What do you all think of this?

[mad_scotsman]

There was an article published recently in my local newspaper written by a psychiatrist from my local hospital. It was titled "Antidepressants: Mythbusting".
The article was basically a plea to people suffering from depression not to be swayed by the recent 'bad press' concerning anti-depressants. The psychiatrist was concerned that people who needed help may not come forward or people who were already on these drugs may stop taking them. Whilst I could understand the motive of publishing this article, the doctor went on to make this statement;

"People are sometimes concerned antidepressants may be "addictive",
this is not the case: after being on them for some time it is advisable
to come off them slowly or you may experience some effects of
withdrawal."

He then went on to say that these drugs had "very few side-effects".

So after reading this article I sat and reflected for a while and the more I thought about it the more angry it made me. I wasn't shocked because I would expect a psychiatrist to make that statement. But I just couldn't let it lie. So I Googled this guy's name and found his email address. I sent him this email -

"I read your article "Antidepressants: Mythbusting" in the Evening
Express.


On what basis do you make the following statement;

"People are sometimes concerned antidepressants may be "addictive",
this is not the case: after being on them for some time it is advisable
to come off them slowly or you may experience some effects of
withdrawal."

I can assure you that there are plenty of people out there who would
disagree with that statement. There are plenty of people who withdraw
from these drugs very very slowly and still experience intolerable
withdrawal symptoms. Surely this would indicate some sort of mental and
physical dependency.

And the 'very few side effects' can prove to be very significant.
Apathy, lack of empathy, increased anxiety and depression, emotional
numbness and changes in personality are hardly trivial.

Surely the 'bad press' is necessary to highlight the negative aspects
of these drugs? In my case, anti-depressants have caused more problems
than they have solved. If I could live my life again I would never
have taken them in the first place.

I believe your motive is good - to persuade people that they should
still take their medication and still seek medical help if they are
severely depressed.
However, to claim that these drugs are not addictive and to downplay
the side-effects is just plain wrong and irresponsible. You almost
sound like a GSK salesman.
At the end of the day we know very little about what these drugs
actually do. We are trying to solve a complex problem with a very blunt
instrument."


A few days later I received this reply.


"I have now read the edited article myself and can thus reply!

Withdrawal effects alone do not in medical parlance make medications
addictive. Generally, other features such as craving, tolerance and dose
escalation (as with heroin for example) are needed to fulfil the
definition.. I agree that withdrawal effects and side-effects can both be
very problematic. As you seem to be aware, the point of the article was
to attempt to address the demonisation of antidepressants which may
prevent depressed people from seeking appropriate help. The most
difficult thing, perhaps, is trying to ensure that the right people get
antidepressants and the wrong people do not!"


To which I replied -


"Then our argument comes down to the semantics of the word 'addictive'.

I agree that it would be unfortunate if the bad press stopped people seeking help. But on the other hand I believe that people should be made fully aware of both the positive and negative aspects of these drugs. That they may experience significant side-effects, the drug may stop working for them and they may have a terrible time getting off it.

I agree with the point of your article but I still think it is misleading to claim these drugs are not addictive and have very few side effects."


So according to this article paxil addiction is a myth to be busted and the side effects are a walk in the park. People will trust the article because it was written by a professional psychiatrist. I wonder how many people will find out the hard way what paxil is really like.

[scotty]

Ah, the semantics of addiction! GSK tried this when the FDA took them to task about their advertising of Paxil as "non addictive". GSK was forced to remove that phrase from their commercials. So.....the reality of the definition is the only aspect of additive that it doesn't meet is "committing crimes to obtain the drug", which will all know is ridiculous since you can get it from any doctor just by asking.

One reputable psychiatrist said"If you can't stop taking a drug when you want to stop taking it without severe symptoms....then it's addictive!"

Good for you for taking him on!

[scotty]

http://www.businessday.co.za/article...?ID=BD4A748549

Looks like Scotland is starting to see the light...here's another article:

Posted to the web on: 16 April 2008
‘Loss of sadness’ as drugs are dished out


“THE drugs don’t work”, say media headlines around the world: some antidepressants are no better than placebos. This raises important questions not just about the treatment of depression (a global problem), but also about its diagnosis.


Over the years, doctors have been accused of either underdiagnosing or overdiagnosing depression.

In the UK in the 1990s, they were called upon to Defeat Depression, a campaign led by the Royal Colleges of Psychiatry and General Practitioners. The message was that depression was underdiagnosed and doctors were encouraged to seek out cases and instigate treatment.


More recently, there have been concerns, particularly from the UK National Institute for Clinical Excellence, the body that recommends which treatments the country’s National Health Service should adopt, that GPs are reaching for a prescription pad too readily.

Similar concerns have been expressed in SA.


While doctors may be opting for antidepressants because of the scarcity of quick access to talking therapies, they may also be overdiagnosing.


Depression is not an illness that has a blood test to exclude or diagnose it. Rather, it is a diagnosis reached by observation, talking, and sometimes also by questionnaire, using criteria set out by the Diagnostic and Statistical Manual (DSM).


A depressed person may suffer loss of appetite or loss of the ability to feel pleasure, early-morning wakening, a feeling of hopelessness, fatigue, and often a feeling that life is not worth living. The number and intensity of these feelings results in categorisation of the disorder into mild, moderate or severe.


But not all such feelings are necessarily abnormal. After bereavement, or a relationship breakdown, it is normal to have a disturbance of mood. However, the criteria used to diagnose depression do not take account of the context of the life in which they occur. The DSM criteria suggest that symptoms of depression lasting over two weeks merits a diagnosis. This means that an understandable and proportionate response to a significant loss in a person’s life is instead viewed as an abnormality, and the patient is diagnosed as depressed.


This failing of the DSM to allow for the vagaries of life is explored in a recent book, The Loss of Sadness (Oxford University Press), by two sociologists, Allan Horowitz and Jerome Wakefield. They argue that many patients who are having a normal response to major life events are being diagnosed with depression and treated with antidepressants.


This is not to trivialise depression. But it does partly explain the recent research, published in the Public Library of Science Medicine, and reported by the press to mean that “the drugs don’t work”.


This study, which looked at unpublished trials obtained under US freedom of information law, revealed that placebo treatment resulted in clinically important improvements. However, when they examined research into four of the SSRI-type antidepressants, they found that when used in mild or moderate depression, they had only a small clinical effect in addition to that produced by placebo. Crucially, this small additional effect was not clinically significant. However, antidepressants did help patients with severe depression.


The problem is that under our current diagnostic system, we are overmedicalising the condition of sadness. First, people who are “normally sad” have been given a medical diagnosis. These people are therefore also at risk of being treated with medication, which is unlikely to have an effect beyond that of placebo. But worse, they are labelled with an illness.


As Horowitz and Wakefield say, “virtually the entire population could be conceived as ill to some degree”. The inclusion of these “normally sad” cases under the umbrella of “depression” means that the cases of true depression — people who, as Horowitz and Wakefield say, have a disorder and are abnormally sad — are at risk of having their illness trivialised . Financial Times


Margaret McCartney is a GP in Glasgow and a columnist for the Financial Times. E-mail her at margaret.mccartney@ft.com.

[mad_scotsman]

I know the psychiatrist who wrote the article. I was referred to him a number of years ago.
The fact that he is in the paper perpetuating this myth while I am going through withdrawal hell is part of the reason I no longer trust shrinks.