Depressingly Familiar “Doc, We Need More Antidepressants”
This week, work has taken me to Thessaloniki, Greece, for a medical conference. Yesterday, I viewed the White Tower, in the town centre, as impressive a six hundred year old building, as you’ll ever see. The White Tower, I’d assumed, was named after purity of intent – though as it’s a former fort that may be a romantic jump, too far. The name actually came from when it was painted white, as in, it being ‘whitewashed’. If your time is very limited, just skip to the Slide Rules, last paragraph. Things so often, just aren’t how they are painted. But, if you’re looking to piece together a coincidence jigsaw puzzle, then read on…
While in Greece, my email in-box started to fill up, ‘interestingly’ with the same theme, a near identical message about the UK’s current ‘lack’ of antidepressants. The friends who had emailed me, all sport a different stripe, so I received articles from their ‘news’ channel – their newspaper of choice: The Times, then The Telegraph, then The Independent. Soon my in-box could take no more, but it had piqued my interest. So I went a huntin’ and found that yes, the Daily Mail, The Daily Express, The Sun, The Times, The Irish Times and The Guardian, ALL had articles on 21st or 22nd February explaining that a neat and dandy 1 million (or more) people ‘should’ be on antidepressants. A nice round number, but then so too, is nought, zero, nada. Reading such consistent journalism would make anyone depressed – well, not quite everyone, if we may, just for a second, play the cynic. Let’s see if these ‘lone wolf’ and hungry journo’s arrived at their unique scoops, fully independently of each other.
Your Guardian ?
Armed with a water cooled search engine I went looking for similar topics in The Guardian. I was in luck, it too was leading the charge with: ‘it’s official, not only are antidepressants not snake oil nor a conspiracy – they work. That’s all right then. But IF we examine what the word ‘guardian’ means, it’s ‘someone to look out for us, to serve our best interests, someone to look up to’. Someone, no doubt, not given to spouting the collective views of others, without a contextual viewpoint – not just that of upside only with antidepressants and that more is going to be better.
Daily Mail – Return to Sender ?
Their Health Reporter had been busy too, on 21st February, stating that millions (plural) more of us should be taking antidepressants citing claims that they do work, and that GP’s should be ‘dishing’ them out. The researchers had ‘warned’ that only one in six people were receiving effective treatments for depression with 10% of British adults now on antidepressants.
However, if a week is a long time in Politics, then, hats off – it seems 48 hours is even longer, in journalistic terms. By 23rd February, we were ‘treated’ to this about turn headline: Doctors say ‘hyped’ antidepressant study is misleading patients by ignoring the dangers and side effects. It quoted Professor David Healy, Professor of Psychiatry at Bangor University (author of Let Them Eat Prozac) saying the benefits were hyped while the harms were hidden. He also criticised the short term (eight weeks) duration of the studies. Professor Healy continued: ‘you could put alcohol through these trials and show it is an antidepressant – but it wouldn’t be a good idea to have 10 per cent of the population taking alcohol’.
Dr Healy also found time to research and write the book: Pharmageddon.
Bush Telegraph – Send Me a Missile !
Penned by the Health Editor no less, the Daily Telegraph stated ‘at least’ a million more Brits should be on anti-depressants, citing Oxford University led research with findings published in The Lancet, no less. Cited too were over 500 trials featuring 21 ‘meds’ over four decades. The Telegraph lamented that GPs were often ‘squeamish’ about offering ‘medication’ for depression. It did however ‘warn’ that the best known antidepressants such as Prozac and the most widely prescribed citalopram. were found to be among the least effective…
For The Times they are a Changin…
In The Times too, their Health Editor took it up front and centre, with: ‘more people should get pills to beat depression, millions of sufferers would benefit, doctors told’. Plus a snazzy Prozac piccie. Not just The Times, but in the Irish Times too, with coincidental headlines: ‘Antidepressants work for treating depression, study finds – following up with the debate denying: new analysis ‘puts to bed the controversy’ surrounding medication, says professor’. So it seems, even that great wordsmith Bob Dylan had it all wrong, but then, ‘for The Times’s they are a similar’ likely wouldn’t have topped the charts.
Simply, Expressing a View
Like an ‘express’ train, this too was on the narrow tracks, very on message, jumping its’ green signal, not waiting for the stop light with: ‘Antidepressants DO work and millions more should be on them’ it chimed in. But, could the message be from the selective steam age – leading more, well intentioned drivers, to sadly chuff about.
The Independent View – The Patient “Voice”
About time, the patient voice was heard. One lady aired her struggles with mental illness for 17 years and had tried most pills available. Her view was that antidepressants absolutely worked for her ‘antidepressants can enable a person to participate in their own life, when they simply cannot otherwise’. The Independent also aired a counter point of view in the same article: ‘I was like a numb zombie on antidepressants – pills should only be one part of the solution. No other treatment paths had been suggested to me and it was only after I had gained two stone in weight, without changing my diet, and was throwing up a few times a week that I realised that maybe my antidepressants weren’t working for me’.
Ask An Insider ?
Seems we’re not learning from even recent history as two years ago this month, Business Insider stated: ‘in every single Country the OECD looked at, antidepressant use was on the rise: in Germany it had risen by 46% in four years. Normally those pesky Germans win soccer matches on penalties, but it seems that this time, they may concede late penalties – but of a different kind. Spain and Portugal struggled to keep up, but made double digit ‘advances’ in antidepressant prescriptions. Iceland, ‘led the pack’ with one in ten people now taking an antidepressant.
Storm Clouds Block Out Even The Strongest Sun
The Sun was in on the act too – in strict ‘no tabloid left behind’ fashion. It had antidepressants as a main story, encouraging its readers to ‘Take More Happy Pills’. That may not take us too far forward in a reasoned debate – while ever greater pill use is confirming that storm clouds are gathering that will likely block out the sun in the lives of many.
When You Look In The Mirror, What do You See ?
But, one daily, the Daily Mirror, seemed to be out of step – or they were when we look back to 13th May 2015. Back then they reported on the findings of Dr Peter Gotzsche, a Danish Medical Researcher (and co-founder of the Nordic Cochrane Centre). He investigated antidepressant deaths and claimed that across the US and EU there are over 500,000 deaths, in people over 65, per year. His view is that such psychotropic drugs should almost exclusively be used in acute, short term, situations. He feels their long term use is immensely harmful and their use requires, for many patients, a firm plan to ‘taper’ off their use over time. Perhaps that’s why The Mirror this time, wasn’t invited to the 21/22 Feb 2018 Fleet Street Party – or perhaps they just chose not to go?
Mad In America
With apologies for reaching beyond British shores – it’s not just the chill of US weather that finds its way onto British shores, given time. One day all Countries will have to go ‘upstream’ to treat causes, not just demand cures – but the money doesn’t lie there. Talking of following the money, it was amazing that the FT (Financial Times) didn’t lead on upselling antidepressant use, after all with such a monetary message prize, cynics might have assumed they might – bowler hats off to you guys and girls..
Below are two slides (from a total of 51) of a study from Robert Whittaker, Journalist and author of: Mad In America and Anatomy of an Epidemic. The slides formed part of a presentation to a British Parliamentary Committee entitled: Causation Not Just Correlation – Antidepressants Increase The Risk of Long Term Disability.
Slide 3: People on US Government Disability due to Affective Disorders
The years studied were from 1988 to 2013 and in:
1994 there were 440,000 people on antidepressants, while in:
2013 there were over 2,000,000 on antidepressants
The Percentage of the population who used antidepressants (in the past month) was constant at around 2% between 1988 and 1994, but it had risen to around 9% in 2012. That’s a near 500% increase on both measures – we should investigate that increase as an upstream cause.
Slide 28: Patient Remission Rates and Benefits of Exercise
Zoloft, below, also known as ‘Sertraline’ is an SSRI (Selective Serotonin Reuptake Inhibitor) it is compared with a treatment of: Zoloft plus exercise, and also exercise alone (i.e. without Zoloft):
Zoloft alone, patients in remission at 16 weeks, was 69%
Zoloft alone, patients depressed at end of ten months, was 52%
Zoloft plus exercise, patients in remission at 16 weeks, was 66%
Zoloft plus exercise, patients depressed at end of ten months, was 55%
Exercise alone, patients in remission at 16 weeks, was 60%
Exercise alone, patients depressed at end of ten months, was 30%
In the real world, exercise seems to win and doesn’t generally incapacitate people. For many, but not for all, exercise is a kinder and cheaper, long term, option.