HOW ADDICTIVE ARE ANTIDEPRESSANTS?
"The truth is that the state of the science is absolutely inadequate." Dr. Derelie Mangin of McMaster University, from Matt Wynn's headline for MedPage Today (Antidepressant Withdrawal...)
There are any number of drugs, which, over the years have been touted by 'experts' as non-addictive (POT is one that comes immediately to mind), only to later 'discover' that they were (gulp) wrong. The latest in this category are ANTIDEPRESSANTS. This past weekend the New York Times ran a major article by Benedict Carey and Robert Gebeloff called Many People Taking Antidepressants Discover They Cannot Quit. What's interesting is that when you realize how the majority of these drugs work (particularly the Selective Serotonin Reuptake Inhibitors or SSRI's), addiction is a no-brainer that I've been warning both my patients and readers about for years. Another no-brainer is what's driving this discussion. Can anyone say OVERDIAGNOSIS & OVERTREATMENT?
"Long-term use of antidepressants is surging in the United States, according to a new analysis of federal data by The New York Times. Some 15.5 million Americans have been taking the medications for at least five years. The rate has almost doubled since 2010, and more than tripled since 2000. Nearly 25 million adults have been on antidepressants for at least two years, a 60 percent increase since 2010."
HOLY SCHNIKIES TOMMY! Think about that for a moment; almost 8% of our nation's population have been taking these drugs for over two years, while just under 5% have been on them for over five. And heaven only knows how many have been yo-yoing on and off of them, and not even counted in these statistics. It's yet another example of our medical profession's attempt at short-term patches causing long-term problems. Firstly, remember there are many smart people who have shown that serotonin may be less involved in Depression than the public has been led to believe (HERE). Secondly, when you inhibit the reuptake (recycling) of serotonin, it's a given that there will be more of it in the body. In most cases, what does the body do when you give it more of any chemical?
Firstly, when one starts taking or increasing the amount of exogenous chemicals or drugs one is taking, it slows down (or in some cases even shuts down) endogenous production. A great example is anabolic steroids. A guy takes steroids, has lots of male hormone circulating through his body, gets really big and lean, but...... Because his body has so much hormone coursing through it, the testicles are told to shut down endogenous production (HERE). In other words, unneeded testicles shrink and shrivel. Not surprisingly, once this person goes off the juice it will take a substantial amount of time (and in many cases, other drugs) to get them working normally again.
Number two, if you increase the amount of a natural chemical or hormone in the body, it frequently causes the body to need more. A great example here is insulin. Insulin is the hormone made by the pancreas that moves blood sugar out of the blood and into the cells where it can be used. Americans have been LIVING THE HIGH CARB LIFESTYLE for decades. The more sugar or high glycemic carb one consumes, the more insulin the body will need in order to move the sugar, eventually hitting a saturation point, where the body actually starts "RESISTING" its effects. All while the body continues to tell the pancreas that it needs even more insulin. The result is both high blood sugar and high insulin at the same time. This vicious cycle will go on indefinitely until the pancreas is overworked to the point that it starts burning itself out (DIABETES).
Thus, we cannot be even remotely surprised that when people take SSRI's, their body decreases endogenous production of serotonin. And here is the kicker; we've known for decades that Depression is considered an "inflammatory" disease (IT'S CAUSED BY INFLAMMATION), as well as being associated in peer review with a myriad of inflammatory diseases such as OBESITY, ARTHRITIS, AUTOIMMUNITY, etc, etc, etc. It's not surprising that our society is dealing with large amounts of Depression. With this many people on a drug with so many known side effects, you would think there would be a concerted effort to create a way to get them off the drugs. "Withdrawal has never been a focus of drug makers or government regulators, who felt antidepressants could not be addictive and did far more good than harm." There it is folks, just like I've been telling you for years. The medical community has out-and-out lied to you. Furthermore, you must be aware that in most cases, the "government" and Big Pharma ARE A SINGLE UNHOLY ENTITY.
Let me show you another phenomenon associated with antidepressant use that has also been associated with other drugs. "The drugs initially were approved for short-term use (six to nine months), following studies typically lasting about two months. Even today, there is little data about their effects on people taking them for years, although there are now millions of such users.... What you see is the number of long-term users just piling up year after year." Guess what other super common drug is going through the exact same scenario right now? Can any one say PROTON PUMP INHIBITORS?
PPI's (heartburn / refulx drugs) say right on the label not to use them for more than two weeks at a time, or more than three times per year (a total of six weeks). I see people that have not been off these drugs for decades --- the reason that the "S" is starting to "HTF" as far as this class of drug's ugly side effects are concerned (see previous link). Oh; and as for studies lasting only two months? This is done purposefully because industry knows good and well that MOST SIDE EFFECTS will only show up after this period. And none of this begins to address the fact that your stomach acid is supposed to be absurdly strong / potent in the first place (HERE).
"Antidepressants are not harmless; they commonly cause emotional numbing, sexual problems like a lack of desire or erectile dysfunction and weight gain. Long-term users report in interviews a creeping unease that is hard to measure: Daily pill-popping leaves them doubting their own resilience..."
All you have to do is read my posts on DEPRESSION to see that SEXUAL SIDE EFFECTS are almost universal with SSRI's. Furthermore, the authors went on to interview drug manufactures about their suggestions to "taper off." Unfortunately, when pressed about specific guidelines, industry representatives could not provide any protocols / advice for doing so. As for peer-review on this topic, the December 2017 issue of Psychiatric Services (Discontinuing Psychiatric Medications: A Survey of Long-Term Users) and July 2016 issue of Patient Preference and Adherence (Long-Term antidepressant Use: Patient Perspectives of Benefits and Adverse Effects) addressed antidepressant withdrawal with studies of 250 and 180 patients respectively. Below are their respective cherry-picked conclusions.
"About half (54%) met their goal of completely discontinuing one or more medications; while 46% reported another outcome (use was reduced, use increased, or use stayed the same). They used various strategies to cope with withdrawal symptoms, which 54% rated as severe. Although more than half rated the initial medication decision with prescribers as largely collaborative, only 45% rated prescribers as helpful during discontinuation. Discontinuing psychiatric medication appears to be a complicated and difficult process."
"Long-term antidepressant treatment has increased and there is evidence of adverse effects; however, little is known about patients’ experiences and views of this form of treatment. ...30% reported moderate-to-severe depression on antidepressants. Common adverse effects included withdrawal effects (73.5%), sexual problems (71.8%), and weight gain (65.3%). Adverse emotional effects, such as feeling emotionally numb (64.5%) and addicted to the antidepressant (43%), were also common. While the majority of patients were pleased with the benefits of antidepressant treatment, many were concerned about these adverse effects."
Remember the old saying, with friends like these, who needs enemies? How bad must it have been for these women (the vast majority of antidepressant users are middle and upper class white women) to have been able to say that weight gain, SEXUAL DYSFUNCTION, SSRI addiction, and emotional numbness were worth it? What's the solution?
For starters, realize that grief is different than Depression. I see many many women who start their antidepressants after some sort of tragedy (the death of a loved one is common). While I certainly "EMPATHIZE" with these women; is taking a class of drug that has been shown to be at best "SLIGHTLY BENEFICIAL" the most productive way of dealing with grief? Not considering the side effects, and certainly not considering the withdrawal symptoms (addiction) she is almost invariably setting herself up for in the future. Unfortunately, the longer she takes the drug, the harder it is going to be to get off of it.
Secondly, to get off these drugs (or avoid them in the first place) you will need to understand and control INFLAMMATION, with a particular emphasis on managing GUT HEALTH. Gut Health? Darn straight! Remember the study I showed you where scientists took normal mice, used stressful situations to cause "Depression," and then used FECAL MICROBIOTA TRANSPLANTATIONS from other normal mice to make the depressed mice 'happy' again? And if that wasn't enough, the same scientists then turned the normal mice depressed again simply by doing another FMT from depressed mice. That's how big a deal your MICROBIOME is when it comes to mood and psychiatric health!
Fortunately, when it comes to knowing what to do, I've done a great deal of heavy lifting for you by creating a general protocol to effectively deal with inflammation and its consequences --- Depression being just one of many (HERE). While some of you certainly may require a more personalized plan, at least study this as it will provide a frame of reference for whatever else you choose do. And if you like what you're seeing on my site, be sure and get it in front of those you love and care about most. One of the easiest ways is with FACEBOOK.
Dr. Schierling completed four years of Kansas State University's five-year Nutrition / Exercise Physiology Program before deciding on a career in Chiropractic. He graduated from Logan Chiropractic College in 1991, and has run a busy clinic in Mountain View, Missouri ever since. He and his wife Amy have four children (three daughters and a son).