In the U.S., an estimated 21 million American adults experienced at least one major depressive episode in 2020.1 The reported numbers for the past several years2 have consistently been highest among those aged between 18 and 25.3 However, not only is there evidence that depression is vastly overdiagnosed, but there’s also evidence showing it’s routinely mistreated.
With regard to overdiagnosis, it’s been ongoing for a long time, with one 2013 study4 finding only 38.4% of participants with clinician-identified depression actually met the DSM-4 criteria for a major depressive episode, and only 14.3% of seniors 65 and older met the criteria.
As for treatment, the vast majority are prescribed antidepressant drugs, despite the fact there’s little to no evidence to suggest they provide meaningful help, and plenty of evidence showing the harms are greater than patients are being told.
According to a 2017 study,5 1 in 6 Americans between the ages of 18 and 85 were on psychiatric drugs, most of them antidepressants, and 84.3% reported long-term use (three years or more). Out of 242 million U.S. adults, 12% were found to have filled one or more prescriptions for an antidepressant, specifically, in 2013. By 2021 in the midst of the pandemic, 1 in 4 Americans over age 18, or 50 million persons, were on prescription mental health drugs.6
According to data7 presented by a watchdog group in 2014, hundreds of thousands of toddlers are also being medicated with powerful psychiatric drugs, raising serious ethical questions, along with questions about the future mental and physical health of these children.
And, a study published in The BMJ in 20138 found that “In utero exposure to both SSRIs and non-selective monoamine reuptake inhibitors (tricyclic antidepressants) was associated with an increased risk of autism spectrum disorders, particularly without intellectual disability” in the offspring.
Studies are also shedding much needed light on the addictive nature of many antidepressants, and demonstrate that the benefits of these drugs have been overblown while their side effects — including suicidal ideation — and have been downplayed and ignored for decades, placing patients at unnecessary risk.
The Chemical Imbalance Myth
One researcher responsible for raising awareness about these important mental health issues is professor Peter C. Gøtzsche, a Danish physician-researcher and outspoken critic of the drug industry (as his book, “Deadly Medicines and Organized Crime: How Big Pharma Has Corrupted Healthcare,”9 suggests).
Gøtzsche helped found the Cochrane Collaboration in 1993 and later launched the Nordic Cochrane Centre. In 2018, he was expelled by the Cochrane governing board following the publication of a scathing critique of a Cochrane review of the HPV in which he and his coauthors pointed out several methodological flaws and conflicts of interest.
Over the past several years, Gøtzsche has published a number of scientific papers on antidepressants and media articles and a book discussing the findings. In a June 28, 2019 article,10 Gøtzsche addresses “the harmful myth” about chemical imbalances — a debunked hypothesis that continues to drive the use of antidepressants to this day. He writes, in part:11
“Psychiatrists routinely tell their patients that they are ill because they have a chemical imbalance in the brain and they will receive a drug that fixes this …
Last summer, one of my researchers and I collected information about depression from 39 popular websites in 10 countries, and we found that 29 (74%) websites attributed depression to a chemical imbalance or claimed that antidepressants could fix or correct that imbalance …
It has never been possible to show that common mental disorders start with a chemical imbalance in the brain. The studies that have claimed this are all unreliable.12
A difference in dopamine levels, for example, between patients with schizophrenia and healthy people cannot tell us anything about what started the psychosis … [I]f a lion attacks us, we get terribly frightened and produce stress hormones, but this does not prove that it was the stress hormones that made us scared.
People with psychoses have often suffered traumatic experiences in the past, so we should see these traumas as contributing causal factors and not reduce suffering to some biochemical imbalance that, if it exists at all, is more likely to be the result of the psychosis rather than its cause.13
The myth about chemical imbalance is very harmful. It makes people believe there is something seriously wrong with them, and sometimes they are even told that it is hereditary.
The result of this is that patients continue to take harmful drugs, year after year, perhaps even for the entirety of their lives. They fear what would happen if they stopped, particularly when the psychiatrists have told them that their situation is like patients with diabetes needing insulin.”
Real Cause of Depression Is Typically Ignored
According to Gøtzsche, there is no known mental health issue that is caused by an imbalance of brain chemicals. In many cases, the true cause is unknown, but “very often, it is a response to unhealthy living conditions,” he writes.14
He also cites the book,15 “Anxiety — The Inside Story: How Biological Psychiatry Got It Wrong,” written by Dr. Niall McLaren, in which the author shows that anxiety is a major factor in and trigger of most psychiatric disorders.
“A psychiatrist I respect highly, who only uses psychiatric drugs in rare cases … has said that most people are depressed because they live depressing lives,” Gøtzsche writes.
“No drug can help them live better lives. It has never been shown in placebo-controlled trials that a psychiatric drug can improve people’s lives — e.g., help them return to work, improve their social relationships or performance at school, or prevent crime and delinquency. The drugs worsen people’s lives, at least in the long run.16“
Gøtzsche rightfully points out that antipsychotic drugs create chemical imbalances; they don’t fix them. As a group, they’re also somewhat misnamed, as they do not address psychotic states. Rather, they are tranquilizers, rendering the patient passive. However, calming the patient down does not actually help them heal the underlying trauma that, in many cases, is what triggered the psychosis in the first place.
As noted in one 2012 meta-analysis17 of studies looking at childhood trauma — including sexual abuse, physical abuse, emotional/psychological abuse, neglect, parental death and bullying — and subsequent risk of psychosis:
“There were significant associations between adversity and psychosis across all research designs … Patients with psychosis were 2.72 times more likely to have been exposed to childhood adversity than controls … The estimated population attributable risk was 33% (16%-47%). These findings indicate that childhood adversity is strongly associated with increased risk for psychosis.”
Economy of Influence in Psychiatry
A related article,18 written by investigative journalist Robert Whitaker in 2017, addresses the “economy of influence” driving the use of antidepressant drugs in psychiatric treatment — and the “social injury” that results. As noted by Whitaker, mental disorders were initially categorized according to a disease model in 1980 by the American Psychiatric Association.
“We’re all familiar with the second ‘economy of influence’ that has exerted a corrupting influence on psychiatry — pharmaceutical money — but I believe the guild influence is really the bigger problem,” he writes.
Whitaker details the corruption within the APA in his book “Psychiatry Under the Influence,” one facet of which is “the false story told to the public about drugs that fixed chemical imbalances in the brain.” Other forms of corrupt behavior include:
The biased designs of clinical trials to achieve a predetermined result
Spinning results to support preconceived conclusions
Hiding poor long-term outcomes
Expanding diagnostic categories for the purpose of commercial gain
Creating clinical trial guidelines that promote drug use
In his article, Whitaker goes on to dissect a 2017 review19 published in the American Journal of Psychiatry, which Whitaker claims “defends the profession’s current protocols for prescribing antipsychotics, which includes their regular long-term use.”
As Whitaker points out, there’s ample evidence showing antipsychotic drugs worsen outcomes over the long term in those diagnosed with psychotic disorders such as schizophrenia.
The review in question, led by American psychiatrist Dr. Jeffrey A. Lieberman, was aimed at answering persistent questions raised by the mounting of such evidence. Alas, their conclusions dismissed concerns that the current drug paradigm might be doing more harm than good.
“In a subsequent press release and a video for a Medscape commentary, Lieberman has touted it as proving that antipsychotics provide a great benefit, psychiatry’s protocols are just fine, and that the critics are ‘nefarious’ individuals intent on doing harm,” Whitaker writes.20
The Scientific Bias of Psychiatric Treatment
Five of the eight researchers listed on the review have financial ties to drug companies, three are speakers for multiple drug companies and all eight are psychiatrists, “and thus there is a ‘guild’ interest present in this review, given that they are investigating whether one of their treatments is harmful over the long-term,” Whitaker notes.21
Not surprisingly, the review ignored studies showing negative effects, including studies showing antipsychotics have a detrimental effect on brain volume. What’s more, while withdrawal studies support the use of antipsychotics as maintenance therapy over the long term, these studies do not address how the drugs affect patients’ long-term health.
“They simply reveal that once a person has stabilized on the medication, going abruptly off the drug is likely to lead to relapse,” Whitaker writes.22 “The focus on long-term outcomes, at least as presented by critics, provides evidence that psychiatry should adopt a selective-use protocol.
If first-episode patients are not immediately put on antipsychotics, there is a significant percentage that will recover, and this ‘spontaneous recovery’ puts them onto a good long-term course. As for patients treated with the medications, the goal would be to minimize long-term use, as there is evidence that antipsychotics, on the whole, worsen long-term outcomes.”
Vast Majority of Psychotic Patients Are Harmed, Not Helped
In his deconstruction of Lieberman’s review, Whitaker details how biased thinking influenced the review’s conclusions. It’s a rather long article, but well worth reading through if you want to understand how a scientific review can be skewed to accord with a preconceived view.
Details I want to highlight, however, include findings relating to the number needed to treat (NNT) and the percentage of patients harmed by the routine use of antipsychotic drugs as a first-line treatment.
As noted by Whitaker, while placebo-controlled studies reveal the effectiveness of a drug compared to an inert substance, they do not effectively reveal the ratio of benefit versus harm among the patient population. NNT refers to the number of patients that have to take the drug in order to get one positive response.
A meta-analysis cited in Lieberman’s review had an NNT of 6, meaning that six patients must take the drug in order for one to benefit from the treatment. The remaining five patients — 83% — are potentially harmed by the treatment. As noted by Whitaker:23
“The point … is this: reviewers seeking to promote their drug treatment as effective will look solely at whether it produces a superior response to placebo. This leads to a one-size-fits-all protocol.
Reviewers that want to assess the benefit-harm effect of the treatment on all patients will look at NNT numbers. In this instance, the NNT calculations argue for selective use of the drugs …”
Antidepressants Are Not Beneficial in the Long Term
While typically not as destructive as antipsychotics, antidepressants also leave a trail of destruction in their wake. A systematic review24 by Gøtzsche published in 2019 found studies assessing harm from selective serotonin reuptake inhibitors (SSRIs) fail to provide a clear and accurate picture of the harms, and therefore “cannot be used to investigate persistent harms of antidepressants.”
In this review, Gøtzsche and colleagues sought to assess “harms of SSRIs … that persist after end of drug intake.” The primary outcomes included mortality, functional outcomes, quality of life and core psychiatric events. In all, 22 papers on 12 SSRI trials were included. Gøtzsche found several distinct problems with these trials. For starters, only two of the 12 trials had a drop-out rate below 20%.
Gøtzsche and his team also note that “Outcome reporting was less thorough during follow-up than for the intervention period and only two trials maintained the blind during follow-up.” Importantly, though, all of the 22 papers came to the conclusion that “the drugs were not beneficial in the long term.”
Another important finding was that all trials either “reported harms outcomes selectively or did not report any,” and “Only two trials reported on any of our primary outcomes (school attendance and number of heavy drinking days).”
A few years later, in April 2022, a study using data from the United States’ Medical Expenditures Panel Survey for patients who had depression found, “The real-world effect of using antidepressant medications does not continue to improve patients” health-related quality of life (HRQoL) over time.25
Antidepressants Are More Addictive Than Admitted
In a June 4, 2019, article,26 “The Depression Pill Epidemic,” Gøtzsche writes that antidepressant drugs:
“… do not have relevant effects on depression; they increase the risk of suicide and violence; and they make it more difficult for patients to live normal lives.27 They should therefore be avoided.
We have been fooled by the drug industry, corrupt doctors on industry payroll, and by our drug regulators.28 Surely, many patients and doctors believe the pills are helpful, but they cannot know this, because people tend to become much better with time even if they are not treated.29
This is why we need placebo-controlled trials to find out what the drugs do to people. Unfortunately, virtually all trials are flawed, exaggerate the benefits of the drugs, and underestimate their harms.”30
Addictive Nature of Antidepressants Skews Results
In his article,31 Gøtzsche reviews several of the strategies used in antidepressant drug trials to exaggerate benefits and underestimate the harms. One little-known truth that helps skew study results in the drug’s favor is the fact that antidepressants tend to be far more addictive than officially admitted. He explains how this conveniently hides the skewing of results as follows:32
“Virtually all patients in the trials are already on a drug similar to the one being tested against placebo. Therefore, as the drugs are addictive, some of the patients will get abstinence symptoms … when randomized to placebo …
These abstinence symptoms are very similar to those patients experience when they try to stop benzodiazepines. It is no wonder that new drugs outperform the placebo in patients who have experienced harm as a result of cold turkey effects.
To find out how long patients need to continue taking drugs, so-called maintenance (withdrawal) studies have been carried out, but such studies also are compromised by cold turkey effects. Leading psychiatrists don’t understand this, or they pretend they don’t.
Most interpret the maintenance studies of depression pills to mean that these drugs are very effective at preventing new episodes of depression and that patients should therefore continue taking the drugs for years or even for life.”
Scientific Literature Supports Reality of User Complaints
Over the years, several studies on the dependence and withdrawal reactions associated with SSRIs and other psychiatric drugs have been published, including the following:
•In a 2011 paper33 in the journal Addiction, Gøtzsche and his team looked at the difference between dependence and withdrawal reactions by comparing benzodiazepines and SSRIs. Benzodiazepines are known to cause dependence, while SSRIs are said to not be addictive.
Despite such claims, Gøtzsche’s team found that “discontinuation symptoms were described with similar terms for benzodiazepines and SSRIs and were very similar for 37 of 42 identified symptoms described as withdrawal reactions,” which led them to conclude that:
“Withdrawal reactions to selective serotonin re‐uptake inhibitors appear to be similar to those for benzodiazepines; referring to these reactions as part of a dependence syndrome in the case of benzodiazepines, but not selective serotonin re‐uptake inhibitors, does not seem rational.”
•Two years later, in 2013, Gøtzsche’s team published a paper34 in the International Journal of Risk & Safety in Medicine, in which they analyzed “communications from drug agencies about benzodiazepine and SSRI withdrawal reactions over time.”
By searching the websites of drug agencies in Europe, the U.S., U.K. and Denmark, they found that it took years before drug regulators finally acknowledged the reality of benzodiazepine dependence and SSRI withdrawal reactions and began informing prescribers and patients about these risks.
A significant part of the problem, they found, is that drug agencies rely on spontaneous reporting of adverse effects, which “leads to underestimation and delayed information about the problems.”
In conclusion, they state that “Given the experience with the benzodiazepines, we believe the regulatory bodies should have required studies from the manufacturers that could have elucidated the dependence potential of the SSRIs before marketing authorization was granted.”
•A 2019 paper35 in the Epidemiology and Psychiatric Sciences journal notes “It took almost two decades after the SSRIs entered the market for the first systematic review to be published.” It also points out that reviews claiming withdrawal effects to be mild, brief in duration and rare “was at odds with the sparse but growing evidence base.”
In reality, “What the scientific literature reveals is in close agreement with the thousands of service user testimonies available online in large forums. It suggests that withdrawal reactions are quite common, that they may last from a few weeks to several months or even longer, and that they are often severe.”
Antidepressants Increase Your Risk of Suicide and Violence
In his June 2019 article,36 Gøtzsche also stresses the fact that antidepressants can be lethal. In one of his studies,37 published in 2016, he found antidepressants “double the occurrence of events that can lead to suicide and violence in healthy adult volunteers.”
Other research38 has shown they “increase aggression in children and adolescents by a factor of 2 to 3 — an important finding considering the many school shootings where the killers were on depression pills,” Gøtzsche writes.
In middle-aged women with stress urinary incontinence, the selective serotonin and norepinephrine reuptake inhibitor (SNRI) duloxetine, which is also used to treat incontinence, has been shown to double the risk of a psychotic episode and increase the risk of violence and suicide four to five times,39 leading the authors to conclude that harms outweighed the benefits.
“I have described the dirty tricks and scientific dishonesty involved when drug companies and leading psychiatrists try convincing us that these drugs protect against suicide and other forms of violence,”40 Gøtzsche writes.41 “Even the FDA was forced to give in when it admitted in 2007, at least indirectly, that depression pills can cause suicide and madness at any age.
There is no doubt that the massive use of depression pills is harmful. In all countries where this relationship has been examined, the sharp rise in disability pensions due to psychiatric disorders has coincided with the rise of psychiatric drug usage, and depression pills are those which are used the most by far. This is not what one would expect if the drugs were helpful.”
Drugmaker Lied About Paxil’s Suicide Risk
In 2017, Wendy Dolin was awarded $3 million by a jury in a lawsuit against GlaxoSmithKline, the maker of Paxil. Dolin’s husband committed suicide six days after taking his first dose of a Paxil generic, and evidence brought forth in the case convincingly showed his suicide was the result of the drug, not emotional stress or mental illness.42
The legal team behind that victory, Baum Hedlund Aristei Goldman, also represented other victims of Paxil-induced violence and death. At the time, attorney R. Brent Wisner said:43
“The Dolin verdict sent a clear message to GSK and other drug manufacturers that hiding data and manipulating science will not be tolerated … If you create a drug and know that it poses serious risks, regardless of whether consumers use the brand name or generic version of that drug, you have a duty to warn.”
GSK’s own clinical placebo-controlled trials actually revealed subjects on Paxil had nearly nine times the risk of attempting or committing suicide than the placebo group. To gain drug approval, GSK misrepresented this shocking data, falsely reporting a higher number of suicide attempts in the placebo group and deleting some of the suicide attempts in the drug group.
An internal GSK analysis of its suicide data also showed that “patients taking Paxil were nearly seven times more likely to attempt suicide than those on placebo,” Baum Hedlund Aristei Goldman reports, adding:44
“Jurors in the Dolin trial also heard from psychiatrist David Healy, one of the world’s foremost experts on Paxil and drugs in its class … Healy told the jurors that Paxil and drugs like it can create in some people a state of extreme ’emotional turmoil’ and intense inner restlessness known as akathisia …
‘People have described it like a state worse than death. Death will be a blessed relief. I want to jump out of my skin,’ Dr. Healy said. Healthy volunteer studies have found that akathisia can happen even to people with no psychiatric condition who take the drug …
Another Paxil side effect known to increase the risk of suicide is emotional blunting … apathy or emotional indifference … [E]motional blunting, combined with akathisia, can lead to a mental state in which an individual has thoughts of harming themselves or others, but is ‘numbed’ to the consequences of their actions. Drugs in the Paxil class can also cause someone to ‘go psychotic, become delirious,’ Dr. Healy explained.”
Hundreds of Thousands of Toddlers on Psychiatric Drugs
Considering the many serious psychological and physical risks associated with psychiatric drugs, it’s shocking to learn that hundreds of thousands of American toddlers are on them. In 2014, the Citizens Commission on Human Rights, a mental health watchdog group, highlighted data showing that in 2013:45
274,000 babies aged 1 and younger were given psychiatric drugs — Of these, 249,699 were on anti-anxiety meds like Xanax; 26,406 were on antidepressants such as Prozac or Paxil, 1,422 were on ADHD drugs such as Ritalin and Adderall, and 654 were on antipsychotics such as Risperdal and Zyprexa
In the toddler category (2- to 3-year-olds), 318,997 were on anti-anxiety drugs, 46,102 were on antidepressants, 10,000 were prescribed ADHD drugs and 3,760 were on antipsychotics
Among children aged 5 and younger, 1,080,168 were on psychiatric drugs
These are shocking figures that challenge logic. How and why are so many children, babies even, on addictive and dangerously mind-altering medications? Considering these statistics are 6 years old, chances are they’re even higher today. Just what will happen to all of these youngsters as they grow up? As mentioned in the article:46
“When it comes to the psychiatric drugs used to treat ADHD, these are referred to as ‘kiddie cocaine’ for a reason. Ritalin (methylphenidate), Adderall (amphetamine) and Concerta are all considered by the federal government as Schedule II drugs — the most addictive.
ADHD drugs also have serious side effects such as agitation, mania, aggressive or hostile behavior, seizures, hallucinations, and even sudden death, according to the National Institutes of Health …
As far as antipsychotics, antianxiety drugs and antidepressants, the FDA and international drug regulatory agencies cite side effects including, but not limited to, psychosis, mania, suicidal ideation, heart attack, stroke, diabetes, and even sudden death.”
Children Increasingly Prescribed Psych Drugs Off-Label
Making matters even worse, recent research shows the number of children being prescribed medication off-label is also on the rise. An example offered by StudyFinds.org,47 which reported the findings, is “a doctor recommending antidepressant medication for ADHD symptoms.”
The study,48 published in the journal Pediatrics, looked at trends in off-label drug prescriptions made for children under the age of 18 by office-based physicians between 2006 and 2015. Findings revealed:
“Physicians ordered ≥1 off-label systemic drug at 18.5% of visits, usually (74.6%) because of unapproved conditions. Off-label ordering was most common proportionally in neonates (83%) and in absolute terms among adolescents (322 orders out of 1000 visits).
Off-label ordering was associated with female sex, subspecialists, polypharmacy, and chronic conditions. Rates and reasons for off-label orders varied considerably by age. Relative and absolute rates of off-label orders rose over time. Among common classes, off-label orders for antihistamines and several psychotropics increased over time …
US office-based physicians have ordered systemic drugs off label for children at increasing rates, most often for unapproved conditions, despite recent efforts to increase evidence and drug approvals for children.”
The researchers were taken aback by the findings, and expressed serious concern over this trend. While legal, many of the drugs prescribed off-label have not been properly tested to ensure safety and efficacy for young children and adolescents.
As noted by senior author Daniel Horton, assistant professor of pediatrics and pediatric rheumatologist at Rutgers Robert Wood Johnson Medical School, “We don’t always understand how off-label medications will affect children, who don’t always respond to medications as adults do. They may not respond as desired to these drugs and could experience harmful effects.”
In 2020 mental health experts and reviewers were still at-odds over prescribing these drugs for children, yet hesitant to call a stop to it:49
“Antidepressants are prescribed for the treatment of a number of psychiatric disorders in children and adolescents, however there is still controversy about whether they should be used in this population …
Treatment decisions should be tailored to patients on an individual basis, so we recommend clinicians, patients and policy makers to refer to the evidence provided in the present meta-review and make decisions about the use of antidepressants in children and adolescents taking into account a number of clinical and personal variables.”
Educate Yourself About the Risks
If you, your child or another family member is on a psychiatric drug, I urge you to educate yourself about the true risks and to consider switching to safer alternatives. When it comes to children, I cannot fathom a situation in which a toddler would need a psychiatric drug and I find it shocking that there are so many doctors out there that, based on a subjective evaluation, would deem a psychiatric drug necessary.
Dr. Peter Gotzsche has created a controversy and sparked criticism over what he sees as a damaging over-prescription of drugs by psychiatrists.
Gotzsche recently compiled a list of ten common myths held not only by the general public, but also trained psychiatrists concerning the safety of psychotropic drugs, and the rationale for their use.
As an internist, Gotzsche remarked that since he was outside of the political orthodoxy of the world of psychiatric medicine, he was free to express what he believed to be the sentiments of many psychiatrists who must remain quiet in their objections for fear of hurting their careers.
1. Mental diseases are caused by a chemical imbalance in the brain
“We have no idea about which interplay of psychosocial conditions, biochemical processes, receptors and neural pathways that lead to mental disorders and the theories that patients with depression lack serotonin and that patients with schizophrenia have too much dopamine have long been refuted.”
2. It’s easy to go off antidepressants any time you want to
Here, Gotzsche points to drug trails involving agoraphobics and people suffering from panic disorder, whom were not depressed. Fifty percent of the patients found it difficult to come off antidepressants even though they were gradually reducing their doses. It could not be that the patients saw their depression returning, as they were not depressed to begin with.
3. Psychotropic drugs are to mental illness as insulin is to diabetes
“When you give insulin to a patient with diabetes, you give something the patient lacks, namely insulin. Since we’ve never been able to demonstrate that a patient with a mental disorder lacks something that people who are not sick don’t lack, it is wrong to use this analogy.”
4. Psychotropic drugs reduce the number of chronically ill patients
“In 1987, just before the newer antidepressants (SSRIs or happy pills) came on the market, very few children in the United States were mentally disabled. Twenty years later it was over 500,000, which represents a 35-fold increase. The number of disabled mentally ill has exploded in all Western countries.”
5. SSRIs don’t cause suicide in children and adolescents
“The companies and the psychiatrists have consistently blamed the disease when patients commit suicide. It is true that depression increases the risk of suicide, but happy pills increase it even more, at least up to about age 40, according to a meta-analysis of 100,000 patients in randomized trials performed by the US Food and Drug Administration.”
6. SSRIs don’t have side effects
“Patients care less about the consequences of their actions, lose empathy towards others, and can become very aggressive. In school shootings in the United States and elsewhere a striking number of people have been on antidepressants.”
7. SSRIs are not addictive
“The worst argument I have heard about the pills not causing dependency is that patients do not require higher doses. Shall we then also believe that cigarettes are not addictive? The vast majority of smokers consume the same number of cigarettes for years.”
8. The prevalence in depression has increased a lot in recent history
Gotzsche points out that this is difficult if not impossible to determine, as the criteria for being diagnosed as clinically depressed has been drastically lowered over the last 50 years.
9. The main problem is not overtreatment, but undertreatment
“In a 2007 survey, 51% of the 108 psychiatrists said that they used too much medicine and only 4 % said they used too little. In 2001-2003, 20% of the US population aged 18-54 years received treatment for emotional problems.”
10. Antipsychotics prevent brain damage
“Some professors say that schizophrenia causes brain damage and that it is therefore important to use antipsychotics. However, antipsychotics lead to shrinkage of the brain, and this effect is directly related to the dose and duration of the treatment.”
As for a solution, Gotzsche states that he is not against the use of psychiatric drugs, but that doctors must do everything that can before resorting to their use, and only then as a short-term solution.
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.
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.
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?
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-drugJED 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.
Internment of civilian nationals belonging to opposing sides was carried out in varying degrees by all belligerent powers in World War Two. It was also the fate of those servicemen who found themselves in a neutral country.
At the outbreak of war there were around 80,000 potential enemy aliens in Britain who, it was feared, could be spies, or willing to assist Britain’s enemies in the event of an invasion. All Germans and Austrians over the age of 16 were called before special tribunals and were divided into one of three groups… continue
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