Anti-depressant drugs in the news

One thing we can say for sure about depression is that it is a modern epidemic, with rates of diagnoses soaring every year to new highs. Statistics show that in 1987 there were 14 million physician consultations for depression in the United States. In 2001, consultations totaled 25 million with 90% of patients leaving the doctor s office with a prescription for an antidepressant medication. In spite of this phenomenal growth, experts concur that depression in this country is significantly under-diagnosed.

The reasons for this epidemic are not immediately clear and are surely complex in nature. From my point of view, this epidemic should be seen in the context of many other epidemics of brain disorders, from ADHD and autism to Alzheimer s and Parkinson s diseases.

When we see that it is not a single condition becoming more prevalent, but a global increase in brain disorders, we may consider that all of this has something to do with our unprecedented exposure to environmental toxins, including heavy metals such as mercury and arsenic and a broad range of environmental chemicals. Many of these metals and chemicals are known to affect the brain; others disrupt hormonal processes and the disruption can lead to depression.

In conjunction with this exposure, our diet has continued to deteriorate in terms of what is available, what people choose to eat, and the quality of the food supply – much of which is grown on soil that is becoming progressively impoverished.

Depending on your opinion, pharmaceutical companies have either come to the rescue in a time of crisis or, as I tend to see it, they have profited enormously from this epidemic without offering an adequate solution. But do the drugs even work and are they truly safe as we have been told?

An article in The New York Times (August 7, 2003) questions the effectiveness of antidepressants, revealing that in many studies the drugs either do worse than a placebo or barely better. However, many of the negative conclusions are never shared with the public.

As an example, five consecutive studies for Prozac had to be performed in order to obtain the two required for FDA approval in which the drug outperformed a placebo. In the remaining three studies, apparently a sugar pill was more effective in curing depression!

Safety of these medications was not in question until a review article was published earlier this year in the British Medical Journal (BMJ 2003; 326:1282). The article was based on the results of nine separate studies and revealed that children and teenagers who were prescribed Paxil were more than three times as likely to have suicidal thoughts and behaviors than those on placebo.

Paxil is one of several drugs that are classified as selective serotonin reuptake inhibitors, or SSRI s, a category that also includes Prozac and Zoloft. Since all of these drugs have the same mechanism of action, it is likely that the other drugs will be shown to have the same effects.

Another review article published in the Journal of Clinical Psychiatry (2003 Feb; 64 (2): 123-33) raises a completely different safety concern. This article looked at long-term outcomes in severely depressed individuals treated with antidepressant medications.

Results were very negative. Researchers found that, in the long term, medications were likely to lead to one of several unfavorable outcomes: worsening depression, development of bipolar disorder, tolerance to the medication rendering it ineffective, and withdrawal syndromes following removal of the medication.

These conclusions are not at all surprising, because these medications only work by “tricking” the brain to keep serotonin and other neurotransmitters around a bit longer. None address the insufficient output of neurotransmitters, which is the root cause of depression. Since neurotransmitters are made from the protein in our diet, with a hand from a few vitamins and other nutrients, the only lasting solution is one that includes dietary and nutrient-based therapies.

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