Overprescribing and over-use of antidepressants downright depressing

Posted: August 25, 2015 in Medical Industrial Complex
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Even more depressing than our ever-increasing reliance on drugs to combat high blood pressure is the overprescribing and over-use of antidepressants – especially where children are concerned.  We address this in our book MEDICAL INDUSTRIAL COMPLEX: The $ickness Industry, Big Pharma and Suppressed Cures, and we examine the role mainstream medicine plays in all of this.

 

An excerpt from Medical Industrial Complex  follows:

Statistically, there’s a very good chance you know someone who is taking Prozac or some other antidepressant right now. It may be a neighbor, or colleague, or a friend or family member, or, it may be you.

This no doubt has something to do with the readiness of people to talk about their depression or even their mental illness – conditions which, thankfully, are no longer burdened by stigma. It no doubt also has something to do with the widespread consumer acceptance of antidepressants as a solution for their depression.

According to some estimates, depression, that most common of mental illnesses, affects one quarter of all Americans.

A March 24, 2014 report in The Atlantic claims Americans are awash in pills. “The use of antidepressants has increased 400 percent between 1988 and 2008. They’re now one of the three most-prescribed categories of drugs, coming in right after painkillers and cholesterol medications”.

The situation, it seems, is little better elsewhere in the Western world. In the UK, for example, more than 50 million prescriptions for antidepressants are written every year if latest estimates are correct.

This figure is “staggeringly high,” according to an article in The Guardian dated April 13, 2014. It quotes Dr Matthijs Muijen, head of mental health at the World Health Organization Europe, as saying prescription levels have gone through the roof, claiming “There’s a degree of fashion about antidepressants”.

Dr Muijen admits his worry is “We are medicalising all forms of sadness in the belief that antidepressants are a safe drug that you just prescribe”.

In a report dated August 3, 2013, BBC News asks the question: “Is England a nation on anti-depressants?” It also asks why we are seeing “such huge and rising numbers of people” regularly taking anti-depressants when GPs are advised to prescribe them only for more seriously ill patients.

The report continues, “In some places the number of patients prescribed anti-depressants exceeds the number of people in that area estimated to suffer from depression and anxiety by the NHS England’s Psychiatric Morbidity Survey (PMS)”.

On June 21, 2013, Healthline News reported that a Mayo Clinic study found that nearly 70% of Americans are prescribed at least one medication, with antidepressants (along with antibiotics and opioids) topping the list.

The article quotes the National Alliance on Mental Illness as estimating one in four Americans experience a mental health disorder, such as depression or anxiety, in a given year. “Typical first-line treatments for mental health issues are medication and some type of psychotherapy…Critics who say antidepressant medications are overused often claim there is a chicken-and-egg phenomenon, saying that antidepressants are prescribed for normal human reactions to life events, leading to a lasting diagnosis of mental illness”.

The article concludes, “However, as the public mindset continues to change, there’s now less stigma attached to getting help for mental disorders, which may help explain the rise in antidepressant use”.

“Suicide rates have not slumped under the onslaught of antidepressants, mood-stabilizers, anxiolytic and anti-psychotic drugs; the jump in suicide rates suggests that the opposite is true. In some cases, suicide risk skyrockets once treatment begins (the patient may feel not only penalized for a justifiable reaction, but permanently stigmatized as malfunctioning). Studies show that self-loathing sharply decreases only in the course of cognitive-behavioral treatment.”Antonella Gambotto-Burke, The Eclipse: A Memoir of Suicide

Predictably, the Psychiatric Times, whose audience is American psychiatrists and mental health professionals, doesn’t agree that antidepressants are overprescribed in the US. In an article dated September 1, 2014, that publication’s editor-in-chief Ronald W. Pies, MD, reports that, “by and large”, he doesn’t agree with the allegation that America has become a kind of Prozac Nation – a none-too-subtle reference to the title of Elizabeth Wurtzel’s 1994 memoirs perhaps.

“In many respects, the claim that ‘too many Americans are taking antidepressants’ is a myth,” according to Dr. Pies. “…To be sure: in some primary care settings, antidepressants are prescribed too casually; after too little evaluation time; and for instances of normal stress or everyday sadness, rather than for MDD (major depressive disorder),” he says.

“And, in my experience, antidepressants are vastly over-prescribed for patients with bipolar disorder, where these drugs often do more harm than good: mood stabilizers, such as lithium, are safer and more effective in bipolar disorder. But these kernels of truth are concealed within a very large pile of chaff”.

Dr. Pies continues, “For example, the media often report that antidepressant use in the United States has ‘gone up by 400%’ in recent years—and that’s probably true…But the actual percentage of Americans 12 years or older taking antidepressants is about 11%—a large proportion of the population, for sure, but not exactly Prozac Nation”.

So, though Dr. Pies – and by default Psychiatric Times and no doubt the majority of psychiatric professionals in the US – disputes the allegation that America has become a kind of Prozac Nation, there seems to be a reluctant acknowledgement that antidepressants are vastly over-prescribed for patients suffering one type of mental illness at least, and that it’s probably true that antidepressant use has risen 400% in the US.

If that doesn’t constitute a Prozac Nation, not sure what does…

Washington D.C. writer Brendan L. Smith, reporting on the American Psychological Association’s website in June 2012, reports that research shows that all too often, Americans are taking medications that may not work or that may be inappropriate for their mental health problems.

Smith observes that writing a prescription to treat a mental health disorder is easy, but it may not always be the safest or most effective route for patients, according to some recent studies and a growing chorus of voices concerned about the rapid rise in the prescription of psychotropic drugs.

“Today, patients often receive psychotropic medications without being evaluated by a mental health professional, according to…the Centers for Disease Control and Prevention. Many Americans visit their primary-care physicians and may walk away with a prescription for an antidepressant or other drugs without being aware of other evidence-based treatments…that might work better for them without the risk of side effects”.

Smith quotes Steven Hollon, PhD, a psychology professor at Vanderbilt University, as saying at least half the folks who are being treated with antidepressants aren’t benefiting from the active pharmacological effects of the drugs themselves but from a placebo effect. “If people knew more,” Hollon says, “I think they would be a little less likely to go down the medication path than the psychosocial treatment path”.

Smith claims Prozac opened the floodgates. “Since the launch of Prozac, antidepressant use has quadrupled in the United States…Antidepressants are the second most commonly prescribed drug in the United States, just after cholesterol-lowering drugs”.

Smith also quotes Daniel Carlat, MD, associate clinical professor of psychiatry at Tufts University, as saying health insurance reimbursements are higher and easier to obtain for drug treatment than therapy, which has contributed to the increase in psychotropic drug sales.

“There is a huge financial incentive for psychiatrists to prescribe instead of doing psychotherapy,” Dr. Carlat says. “You can make two, three, four times as much money being a prescriber than a therapist”.

“As James Surowiecki noted in a New Yorker article, given a choice between developing antibiotics that people will take every day for two weeks and antidepressants that people will take every day forever, drug companies not surprisingly opt for the latter. Although a few antibiotics have been toughened up a bit, the pharmaceutical industry hasn’t given us an entirely new antibiotic since the 1970s.” -Bill Bryson, A Short History of Nearly Everything

 

You have been reading an excerpt from Medical Industrial Complex. Watch this space for our take on the prescribing of antidepressants to children. Meanwhile, you can find this book on Amazon:  http://www.amazon.com/MEDICAL-INDUSTRIAL-COMPLEX-Suppressed-Underground-ebook/dp/B00Y8Y3TUM/

MEDICAL INDUSTRIAL COMPLEX: The $ickness Industry, Big Pharma and Suppressed Cures (The Underground Knowledge Series Book 3)

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