Meds, Mind, Body & Benefits > Mental Health & HIV

Anti-Depressants May Be Doing More Harm Than Good

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J.R.E.:


Having never been, on anti depressants it's hard for me to comment on this, but found the article interesting:( Video)

http://www.medicalnewstoday.com/releases/244562.php

Commonly prescribed anti-depressants appear to be doing patients more harm than good, say researchers who have published a paper examining the impact of the medications on the entire body.

"We need to be much more cautious about the widespread use of these drugs," says Paul Andrews, an evolutionary biologist at McMaster University and lead author of the article, published in the online journal Frontiers in Psychology.

"It's important because millions of people are prescribed anti-depressants each year, and the conventional wisdom about these drugs is that they're safe and effective."

Andrews and his colleagues examined previous patient studies into the effects of anti-depressants and determined that the benefits of most anti-depressants, even taken at their best, compare poorly to the risks, which include premature death in elderly patients.

Anti-depressants are designed to relieve the symptoms of depression by increasing the levels of serotonin in the brain, where it regulates mood. The vast majority of serotonin that the body produces, though, is used for other purposes, including digestion, forming blood clots at wound sites, reproduction and development.

What the researchers found is that anti-depressants have negative health effects on all processes normally regulated by serotonin.

The findings include these elevated risks:

    developmental problems in infants
    problems with sexual stimulation and function and sperm development in adults
    digestive problems such as diarrhea, constipation, indigestion and bloating
    abnormal bleeding and stroke in the elderly

The authors reviewed three recent studies showing that elderly anti-depressant users are more likely to die than non-users, even after taking other important variables into account. The higher death rates indicate that the overall effect of these drugs on the body is more harmful than beneficial.

"Serotonin is an ancient chemical. It's intimately regulating many different processes, and when you interfere with these things you can expect, from an evolutionary perspective, that it's going to cause some harm," Andrews says.

Millions of people are prescribed anti-depressants every year, and while the conclusions may seem surprising, Andrews says much of the evidence has long been apparent and available.

"The thing that's been missing in the debates about anti-depressants is an overall assessment of all these negative effects relative to their potential beneficial effects," he says. "Most of this evidence has been out there for years and nobody has been looking at this basic issue."

In previous research, Andrews and his colleagues had questioned the effectiveness of anti-depressants even for their prescribed function, finding that patients were more likely to suffer relapse after going off their medications as their brains worked to re-establish equilibrium.

With even the intended function of anti-depressants in question, Andrews says it is important to look critically at their continuing use.

"It could change the way we think about such major pharmaceutical drugs," he says. "You've got a minimal benefit, a laundry list of negative effects - some small, some rare and some not so rare. The issue is: does the list of negative effects outweigh the minimal benefit?"

mecch:
Debate which flared up all last summer and fall in therapeutic domains and the popular press.
And I'm with Peter Kramer.
http://www.nytimes.com/2011/07/10/opinion/sunday/10antidepressants.html?pagewanted=all

I used them and found them helpful.  Also I trust the professional expertise of the doctors who prescribed them for me.  Of course, hindsight is easier than foresight. Maybe 40 years from now people will think how utterly ridiculous medicine was to go on this antidepressant jag for two decades.  Cause there will be some much better molecule, or therapy treatment that works, etc.  Or cause today's antidepressants will have been thoroughly discredited.   I don't think we are at that point.

BT65:
If a person who is truly suicidal starts taking an anti-depressant along with talk therapy, and sees his/her life improve to the point of getting suicide out of his/her brain, then the benefit far outweighs the risk.  Who wants to walk around feeling like killing themselves? 

This may warrant more research, but I wouldn't discount anti-depressants for fear of stroke in the elderly.

wylidas:
I believe this is a good conversation to have. On one hand, I know people who these drugs have worked for, and used for a set period of time along with therapy (this is KEY as the drug alone without therapy has been proven to be less effective over time) can provide relief for many people.

Now, that being said, everyone's chemistry is different. That's why some people can  eat a peanut butter sandwich and be fine, and others have their throat close up and could potentially die. So to say that these drugs are perfectly safe for all people is just absolutely not true. I am living proof of that. I had a very bad reaction coming off a benzo (which is not an SSRI I know), but it has made me question the efficacy of a lot of these drugs. I believe SSRIs and many other psychiatric drugs are rampantly over-presecribed to people and by doctors who don't always know what they are doing. And the truth is we really don't know many of the long term effects that these drugs have on our bodies, because many of them (just like HIV drugs) have only been around for 10-20 years. And there are an increasing number of studies like this one, being conducted by independent parties, that are starting to show that many SSRI-course treatments are found to be no more effective than diet and exercise along with CBT. Again, we are not talking about the suicidal person here, but therapy more for the average person prone to bouts of depression through their life, which I would say are most living adults.

So again this is a great discussion to have. I don't think it's all one way or the other. I think it's up to the individual and their doctor. But, I would strongly caution anyone from seeking a drug as a magic cure, as I did. You may wind up regretting it later.

joemutt:
This is my experience.

I was diagnosed with hiv and chronic depression in 1997. I saw a psychiatrist who prescribed antidepressants and I also went into therapy.

I have stopped taking antidepressants last September after 14 years on them.

The most I was taking was 80 mg daily (remeron and tofranil) which I slowly got down to 15 mg (remeron). These 15 mg were hard to kick but one day after sedation in hospital I forgot to take them and the next day tried (again) to stay off them. That withdrawal was pleasant for the first few days but quickly turned into 6 weeks of pain much worse than any depression I had had.

I stopped them because I didn't like the side effects; numb, difficult to get going, felt like living under a cloak, cut off from more refined feelings. I also thought the doses were too high and fourteen years was rather long.

I had made some changes where I could; I got out of a few situations that were not good for me, I continue Acceptance and Commitment Therapy, yoga and meditation, joined a few self-help groups. My best friend is the book 'The Mindful Way through Depression'. Basically I learned to get familiar with feelings, thoughts and sensations but also realized they do not have to rule me. Stopped trying to solve feelings with thinking. Most times I can catch negativity by trying to be aware. And some days are bad. I still prefer it to the meds.

I appreciate antidepressants have had their use for me and have saved lives and that experiences vary much.

One thing that I have great difficulty accepting is the trial and error prescription of antidepressants; 'add this, take more, decrease' without anyone being able to measure what are called the 'chemical imbalances' in the brain. Ideally one needs a therapist, a psychiatrist and a psychopharmacologist. Neither country I have lived in did have the latter.

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