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Do anti-depressants work?

By Sebastian Rushworth, M.D. | April 30, 2021

Anti-depressant drugs are common. Very very common. According to the Centers for Disease Control in the United States, 13% of adults reported taking an anti-depressant when surveyed a few years ago. Among women over the age of 60, almost one in four was taking an anti-depressant!

When I work in the hospital, I frequently see elderly people who are on five, ten, fifteen, or even twenty drugs simultaneously. Invariably, one or more of these drugs is an anti-depressant. This absurd overuse of medications, an issue known as polypharmacy, is one of the biggest health problems facing elderly people today. Anti-depressants are one of the main drug classes contributing to polypharmacy.

With so many people taking anti-depressants, you would think that they must at the very least be effective. And safe. Why else would so many millions of people be taking them on a daily basis? Why else would doctors prescribe them so freely?

The most commonly prescribed type of anti-depressant is the selective serotonin reuptake inhibitor (SSRI). Examples of this type of drug include sertraline (a.k.a. zoloft), escitalopram (a.k.a. cipralex), and fluoxetine (a.k.a. prozac). SSRI’s increase serotonin signalling in the brain, which is hypothetically a good thing for people who are depressed. They are generally considered to have the best balance of efficacy and safety of any anti-depressant drug, which is why they are the first line therapy.

So, how effective are SSRI’s at treating depression?

A systematic review and meta-analysis was published in BMC Psychiatry in 2017 that sought to answer this question. The review was funded by the Danish government. It identified 131 randomized placebo-controlled trials investigating SSRI’s as a treatment for depression in adults, with a total of 27,422 participants, and meta-analyzed them (i.e. added all their results together to create one big “meta” trial – this gives a more reliable result than the individual trials can provide).

Before we get in to the results, we need to quickly discuss the Hamilton Rating Scale for Depression (HDRS). The HDRS is the scale most commonly used to assess severity of depression in studies, and also to assess how the severity changes over time. It is a 52 point scale, so a score of 52 is as bad as it can get. A score below eight is considered normal (i.e. not depressed). 8 to 13 is considered to be “mild” depression. 14-18 is considered to be “moderate” depression. 19-22 is considered to be “severe” depression, and anything from 23 and up is considered to be “very severe” depression.

The authors of the review decided, before analyzing the data, that anything less than an average reduction of three points on the scale would be considered a negative result. Personally I think that this is a bit generous. I find it hard to believe that anyone would be able to notice a three point reduction on a 52 point scale. I would have set the threshold higher, at more like six points at the very least. One article published back in 2015 came to the conclusion that people are unable to detect anything less than a 7 point difference on the 52 point Hamilton scale. But as we shall soon see, setting the threshold higher wouldn’t have made a difference anyway. So, let’s get to the results.

Overall, SSRI’s resulted in a 1.94 point greater reduction on the 52 point HDRS scale than placebo. Even when only trials of people with very severe depression (a score of 23 or higher) were included, the improvement over placebo was still only 2.69 points.

So, SSRI’s were not able to get over even the generously low bar set by the reviewers. And let’s remember that most of the studies included in the analysis were industry funded, and industry funded studies usually show a bigger benefit than is seen in reality, so it is likely that the real effect is even smaller than was found in the systematic review.

In other words, SSRI’s are not effective as anti-depressants. Considering that they are currently the first line drug therapy for depression, that would seem to be quite a big problem. And before you suggest that we should use non-SSRI anti-depressants instead, like for example tricyclics, I would note that these have not been shown to be markedly more effective than SSRI’s in head-to-head comparisons. Otherwise we’d be using them as the first line therapy, not SSRI’s.

What about safety? Did SSRI’s cause any serious adverse events?

2.7% of participants in the SSRI arm developed a serious adverse event, as compared with 2.1% in the placebo arm. That is a 0.6% absolute difference, which would mean that roughly one in 170 people treated with an SSRI will suffer a serious adverse event as a result of the treatment. Note that the definition of a serious adverse event is an event that causes death, significant risk of death, disability, and/or hospitalization. In other words, “serious” is serious. So even a small increase in serious adverse events is something that needs to be taken quite, well, seriously.

Medical treatments should ideally result in a decrease in serious adverse events. They certainly should not cause an increase. A truly effective anti-depressant would not just make people feel better, it would also make them less likely to try to commit suicide, which would result in an overall reduction in serious adverse events. No such signal was seen here. Even if you look just at suicide attempts, rather than at adverse events overall, there was no signal that SSRI’s decrease their frequency.

Note that the trials in the review were generally of healthy people under 65 years of age. Frail elderly people treated with SSRI’s will likely experience serious adverse events at a much higher rate than that found here.

Speaking of frail elderly people, in particular those living in nursing homes, I want to take the opportunity to point out that they are frequently the heaviest users of anti-depressants. So you would think that there would be a lot of research showing that anti-depressants are useful to give to the frail elderly… Well, having seen that the evidence doesn’t support using anti-depressants in younger people, you might be a bit skeptical by now. A systematic review was published in the Journal of the American Medical Directors Association in 2012, that sought to determine how beneficial anti-depressants are when used as a treatment for depression in people over the age of 65 who are living in nursing homes. The review was funded by the US government.

Two(!) randomized controlled trials were identified that compared anti-depressants with placebo in nursing home residents, with a total of 55(!) participants. It’s pretty shocking that the evidence base is so small, when you consider that nursing home residents are such heavy user of anti-depressants. Basically, when we (doctors) use these drugs on elderly nursing home residents, we have pretty much zero idea what we’re doing, because there is so little evidence.

Neither of the two trials found any benefit to treating nursing home residents with anti-depressants (although to be fair, they were so small that I wouldn’t have expected them to find anything – they were statistically underpowered). The number of participants was far too small to gain any kind of estimate of the prevalence of serious adverse events, although I think it’s fair to assume, as mentioned above, that it would be much higher in this group than in the younger healthier group included in the studies in the previous review.

I’m mainly bringing this tiny systematic review up to illustrate how atrociously small the knowledge base often is when it comes to the effects of drugs on the frail elderly.

What conclusions can we draw these systematic reviews?

Anti-depressant drugs are ineffective against depression. The harms of these drugs clearly outweigh the practically non-existent benefits. That is true for everyone, but especially so for the frail elderly who are at much higher risk of side effects than the general population. In light of this information, which has now been in the public domain for at least a few years, you would expect large campaigns to get doctors to stop prescribing these drugs. Funnily enough, that hasn’t happened yet.

May 2, 2021 Posted by | Science and Pseudo-Science | | 2 Comments

Magic mushroom treatment on par with pharma drugs for combating depression, study finds

RT | April 15, 2021

In a small phase two trial, Imperial College researchers have found that psilocybin, the active ingredient of magic mushrooms, is at least as effective as pharmaceutical medication at treating depression.

In their admittedly small scale study, some 59 volunteers with depression were split into two groups.

One group was given a daily dosage of the widely used antidepressant escitalopram (AKA Lexapro, Cipralex, and others). They were also administered very weak doses of psilocybin twice, three weeks apart, over the course of the study.

The second group received much stronger doses of psilocybin, with a placebo instead of antidepressant medication.

After six weeks, the self-reported results from the patients suggested the psilocybin was just as effective as the pharmaceutical, and in many cases showed a slightly bigger – but ultimately statistically insignificant – improvement in symptoms.

The research team, led by Imperial College London neuroscientist Robin Carhart‑Harris, also highlighted the limited timeframe of the study as playing an important factor in the results, and suggested that a longer study might yield different results, possibly favouring pharmaceutical intervention.

The scientists were also quick to highlight the importance of guided psychotherapy to manage any hallucinatory experiences among the trial volunteers, lest members of the public attempt to self-medicate.

“We strongly believe that the … psychotherapy component is as important as the drug action,” Carhart-Harris said.

“With a psychedelic it is more about a release of thought and feeling that, when guided with psychotherapy, produces positive outcomes.”

Some five patients taking the SSRI stopped or reduced their doses due to negative effects, but none in the psilocybin group did. Furthermore, volunteers with a family history of psychosis were excluded from the trial, which may have tipped the results positively in favour of the psychedelic intervention.

Previous research has found that psilocybin treatment had fewer side effects and had an almost immediate impact compared with common antidepressant medication, such as selective serotonin reuptake inhibitors (SSRIs).

SSRIs are often perceived to blunt emotional response, whereas the psilocybin had the opposite effect, according to fMRI scans which showed an apparent increase in emotional connections within the patients’ brains.

There are often a slew of side effects associated with SSRIs, ranging from lethargy and mood swings to so-called ‘brain zaps’, or the sensation of electrical shocks in the brain associated with the use (or discontinuation) of the medication.

SSRIs also typically have a lead time of up to six weeks to reach full effect, while ongoing side effects which can persist beyond this initial phase include insomnia, weight gain, and persistent fatigue, among others.

Further, the efficacy of such antidepressants can wane for some patients over time, so breakthroughs in the field of psychedelic treatments may provide huge relief for patients with adverse reactions to the more common interventions – though it is still too early to make any sweeping assertions about psilocybin treatments among the wider populace.

Still, with an estimated 800 million people with mental health disorders worldwide, new treatment options could soon be available.

April 15, 2021 Posted by | Civil Liberties | , | 1 Comment

FOX News Cuts Off Reporter When She Links Psychotropic Drugs to Florida Shooter

By Matt Agorist | Free Thought Project | February 17, 2018

Stephen Paddock, Omar Mateen, Gavin Long, Eric Harris, Dylan Klebold, James Holmes, and now, Nikolas Cruz all have one thing in common other than the mass murders they carried out. They were all reportedly taking prescription drugs which alter their state of mind and carry a host of negative side effects ranging from aggression and suicide to homicidal ideation.

Suicide, birth defects, heart problems, hostility, violence, aggression, hallucinations, self-harm, delusional thinking, homicidal ideation, and death are just a few of the side effects caused by the medication taken by the monsters named above, some of which are known as SSRIs (selective serotonin reuptake inhibitors), or antidepressants.

There have been 150 studies in 17 countries on antidepressant-induced side effects. There have been 134 drug regulatory agency warnings from 11 countries and the EU warning about the dangerous side effects of antidepressants.

Despite this deadly laundry list of potential reactions to these medications, their use has skyrocketed by 400% since 1988. Coincidentally, as antidepressant use went up, so did mass shootings.

The website SSRIstories.org has been documenting the link between selective serotonin reuptake inhibitors (SSRIs) and violence. On the website is a collection of over 6,000 stories that have appeared in local media (newspapers, TV, scientific journals) in which prescription drugs were mentioned and in which the drugs may be linked to a variety of adverse outcomes including most of the mass shootings which have taken place on US soil.

As the Citizens Commission on Human Rights notes, before the late nineteen-eighties, mass shootings and acts of senseless violence were relatively unheard of. Prozac, the most well known SSRI (selective serotonin reuptake inhibitor) antidepressant, was not yet on the market. When Prozac did arrive, it was marketed as a panacea for depression which resulted in huge profits for its manufacturer Eli Lilly. Of course other drug companies had to create their own cash cow and followed suit by marketing their own SSRI antidepressants.

Subsequently, mass shootings and other violent incidents started to be reported.  More often than not, the common denominator was that the shooters were on an antidepressant, or withdrawing from one.  This is not about an isolated incident or two but numerous shootings.

The issue of psychotropic medication playing a role in mass shootings is not some conspiracy theory. It is very real and the drug manufacturers list these potentially deadly side effects on the very inserts of every one of these drugs. But the mainstream media and the government continue to ignore or suppress this information. Why is that?

In a clear example of how beholden mainstream media is to the pharmaceutical industries who manufacture and market these drugs, FOX News’ Sean Hannity was recorded this week, blatantly cutting off a reporter who dared mention Nikolas Cruz’s reported association with antidepressants.

In a news segment this week, Hannity was interviewing radio talk show host, Gina Loudon who tried to bring up Cruz’s association with SSRIs.

“I think we have to take a hard look at one thing we’re not talking about yet too, Sean, and that is psychotropic drugs,” Loudon says.

“My guess is, we’ll find out like most of these shooters…..” she says, just before Hannity jumps in to silence her.

Hannity then shuts up Loudon and moves to the doctor next to her. Just like that, all talk which was implicating big pharma in their role in mass shootings was effectively silenced.

It is no secret that the pharmaceutical industry wields immense control over the government and the media. It is their control which keeps any negative press about their dangerous products from airing. However, most people likely do not know the scope of this control.

As Mike Papantonio, attorney and host of the international television show America’s Lawyer, explains, with the exception of CBS, every major media outlet in the United States shares at least one board member with at least one pharmaceutical company. To put that into perspective: These board members wake up, go to a meeting at Merck or Pfizer, then they have their driver take them over to a meeting with NBC to decide what kind of programming that network is going to air.

In the report below, Papantonio explains how the billions of dollars big pharma gives to mainstream media outlets every year is used to keep them subservient and complicit in covering up the slew of deadly side effects from their products.

How much longer will we allow these billion-dollar drug companies to control the narrative and not let this conversation take place? How many more mass shootings will take place before Americans wake up to this reality?

February 18, 2018 Posted by | Corruption, Full Spectrum Dominance, Science and Pseudo-Science, Timeless or most popular, Video | , | 1 Comment

Stop Suicide By Helping Big Pharma, Says Shady Suicide Prevention Group

By Martha Rosenberg | CounterPunch | August 23, 2017

Next month, hundreds across the country will participate in “Out of the Darkness” walks to raise awareness about suicide and to support the American Foundation for Suicide Prevention (AFSP).

AFSP and similar groups like the National Alliance on Mental Illness (NAMI) and Active Minds claim there are “stigmas” and “barriers” to treatment for mental illness and there is not enough “awareness.” Two facts are missing in their messaging.

First, with as much as a fourth of some U.S. populations on antidepressants and ubiquitous quizzes and ads for them, there is neither a lack of “awareness” ––or are the drugs working. Why are suicides at an all time high at the same time psychoactive drug use is at an all time high?

Secondly, the groups are funded by Pharma to increase drug use and are widely considered unethical front groups, also called astroturf.

The American Foundation for Suicide Prevention, founded in 1987, is steeped in Pharma money. In 2008, AFSP merged with the Suicide Prevention Action Network USA or SPAN which had announced in 2004 that “SPAN USA’s efforts to develop and expand its suicide survivor network received a major boost with a recent grant from Eli Lilly and Company Foundation,” and “The foundation generously provided funding to support training, education and collaborative opportunities for SPAN USA’s existing network and enable further expansion into all 50 states.” No lack of transparency there.

In AFSP’s 2009 report, its leading donors were Pharma companies and it attributes a new screening project to “funding from Eli Lilly and Co., Janssen, Solvay Pharmaceuticals Inc. and Wyeth Pharmaceuticals.” It also credits Eli Lilly for printing its brochures. No lack of transparency there, either.

In 2011, AFSP appointed psychiatrist Charles Nemeroff president of the organization until his troubles began. Nemeroff became the subject of a congressional inquiry and was found to have so much unreported Pharma income, the $9.3 million National Institutes of Health (NIH) grant to study depression that he managed was suspended, which happens rarely. He left Emory University in disgrace.

A 1999 textbook written by Nemeroff and his colleague Alan Schatzberg was found, in 2010, to be written and funded by GlaxoSmithKline. Both Nemeroff and Schatzberg remain at AFSP and are termed “leaders.”

AFSP’s 2012 annual report reveals a $100,000 donation from Forest Laboratories, and donations from Eli Lilly, Pfizer and five other Pharma companies.

“AFSP also boasts the honor of having a former president – David Shaffer – who was responsible for leading the development of the now somewhat infamous TeenScreen,” writes Mad in America. “TeenScreen is a controversial tool that Marcia Angell (Harvard Professor and former editor-in-chief of the New England Journal of Medicine)…described as, “just a way to put more people on prescription drugs.”

The now defunct TeenScreen which screened young people for early signs of depression had “ties to the pharmaceutical industry,” reported the Scientific American.

Screening and intervention are widely accepted now to be nothing but sales tools—even to the mainstream medical establishment. In “How We Do Harm,” Dr. Otis Brawley, chief medical and scientific officer of the American Cancer Society and an oncologist, devotes a chapter to how prostate screening is often done just for money sometimes with disastrous and deadly results.

AFSP’s annual report names Pharma companies Sunovion, Janssen, Forest, Pfizer and Otsuka America Pharmaceuticals as financial donors. AFSP also named Phil Satow, former Forest executive, to its Project 2025 Advisory Committee. Satow has worked for many Pharma companies and is co-founder and board chair of the very pro-drug JED Foundation.

Preventing Suicides or Causing Them?

While SSRIs can be useful in some depressions, they can also cause suicide–a fact written clearly on all their package inserts. In 2005, after meeting with parents whose children killed themselves on the drugs and public health officials, the FDA attached the following “Black Box” warning to SSRI antidepressants.

Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of PAXIL [one SSRI] or any other antidepressant in a child, adolescent, or young adult must balance this risk with the clinical need. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber.

One chilling demonstration of the danger to young adults is seen in the military where SSRI use and suicides have reached astounding proportions. More than a third of the deaths were in soldiers who never deployed so combat stress was not a factor.

Both NAMI and Active Minds swoop down on campuses after suicides to suggest that not enough antidepressants are being prescribed–despite the clear dangers posed for that age group and sometimes without knowing if the victim was already on the pushed drugs. To remove the fabricated stigma to mental problems, Pharma funded groups visit public schools to suggest more young people should be on drugs. They even produce posters with the message that mental illness is “cool.” Their efforts may not help the young people but they sure help Pharma.

Martha Rosenberg is an investigative health reporter. She is the author of  Born With A Junk Food Deficiency: How Flaks, Quacks and Hacks Pimp The Public Health (Prometheus).

August 23, 2017 Posted by | Deception, Science and Pseudo-Science, Timeless or most popular | , , | Leave a comment

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