Who Am I? Growing Up On Antidepressants
44 CommentsBy Ed Silverman // April 16th, 2008 // 8:51 am
Amid the ongoing debate over antidepressants is a point that, sometimes, gets overlooked. And that is the extent to which these drugs may affect psychological development and even identity. That’s the issue raised in a thoughtful essay by Richard Friedman, a psychiatry professor at Weill Cornell Medical College. “Most of my patients, who are adults, developed their psychiatric problems after they had a pretty clear idea of who they were as individuals. During treatment, most of them could tell me whether they were back to their normal baseline,” he writes in The New York Times.
But then there Julie, 31, who had been on one antidepressant or another nearly continuously since she was 14, experienced serious depression and survived several suicide attempts. “Julie could certainly remember what depression felt like, but she could not recall feeling well except during her long treatment with antidepressant medications,” Friedman writes. “And since she had not grown up before getting depressed, she could not gauge the hypothetical effects of antidepressants on her emotional and psychological development.”
Another patient, a woman in her mid-20s, told him she felt pressured by her boyfriend to have sex more often than she wanted. “I’ve always had a low sex drive,” she said. For the past eight years she had taken Zoloft, which like all the antidepressants in its class is known to lower libido and to interfere with sexual performance, he writes. Her reaction after he explained this? “And I thought it was just me!”
He then makes a few important observations - first, Julie is far from unique. An entire generation has come of age during a period when antidepressants became increasingly popular and were widely prescribed. Second, we know a good deal about untreated depression. But how much do we know about the long-term effects of antidepressants that are taken for 15 years or more starting in adolescence? His answer: “Not enough.”
And this is problematic, he writes. The drugs are approved on the basis of short-term studies, which by definition means there is no evidence of a long-term risk. Meanwhile, controversy over clinical trial data has made research suspect. He points to a recent study involving 74 clinical trials with 12 antidepressants, which found that 97 percent of positive studies were published, versus 12 percent of negative studies.
The upshot: Using antidepressants during adolescence is tricky business. As he notes, the brain and identity are still developing. In his view, the drugs save lives, and so “we often have no choice but to use them, even if we have questions about their long-term use. But the questions are big ones, and we owe it to our patients to try to answer them.”
Lisa Van S
Maybe he should have thought about that twenty years ago,… Lives could have been saved, and tragedy could have been prevented.
Atlex
Lisa, you should really read the article in full before commenting. He came to the opposite conclusion–these drugs save lives in this population despite the side effects or risks. Though, I’m sure you’ll disagree with this.
Matt
These drugs aren’t saving lives, their killing people daily.
I’ve seen kids in the local psych ward on these drugs, and the vacant look in their eyes is pretty depressing. The neurological side effects of these drugs, like facial twitches, restlessness, and psychotic episodes are already present in 9 and 10 year olds that have been forced or duped in to taking psych meds. It’s very sad to see.
The saddest patient I have seen come in to my local hospital was a 24 year old woman who had been on psych meds for 10 or 12 years. She was nothing more than a zombie.
That’s what these drugs are doing to people if they aren’t out at their local school killing their classmates.
Jack2
These are SSRIs. You’re probably thinking of a different class of meds Matt.
truthman30
these drugs save lives in this population despite the side effects or risks. Though, I’m sure you’ll disagree with this.
Atlex we are all sick to death of hearing “these drugs save lives” , you could say that alcohol or heroin prevent people from killing themselves too, if you want to get into that argument.. Some people use “street” drugs when they feel hopless or despairing, and people use the legal drug alcohol in times of crisis, does that make it OK? ..
The only difference between “street” drugs and Psych meds is the legality…
Lisa Van S
Atlex,
“these drugs save lives in this population despite the side effects or risks”…. This is an anecdotal conclusion on his part! Long term,.. double blind, Placebo controlled studies are needed to determine long term effects.
There are no clinical studies that show safety an efficacy for children and adolescents for MDD, thats why they carry a Black Box.
Bottom Line, Inform the parents, allow them to decide what is best for their children.
Lisa Van S
Ed,
Did this Doc. disclose his financial ties to Industry? Probably not.
Nathan
Lisa says: “Long term,.. double blind, Placebo controlled studies are needed to determine long term effects.”
Very true. This is related to the discussion we were having yesterday about reform of business practices. There really isn’t an incentive for pharma companies to look at long-term studies. The way our system is set up, the “patent clock” starts ticking when the patent is filed (years prior to the drug entering clinical trials) - not when the drug is approved. Therefore, every year that the company “wastes” doing trials is money down the drain. I’m becoming more and more convinced that we need to have a system the relieves this “time pressure” by allowing companies to exclusively market prescription medication for a fixed number of years FOLLOWING FDA approval. That would encourage companies to do long term safety and efficacy testing BEFORE submitting the drug for FDA approval. (they would WANT to do those long-term studies because it would mean capturing a larger market share during the fixed years of exclusivity) The current system encourages companies to submit the drug for FDA approval after it meets only the minimum requirements for safety and efficacy. True long-term studies are economically prohibitive because the company would have to squeeze all of its profits into just the final few years of product lifetime before generic competition ensues.
truthman30
http://en.wikipedia.org/wiki/Richard_A._Friedman
http://ahrp.blogspot.com/2007/02/response-to-dr-richard-friedmans.html
This guy Richard Friedman (psych) seems to be in favour of teenscreen…
Here’s a link to some of his articles in the New York Times
http://health.nytimes.com/gst/health/healthsearch.html?st=a&query=Richard+Friedman+&date_select=full
This article from 2003 about Paxil..
http://query.nytimes.com/gst/fullpage.html?sec=health&res=9801E0D71031F931A2575BC0A9659C8B63&n=Top%2FNews%2FBusiness%2FCompanies%2FGlaxoSmithKline%20P.L.C.
At the end of the day this Freidman guy is a psychiatrist with a belief in the biological mental illness agenda…
If psych drugs disappeared tomorrow he would be out of a profession as would all psychiatrists..
That said, he seems to be quite balanced in his views on mental illness, which is good to see…
Former pharma Marketing Exec
“we often have no choice but to use them, even if we have questions about their long-term use. But the questions are big ones, and we owe it to our patients to try to answer them.”
Not only should they answer them, they should point out the questions first. Let the patients with their parents decide if this risk is one they want to take.
Is it right to have this type of decision making left entirely in the clinicians hands (often biased by industry influence) - no! It is never right.
This is not only happening with SSRI’s. This is happening right across the prescription drug spectrum. We have to stop selling “magical pills” that cure everything, when in fact they are band aids in some cases with long term effects no one gambled on. Does this mean they don’t come to the market? No, it means disclosure and close monitoring.
In my mind there is no way to spin the harm that was done. It was carelessness and it completely erodes the trust that we as society must have in order for society to function.
More than just irritated…
truthman30
In my mind there is no way to spin the harm that was done. It was carelessness and it completely erodes the trust that we as society must have in order for society to function.
Thank You FormerPharmaMarketingExce
It is refreshing to see someone who once worked in the industry tell it like it is..
Lisa Van S
Dr. Friedman supports teenscreen?.. A screening test that has an 84% failure rate! Thats Pretty Scary….
Atlex
Lisa, we are in complete agreement about informing parents on the pros and cons of various treatments. I haven’t seen anyone arguing for keeping physicians from informing parents.
Laurie
This was a big topic of discussion on my site in the last few days. I have seen firsthand the effects on the growth and development of a child/teen on an ssri. The effect is not only the physical effect on the brain. The stunting of pattern of developmental tasks are poorly acknowledged. The simple thing that we all experience as teenagers are not percieved the same when you are working with an altered brain. With my son we have seen the social isolation caused by withdrawal, the lack of empathy towards others, the cognitive impairment is a HUGE factor for a child in high school. We had our son tested during withdrawal and this cognitive impairment was documented in that scientific testing. Today at age 20 he remembers nothing of the information taught during his first two years of high school(when he was on Paxil).
My son lost 3 years of his life to paxil use and subsequent withdrawal, but the price is much higher than that in years lost due to the delay in growth and development.
Todays ssri users are the long term study, but sadly instead of listening to those who have firsthand experience with these effects, they are dismissed as “anecdotal evidence”. Teenage angst is there for a reason. It’s all part of learning about life and how to handle it. These children don’t learn this living the emotionally blunted world of ssri’s.
Think about how not having an high school experience would have changed who you are today. That’s what these children deal with.
Lisa Van S
Atlex,
I have,.. during a hearing of the NJ State Assembly, Lobbyists from AAP, APA and Nurse practioners were in opposition of Parental Consent, their reasons for opposing A378 was absolutely mind boggling. You can listen to the audio of the hearing on NJ’s legislative website.
truthman30
“Atlex
Lisa, we are in complete agreement about informing parents on the pros and cons of various treatments. I haven’t seen anyone arguing for keeping physicians from informing parents.”
What about STUDY 329 then Atlex?
http://www.healthyskepticism.org/documents/PaxilStudy329.php
http://www.youtube.com/watch?v=kiBRbNNFzlA
http://seroxatsecrets.wordpress.com/2007/02/14/drs-keller-ryan-study-329/
http://clinpsyc.blogspot.com/2007/01/keller-bad-science-and-seroxatpaxil.html
http://www.nytimes.com/2004/06/03/business/03drug.html?ex=1401595200&en=30652ece2753a61b&ei=5007&partner=USERLAND
Atlex
Lisa, thanks for pointing that out. I’m not sure if they are actually arguing to keep physicians from informing patients or instead arguing against a legislated mandate. From your perspective, I can understand equating the two. By the way, did you know that OBRA 90 requires that pharmacists “counsel” patients on each prescription they fill? Pharmacists, though, have fulfilled this requirement through printed patient information sheets and a signature from the patient verifying that counseling was offered.
AA
I first wanted to address this part of the article that was not included in Ed’s summary:
“What do I say to a depressed patient who is doing well after five years on such a drug but can’t stop without a depressive relapse and who wants reassurance that the drug has no long-term adverse effects?”
As a person tapering off of antidepressants due to horrific side effects, this has nothing to with stopping without a depressive relapse. Most relapses occur because of way too fast tapering schedules given to patients by doctors.
I am so tired of this myth being accepted as fact.
As far as AD’s saving lives, they have destroyed mine. I was left with these
“gifts”
1. Mild to moderate hearing loss from Remeron.
2. Considerable worsening of LD issues. What is scary is so many kids with LD/ADHD are given these meds to improve their lives.
LD issues that worsened considerably with meds are memory impairment and executive function problems. For those of you not familiar with the term executive function, in simplistic language, it means making plans and following up on them.
3. Tinnitus which is a sign of ear poisoning.
4. Extensive Dental Work - I can’t totally blame it on the drugs but there is no doubt in my mind, it wouldn’t have been as bad without the meds.
5. Complete emotional numbing - This is the worst one as I neglected so many things in my life including relationships. According to what I have read, this quite common.
It takes every ounce of willpower I have to not cry over what I have missed for all these years. I realize that being bitter is not going to help matters but it is hard not to be.
To address Dr. Friedman’s point about there being no choice, again, i am so tired of that garbage. I have read that CBT is even helpful in cases of severe depression.
To those of you who say, medicine is the quickest route, not quite as it can take ADs up to 12 weeks to work. And according to the Star D study, they are effective 33% of the time.
Finally, former marketing exec, thank you for the points you made about informed choice. I was never given that. Of course, I have to take responsibility for my share of the blame. But to prescribe these meds like they are candy is just wrong.
AA
Laurie
AA, you are absolutely right. Until withdrawal and it’s devastating effects are recognized, those who are uninformed will continue to believe that it’s “their disease”. One of the first questions we ask a new poster on my site is “what brought you to antidepressants” and then the follow up is “how do your current symptoms compare”. Overwhelmingly the answer is ” What I’m experiencing now, in withdrawal, is nothing like what I started taking the drug for. This is SO much worse”.
There are SO many who are now polydrugged for symptoms that are classic withdrawal.
Lisa Van S
Atlex,
I mean no disrespect,… But what rock have you been hiding under!!!! Dr.s dont want to inform parents, they site problems with compliance,..sorry,.. but thats not an excuse. Havent you read Ed’s posts in regards to Medication Guides. Please!… Search med guides here on Pharmalot. You,.. really do need to educate yourself…
Atlex
Lisa, you do mean to be disrespectful when you use derogatory remarks. Frankly, the only thing that it does is weaken your standing among rational people who recognize that the world is not black and white. It is evident from your posting that you don’t bother to even read what I’ve been writing. I have not said that I’m against mandatory counseling. I merely pointed out that the argument used by the other side is a little more nuanced than you make it out to be. In addition, I pointed out that a law mandating physician couseling associated with prescribing may not get you what you are looking for if it is implemented similar to the law focused on pharmacy.
Kelly
Laurie,
The problem is, that depression itself can cause people to be unable to remember and learn. So many people are in a no win situation. Their memory is going to be impacted either by the depression itself or by the medication.
pg
None of us can possibly know how a child will feel who has had its developing brain flooded with ‘mind altering’ drugs from as long as the child can remember, increasingly now from preschool age.
The thought of children might ‘feel’ being brought up on industrial drugs and who equally have no possible way of knowing how ‘normality’ (developing a brain from infant to adulthood without drugs) feels, is absolutely horrific to me. Its something that developing life is not designed to go through and the drug industry should never have targetted.
truthman30
Kelly
Laurie,
The problem is, that depression itself can cause people to be unable to remember and learn. So many people are in a no win situation. Their memory is going to be impacted either by the depression itself or by the medication.
I disagree..
Depression does cloud the mind and thoughts, but it does not damage the brain…
Unlike Drugs which do cause cognitive and memory impairment which can be irreversible
pg
“Who Am I? Growing Up On Antidepressants”
How will they answer when they become adults.
The ‘who’ they are, or feel they are, will never be the ‘who’ nature meant them to be because industrial mind altering chemicals will have nutured their developing brains in anything but the way life was designed.
The mass targetting of the brains of developing infants, toddlers and children by industry, key opinion leaders and whoever else is knowingly involved, has to be the most horrendous crime ever committed against humanity.
What will history record about what is happening to our young in our lifetime?
pg
What will history say about the industry, the key opinion leaders and the rest of our society when they look back at what happened en masse?
“First they came for the Communists but I was not a Communist so I did not speak out. Then they came for the Socialists and the Trade Unionists but I was not one of them, so I did not speak out. Then they came for the Jews but I was not Jewish so I did not speak out. And when they came for me, there was no one left to speak out for me.”
(Martin Niemoeller
Laurie
Kelly, in my son’s case he was not given Paxil for depression, yet he had documented short term memory loss while on it and in withdrawal. Previous testing was completely normal. The “brain fog”,short term memory loss is commonly reported amongst ssri users by patients who never had this prior to the drug.
pg
The mass targetting of the brains of children is an horrendous crime against humanity.
Lisa Van S
Kelly,
My daughter was an honor roll student who was fluent in the French Language. While on Paxil she had difficulty concentrating and retaining information, and could no longer speak the French Languauge. My daughter was misdiagnosed with depression and anorexia. She actually had Lyme Disease. Increased Suicide/Violence arent the only issues surrounding SSRI’s. Children and teens are developing significant Metabolic changes.
pg
‘And when they came for me [the infant/toddler/child], there was no one left to speak out for me.”
pg
“First they came for the Communists but I was not a Communist so I did not speak out. Then they came for the Socialists and the Trade Unionists but I was not one of them, so I did not speak out. Then they came for the Jews but I was not Jewish so I did not speak out. And when they came for me, there was no one left to speak out for me.”
pg
Who are we as GROWN ADULTS damaged by antidpressants? And how do INFANTS, TODDLERS and CHILDREN deal with something that can radically alter the lives (for the worst) of adults that were not ‘chemically altered’ as children?
pg
MASS DRUGGING OF CHILDREN - the most horrendous crime ever committed against humanity.
HOW COULD YOU DO THAT TO INFANTS AND PRESCHOOLERS AND SLEEP AT NIGHT?
pg
Doing it to preschoolers knowing full well the many nasty deadly side effects there are on those drugs.
truthman30
pg
MASS DRUGGING OF CHILDREN - the most horrendous crime ever committed against humanity.
HOW COULD YOU DO THAT TO INFANTS AND PRESCHOOLERS AND SLEEP AT NIGHT?
They sleep on pillows of cash made from profits soaked in misery…
Pretty sick really..
Doug Bremner
Truthman, Matt, Nathan, Lisa, pg… the gangs all here. I was starting to miss you guys.
Since prozac has gotten into the the drinking water now it isnt just some of us that are growing up psychopharmacologized.
http://www.beforeyoutakethatpill.com/2008/3/theyre-drugging-our-drinking-water.html
my son asked if our little flimsy filter system would keep the prozac and lipitor out of our systems. The answer was… nope!
Doug Bremner
My cardiology colleagues have said about statins ‘they ought to put that stuff in the drinking water.’ Well now we can say… too late! It’s already been done!
btw a little bird was sitting in on a meeting of government officials involved in public health and academic physicians where there was a discussion of heart disease prevention. Most were focused on ways to get more medications like statins to people for primary prevention, or the use of a ‘poly pill’ that combines a statin, aspirin, ace inhibitor and beta blocker in one pill (i’m not kidding). One someone said ‘how about teaching diet and lifestyle changes?’ they said ‘that doesn’t work, already tried that, not worth the effort.’
Doug Bremner
btw I say they should add prozac to the poly pill since hypertension meds can make you depressed.
Dan
Doug,
You may want to check on the depression claim. Beta Blockers, however, are comparative to the others likely to give one impotence.
Doug Bremner
Calcium channel blockers associated with seven fold increase in suicide in Swedish national database. I’d check on the reference but I’m too busy prescribing my placebos. (actually I didn’t put anyone on an ssri today. pg would be proud. told the secretary that is probably why everyone showed up today. they know they aren’t likely to get a prescription med).
pg
Doug, I’m really tired and confused today and really can’t take much in well. I’m not SURE if you’re being sarcastic but I dont think you are - though of course you might be.
If you ARE (being sarcastic) then, I’m not ‘anti drugs’, but I’m VERY anti fraudulent science which as far as I can see has happened with a lot (maybe all?) of psychiatric drugs (easier to blame side effects on the patient’s ‘mental disorder’) and a number of ‘medical’ drugs… for whatever reason (because it isn’t so easy to blame the side effects on the patients as it is re ‘psych’ drugs).
Mostly, I’m anti drugging children with psych drugs - fraudulent or not - because its a scary thought of what they may be going through, but don’t know how to tell anyone as the ‘anyones’ they know are the the ones giving them their daily drugs - so who do they turn to while they’re still able, and what happens when they understand there is nobody to turn to? And so their ‘normality’ is that whatever they go through is what they have to, until its too late to even consider that their thinking is not natural at all.
If you’re NOT being sarcastic, then the world desperately needs people like you to try to stop this happening to infants, preschoolers and children generally. And thats who I think you are, a good guy. But I might end up looking an idiot for saying that if you turn out to be only sarcastic :-)
Whatever, if you are a good guy, a huge, genuine thank you for taking a stand to try to protect people in a world where powerful but unethical people are doing a huge amount of damage to others. If you’re not, I’ll just have to have a go back at you when I’m not so tired and can work it all out better than I can today :-| At the moment I THINK you’re a good guy.
DaveD
The similarities between street drug abuse and psychotropic prescription drug use are disturbing. Both types are toxic. Both can cause psychosis, damage the brain and other organs, and even cause death. And neither type of mind-altering drugs, legal or illegal, treats disease. It’s important to recognize that the only significant difference between many prescription psychotropic drugs and street drugs such as “speed” and “downers” is that prescription drugs are legal.
Neuro-psychiatrist Sydney Walker in “Dose of Sanity”
Doug Bremner
pg, I don’t treat children but if I did I don’t thing I would use alot of ssri’s since there isn’t much evidence for their efficacy. And no I am not being sarcastic in saying that I prefer not to jump to prescribing ssri’s given the evidence that the benefits are not as great as what people think.
pg
Doug, I appreciate your explanation. Might get back to you next time I’m here, I think from looking at your website that there’s nowhere (as far as I could work out) to leave a comment so I can’t answer you at your own website (is that right or did I miss a link, which I do sometimes?). Thanks for taking the time to reply.