British Officials Advise Less Use of Antidepressants

[MountainLaurel]

British health officials advised doctors yesterday not to prescribe antidepressants for about 70 percent of the patients who show up complaining of depression without first trying exercise, self-help, talk therapy or just waiting a couple of weeks to see if they got better.

In issuing new treatment guidelines for doctors, the British regulators and a standards-setting panel said patients with mild depression who are able to go to work and function normally, even if they complain of symptoms such as a lack of interest in things, low energy, dark mood, difficulty sleeping or difficulty concentrating, should avoid widely used antidepressants at first because of the possibility of side effects and withdrawal symptoms.

The regulatory panel is the same one that last year triggered a major reevaluation of the use of antidepressants in children after it concluded that the drugs were associated with an increased risk of suicidal tendencies in children. The recommendations that the drugs not be used as first-line treatment for mild depression are the latest evidence that some experts are reexamining the widespread enthusiasm for the medications.

Numerous studies have shown that antidepressants are among the fastest-growing sectors of the U.S. pharmaceutical industry. A government report last week said the latest figures indicated that one in 10 American women is taking an antidepressant.

http://www.washingtonpost.com/wp-dyn/articles/A41332-2004Dec6.html

This is a great idea, but the U.S. insurance industry would never allow it: pills are a much cheaper alternative for them than talk therapy.

[DireStrike]

1. Yeah, too late for me

Withdrawal symptoms indeed. They really suck. I've got to get off these things.

I was on prozac earlier for OCD, and that went away. Later I went on meds for general depression and lack of interest in things. At one point my dad actually hospitalized me for poor schoolwork and not caring about stuff! Hello? I'm a teenager?

To be fair, I'd contemplated suicide, but only in that way where "if things get bad enough, it's an option." Now I've been on meds for like... 4 or 5 years, with no end in sight. I don't even know what they're doing anymore, I can't remember how I felt without them.

[Stephanie]

3. Do you like your doctor?

Please don't do anything without working it through with your doctor. If necessary find a different doctor. If I were your dad I'd be worried just from reading your post.

[DireStrike]

6. Oh, of course. I know better than that.

What do you find worrisome?

I just find it odd that I've been on these damn things for so long. My mood is normal, as far as I can tell, and I haven't even thought about suicide in years. I don't know how much of my depression, or its withdrawal, can be attributed to drugs and how much to simply growing up. I was in a particularly tough HS also (you're from NYC: heard of Stuyvesant?) and was/am working through issues with school, assignments, "the system", etc.

Edit: I'm not trying to get off the meds. The withdrawal symptoms are easily notable from even one accidentally missed dose. Ruins your day.

[Stephanie]

9. Yes, I've heard of Stuyvesant

A lot of pressure for you, I'm sure. I get it. Glad that you're doing better. :hi:

[DARE to HOPE]

4. The brain needs better nutrition to really thrive...

like omega-3 fatty acids--"a sardine a day keeps depression away" (also anchovies!)

Also, medium chain saturated fatty acids found in coconut boost the omega-3's. (Yum, puddings and other desserts made with coconut milk and no sugar.) :-)

Finally, magnesium (lost in refined flours and cereals) and B vitamins (same) really make us feel secure and happy, and cut the craving for sugar, too.

Sunshine, walking, hugs, and talking out feelings in a supportive environment--hey, also singing, and going to church (a real one)--all of these are so much better than deadening your hurt with meds.

The world is a magnificent place, and you are a blessing to it!

God bless.

[DireStrike]

7. Thanks.

I hate coconuts, but I hate sardines even more! Oh well, I'll find some omega-3s.

I don't like church either. I could use more social interaction but it's not gonna be that way! =p

[AP]

2. Only a country with nationalized health would say consume less.

In the US, the message is always "consume more drugs!"

[tngledwebb]

5. NHS costs a bit,

but the UK isn't in the palm of big pharm's hand, like we are. Our MD's are bribed to hand out this stuff like candy.

[Susang]

8. If only the US would undertake a similar reevaluation

I was given anti-depressants when my doctors should have been treating my sub-clinical hypothyroidism, as that was the cause of my depression.

Instead, I had a horribly reaction to the anti-depressants (they triggered a manic episode) and my thyroid continued to get worse. I ended up in the ER and had to be taken off the Effexor slowly, to avoid severe withdrawal.

Turns out I really had Hashimoto's thyroid disease and a simple antibody test would have told them that, I had all of the clinical symptoms. Unfortunately, my doctors at the time were so anxious to prescribe one of my symptoms (the depression) with the new shiny drugs that they ignored the whole picture.

I have nothing against the use of anti-depressants. My issue with them is that the doctors (usually GPs) who prescribe them are not examining the entire health of their patients, instead using them as the first line of treatment. Since there are so many physical ailments that cause depression that when treated, actually cure the depression, every effort should be made to rule those out before prescribing SSRIs and other similar atypical anti-depressants.

[MountainLaurel]

10. As someone mentioned above

The U.S. medical profession as well as the government agencies tasked with researching and regulating medical treatments, are too far into the pockets of the pharmaceuticals industry for something like this to happen.

[shrike]

11. Excellent point

These are psychotropic drugs and should not be messed with. I suffer from chronic depression and NOTHING -- not exercise, not diet, not talk therapy -- helped me but meds. The average person, I think, does not need them, particularly if the depression is transitory and stems from other causes.

I get furious when I hear of doctors passing them out like candy.

[davsand]

12. As consumers we have to protect ourselves.

I had an issue with insomnia earlier this year. I went to the Doc and the first thing they did was to ask if I WANTED to go on anti depressants.

I explained that it was most likely situational stress (My Mom and my Dad both had pretty serious surgery in a space of about two months, I had just started a new job a couple of months before that, and my husband was running for office.)

The response was to urge me to consider anti depressants AND high blood pressure meds.

I explained that I really just wanted to have a good night's sleep and I thought the rest of it would resolve with the passage of a short time. Finally, reluctantly, they wrote me a 'scrip for Ambian IF i would agree to come back in two weeks...

I slept great for three nights, and on the fourth day started having wave after wave of panic attacks followed by crying jags. I have NEVER had anything like that in my life. I felt I was completely out of control. I stopped the Ambian, called the Doc, and in about three days the crushing panic and crying jags were gone.

The Doc wanted me on anti depressants AND high blood pressure meds (AGAIN with that discussion!) We settled for a 'scrip for Valium, and I kept my original follow up appointment.

I went in for the follow up--feeling a lot better, with a lower BP, and thinking all was not terribly wrong with what we had been doing. The Doc just lays into me that I need to be on anti depressants.

I finally cave, but tell the Doc that I want to go on Wellbutrin (Known as Zyban for some folks, but commonly used to as an anti depressant for a lot of people) so I can quit smoking, and maybe kill two birds with one stone. Doc gets all happy and writes the 'scrip with a flourish.

As some of you may remember, I was on Wellbutrin election night--and i had my last nicotine fix when they called Ohio for Bush. I was still taking the Valium, and it was working fine.

I go in for my last follow up, and my BP is high. It is high enough that they really think they need to begin treatment. (155/93 for those of you who care.) No cigarettes any more--but I have this BP that is higher than it ever has been before. I agreed to let them write a 'scrip for a diuretic to begin working to get my BP down.

I get back to my office, and start to wonder about the effects of the Wellbutrin--is it possible that IT is raising my BP? Sure enough--I get on line and find about a kerjillion sites talking about the fact that it can elevate BP in some people.

I call the Doc and say, "Hey--how about I go off the Wellbutrin and see if MAYBE that is why my BP is so high?" Doc gets all strange about it--like I'm proposing brain surgery or something equally radical.

Finally, I tell the Doc that I'm gonna go off the Wellbutrin, and I'd like to know the safest way to do it. I explain that I've got such a chemical stew going on I have no idea what I'm even feeling like these days after quitting smoking--that I just need to De-tox on all the chemicals.

I tell him that I'll be back in Jan with a a daily BP log and we can decide then WHAT exactly we need to be doing.

I went off the Wellbutrin, my BP is down now to normal ranges (131/73 last time I looked at it which was last night,) and I am now able to sleep without any pills or other chemicals. I have not taken a Valium in over a week now.

The Docs load you up with all kinds of drugs that do different stuff to every person--then they give you more drugs to counteract the negatives from the first drug. It is a vicious cycle, and I want no further part of it.

Take what you want from my experience, but I agree that maybe they do push the anti depressants WAY too much!


Laura