Taking drugs that do not work

I was going to write a light hearted blog about TV ads that have caught my attention. Like the one that asks if I am hindered by my mobility. Apparently, if I am getting around too much, I might want a wheelchair. Or the ad where mom plunks down a bucket of fried chicken on the table and the kids run and get in the car. “It will take a while for them to get used to dinner at home,” she says. Yes, there is nothing quite as unexpected as dinner at home, even if not home cooked. But then I started exploring one of my favorite ads for a new antidepressant and got side tracked into more serious issues.

The ad begins by citing a government study showing that 70% of the people taking prescription anti-depressants remain depressed. That is amazing. Why are so many people ignoring cost and side effects and taking these ineffective drugs?

Probably patients and their doctors simply assume that the drugs are working “a bit” and that life would be worse off without them. This is a false assumption as people either respond or do not respond to a medication. In fact, close to 90% of prescription medicines only work in 30-50% of those who are prescribed them. It follows that, leaving aside the placebo effect of doing something about one’s state of mind and having someone (the doctor) identify it as a biochemical problem, one’s attitude toward life would remain the same with or without these antidepressants.

Another reason may be that it can be difficult to quit the drugs. Most of the antidepressants in question are SSRI (serotonin reuptake inhibitors), and one of their benefits is supposedly that they are not addictive. However, it turns out that they may make you feel absolutely miserable when you stop them, especially if you do so abruptly. One site claims that about 1/3 of those who stop taking SSRIs experience some or all of these effects: Stomach upsets, flu like symptoms, anxiety, dizziness, disturbingly vivid dreams (basically a euphemism for nightmares), and sensations in the body that feel like electric shocks. This is referred to as the SSRI discontinuation syndrome. It is said to be different from drug addiction although the distinction somewhat escapes me.

And those who have the hardest time quitting are apparently newborns and young infants. They are exposed to the drugs in utero and through breast milk, and can suffer very serious withdrawal symptoms when either their mom, or they at birth, quit taking the drugs.

So, for many (actually the majority), SSRIs are going to be expensive, ineffective, have numerous side effects, and be difficult and painful to quit. Nonetheless, the medical establishment favors SSRIs over St. John’s wort (Hypericum perforatum). The latter is often helpful in depression, has few side effects aside from changing the metabolism of other pharmaceutical drugs the patient may not be taking, and there is no “St. John’s wort discontinuation syndrome” for those cases where it is not the right choice for the patient. Go figure.

For more information on SSRI discontinuation syndrome see

http://www.antidepressantsfacts.com/addiction-withdrawal.htm

The statistics on how often prescription medicines may not work are from http://www.ghchealth.com/glaxo-chief-our-drugs-do-not-work-on-most-patients.html

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