Antidepressants, and the antidepressant industry, do more harm than good

Peter Kramer, a psychiatrist, describes one of his patients:"A young woman comes to the office complaining she is boy-crazy. Last week, she found herself walking though a dangerous part of town at two in the morning in the cold and dark She had a crush on a certain young man, and she knew he liked a rock band that was playing a one-night stand at a small club. .. She says her focus on this young man and others like him - they are all dismissive of her and a bit wild - is disconnected from the way she ordinarily sees herself. She is a quiet and self-effacing young woman, dressed in a way that plays down her femininity, devoid in any manner of any hint of seductiveness. " (1)The psychiatrist concludes that she is "a young woman with a damaged self-image, a tendency to place men first, and a willingness to place herself at risk". She's an ivy league student. He puts her on therapy and then, because although she gets a more suitable boyfriend, she's too intense with him - on Prozac. It works, at least for a bit. She calms down. This is case is absolutely typical of what I'm seeing everywhere. Women with inconvenient emotions are put on antidepressants. They calm down. Plenty of men are on antidepressants too, of course. This year is the 50 year anniversary of Betty Friedan's The Feminine Mystique, the polemic against women being trapped in the house. Since then, there have been great advances in women's education and career opportunities for women. You can't help but wonder if all that would have happened if that generation of women had been on antidepressants. Or, since I don't want this to be limited to feminism, writers such as Nelson Algren, and artists such as Frieda Kahlo, scientists who insist on perfect methodology, often seem dogged by strange urges and negative emotions. The new rhetoric about depression and mental illness, that it's a chemical imbalance that can be righted with a purchase from a drug company, has taken over our reactions to our own emotions. Maybe it's good for us to have emotions that make us uncomfortable and drive us to behave in ways we don't expect. A society of people who get good marks, marry nice clean boys and live comfortably in the suburbs is, surely, a society in decline. The marketers of antidepressants have done a brilliant job convincing healthy people that they are sick and need to take antidepressants regularly. Most people on antidepressants would be better off without. the placebo effectThere is a very large placebo effect associated with drug intervention for depression (1). For mild and moderate depression, the placebo effect is not significantly different from the drug effect for most popular antidepressants (2). This means that although these patients do benefit significantly from taking antidepressants, they would benefit as much from taking a placebo. It is only for severely depressed patients that the drug effect exceeds the placebo effect. These patients do benefit from antidepressants. A recent US survey of antidepressant use found that only one third of people taking antidepressants had severe depression (3). Therefore, two thirds (most) of the people taking antidepressants are benefitting from the medication no more than they would from a placebo. Finally, the placebo effect associated with antidepressants has been increasing in the decades since they were introduced into our society (4). As antidepressants become more popular, and people believe more and more in the drug company rhetoric, they have more faith in the effects of the drug and the placebo effect is enhanced. If people are benefitting from antidepressants, who cares if the effect is a placebo effect or a pharmacological one? A benefit is a benefit, right? Yes, which is no doubt why general practitioners keep on writing those prescriptions. (In fact, four of every five prescriptions for anti-depressants in the US come from non-psychiatrists (5)). However, antidepressants:a) are more expensive than a simple placebo (over $10 billion dollars spent on them each year in the US (6)); and b) have serious side-effects. Side effects include nausea, insomnia, anxiety, decreased sex drive, weight gain, fatigue, and headaches. There is also the risk of increased depression and suicidal behavior, especially in young people. Older people have an increased risk of fractures and bone loss. A recent study of GPs in the UK (7) showed that although most of them prescribed antidepressants (92%), the majority (60%) would have preferred to provide a different kind of therapy, but said that it was unavailable. Most GPs (57%) agreed that antidepressants are prescribed too often. DependencyThere are serious withdrawal symptoms associated with antidepressants (8). These withdrawal symptoms can include anxiety and depression, which can make people think they're having a relapse (9). The danger of this is that people can think they're unwell when they're not. They might think that they're the sort of person who needs to always be on antidepressants when, actually, they're just suffering from withdrawal symptoms. I have been unable to find research to show how long people stay on antidepressants, but around here it's not uncommon to meet people who've been on them for years. However, depression left untreated rarely lasts beyond a year (10). (1) . http://www.amazon.com...(2) . http://psychrights.org......(3)http://www.plosmedicine.org......http://jama.jamanetwork.com......(4) . http://www.cdc.gov......(5) . http://jama.jamanetwork.com......(6) . http://www.apa.org......(7) . http://www.nimh.nih.gov......(8) . http://www.psychminded.co.uk...(9) . http://www.helpguide.org......(10) . http://www.health.harvard.edu...(11) . http://www.health.am...