Commentary

What Does the ‘Best Evidence’ Say About Antidepressants?

What Does the ‘Best Evidence’ Say About Antidepressants?

According to the latest statistics,1 17.3 million American adults (7.1 percent of the adult U.S. population) and 3.2 million adolescents (13.3 percent of U.S. population aged 12 to 17) suffered at least one major depressive episode in 2017.

Depression can interfere with personal and work relationships, reduce work or academic performance and affect physical health by impairing your ability to properly care for yourself and make good health decisions, including decisions about nutrition and sleep. Imbalances in nutrition, weight fluctuations and poor sleep habits may in turn compromise your immune function.2

The condition can also be lethal, as depression is a contributing factor in up to 70 percent of all suicides.3 In 2016, 44,965 Americans committed suicide.4 Depression can also lead to self-harming behaviors such as drug or alcohol abuse,5 and 90 percent of people who struggle with suicidal thoughts experience a combination of depression and substance abuse.6

Unfortunately, antidepressant drugs — the most widely used therapy for depression — are also among the least effective. In fact, statistics suggest that far from being helpful, psychiatric drugs are making the situation worse.

According to research7,8 published in February 2017, 16.7 percent of the 242 million U.S. adults (aged 18 to 85) included in the survey reported filling at least one prescription for a psychiatric drug in 2013.

Twelve percent reported using an antidepressant; 8.3 percent used anxiolytics, sedatives and hypnotics; and 1.6 percent used antipsychotics. With nearly 17 percent of the adult population in the U.S. taking psychiatric drugs, it would be prudent to evaluate the larger ramifications of these types of medications.

Sadly, statistics overwhelmingly fail to support their use, yet they continue to be the leading form of treatment.

Medication Madness — A Psychiatrist Speaks Out

In a recent segment of Full Measure (above), award-winning investigative journalist Sharyl Attkisson interviewed psychiatrist and director of the International Center for Patient-Oriented Psychiatry, Dr. Peter Breggin. He is known to many as “the conscience of psychiatry,” as he was instrumental in preventing the return of lobotomy as a psychiatric treatment in the early 1970s.

Breggin is also the author of “Medication Madness,” in which he details the many hazards of psychiatric drugs. In his 50 years of practice, he has never placed a patient on drugs. In fact, he specializes in getting people off them, and wrote a book on psychiatric drug withdrawal, “Psychiatric Drug Withdrawal: A Guide for Prescribers, Therapists, Patients and Their Families.”9

When asked what he thinks people don’t know about psychiatric treatment, and ought to, Breggin responds, “They don’t know that all psychiatric drugs are neurotoxins. They don’t know that they aren’t correcting biochemical imbalances, they are causing biochemical imbalances.”

Prozac was the first selective serotonin reuptake inhibitor (SSRI), approved by the U.S. Food and Drug Administration (FDA) in 1987.10 Over the years, Prozac became the target of a number of lawsuits, as patients suffered all sorts of ill effects, from birth defects to suicide and serotonin syndrome, a condition caused by excess serotonin in the brain, leading to agitation, confusion, high blood pressure and more.11

Already by 1996, 35,000 complaints about the drug had been lodged with the FDA.12 In the early 1990s, Breggin was appointed by a federal court as the medical and scientific expert for the plaintiffs in all combined lawsuits facing Eli Lilly with regard to Prozac, a role that gave him access to corporate records.13 Breggin tells Attkisson:14

“Prozac … had amphetamine affects. The chief investigators said and wrote, ‘this drug has amphetamine like effects. We need to put this into the label. It can make depression worse, can make people agitated, make them angry, might increase the suicide rate,’ but the FDA wouldn’t allow onto the label what it’s chief investigator into adverse effects was telling them.

So, from the beginning, it was all a house of cards. And, as for it’s being useful, I looked it over, carefully analyzed the statistics and said the drug actually doesn’t work. It’s about as good as placebo.

Now, placebo will help anywhere between 40 and 80 percent of people, so it’s a huge effect and that especially with depression, because depression is not about a biochemical imbalance. It’s about hopelessness. Depression is part of the human experience.”

In Breggin’s view, “There is no promising medical treatment and probably there never can be,” for the simple reason that depression is primarily rooted in the complexity of human emotions and experiences. He believes one needs to avoid numbing and escapist behaviors such as drug and alcohol use, and implement strategies to support healthy brain function instead, in order to “be able to deal with your issues.”

Contrary to Popular Opinion, Antidepressants Don’t Work

In 2010, I interviewed medical journalist and Pulitzer Prize nominee Robert Whitaker about the use of psychiatric drugs, as he has written two books on this topic. I’ve included that interview again for your convenience. In it, Whitaker details the science showing antidepressants don’t work — and what actually does.

The available science has also brought Jacob Stegenga, a philosophy of science lecturer at the University of Cambridge and author of “Medical Nihilism,” to the same conclusion. In a recent essay, he notes:15

“Diving into the details of how antidepressant data are generated, analyzed and reported tells us that these drugs are barely effective, if at all … The best evidence about the effectiveness of antidepressants comes from randomized trials and meta-analyses of these trials.

The vast majority of these studies are funded and controlled by the manufacturers of antidepressants, which is an obvious conflict of interest. These trials often last only weeks — far less than the duration that most people are on antidepressants.

The subjects in these trials are selected carefully, typically excluding patients who are elderly, who have other diseases, or who are on several other drugs — in other words, the very kinds of people who are often prescribed antidepressants — which means that extrapolating the evidence from these trials to real patients is unreliable.

The trials that generate evidence seeming to support antidepressants get published, while trials that generate evidence suggesting that antidepressants are ineffective often remain unpublished …

To give one prominent example, in 2012 the U.K. pharmaceutical company GlaxoSmithKline pleaded guilty to criminal charges for promoting the use of its antidepressant Paxil in children (there was no evidence that it was effective in children), and for misreporting trial data … When analyzed properly, the best evidence indicates that antidepressants are not clinically beneficial.

What Does the ‘Best Evidence’ Say About Antidepressants?

While some psychiatric drugs may be helpful for a small minority of people with very severe mental health problems, such as schizophrenia, it’s quite clear that a vast majority of people using these drugs do not suffer from the type of psychiatric illnesses that might warrant their prudent use.

Most are struggling with sadness, grief, anxiety, “the blues” and depression, which are in many ways part of your body’s communication system, revealing nutritional or sunlight deficiencies and/or spiritual disconnect, for example.

The underlying reasons for these kinds of troubles are manifold, but you can be sure that, whatever the cause, an antidepressant will not correct it. In fact, as noted by Breggin, studies16,17,18 have repeatedly shown antidepressants work no better than placebo for mild to moderate depression.

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