"This is to show the world that I can paint like Titian. Only technical details are missing." – Wolfgang Pauli, caption for a blank page
August 14, 2014 § 27 Comments
They don’t prevent it.
See also here (HT Andrew E. in the comments).
(Note – I am a regular reader and irregular commenter, but am temporarily changing my name because I’ll be talking about more private things I don’t want linked to my main identity.)
I’m pretty sure they do both. All of me, my brother, and my sister have had problems with depression. I got through it – in college – with the help of a therapist who told me that I wasn’t depressed, but unhappy for good reasons, and helped me fix the underlying problems. My brother and my sister went on antidepressants. They do help in the short term. They stopped feeling so bad all the time, stopped acting out in impulsive ways, and started improving. And then they started getting side effects. My sister had auditory and visual hallucinations of violent and traumatic experiences. My brother started getting suicidal ideation and behavior that he described as outside of his control and had to be temporarily committed while weaned off the medication so he wouldn’t hurt himself.
I don’t know if these side effects are common in general, or if my family is particularly susceptible. I do actually know several close friends who have been on SSRIs for years without major mental side effects, and who think that it’s done a lot of good for them. So I suspect it’s at least partially the latter. Maybe they could be used profitably if there was a better way to screen for people who were susceptible to those really bad symptoms. But I know that I’m never going near them, and I’m very grateful to my therapist who helped me quite a lot without any drugs.
Thanks for the comment.
Like cocaine, alcohol, PCP, and other psychotropic drugs, SSRI’s can help people feel better/numb/forgetful/etc in the short term, yes. And I’m sure there are people who are convinced that their lives are more subjectively tolerable because of regular heavy drinking, and some of them may even be right.
But I’m not talking about people ‘feeling better’ within some carefully constrained timeframe, etc. Psychotropic drugs wouldn’t have any appeal if they didn’t make people feel good. The statistical arrow points unequivocally one way when it comes to suicidal and impulsive, violent behavior. Suicidal and violent behavior isn’t always caused by alcohol, but regular alcohol consumption doesn’t generally make otherwise suicidal and violent people nonsuicidal and nonviolent. As poisons go prescription drugs aren’t ‘special’ just because they have been officially blessed by High Priest, MD.
That’s without even touching on the physiological harm of long term use.
Also, withdrawal effects – although they do get better with time – have two characteristics that trap people in the prescription drug roach motel.
First, they can go on for a lot longer than most doctors will admit – years even. The physiological effects of ten years on an SSRI (or other psychotropic drug) aren’t reversed as soon as blood serum levels reach zero.
Second, withdrawal symptoms can be very severe, frequently mimic what got the person to seek help in the first place, and come in what some folks refer to as “windows” and “waves”. The patient can feel better for months (in a “window”) and then get hit with a “wave” of symptoms which can last quite a long time. When they go to the doctor, the doctor diagnoses this as a condition of the patient rather than a wave of withdrawal symptoms – and puts him back on the drug or on some new drug, perpetuating the cycle.
Dr. Charlton had another excellent post a few months back laying out the macro picture and the prospects for change.
[…] Source: Zippy Catholic […]
Your title is unduly hysterical, I’m afraid (and misspelled). Yes, antidepressants, like all drugs, may cause these and many other side effects. But they also help many people, as tn notes, for whom there is little hope.
“The statistical arrow points unequivocally one way when it comes to suicidal and impulsive, violent behavior.”
And? You may as well say that the statistical arrow showing a correlation between the global warming and suicidal behavior points unequivocally one way.
There is no clear-cut causative relationship between antidepressants and violent and/or suicidal behavior. Read that sentence again. We know there is a possible correlation — thus the black box warnings, especially for the young* — but we cannot say for certain whether the drugs are responsible for it.
You are either a victim of anti-psychiatry propaganda, or you make this up on your own, which is not much better. Dr. Charlton, whom you reference, offers his own personal opinion on his blog, and one not supported by any research studies (even though he mentions two supposedly better informed authors in his comment underneath, his arguments are disturbingly free of hard data — but that does not stop him any more than it stops you).
“That’s without even touching on the physiological harm of long term use.”
Why not? Please do touch on the physiological harm of long term use. I’d be very curious to learn about it, as, I’m sure, would be all involved in medical and mental health professions.
And since you raise such urgent alarm on the dire consequences of psychoactive drugs, what would you propose as effective treatment for mentally ill? Surely taking a chance on drugs which just may help beats doing nothing (as we know, psychotherapy is no more effective than drugs)?
I notice that Dr. Charlton himself is, again, charmingly free of responsibility for helping the mentally ill, other than inform them and the general public that, oops, sorry, nothing works. As a psychiatrist, the man is irresponsible at best; I’d hope that people reading his blog understand he just shares his own personal take on assorted matters that interest him and does not act in a professional capacity, although he creates appearances to that effect.
*Even with the black box warning for children and teens, the available data shows that:
“(…) the benefits of antidepressant medications likely outweigh their risks to children and adolescents with major depression and anxiety disorders. The study, partially funded by NIMH, was published in the April 18, 2007, issue of the Journal of the American Medical Association.”
These folks actually did some research and have hard data, including the statistical sort, not from tabloids and blogs, but from objective and peer-reviewed studies.
I’ve treated people with anti-depressants for over 20 years and fortunately have never had anyone suicide. This has to be one of the most idiotic posts ever.
@The pseudonymous Mike.
Unless you have read, *and refuted*, the vastly documented evidence of David Healy (Let them eat Prozac, or Pharmageddon) or Bob Whitaker (Anatomy of an Epidemic) then you do not understand the extent to which the “evidence” has been corrupted.
“As a psychiatrist, the man is irresponsible at best; I’d hope that people reading his blog understand he just shares his own personal take on assorted matters that interest him and does not act in a professional capacity, although he creates appearances to that effect.”
Could you just let me know of any time, any place that I have done this creating of appearances?
I don’t claim anywhere to be “a psychiatrist” although I have done a few years of training as one, and published a few dozen papers, done a few years of research, written a book and many chapters on the subject and taught the subject for more than 15 years.
All this is readily accessible on the internet.
But then, “Mike”, I blog under my own name and address – and am responsible for my expressed views – whereas you don’t, and aren’t.
Thanks for the typo correction.
Who am I going to believe: my own lying eyes, well established research, and whole communities of people who have experienced this for themselves; or some commenters on the Internet, at least one of whom overtly claims a vested interest?
[…] immediate hospitalization, alcohol is a more effective and safer pharmacological treatment than antidepressants, if a drug is really necessary. It is better to avoid psychotropic remedies entirely; but if you […]
[…] https://zippycatholic.wordpress.com/2014/08/14/antidepressents-cause-suicide-and-other-violent-impuls… […]
Zippy, Prozac saved my life.
I don’t think anti-depressants cause suicide or violence. However, whenever some abruptly stop taking the drugs, a horrendous rebound effect occurs which in turn causes such behavior. If the SSRI is taken consistently and properly and never stopped abruptly(weaning is the only way to get off of these drugs) there will be no problems in all but a small minority of individuals.
As good as alcohol is for PTSD, zoloft is much better for the long term; alcohol is only the best for acute PTSD attacks. PTSD takes a while to get a grip on via therapy so SSRIs are good in this case.
[pmaa: In a follow-up you wrote:
I am relieved to come back and find that my comment is still in moderation. I get too emotional about this subject, and did not think clearly about the folly of oversharing this sort of information. Unless you think it can do some good, please don’t post it.
Personally I think your comment does contribute, and you can feel free to throw away the handle and never use it again. However, if you would like the comment removed, just post ‘please remove’ using the same handle and I will remove it. Pax -Z]
Svar is mostly wrong, though no doubt well-intentioned. Similarly well-intentioned people coerced me into taking Prozac (fluoxetine), which within five weeks had me in a suicidal mixed state of mania and depression. It was indescribably awful, unbearable, worse than anything I have ever experienced before or since. These idiots’ good intentions paved my road to hell, which I escaped (thus far) only by abandoning my doctor and stopping the Prozac cold turkey. This you can (and should) do, pace Svar, because the half-life of Prozac is so long.
[I do disagree with pretty much any ‘cold turkey’ taper plan, because results vary so much by the person. Long half-life drugs can still be very difficult to stop symptom-wise, though they are definitely easier than short half-life drugs, which is why people coming off of benzos try to switch over to valium or librium before beginning a taper. — Z]
Paxil has a much shorter half-life, and patients must be tapered off slowly. (But no one should ever take Paxil.) Unfortunately, Paxil is prescribed for PTSD, with predictably grievous consequences.
I am not someone who can handle alcohol; I wish I could, because life is tough. But I do recommend the novena to the Sacred Heart for final perseverance.
I don’t think anti-depressants cause suicide or violence.
It has been proven otherwise. Read Pharmageddon.
@ PMAA and Zippy
I am speaking from personal experience.
Personal experience doesn’t refute a statistical fact. It just means you are one of the lucky ones – so far. Different folks have radically different experiences with alcohol too.
Then what do we do for the ones that have bad experiences with SSRIs? Couldn’t it be possible that Pharmeggedon is wrong, however? I mean, Slumlord is a physician and he and other patients are saying they are generally helpful for most of the population who need them but dangerous for a small few.
You should really read David Healy’s books yourself, and make up your own mind whether he presents a convincing case.
“Unless you have read, *and refuted*, the vastly documented evidence of David Healy (Let them eat Prozac, or Pharmageddon) or Bob Whitaker (Anatomy of an Epidemic) then you do not understand the extent to which the “evidence” has been corrupted.”
There is no doubt that Big Pharma as any Big Corp will resort to shady and potentially criminal tactics in service of its profits. The problems with creating and especially marketing of SSRIs and just about any drugs are to be expected when billions of dollars are at stake.
But the anti-drug crusaders often go too far and end up dispensing harmful advice to people who suffer.
“Could you just let me know of any time, any place that I have done this creating of appearances?”
…and then answer yourself, sorta:
“I don’t claim anywhere to be “a psychiatrist” although I have done a few years of training as one, and published a few dozen papers, done a few years of research, written a book and many chapters on the subject and taught the subject for more than 15 years.
All this is readily accessible on the internet.”
There you go.
You are Professor Bruce Charlton, who trained extensively in psychiatry, even though you may or may not practice it (now or ever). It is understandable — or should be — that people reading your blog will consider your views as those of an expert and give them more credence than similar ideas coming from Joe Q. Public. And as a doctor, whether practising or not, you are bound by the Hippocratic Oath.
But your expertly views on depression and drugs currently used to treat it can be summed up as “Don’t” (because the drugs will — not even may — kill you, i.e., cause violent behavior and suicide). Not only you present a starkly unequivocal take on this issue, at odds with the available data that a reasonable person would consider objective, but you do not offer any alternatives or useful advice for people who need it and may come to your blog looking for it (you are an expert after all, whether you like it or not). This is what I mean as irresponsible. Essentially, you say, “Tough luck.”
Sure, the purpose of your blog is not to counsel people directly, but even WebMD has a disclaimer advising readers to seek competent medical help. You — the medical professional yourself, whether you want to see yourself in this role or not — tell people… well, nothing, other than that what they think may work for them, won’t. That’s what I mean by irresponsible.
What depressed people need, desperately, is hope. They don’t necessarily seek statistical odds of successful treatment, but something tangible here and now that would make life bearable for just another moment.
You are taking that chance away by making irresponsibly unequivocal statements about findings that may NOT apply to particular individuals.
Sometimes drugs work. Sometimes psychotherapy works. The risk of suicide is there, but we don’t quite understand its causality. You, however, smugly positioned on your anti-Pharma bandwagon tell them to abandon all hope — just because you’ve glimpsed the shattering “truth” (while offering no viable treatment alternatives for treatment of their suffering).
In case it is not clear, I am NOT advocating that you should lie or sugarcoat your views and message; but, first, do not harm.
You can truthfully underscore the ambiguity — because it is there — of both the data we currently have on the subject and the treatment options and therapeutic process itself, instill hope by suggesting alternative approaches (probably not alcohol, though), or, at the minimum, issue a disclaimer that anyone reading your blog should not mistake your words for medical advice and should seek medical help. It does not take much.
That is a lot of words to point out that you don’t think the disclaimers are in large enough print. Your view on print size is noted. But it doesn’t actually address the central subject matter.
What I advocate is that people understand what they are getting into, and the extent of the ignorance of the “experts”. The people I’ve known didn’t understand until it was too late. One is dead, and another is alive only because of my personal cussed stubbornness and people like David Healy and Heather Ashton.
So if there is a problem with the fine print being too small, I suggest you’ve got much bigger problems to tackle than Bruce Charlton.
I read these posts on pharmaceuticals with great interest, Zippy. And I agree for the most part.
But I also have a family member who is functional when she’s on her meds, while wrecking her life (not to mention turning the rest of ours upside down) when she decides that she no longer needs her meds.
It’s been 2 years that she’s taken her meds faithfully and two years without a mani episode and all the devastation that accompanies them.
I’m not sure how to translate your (and other writers) admonitions in the face of real life experience.
And I’ve done a lot of reading on this as well.
It is impossible to say. People report relatives who are “happy drunks” too. You don’t know what a person is “really like” until they have been several years without meds; and you never know what they “would have been like” if they had never taken them.
You also don’t know what they will be like next year and the year after even if they stay on meds. The phenomenon of “tolerance withdrawal” means that for some unknown number of people it will look like their mental problems escalate and recur despite (really because of) being on meds.
But you generally won’t hear all that, even in the fine print. Heck, David Healy, Bruce Charlton, Heather Ashton and the like are the fine print, and like all fine print are rarely read and understood.
One thing that is a virtual guarantee is that when something goes wrong, it will always be blamed on the patient never on the meds. You are either a mental patient or an addict, with all the baggage those things imply. You are never a victim of iatrogenesis, even though it is a well-established fact that only heart disease and cancer kill more patients than doctors.
That’s the beauty of an industry in which, when things go wrong, it looks just like the kind of problem that the products putatively treat.
[…] a drug like alcohol objectively has a similar profile of risks and benefits for improving mood to other drugs, it is unsuitable because it cannot be an instrument of social control. So the use of alcohol to […]
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