Pandemic fuelled stress has resulted in a worrying rise not only in mental health issues but in prescriptions for the antidepressants that are meant to help us cope with those issues. But do they help? And what are the side effects of taking them? Questions that we surely need to ask, especially as these drugs are being handed out to ever younger patients.
Do they cure?
- Many of the trials included in the major review most often cited are ‘very old and carried out for regulatory purposes rather than to inform clinical practice in the NHS’ (Glyn Lewis, Professor of Psychiatric Epidemiology, UCL Division of Psychiatry). Moreover, they only looked at short term outcomes up to about 8 weeks.
- Research results suggests that antidepressant drugs are more successful for people with moderate to severe depression rather than mild depression.
- It also suggests that they work better when combined with a ‘talking therapy’ such cognitive behavioural therapy (CBT).
- The findings of this meta analysis suggested that ‘all antidepressants included in the meta-analysis were more efficacious than placebo in adults with major depressive disorder; the summary effect sizes were mostly modest’.
- ‘The present findings in adults contrast with the efficacy of antidepressants in children and adolescents, for which fluoxetine is probably the only antidepressant that might reduce depressive symptoms.’
So while it would appear that antidepressants do help some people, this is hardly a ringing endorsement for their effectiveness as the only line of treatment on offer for an ever growing section of the population.
At what cost?
Side effects and withdrawal effects are acknowledged to vary from person to person and from slight to debilitating to lethally dangerous.
The MIND website offers a comprehensive list of why you should be cautious about taking anti-depressants in the first place. It then lists the side effects you might experience when you start the drug (from nausea, headaches and decreased alertness to diabetes and suicidal feelings) and the withdrawal effects that you could experience when you stop taking it.
Depending on the drug withdrawal symptoms can include vertigo, flu like symptoms, balance issues or tinnitus. They can also mimic your original symptoms – anxiety, depression, disturbed sleep or insomnia, hallucinations, mania, suicidal thoughts. This is one reason why so many people go back on the drugs; they think they are not yet ‘cured’ as the withdrawal symptoms are as bad, if not worse than the originals. As a result they can all too easily end up in a never ending cycle of drug dependency.
But can they also kill?
In a very small proportion of people, yes they can.
At a recent on line conference on nutrition and mental health both Sandra Breakspeare of The Chy-Sawel Project and Katinka Blackford described the catastrophic effects that taking anti depressant drugs had both on Sandra’s son and on Katinka herself.
Both Katinka and Anthony, Sandra’s son, were among the 2-5% of people who lack the liver enzymes needed to metablise antidepressant drugs. (See below* for details.) As a result, even a small dose will cause overwhelming and disastrous symptoms. A massive exacerbation of existing symptoms often escalating into hallucinations and psychosis which magnify suicidal thoughts and all too often result in the patient indeed committing suicide.
Because the condition is rarely recognised, the simple liver function test that would reveal the enzyme deficiency is never done; the only treatment offered by psychiatrists is to increase the dose of the drugs yet further. While this is obviously intended to be calming, in fact all it does is to ramp up symptoms yet further.
As a result Anthony spent over 19 years detained in secure mental hospitals on massive doses of medication despite his constant and desperate pleas to be taken off all drugs. Katinka, a slim and fit mother of two young children put on four stone in weight, took up drinking and smoking 70 cigarettes and day, never washed, never dressed and became a complete zombie. She was only ‘rescued’ by being checked into an NHS hospital where they took her off all the prescribed drugs and she went, painfully, but successfully cold turkey.
In these cases, they kill all too often
Katinka now runs a website, AntidepressantRisks on which others who, like her, have been unable to metabolise the drugs have told their stories – or have had their stories told by family members as they are no longer alive to tell them themselves. Of the 64 stories that appear on her ‘Stolen lives’ page, 28 out of those 64 have either killed themselves or killed someone else. The remaining 34 are still alive but have had their lives destroyed, often irreversibly.
On the site there are also two films, one a Panorama investigation, the other a 48 Hours one. These suggest that in two horrendous killings in the US (the mass shooting in a cinema in Colorado in 2012 by 25 year-old James Holmes and 12 year-old Chris Pittman’s shooting of his grandparents in 2002) both James Holt and Chris Pittman, neither of whom had any previous record of violence, acted under the influence of prescription drugs which they could not tolerate. In neither case were the jury convinced and both are now serving long sentences – but in neither case were the jury informed about the liver enzyme deficiency which could have resulted in standard antidepressant drugs so distorting their psyches as to turn them into killers.
* This brief explanation is taken from this review of the Cytochrome P450 system:
Cytochrome P450 (CYP) is a hemeprotein that plays a key role in the metabolism of drugs…. Drug metabolism occurs in many sites in the body, including the liver, intestinal wall, lungs, kidneys, and plasma. As the primary site of drug metabolism, the liver functions to detoxify and facilitate excretion of xenobiotics (foreign drugs or chemicals) by enzymatically converting lipid-soluble compounds to more water-soluble compounds…..
Genetic mutations or polymorphisms (genetic variants) of CYP are known to exist among patients….. Each person’s ability to metabolize drugs is determined by the pairing of individual alleles (forms of genes) he or she has inherited from his or her parents. Each allele may be categorized as a wild-type (functional) or variant (defective) allele. Wild-type alleles are considered “normal” and occur predominantly in the general population, whereas variant alleles may result in diminished or no activity. People who carry two wild-type alleles will generally have “normal” rates of metabolism (extensive metabolizers), whereas a person who carries two variant (defective) alleles will inherently have little to no enzyme activity (poor metabolizers).