5 reasons to think twice before taking antidepressants

The class of drugs known as selective serotonin reuptake inhibitors (SSRIs) brought about a revolution in the treatment of depression. Previous classes of antidepressants had such severe side effects, and were so easy to overdose on (intentionally or accidentally), that they were reserved for severe cases of depression.

SSRIs – such as Prozac, Efexor, Cipramil, Lexapro, Zoloft and Paxil – were claimed to have such a low risk of causing side effects, that they could safely be prescribed even in mild depression. The promise of ‘better living through changing your brain chemistry’ proved enormously appealing to both the general public and to doctors.

In fact, doctors began diagnosing depression in patients who would previously have been labelled ‘nervous’ or ‘anxious’ – and prescribed a sedative such as Valium – and instead prescribing an SSRI to correct their ‘imbalanced brain chemistry’ (1).

But SSRIs are far from harmless ‘feel-good’ pills, and the science behind their prescription is dubious, at best.

Here are some disturbing facts on SSRIs:

#1. There is no hard science supporting the theory that depression is due to a biochemical imbalance, and that SSRIs correct that imbalance.

As shocking as it may seem, the entire scientific basis for prescribing SSRIs is built on quicksand. The notion put forward by the drug companies that make SSRIs, and accepted as gospel truth by most GPs, psychiatrists and popular magazines, is that depression is caused by low serotonin levels in the brain, and that SSRIs, by raising serotonin levels, treat the depression at its biochemical root.

But numerous researchers have pointed out that this is pure speculation, with no hard proof.

David Healy, professor of psychiatry at Cardiff University and author of Let Them Eat Prozac, devoted 10 years to studying serotonin levels and activity in depressed people. He found next to no evidence to support the idea that they had any abnormality in their serotonin metabolism. He describes the ‘chemical imbalance’ theory as “bio-babble” which has replaced the “psychobabble” of the Sixties and Seventies (1).

George Ashcroft, the psychiatrist who first advanced the serotonin theory of depression in the late 1950s, abandoned it due to lack of evidence by the 1970s. He wrote:

“What we believed was that 5-HIAA [i.e. serotonin] levels were probably a measure of functional activity of the systems and not a cause. It could just as well have been that people with depression had low activity in their system and that 5-HIAA was mirroring that.” (my emphasis) (2).

In other words, he realised that it was just as likely that our emotions cause changes in neurotransmitter levels, as it was that neurotransmitters such as serotonin governed our emotions.

Consider this: if you you take aspirin or paracetamol for a fever and your body temperature drops, no doctor would argue that the fever was due to an aspirin deficiency! Likewise, the fact that SSRIs raise serotonin levels, and that some people feel better when they take SSRIs, does not prove that these patients had a deficiency of serotonin while they were depressed. In fact, as David Healy categorically states,

No abnormality of serotonin in depression has ever been demonstrated (Let Them Eat Prozac, p. 12).

 

#2. SSRIs are barely more effective than placebo, and then only in severely depressed patients.

Numerous studies have found that SSRI antidepressants don’t relieve mild to moderate depression any better than placebo (an inactive ‘dummy pill’) (3), but it had long been thought that they offer significant benefits to severely depressed patients. However, even this benefit was called into question by a 2008 metanalysis which included unpublished trial data (bearing in mind that “Studies which show no effect have a tendency to be ‘filed’ rather than being submitted for publication” (4)). These data came from trials submitted to the US Food and Drug Administration (FDA) as a precondition for the licensing of 4 SSRI drugs.

What the authors found was that only the most severely depressed patients did better on an SSRI than on a placebo, and even this was due more to the fact that such patients are less responsive to placebo, than that they respond better to antidepressants. As the editor’s commentary on the article states,

Given these results, the researchers conclude that there is little reason to prescribe new-generation antidepressant medications to any but the most severely depressed patients unless alternative treatments have been ineffective” (5).

Yet the vast majority of my clients who have been prescribed antidepressants, would not meet the diagnostic criteria for even moderate depression, let alone severe depression!

 

#3. SSRIs cause side-effects that are indistinguishable from the symptoms of depression itself, as well as a host of other unpleasant side-effects.

Some of the symptoms known to be caused by virtually all SSRIs include:

  • Increased feelings of depression and anxiety (which may sometimes provoke panic attacks);
  • Anhedonia (the inability to experience pleasure from activities the person usually enjoys);
  • Apathy (loss of interest in life and concern about emotional, social, spiritual, philosophical and/or physical issues, as well as suppression of emotions such as concern, excitement, motivation and passion);
  • Fatigue;
  • Insomnia;
  • Suicidal thoughts;
  • Weight loss or gain; and
  • Loss of libido.

What do all of these have in common? They’re diagnostic criteria for depression itself. It defies logic to prescribe a drug that causes the symptoms of the condition for which it is prescribed!

In addition, SSRIs can cause nausea and vomiting, drowsiness,headache, bruxism (tooth grinding), tinnitus, extremely vivid or strange dreams, dizziness, diarrhoea, increased risk of bone fractures and injuries, mania and psychotic disorders, tremors, kidney impairment, pins and needles, dissociative disorders, cognitive disorders and loss of contact with reality (6).

For many users of SSRIs, they are a case of the cure being worse than the disease.

 

#4. The diagnosis of depression is highly subjective; you may well not ‘have depression’ at all.

The term ‘disease mongering’ was coined to describe the process by which those who sell and deliver treatments (including drug companies and doctors) widen the diagnostic boundaries of illnesses, or simply invent diseases to match the treatments they have developed, and then market awareness of these diseases to the ‘worried well’.

As David Healy points out,

“depression was all but unrecognized before the antidepressants; only about fifty to one hundred people per million were thought to suffer from what was then melancholia. Current estimates put that figure at one hundred thousand affected people per million. This is a thousandfold increase, despite the availability of treatments supposed to cure this terrible affliction.” (Let Them Eat Prozac, p. 2).

Psychotherapist, writer and former depression patient Gary Greenberg, in his book Manufacturing Depression, humorously describes the diagnostic criteria for depression in the Diagnostic and Statistical Manual of Mental Disorders – the reference used by doctors and therapists to diagnose mental conditions including depression – as a Chinese restaurant menu: choose 3 symptoms from List A, 1 from List B, and 2 from List C, and voila – you have a diagnosis of depression.

But all of these symptoms are experiences that any person is likely to have at various points throughout their life, as they face challenges, setbacks, life changes, grief and loss. According to the DSM IV, whether you are depressed or simply enduring the vicissitudes of life, depends on whether having these symptoms bothers you or not! Can you think of any other health condition that is defined so subjectively?

The ‘medicalisation of normal human behaviour’, as psychiatrist and founder of the Black Dog Institute, Gordon Parker, describes it (7) is the apotheosis of disease mongering.

 

#5. Taking SSRI antidepressants during pregnancy may harm your unborn baby.

SSRIs are frequently prescribed to pregnant women, particularly those with a history of postnatal depression or depression prior to becoming pregnant, because untreated depression in the mother is not only bad for her, but can also slow down her baby’s growth.

But a study of nearly 7700 women found that the babies of women who used SSRIs during pregnancy had a two times greater reduction in head growth than babies of untreated depressed women, even though the women on SSRIs had less depressive symptoms.

Furthermore, babies of women who took SSRIs were more than twice as likely to be born prematurely (7). Both retardation of head growth and premature birth have serious and potentially lifelong implications for the health and wellbeing of babies.

There are proven, safe and effective treatments for depressed mood that enhance your overall health and well-being. To find out more, read my article Bringing your black dog to heel.

Important note: if you are currently taking antidepressants, you should not abruptly stop taking them, as a ‘discontinuation/withdrawal syndrome’ may occur, including symptoms such as dizziness, electric shock-like sensations, sweating, nausea, insomnia, tremor, confusion, nightmares, and vertigo, as well as a return of the depression symptoms. Gradual withdrawal under the supervision of a knowledgable doctor is required, and only after implementing the advice given in Bringing your black dog to heel.


Is depression stealing away your life? Apply for a Roadmap to Optimal Health Consultation to learn how I can help you emerge from its dark shadow.

 

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