly educated people who want the very best care and treatment for their patients. They have an aresnal of treatments we could only dream of a generation ago. All I'm saying is that maybe we all need to take a step back and take a really hard look at the whole picture rather than fall into a potentially unwlecome meme because we reckon we're right this time. Put it another way if BOards had existed in the 1960's 0r 70's and I suggested antibiotics would cause the problems we're seeing today, I guarantee I'd be dismissed even laughed at. I'll lay a bet down now for future Google searches of the archives I'll bet in due time we will look back on much of the anti D medications with a fair bit of "what were we thinking?".







*take stents for heart disease. In the heavily insurance influenced US they perform many times more insertions of stents than in the much less insurance influenced Canada, where they prescribe drugs like statins and beta blocker et al. The kicker is long term survival for both is the same statistically speaking. But stent ops cost and earn more money for the hospital subsidised by the insurance companies who make more money themselves. Indeed. Hell closer to home and in a seemingly unrelated area, pet insurance. Since the pet insurance industry has kicked off vet procedures and costs have gone up noticeably. Of course if you're out of that loop with no pet insurance bye bye rover or puss, unless you have the spare cash.