3 recent reports question the claims made by drug companies about the benefits of mental health medications, and also supporting concerns about side effects.
- From the British Medical Journal, a commentary, “No correction, no retraction, no apology, no comment: paroxetine trial reanalysis raises questions about institutional responsibility”, a blistering critique of a large study funded by GlaxoSmithKline, done in 2001, which alleged that the antidepressant parozetine (Paxil) and imipramine were safe for use with adolescents. The BJM commentary questions the methodology of the study, undisclosed financial ties to drug companies on the part of researchers, and distorted interpretations of the data. The BMJ research article, which the commentary discusses, concluded, “There were clinically significant increases in harms, including suicidal ideation and behavior and other serious adverse events in the paroxetine group and cardiovascular problems in the imipramine group.”
Medscape Psychiatry and Mental Health News published a related online article (requires a free subscription to access, “Retract Antidepressant Drug Trial, Experts Say”, which includes:
“Hundreds of thousands” of adolescents took this drug, and “we can’t know how many were harmed,” Jon Jureidini, PhD, Critical and Ethical Medical Research Group, University of Adelaide, South Australia, told Medscape Medical News.
· From Psychology Today (thanks to MN colleague Arthur Lebow, Ph.D., L.P, for bringing this to mhconcierge’s attention), an article summarizing research that raises concerns that antidepressant medications, under certain (fairly common circumstances) may actually worsen depression over time. “Now Antidepressant-Induced Chronic Depression Has a Name: Tardive Dysphoria”, summarized research that strongly supports NOT prescribing antidepressant medication for a first episode of depression (which, of course, would support use of psychological/behavioral treatments) and questions whether long term use of some antidepressants leads to “oppositional tolerance” changes in the patient brain. The author notes, “Once that happens, the patient is at significant risk of becoming chronically depressed. Yet, if patients respond well to an antidepressant and then withdraw from the medication, (one study discussed in the article) shows they are at a higher risk of relapse than if they had gotten better on placebo.”
The article also references a study done in Minnesota, by the highly reliable Minnesota Community Measurement organization: “In 2010, they reported that only 5.8% of the 23,887 patients treated for depression were in remission at the end of six months, and that only 4.5% were in remission at the end of twelve months. In other words, 95% of the patients in Minnesota with major depression now appear to be chronically ill.” Unfortunately, that report appears to have been relocated on the MCM website, so the link in the Psychology Today article does not work.
· Finally courtesy of the ever-prolific Ken Pope, an article from the New York Times about marketing Risperdal for off-label use with geriatric and child/adolescent patients. The article, “When Crime Pays: J&J’s Drug Risperdal”, notes, “(Risperdal) can cause strokes among the elderly. And it can cause boys to grow large, pendulous breasts; one boy developed a 46DD bust.” The latter side effect was found in 5.5 percent of boys who received the drug, a statistic which was reportedly “covered up” by Johnson & Johnson, the drug’s manufacturer.
mhconcierge’s take: the research in support of mental health medications, and how the pharmacy industry is marketing them, is undergoing a much-needed, and long-overdue, critical re-evaluation. Meanwhile, research for psychological/behavioral treatments is consistently demonstrating the effectiveness of what we do! We should promote what we do, expect our professional organizations to do the same, and leave prescribing to the medical professionals.