Editorial Note: I was asked to review Peter Kramer’s Ordinarily Well: The Case for Antidepressants for ISIS. The in print review is HERE. There is a sister post on RxISK – with a better cartoon and where the word Venomagnosia s explained – Come Back When you Have a Medical Degree.
This book was very difficult to review. In Ordinarily Well: The Case for Antidepressants, Dr. Peter Kramer makes two arguments that I agree with. One is that clinical observation—the interaction by which a medical professional learns about a patient—counts for something. The other is that clinical trials, or evidence-based medicine more generally, are not a replacement for clinical wisdom. He values antidepressants, in particular the selective serotonin reuptake inhibitor (SSRI) class of drugs, and so do I.
Applying support for clinical observation and skepticism about controlled trials to the question of whether antidepressants work, Kramer concludes that these treatments work very well. En route, he focuses on the claims of psychologist Irving Kirsch, among others, that based on clinical trial data, the benefits of antidepressants are all in the mind—a placebo effect. Kramer makes a straw man of Kirsch, but I agree with Kramer that antidepressants do things that are not all in the mind. I too reject Kirsch’s arguments that most of what antidepressants do stems from a placebo effect.
So where did my difficulties in reviewing the book come from? The trouble for me is that Kramer’s clinical vision seems strangely rose-tinted. He is an advocate of using antidepressants to treat depression, but he doesn’t seem to see any of the problems antidepressants cause. The fact that over half of the patients put on them don’t take them beyond a month should be telling. For those who do stay on treatment, he claims, no one has difficulties going off antidepressants with a gradual reduction in dosage. I, however, have patients suffering badly months or even a year later. In the case of any enduring problems, Kramer puts these down to the effects of the illness being treated rather than the medication.
There is no discussion in this book of significant problems that the use of antidepressants can cause. These include SSRI-induced alcoholism, SSRI-induced birth defects, including autism spectrum disorder, or permanent post-SSRI sexual dysfunction. In a 336-page book, the topic of SSRI-induced suicidality gets dealt with in one page. I think many surviving relatives would be astonished to hear that once the psychiatrist Martin Teicher had identified the problem of treatment-induced suicide, it became manageable. Kramer claims that “no case [he has had], not one, has looked like those Teicher has described, drug driven.”
Kramer asks us to believe in clinical observations—his observations. Not yours or mine or anyone’s that might cause the antidepressant bandwagon to wobble. He cites me at multiple points, so he is well aware of my work. But he doesn’t engage with the evidence that I and others have put forth, based on both clinical observations and other material, that SSRIs can unquestionably cause suicides and homicides, and do so to a greater extent than they prevent any of these events.
On the issue of children, suicide, and the black box warnings that antidepressants now carry, Kramer notes that “some of the data have trended the other way, although authoritative studies correlate increased prescribing with reduced adolescent suicide.” This fails to acknowledge that the drugs haven’t been shown to work in this age group. There is no mention that suicidal acts show a statistically significant increase in clinical trials in this age group. Kramer also does not indicate that among all ages, when all trials of antidepressants are analyzed together, they show increased rates of death (mainly from suicide) compared to non-treatment. He seems to have no feel for how compromised the “authorities” are that he uses to downplay the risks.
There are good grounds to be skeptical of the evidence-based medicine that Kramer uses to make his case. Quite aside from the fact that almost all the research literature produced by clinical trials is ghost written by pharmaceutical companies, and the data from them entirely inaccessible, controlled trials aren’t designed to show that drugs work. They work best when they debunk claims for efficacy, rather than the reverse. What’s more, the structure of clinical trials and their statistical analyses are the best method to hide a drug’s adverse effects. Ordinarily Well does not address these significant problems.
If a drug really works, then clinical observation should pick it up. We can tell antihypertensives lower blood pressure, hypoglycemics lower blood sugar, and antipsychotics tranquilize within the hour—all without trials. We can see right in front of us that antipsychotics badly agitate many people within the hour and that SSRIs can do so too. But we cannot see anyone get better on an antidepressant in a way that lets us as convincingly ascribe the effect to the drug. There is much to be said for clinical observation, but also a lot to wonder about when clinical trials suggest that drugs work but we can’t actually see it. For anyone keen to defend clinical observation, Kramer’s book poses real problems and would leave many figuring we need controlled trials instead.
I live and work in the United Kingdom and am acutely aware of some differences between America and Europe that also made it difficult to review this book. There is much more “bio-babble” in America than in Europe, from talk of lowered serotonin to chemical imbalances to neuroplasticity and early treatment preventing brain damage—all of which Kramer reproduces. I felt a John McEnroe “you cannot be serious” coming on at many points. The tone in which some of these points are made suggests that everyone reading them will find what is being said self-evident, when in fact it’s gobbledegook.
All medicines are poisons, and the clinical art is bringing good out of the use of a poison. It strikes me as un-American to even suggest that a drug might be a poison, and Kramer’s book gives no hint of this; the book is, in this sense, deeply non-clinical. He is giving an account of a mythical treatment, as far removed from real medicine as an inflatable sexual partner is from the real thing. It seems to me that he would not see or hear many of the patients I see, or at least would not credit their view of what is happening to them on treatment. This book will misinform anyone likely to take an antidepressant.
It will also cause problems for physicians. This book does not balance the risks and benefits that are intrinsic to medical wisdom. If antidepressants are as effective as Kramer claims, and are as free of problems as he suggests, there is no reason why nurses and pharmacists couldn’t prescribe them. Given that they are much less expensive prescribers, the surprise is that health insurers haven’t moved in this direction.
There is a way to bridge the gulf between Kramer and myself, which involves clinical observation. Most of the beneficial effects Kramer describes can be reframed in terms of an emotional blunting, or the numbing of all emotions, not simply the bad ones. Just like people on an SSRI will nearly universally report genital numbing within 30 minutes of taking their first SSRI—if they’re asked—people will also report some degree of emotional numbing—if asked. They don’t necessarily feel better; they simply feel less.
Unlike the somewhat mystical brain re-engineering Kramer invokes, this emotional blunting can be verified by clinical questioning. If clinical trials were designed to assess whether patients are numbed by these drugs, there would be little need for the fancy statistics that pharmaceutical companies use to claim the targeted benefits of their drugs, since emotional blunting would be evident through clinical questioning. And Irving Kirsch’s arguments about placebo would be irrelevant.
If SSRIs numb emotional experience, this would explain why they help some and not others, and explain the results we see in clinical trials, which are similar to the results that might be expected from a trial of alcohol versus placebo in the milder nervous states in which antidepressant trials have been run. This, then, would present us with a question: what do we think about emotional blunting as a therapeutic tool? Emotional blunting is not a romantic option. It’s a much more ordinary one. If that is the process by which antidepressants work, it does patients an enormous disservice to avoid discussing it entirely, which this book does.
Emotional blunting as a therapeutic tool may be helpful in the short term, say six months max for say someone who has just been through a high degree of physical and mental abuse, but not for the long term and especially not for those with minor problems.
Its not good to keep someone emotionally numb long term because it will cause problems. People emotionally numbed do not feel empathy for others, this can cause relationship breakdowns, job losses e.t.c. The longer you are emotionally numbed the more risks you take, you find your self breaking through moral boundary’s you would never had done before causing even more problems to yourself and others. It can actually be very dangerous. From my experience I don’t think Dr’s even notice this happening at all in patients.
Coming off SSRIS especially if you have been on them long term is another problem all in itself. Its like learning to walk again, you have to learn how to deal with emotions again. This can be very hard the first year or two as you have to cope with the withdrawal effects along with intense heightened emotions flooding you all at the same time.
It kind of annoys me that Dr’s or psychiatrists have the first word on the effects of SSRIS (like their word is law) yet they learn their info from a book and get it mostly wrong. They don’t even take the patients personal experiences into account, they don’t even recognise many of the side effects when seeing patients. From my experience patients who have taken the drug know far more about the side effects than any Dr who hasn’t taken them.
Emotional bluntness is a very serious side effect and alongside many of the other serious side effects, its a recipe for disaster.
I am looking for a doctor in miami, florida that specializes in emotional blunting. I have had this problem since march 1, 2021 and need some help desperately.
Catherine
Catherinem1011@yahoo.com
P.O.W!
We know this, those of us, the unclean..tarnished, dirty, woebegone Paroxetine infested patient..
“SSRIs can unquestionably cause suicides and homicides, and do so to a greater extent than they prevent any of these events.”
Super Doc, Mickey Nardo, investigates ‘what we need to know’
http://1boringoldman.com/index.php/2017/01/27/what-we-need-to-know/
Anne-Marie
January 29, 2017 | 3:12 PM
This is whats needed as a patient who was on two different SSRIS I encountered many side effects, you should also add age and ask length of time on said drug. Plus ask what dosage their on. Plus you could give a list of side effects and ask the patient to tick any that applies to them.
I think this should be routine in every Drs surgery and patients notes and filled out or asked at every refill. That way a Dr gets to see the real picture and it makes the patient think more about the side effects their experiencing on SSRIS . I wished they had had that when I was taking them because I wasn’t even aware I was detached or the meaning of it until I came off them. Its really important to ask these very important questions to a patient who is especially in a drug induced haze and not even aware of it. SSRIS destroyed my life this could have made a very huge difference.
Please, please bring something like this out it would be life saving.
Dr. David Healy has seen more than most in his quest to undercover the real rise in anti depressant usage and uses SSRIs diligently which he thinks help some people some of the time, but, not all of the people all of the time.
Generally, I get the impression that the loved-up couple Sir Simon Wellesly, soon relieved of his post, and Dr. Clare Gerada, former chair of Gps, have done us a huge disservice over the course of their careers by failing to address even rudimentary research on our behalf.
Maybe, even Dinesh Bhugra, maybe, Allen Francis, maybe, Peter Kramer, maybe, a huge number of outspoken Psychiatrists who see fit to spread their gospel.
Then we have Peter Gotzsche, Peter Breggin, Joseph Glenmullen, all spreading their gospel.
This is very difficult for the patient on the one hand learning about all the suicides and homicides and then learning of all the people these drugs have helped…
Is it a 50/50 split?
If you are so unlucky to suffer such a tremendous reaction to stopping, restarting, upped doses, reduced doses and do something that you would not do in your ‘right mind’ as an adult, I am acutely distressed as to how any child could remotely cope with this pharmaceutical assassination of spirit and distortion of mind.
The loss of so many youngsters, day in and day out, on anti depressants for ‘their own good’ and their doctors getting away what they do has to be the most mysterious of all.
We have David Carmichael as the prime example, completing losing his marbles on Paxil and I put myself in his shoes when I think about him, which I do quite often.
Seroxat and Paxil has lost children and adults for decades and is still on the market and I would severely rebuke any doctor or psychiatrist with this drug’s nefarious history to even consider using it as part of any strategy.
This drug works by shutting down a fundamental part of who you are and it is so subtle even the person swallowing it doesn’t notice, to start with.
It is subliminally creepy, I didn’t feel any different taking just this one at the time but it is pretty clear to me now that it was doing things without me knowing what it was doing and this is the empty bit of the whole ‘burnt at the stake’ danger.
Doctors and Psychiatrists have been given the ‘tools of trade’ and it is clear that these ‘tools’ bend and warp and distort as do so many in this ‘Field of Psychiatry’ and it takes one to know one..
My own take would be don’t take, its not worth the Rxisk, and however ‘useful’ the prescribers think these drugs are, to know your own mind is not worth the chemically changed body and soul and the loss of so many in my opinion should herald the end of the SSRI era..
Which is exactly what Andrew Witty thinks..it’s just that he didn’t count the dead bodies and mention of his company’s foray will never come from his lips..
what do we think about emotional blunting as a therapeutic tool?
I think you ask the right questions and should get the right answers…
Dr. Kramer argues like a defense lawyer, as if Prozac were a person whose civil rights we are bound to respect. And he does a very good job indeed of kicking up reasonable doubt, going on for chapter after chapter identifying potential confounding effects in clinical trials. Funny how all the potential confounders he can think of seem to work against the drug and in favor of placebo. Are there any that work the other way around?
On the point “if ADs are as effective as Kramer suggests…….there is no reason why nurses and pharmacists couldn’t prescribe them”, I see that student nurses in England are now to be trained ‘to recognise mental health problems’. Not that I have a problem with that – the more people that are ‘trained’ the better, surely. It just concerns me as to whose interpretation of ‘mental health issues’ will they be introduced? There seems to be such a variety of differing opinions that, quite honestly, you could end up with a whole host of ‘differently trained’ nurses. Unless the ‘trainer’ believes in the possibility of adverse reactions to drugs then there is no chance that the ‘trained’ will understand this group of symptoms either. If the adverse reactions are left out of the picture, then I can hardly see the point of the training – the reaction of ‘its all in your head’ would remain. I suppose you could say that would be one step removed from the present A&E response of “We only deal with physical emergencies here”. Patients and their families need to be listened to most definitely – but that only works if they are also BELIEVED. At the moment I feel that ‘believers’ are in even shorter supply than ‘listeners’.
“If antidepressants are as effective as Kramer claims, and are as free of problems as he suggests, there is no reason why nurses and pharmacists couldn’t prescribe them. Given that they are much less expensive prescribers, the surprise is that health insurers haven’t moved in this direction …”
In fact, they have – and the tempo has speeded up in recent years. For quite awhile, Americans have been getting close to 80% of their psychotropic drugs from primary-care doctors – antidepressants especially. Most people medicated for mild to moderate problems, whether labeled “depression” or “anxiety”, never see a psychiatrist anymore.
Meanwhile, people with more severe or chronic problems may never see a doctor at all – they see a nurse practitioner in a clinic labeled a “community mental health center.” Officially all these NP’s practice under the supervision of a psychiatrist, but that supervision can be awfully distant. It sure doesn’t mean the NP has a “shrink” at his or her elbow in case a patient isn’t doing well or has some unusual reaction.
Take a look at the diagram of an “Integrative Care Model” in this post by Dr. Mickey Nardo – it is the current reality for those on disability, and it’s more and more being extolled as the wave of the future: http://1boringoldman.com/index.php/2015/12/01/life-problems/
In fact it wouldn’t be hard to argue that American psychiatry is going extinct. It’s the only medical specialty I know of where over half of the practitioners no longer accept insurance. That’s right – I didn’t say “no longer accept” Medicaid, or even Medicare. They don’t take insurance, period! At the big Rush University Medical Center in Chicago, a regional leader in psychiatry, there are now two outpatient clinics. One takes insurance, and patients are seen by psychiatric residents from the medical school. At the other clinic, patients are seen by actual attending physicians – but it’s cash-only.
This isn’t because shrinks are the highest-paid specialists. Not by a long shot. Rather, it’s because they are increasingly seen by the system as the specialists that patients can do without.
This may be part of Dr. Kramer’s myopia. Increasingly, doctors like him see only patients who can shell out $200-500 cash for a single visit (I shudder to think what the going rate is in Manhattan!) Meaning they are both well-to-do enough to afford those fees, and true believers enough to think it well worth the cost.
I can see many similarities between your system and ours here in Wales ( and probably rest of UK). Our GPs (family doctors) deal with anxiety and depression and dole out the prescriptions for antidepressants. When the problem ( or the patient!) fails to clear up then a referral is made to the community mental health service. After assessment by a psychiatrist, for which the patient will have waited a few months, a different prescription or one for an increased dose will be issued together with the name of a care co-ordinator who will see the patient at follow-up appointments. From then on, the patient will rarely see the psychiatrist unless there is a decline in his/her condition. Maybe a follow-up will take place once a year.Carers or family members are seen as a hindrance, generally, by the psychiatrists – put in the picture of “what we’ve decided today” ( meaning “what I’ve said and the patient has heard”!) in the final five minutes of an appointment. Not once have we seen a note of items covered during such a meeting. That is the general picture of the system as seen by our son over a period of more than ten years.
When I finally blew a gasket over the situation and shared my very real concerns with a different psychiatrist, a dramatic difference was found. Under this ‘new’ system, within a different area grouping, a totally different way is used. Here, the carer/parent is able to be present throughout and, in this way, gets to understand the situation so much better. Here, what the patient and parent/carer have to say becomes the main part of the appointment – and the patient, with guidance should it be needed, makes every decision concerning his/her progress. Every single appointment results in a letter to the GP explaining the current situation and steps being taken to move forwards, a copy of which is sent to the patient. Here, the patient sees the psychiatrist at every appointment which are every two months or so. This is a true picture of the system as seen by us over the last 17 months.
These appointments have all taken place under the same Health Board – why such a difference? As far as I can see, the psychiatrist himself is the difference. One works as if he is quite stressed ( which doesn’t help the patient one bit) whilst the other has eyes and ears only for the patient in front of him at the time – which, of course, brings out the best in the patient. Here, there is shared trust – whereas under the other system there was mere tolerance.
Thank you Dr Healy,
I wrote about my experiences of ’emotional blunting’ on Seroxat, on my blog, back in August 2010. It is the ’emotional blunting’ affect (or emotional suppression/’dulling’) which psychiatrists rely upon in order to claim that anti-depressants are effective. I am extremely wary and critical of SSRI’s (understandably, because of my horrific experience with Seroxat), however, if people ask me do I think SSRI’s work? I say yes. However, that depends on your definition of ‘work’.
SSRI’s do work, yes they do work!- they numb you, they dumb you down, they suppress you. So yes, they work in that regard. When psychiatrists say ‘anti-depressants work’, they know that they are kind of being selective with explaining exactly how they work- they don’t tell the patient that they work in an ’emotional numbing’ sense. They don’t tel the patient that SSRI’s do not work in an ‘anti-depressant curing’ sense. They don’t warn of the dangers of the numbing/blunting effect…
Do SSRI’s make you happy? Are they ‘happy pills’? No, they are far from happy pills. Emotional numbing might be what some people feel they need, perhaps for some, this numbing is a welcome relief- however for others emotional numbing might numb them to the point of zero empathy or compassion for themselves, or others- this can lead to dis-inhibition and this can result in acts of suicide, violence, homicide etc.
Psychiatrists (and the pharmaceutical companies) know full well that SSRI’s cause emotional numbing, and they also know that emotional numbing is often a desired effect for conditions such as depression, anxiety etc. The emotional numbing/blunting is touted as some kind of ‘anti-depressant’ effect when really it’s more of an emotional anesthesia- type effect, which for many can be quite dangerous- particularly when you throw in an unstable state of mind, irritability, and akathsia (a recipe for disaster).
Great post Dr Healy,
About time somebody drew attention to this..
Here’s my post from 7 years ago on SSRI’s and emotional blunting..
https://truthman30.wordpress.com/2010/08/16/ssris-emotional-blunting/
I can see the benefit of short-term use of SSRIs, as you suggest, to give a patient a short respite from themselves, if you wish. We all know the feeling of occasionally being ‘on edge’ due to life experiences – but in cases of severe anxiety or depression, where the individual seems to be in a continuous overwhelmed state, then having something to give the body a short break from those feelings can only be a positive move forward, with the possibility of support for their physical health too. I am sure that most of us would agree with the short-term use of SSRIs in such a situation.
The present problem, however, seems to be so far removed from that ideal that we have all but lost sight of the real possible benefits. In my opinion, no one who is ‘on edge’ due to stress needs such strong intervention. As a ‘quick fix’ for the prescriber (i.e. patient can be sent off with a prescription) it is a disaster waiting to happen. The main problems being – that the prescriber fails to communicate reaction possibilities with the patient’s family and the curse of the ‘repeat prescription’.
Bouts of anxiety or depression are debilitating – we would all agree with that. Doctors have difficulties turning away patients who wish for a ‘quick fix’ so that they can return to normal health – we can sympathise with that situation too. The truth is that such states as anxiety are not synonymous with quick fixes. A prescription or two will do no more than give one a break from the symptoms. They play no part whatsoever in fixing the underlying problems. It is discussion and relaxing techniques that can do that – by improving self-confidence and self-esteem – leading to an appreciation of ‘life’ in its varied states and a belief that coping with changing circumstances is as much a part of our life on earth as is our breathing. This takes many, many hours spent partly in discussion and partly in contemplation. The ability to see the best in any given situation, and to make the most of it, takes training – mainly, of self. This is an impossibility without the interaction with others to kick-start the positive thought process. Neither SSRIs nor any other tablet can replace the company of other humans – animals can come pretty close, but there will still be the need for linguistic interaction.
We are becoming an increasingly lonely race – especially in the western world. We have so much that many others go without – yet we are extremely unhappy. This seems to be true from the youngest to the eldest in our communities. Until we tackle loneliness I’m afraid that we will not see much of an improvement. I welcome the initiative talked about today, whereby Jo Cox’s family are gathering together many groups, with the idea of a move forward in tackling this problem – as their lasting memorial to Jo’s own ideals.
This Thursday is Time To Talk day – what a wonderful chance to start a change around loneliness, as well as removing the stigma surrounding mental health issues. We must, of course, remember that for ‘time to talk’ to work we must also be prepared to be really good listeners!
“One day, these beliefs and treatments will seem as misguided as the theory of the four humours, when bloodletting, blistering and purging were believed to restore the correct balance of blood, phlegm and black and yellow bile.
It may take a decade or more before today’s mass psychiatric drugging is consigned to the bulging dustbin of failed psychiatric treatments — but I hope that telling my story will help bring the date forward, and thereby reduce this entirely unnecessary contribution to human suffering.”
http://www.dailymail.co.uk/health/article-4173468/My-GP-gave-antidepressants-didn-t-need-20-years.html
The Viscount, Luke Montagu, still suffers the antidepressants’ effects 6 years on
He has constant nerve pain all over his body, and suffers tinnitus and twitching
After discovering his psychiatrist’s mistake, he sued him for negligence and won
Now he is launching a campaign to aid thousands trapped in the same nightmare
To blunt ones emotions is akin to being in a partnership with a bully who never allows you a freedom of expression ~ it’s locking you in a room.
Ironic when we read how antidepressants and cognitive therapy are touted as a marriage. How can one freely express themselves when they are blunted emotionally? The therapist will have in front of them a patient who, seemingly, is bereft of empathy. Let’s “Up” the dose to see if that helps.
…and round and round we go on the merry-go-round… that isn’t very merry at all.
I haven’t read Kramer’s offering, to be honest I don’t need to.
Kramer, it would appear, is your typical ‘head in the sand’ kind of professional. He’s right, we (the patient) are wrong. 10 years (or so) of medical school tells him this.
Kramer should be invited to list the “benefits” of antidepressant use, I mean, list them one by one?
Let’s make it easy for him and askhim for 5.
Dr Kramer’s stance on the benefit of antidepressants…
1.
2.
3.
4.
5.
Someone give him a nudge and tell him it’s okay to take your head out of the sand occasionally, you know, to answer your critics.
Five benefits of taking antidepressants please, Mr Kramer.
Over to you…
Andreas Lubitz
Winging-it
https://davidhealy.org/winging-it-antidepressants-and-plane-crashes/
“Rather than being effective like an antibiotic, these drugs have effects – as alcohol does. Their primary effect is to emotionally numb. Patients on them walk a tightrope as to whether this emotional effect is going to be beneficial or disastrous.”
http://www.airplanecrash-lawyer.com/Baum-Hedlund-Files-Germanwings-Crash-Lawsuit-for-Two-Americans-Killed.shtml
the firm has successfully recovered over $1.5 billion in wrongful death and personal injury claims stemming from commercial transportation accidents and defective pharmaceutical products *.
* I take a great interest in Aviation..
I mixed with International Airline Pilots for nigh on 30 years..
My father was an International Ambassador for the Auto-Pilot for Concorde and travelled the world on behalf of his company..
In all these 50 or so years, I never came across a ‘Depressed’ Pilot..
Hang-overs from stop-overs, quite common, as the two pilots arrested in Glasgow from Air Transat, reported drunk, can attest..
I get so easily heartbroken by posts like these, they are firm evidence,to me, that the road to recognition of SSRI’s true effects is a steady climb uphill. I lose my hope, get saddened (mostly because of my own predicament), and shrug my shoulders in hopelessness.
As long as there are professionals, doubling as authors, that write about how convinced they are about SSRI’s positive impact, we are hopelessly lost.
And even though DH does the same, he does it from a critical standpoint, and you will never get the same impact with critique than with praise.
The few glimpses of hope I see now are to try to find recognition among you “believers”, we who read posts here. That is not a good alternative to getting recognised by the world, or people who actually knew me when I wasn’t on the pill.
I loved the line in above post: “maybe they don’t feel better, they just feel less”! It incorporates not only the effect of the pills, but also how arbitrary the DR’s interpretation of his patient becomes. I firmly believe that most DR’s wants to do good, and so they also are prone to interpret their patients in a way that favours their intervention.
So if something backfires, if they have to interpret worsening of symptoms or bad behaviour, it becomes hard and very unlikely that they would suggest their own intervention as the cause.
Ove2017
In the opening words when reviewing Peter Kramer’s book, DH says PK values the antidepressants SSRIs, ‘and so do I’. In other references to the placebo effect of these drugs, Kramer refutes this effect, and so does DH, if I have read this right? And yet elsewhere I think DH has agreed that there is a placebo effect. I’m finding this quite confusing. Bob Fiddaman asks Kramer to list 5 reasons why SSRIs are a good thing. I’d like to understand how DH uses them for patients, and what it is about them that HE finds helpful, in what kinds of illness?
I was once offered antidepressants for neck pain following major surgery after a car crash which shattered/dislocated vertebrae and caused oedema of the spinal cord. I didn’t take up the offer, but what intrigues me is why they were offered? What could they have done to help my bones and muscles heal? Or were they offered to blunt my awareness during the healing period?
Mary writes very clearly on the emotional blunting issue. Bob says so rightly that if your mind is emotionally blunted, it isn’t going to get the best out of CBT. This all makes so much sense, it’s hard to see why it isn’t generally understood.
If someone is going through mental trauma, and needs something to help them ‘hold steady’ whilst they struggle to calm down their cortisol levels, surely diazepam, given low dose and for a carefully monitored and restricted length of time, is a safer option, so long as it’s made clearly understood by doctor and patient that within a certain number of weeks, they will work together to taper and stop it. By which time the patient needs to be helped to make a Plan about coping strategies with the traumatic problem, and move forward with support. Mary is so right about loneliness, we need people around us to help.
A BBC ‘Breakfast’ Report today talks about the ‘Men in Sheds’ project. Men get together to do D-I-Y in workshops, socialise whilst they work, and the result is that they do not need to resort to antidepressants because they are less lonely. Today there is a new idea being launched, for ‘Women in Sheds’ to start, so that ladies can also learn D-I-Y and become able to cope themselves with some household projects that their husbands did, or that they would have to pay someone to come in and deal with. It’s the bonding together though, which probably surely is of the greatest emotional value.
The TV series ‘PARANOIA’ was recommended on these Blogs some months back, and as I missed it when it was screened, I’ve now managed to buy and see it on DVD, as it’s just been released. It IS amazing and shows exactly what drugs can be doing to us. It describes AKATHISIA, first time ever in a film, I would guess. The best part though is seeing the CEO in Big Pharma and the conniving psychiatrist, get their just punishment in the end. But it also shows how difficult it is for us who suffer to get at the truth and finally win. Dangerous at times, as billions of profits for Big Pharma are at stake, and they may defend these, literally, to the death. If you haven’t seen this film, please do. It’s a bit long winded and meandering in part near the beginning but by Episode 6, 7 and 8, it’s well worth having stuck with it and completed the journey. Bill Gallaher who wrote it, must surely have been writing from experience, either his or someone else’s.
As far as I’m aware, David has always voiced an opinion that SSRI have their uses – for some patients. From my understanding of things, his stand has always been about the secrecy which surrounds them and their use – plus, as we now know, the blatant lies given out as facts by some companies.
My own feeling is that there just has to be some positives otherwise each and every user would have negative reactions and be on our side of the fence! I think it’s quite disgusting that SSRIs (or any other controversial medication for that matter) can be given out without GPs warning someone – not necessarily the patient – of the possible reactions. Just having a long list in the PIL leaflet is just not good enough. Another cause for concern is that a repeat prescription can be given for these medications. Repeats are obviously very handy for some cases and medications but, to my mind, mind-altering drugs need consistent weekly reviewing of the patient’s condition – mightn’t this lead to a reduction of the terrible loss of life that we presently see ?
I really feel that in our quest for happiness and satisfaction in our ‘modern-day’ lives, we have become so neglectful of ourselves. It seems that there is a cure for everything – therefore why bother to take care of our consumption levels, be it by mouth or through breathing in fumes etc.? At the first sign of problems, we are off to the doctor who is expected to provide us with ‘the cure’. In turn, the doctors too have an easier life if they DO provide us with a prescription for whatever it may be – and for whatever it may do to our systems by taking it – easier by far than supervising our symptoms in the first place and trying simple remedies or support systems in the first place. Strong
medications should be a last resort.
Men’s sheds are a great idea – the only problem is that, on the whole, it is the elderly that use them. The younger men are still left out in the cold!
As best I understand it, in any drug trial there are TWO factors at work in the Placebo Group:
One is the classic “placebo effect,” or the psychological tendency to start feeling better when a wise doctor gives you what appears to be a powerful medicine. The other is “nature taking its course” – the fact that at least some of the patients were bound to get better on their own. Both these factors affect the Treatment Group as well. So researchers can at least hope that any difference in outcome reflects the difference made by the drug. In SSRI trials, I think it’s usually around 10%: maybe 40% feel better on the placebo, and 50% feel better on the pill.
However, one thing that’s hard to spot in such a trial is the extent to which the drug is making some people worse. Especially in the case of a psych drug that can cause psychological distress (or a heart drug that can mess up your heart). You can’t assume that the SSRI is “helpful for 10% of patients, and has no effect on 90%.” In fact it could be that 50% feel better, 40% feel no different and 10% feel worse on the pill. The difference would still be “around 10%” and the tendency would be to lump the 10% harmed by the drug in with the 40% who were simply not helped. Especially when your definition of depression has gotten so loosey-goosey that any kind of mental distress can be labeled “depression.”
Often, critics of antidepressants will say they do nothing – they’re just like a big sugar pill. This ignores both the positive and negative effects of the drug. Some even write off the people who insist they feel worse as victims of a “nocebo effect” – the psychological tendency to start feeling bad when given a treatment that you know might have nasty side effects.
Well it’s all more complex than that I know, but anyway … it’s one thing to say SSRI’s are “not nearly as effective as they’re made out to be.” It’s something else entirely to say they are “just placebos.” That view is not only mistaken, but could be downright dangerous.
Mary, what could we offer young men to get together in a younger equivalent of the ‘Shed’ idea? Could your son suggest ideas? Something that would stimulate interest and at the same time offer a long term asset. Some IT projects maybe, like learning to do animation, photography, acting, and even using film as a way of getting the best out of self image? We hear that a high percentage of them are worried about their appearance. I’m not saying they should be worried like this, but if they really are, couldn’t their self confidence be given a boost by being able to talk these concerns out together – that way they’d find that lots of others feel just the way they do. (Have to declare an interest here, if they’ve got skin problems they might warn each other about the acne drug RoAccutane), They could advise each other on all kinds of stuff, like how to put oneself across well in job interviews, how to successfully captivate ladies with their own personalities. There could be networking about available jobs. Friendships could be made, which might be amongst a different set of contacts from those they normally chill out with. As my dear old dad used to say ‘you can never have too many friends!’ So much young men’s suicide is due to loneliness and feeling that no one feels as hopeless and helpless as you do. Once you start really talking, you find that everyone has these insecurities but they keep them locked away deep inside. And there’s nothing like helping others, to lift your mood and make you feel you are valued and have a purpose.
Picking up on another point Mary raises on 6th February, about how disgusting she feels it is for SSRIs or any other controversial medication to be given out by doctors without warning the patient – or family/ carers – of their possible reactions to the medication….
Well, yes, in an ideal world, this is culpable and should not happen. But say the patient is a young adult, and say they are literally ‘crawling up the wall’ with anxiety and pleading for respite from it? And even if they have it explained to them that an anti-psychotic like Olanzapine can change their physique radically, if they are at this point in a desperate hell of akathisic anxiety, how can we expect them to make a reasoned judgement? They are just trying to get through the next hour or two, holding their mind together, fending off uninvited inner terror. (This would also apply to ECT, or any other contaversial treatment). When you are really feeling ill, you can’t weigh up all the pros and cons, you just need relief, ‘as fast as possible please.’
And to take up Mary’s other point in answer to mine about Dr David Healy’s attitude to the efficacy of SSRIs in any scenario at all, yes, I can see that they must work for some folk, and he will know that from years of experience of prescribing them. But to cut down the risks of serious side effects, wouldn’t it be worth trying a placebo first whilst running a CYP450 test, and then if the placebo doesn’t produce the desired relief of symptoms, and if the CYP450s are all present and correct, THEN introduce the SSRI, just one, and monitor carefully like Mary suggests.
‘Horizon’ recently made a programme explaining how the placebo effect actually works, showing (in scans) the way the brain behaves when you take a placebo. Even in some cases, where the patient is told it IS a placebo, it STILL works, and they beg to be allowed to keep taking it. Possibly, apparently, because of the interaction between the patient and the doctor, getting attention etc, but more likely because there is something more subtly inexplicable at work. Fascinating. The painful symptoms, mental/ physical are reduced, BUT the nasty side effects do not manifest.
It must take skill to assess whether to tell a severely anxious patient you are offering a placebo – I’d assume to know that would make them even more anxious. I’d assume the priority is to get the cortisol levels, surging adrenaline etc, down for a start, so that they can think more clearly with less fear. However, surely the essential thing is to make sure they do not feel alone when they are feeling vulnerable, because that’s when suicides happen. With the shortage of doctors (or even without it), this is why communities need to start caring for each other, learning how ‘normal’ it is for ANYONE to buckle mentally under an overwhelming stress load, and to offer a helping hand and a listening ear. Like Mary says, we can’t expect doctors to sort our lives out for us, why should they have to, but we can reach out to each other and genuinely care. We can help to reduce stress for others by sharing experiences and thus take away fear of stigma. Much less need then for the doubtful prop of SSRIs?
Heather, your ideas of how to entice younger men to a ‘shed’ are all excellent, and should draw a crowd but, if our area is typical, this just does not happen. We are, of course, talking about young men, possibly with mental health problems or in recovery, possibly addicted to a variety of substances or, possibly in need of support to keep them on the right track. This must add up to a large number – but they seem to be a ‘hidden category’. Wherever you look, in our area anyway, you can see school age participants in a variety of clubs etc. You will also find the late middle-age and upwards quite well represented. I fear that there is a ‘lost generation’ – of men (and women to a lesser degree) who cannot see themselves as part of society. We live on the north wales coast – very close to one of the poorest towns in the country. This town has far more than its fair share of problems – resulting, regularly, in a variety of newspaper reports showing the results of lives lived in crisis. The need for support is obvious but the take-up is low. Where the answer lies, I do not know; it should certainly be in the hands of our communities and not in a prescription from our doctors! I can see that many are drawn to social media – could it be that we are seeing the pattern of the future – that the draw of being ‘invisible’ to some degree (if we can call it that when we see all the selfies on social media!) is the new communicating norm? This works very well in drawing in a wide circle of like-minded ‘friends’ – but when it comes to the crunch, nothing can beat face-to-face human contact can it?
Regarding the prescribing of strong drugs, the main problem is surely lack of communication. Not only doctor/patient due to lack of time and doctor/carer due to patient confidentiality but also, within the further support systems that may be involved. It seems unbelievable that the message ‘these drugs CAN and DO kill as well as cause a whole range of problems – albeit not in every patient’ is not accepted as a part of conversation wherever they are used. I appreciate, Heather, that an individual in crisis may well be unable to grasp what is being said to them – this, I feel, is where a practice nurse, rather than a doctor, could play an important part. Talking through their worries can support an individual in such a way that they may well be able to leave the surgery without the prescription that they felt a desperate need for when making an appointment. The offer of further appointments in this way could build up a picture of the individual and his circle of friends and family so that, if in future, the need for a strong medication is seen as the way forward there will be the knowledge available as to whether the patient will be supported when starting on the medication. Of course, financially, this is not a cheap way of going ahead – but neither is the ‘fast track to prescription’ without its costs – the highest cost of all being the loss of life caused by these medications.
The problem with SSRI’s is the paradigm itself. The premise of SSRI drug treatment hinges upon the idea that the SSRI drugs offer some kind of solution/relief to the experience/symptoms of depression, anxiety etc. However at the root of anxiety and depression is trauma. These drugs are not a solution to the many and varied traumas of humans, and of life itself. In many ways the ‘medcialization of human distress’ model does a great dis-service to people because it de-legitimizes trauma, and it focuses on the symptoms of the traumatized person, not the cause of the symptoms (trauma). This is the crux of the problem with the SSRI paradigm. If SSRI’s work, they work by anesthetizing the individual into am emotionally blunted/numbing state. This might be perceived as ‘useful’, in terms of ‘treatment’ but again it does nothing to address the trauma itself. Psychiatrists don’t seem to recognize trauma in their medicalization paradigm, they treat the symptoms of trauma like biological illnesses- as if these ‘illnesses’ are some kind of inherent defect in a faulty individual. The psychiatric drugs sedate, and alter the personalities, of the patient, they blunt the person into a more passive state. This is why the psychiatrists claim that the drugs work….
Mary and Truthman, you are both right of course.
Maybe the handle to find and grab hold of is that we all, however broken, have a small feeling inside ourselves of wanting to succeed, to be valued. People maybe turn to illegal drugs because their lives long since lost direction. To get that direction back, is the challenge.
Ove has stated on these Blogs that he feels very despondent about the way things are going. I’m feeling much the same way. Our son would have been 37 next week. The Friendship Room for the community we have built with the money he left will, we hope, be a place where we can offer something for someone, somehow, to do some good. The room is being opened for the first time on Olly’s birthday. But it won’t bring him back, and it won’t right the appalling wrongs that were done to him. I guess it might give me a reason to carry on, but I’m not holding my breath. If it offers even one person a feeling of being needed and a sense of hope and belonging, it will have been worth it, perhaps.
Maybe local GPs will hear of any success we have and pass the word. Or maybe not. Maybe we can aim to help young children to build their own resilience so that the hard knocks of life don’t wipe out their dreams so easily when they leave school. Who knows?
Congratulations Heather on being ready to open your Friendship Room. Best wishes with your opening on your son’s birthday – how very fitting that you’re able to do so on this special day. Things will obviously be bittersweet for you – I admire your tenacity – now that the need to support Olly is over you are prepared to put all your efforts into the support of others. I sincerely hope that the community rise to the occasion and support you in ways that you have not yet even dreamt of. I’m sure there will be coverage on Olly’s page – I shall certainly take a look there.
I think you may be onto something when you say that ‘maybe you can aim to help children….’. Starting with the young ones could well be the best way forward. The expectations of schools these days overwhelms many members of staff – the need for ‘Circle Time’ work ( interaction of care and forgiving etc.) is as great as it ever was but time for such an activity seems to be disappearing. Time to deal with any ‘spur of the moment’ topic, whether as a class or whole school has been taken away from the curriculum. In fact, time to treat children as individuals no longer exists – at best they are ‘groups’, at worst ‘classes’. Those who are able, grasp what’s going on – those who need more time to understand get left behind. Lessons are geared for the ‘cream of the crop’, leaving very many feeling that they are failures. Your work will be a welcome relief for these ‘average’ children who fail to flourish. A feeling of failure at such a young age cannot be healthy. Your alternative, strengthening interaction will, I’m sure, be a welcome change for them. The very best of luck with this venture!
Thank you Mary. You are right – it is bittersweet. It’s taken two years to complete this project. It had to be a converted part of a small church, (central to our tiny village) which itself was in such bad repair that it was threatened with closure, so first we had to get all the church structure mended, and then, once it was all stable and safe, divide off the easy-to-heat Room, with loo, kitchen facilities, insulation etc. The little church has been brought back to sparkling life, polished till it shines, glowing with a welcoming energy.
It has given us something to focus on. But, like you said, it may be that what we offer as a community, is not really going to make much difference. We may not attract those who we’d most like to help. We’ll be offering Mindfulness and Relaxation sessions, creative arts, film clubs with discussions about favourite movies, and us oldie locals will do the equivalent of ‘show and tell’ about hobbies and skills we’ve become passionate about, in case others would like to join us. In addition, we’ll be talking about all we’ve learnt since we found RxISK.org, and how we can spread this knowledge so everyone can be well informed and look out for their own health.
In a funny sort of way though, having achieved the aim of the constructed building, we seem to have hit a personal low, a kind of anticlimax. We would really like to set up a training programme at home now, in the building Olly had been about to convert just before he died. He’d gone through all the Planning process, paid the architect, and his wish was to offer a facility for arts training for people, as well as using it for children’s activities. Maybe there will be a way to finish this too and offer a safe haven and distraction for anyone suffering anxiety and finding the world unaccepting, as he did. I think there is a need for places like this, open every day, staffed by trained volunteers, for people to come and feel safe whilst they take some time out from stresses and worries and enjoy being creative. The Room in the church will pull the community together, (and we know that not everyone is comfortable with coming into a church when feeling anxious) whilst the training Centre would be more for enhancing skills and preparing for new ways of managing the ups and downs of life. But even writing this down as an idea sounds somewhat high flown and maybe ridiculous. But the two could interact, and feed from each other. The NHS is shutting down facilities like this almost daily and leaving people alone at home to cope with their anxiety. That did not work for Olly. Medication-induced akathisia, and being left alone to manage it, was a prescription for hopelessness and ultimately death. It seems so obvious, but it goes on and on. We would love to be able to change this in our small way….
I think your chances of success in a rural village are far higher than in a town actually. If nothing else, curiosity is stronger in our rural villages I feel!
With such schemes as Sure Start disappearing, I’m sure that young families will welcome your ‘sanctuary’. As for people’s views of a ‘church’ these days, we find that they are quite willing to come along for ‘messy church’, ‘mums and tots’,
art club, scouts etc. – as long as you don’t expect to seat them in the pews on a Sunday!
Mary, thanks for this glimmer of hope….. I think I am just blindly stumbling along, holding onto the one thing I know, which is that, had Olly’s treatment and our alarm-raising been effective, he would doubtless be alive and coping now. There are however always many elements which contribute to driving someone to suicide. It’s never just one thing. So I need to tackle all these with the aim of making a difference, if I am qualified as a human being, and a grieving mother, to do so.
Olly’s List: what he tried to understand, adapt to, and cope emotionally and physically with.
1. From birth, living with an unpredictably emotionally confusing older brother, due to maybe a form of brother’s difficult birth and ADHD, lying, lack of maturity, which led to wider family disapproval ( grandparents’ displeasure), so Olly’s parents manage alone, somewhat isolated, as best they can, no recognition of dyslexia etc schooling for elder brother full of problems, leading to sense of frustration and further unacceptable behaviour from elder brother. Olly scared, watching parents struggling unsuccessfully to cope. Olly assumes role of helper, has to become old before his time, always adjusting to brother’s constant demands for attention and support.
2. Olly bullied at school because of acne. No peace anywhere, self esteem about appearance undermined. even so,stilll driven on by hope, uses intelligence, acheives qualifications with long term plan to succeed and empower himself, escape into life he chooses. Tried to radiate humour and constructiveness at all times, against all odds.
3. All going well at Uni till prescribed RoAccutane for acne, then additionally Seroxat SSRI for low mood caused by drug. Dreadful mental side effects ensue. No one seems to understand what akathisia is. Then long mental struggle, Olly trying to fathom whether his lost mind is due to some awful fault of his own. Hope never resurfaces for long. Feels confused but goes on building the business of his dreams. Achieves it. But never really well enough to enjoy his hard won success.
4. Eventually side effects from cocktail of prescribed psychotropic meds, kill him. Suicidal urge too strong to overcome, total loss of ability to think. Psychiatrist seems madder than he feels himself to be. No good wise shepherd available to follow, as trusting sheep. No hope left, no point to life. Sees only remaining usefulness as protecting the loving parents who are giving their all to help him, but being admonished by the powers that be for even daring to do so. So, by dying, gives them peace, or so it seems logically to him.
What could have saved Olly’s life:-
Understanding, time for discussion about fears and problems, sharing ideas with peers,so evaporating his confusion. Seeing his parents supported by the medics and wider family, not harangued by medics in NHS for questioning drug side effects which were obviously akathisa. Olly finally died because he truly believed himself to be alone and at fault. Neither of these things were the case. In a word, he was overcome by a terrible form of loneliness and loss of hope. If we can understand this, we can try to identify it in others like him, before they go the same way.
I make no apology for setting out our thoughts like this. Somewhere, somehow, we have to get people to LISTEN UP. But I don ‘t know how, and like Mary wisely points out, it’s a very difficult crusade we are all on. And maybe like another commentator recently said on these Blogs, we are all going to hell in a handcart, so why fight on?
Heather, we MUST fight on – in the name of Olly, Shane, Anne-Marie or any of the others who were so cruelly let-down. If we don’t, then their suffering will have been in vain. We CANNOT let that happen. They have (or did have) very little energy to keep the fight going therefore, as I see it, it has become our duty to carry on in the hope of a recognition of the fight to which they are giving (or gave) their all. If we give up, what hope is left for them? They have been let down, over and over again, and see us as one of the few hopes left. Another of their rocks, of course, is David. He is Shane’s hero – no-one on this earth comes close in his estimation! I know that David is not a person who sees himself as anyone’s ‘hero’ ( this sentence probably will not appear in the comment due to this!) BUT, in his darkest hour, Shane was assessed, in prison, by David, who was able to tell him that the changes in him had indeed been due to Seroxat. That truth sustained him – and continues to do so today, as it will also to the future. It is because of David’s saving ‘truth’ that we fight on, not only for Shane, but for ALL who have suffered – in the hope of putting an end to this suffering.
To make sense of our reasons for being here, and thus to fuel up my courage for ‘fighting on’, I personally have to find a deeper purpose to all that has happened. I need to see a spiritual purpose behind all that happens. And yet I know that this lays me open to ridicule from the scientific Pharma camp, and in order to win our fight for recognition and justice for Shane, Olly, Anne-Marie and all the thousands and thousands like them, I must appear to be credible.
You mentioned Mary on this Blog a few days ago that it is good we’ve managed to complete the Olly’s Friendship Room ready for its opening, (along with the now renovated church inside which it is located), and yes, we hope soon to show pictures of the event, (held on what would have been Olly’s 37th birthday -18th February) on the Olly’s Friendship Foundation facebook page. I’m also thinking of writing out the speech Olly’s dad and I gave to the 70 or so people who came for the dedication ceremony. I’d prepared something the day before, and I was so glad I did. I wanted to seize the chance of telling a captive audience about RxISK.org, AKATHISIA, and explain what happened to Olly, and why he died.
Olly did not have a hero like Dr David Healy to stand beside him in his hour of need. But our local young vicar did talk to him in 2002 when RoAccutane-isotretinoin and Seroxat SSRI in combination had triggered a mini-psychosis, and Olly became confused about his own life. Annette Fea, a NZ psychologist who has worked with hundreds of those affected badly mentally by Isotretinoin, makes the interesting observation that many of them manifest strange ideas about needing to die because they suddenly become convinced that they are needed in Heaven by God to do important work there, or even that they are actually Jesus Christ. These are hallucinations, vividly seen, triggered by whatever the isotretinoin is doing to the brain. Psychosis caused by an overdose of Vitamin A which has crossed the blood/brain barrier because they have not been able to metabolise and get rid of it, ?via the liver.
The vicar who had spoken with Olly when in this state of mind, in 2002/3, made reference to these conversations when he too said a few words at the Opening Ceremony on Saturday. Although well meant, it was obvious that this man had had NO concept of what Olly had really been going through at that time (and intermittently for 11 more years) and how much the medication-induced AKATHISIA had made our son appear lost and questioning his purpose in life. Even though we had given this vicar written evidence of the results of our recent AKATHISIA research, much of it gleaned from RxISK.org, in the hope to enlighten him,
it was obviously not enough to show him that the confused Olly he counselled about life and his thoughts of having ‘messed up’ (as the vicar rather oddly put it) back in 2002/3 was not the ‘real’ Olly, but a young man whose mind had been completely hijacked by unwisely prescribed medication and was behaving totally out of character. Olly had never been particularly religious, he trooped along to church with us sometimes all through his childhood and he believed in a benevolent Universe/God, in an understated comfortable easy-going way. But we have a suicide farewell letter written in 2002 in which he says we mustn’t be upset that he has gone on ahead because he is needed in Heaven to do important work there. We didn’t find this till after he died. He wrote another letter just before he left in 2012 but this one is totally logical, loving, and speaks of the terrifying voids in his thinking which Olanzapine and Sertraline seems to be causing, which is not easing as he tries to withdraw from their use, so he fears he is going permanently mad and fears for a terrible future, unable to run his business any more and feeling he is a burden to others, including us. . So you can see there is a different mechanism working in the brain from the ‘religious’ element RoAccutane-isotretinoin triggers, and this is also seen in data Annette Fea has amassed about those affected by ROCHE’s antimalerial drug Lariam- mefloquine.
My point is that it is incredibly difficult to erase the impression of ‘craziness’ that AKATHISIA causes, in the minds of society. So in my ten minute speech to the visitors on Saturday, many of them from official Funding Organisations, as well as many of the local community, I tried to put this straight, for the sake of raising their awareness to save others from suffering as Olly did, and to get his reputation back. Because these drugs, even if they don’t kill you, take your life away in so many other ways. You are misjudged, your cognitive and creative abilities are reduced or eradicated, your life’s work ruined. And people remember the dramatic AKATHASIC behaviour, not the happy normal reasonable person you always were pre-medication. The ‘truth’ that Dr David Healy shared with Shane about Setoxat’s effects, was the truth Olly so needed to hear from someone with good sense. But no one else around him in 2003 would credit it, even though BBC’s Panorama and the Daily Mail were reporting it, and even MIND, behind the scenes, had been officially aware of it. ‘Telling people something” is not the same as getting them to accept it as truth and acting accordingly and responsibly.
So, maybe Mary, we have been put here and gone through all this, for the purpose of making a difference. And so, yes, you are right, we MUST fight on. I’m so glad Shane had Dr David Healy to turn to in his hour of need. I only wish Olly had been as lucky. But through what happened to Olly, WE have learnt so much. Tired and broken as we are, somehow we must carry on.
I just wish Big Pharma had the sense of honour and responsibility to make funds available, not to necessarily ‘compensate” as nothing can quantify what’s been lost, but to enable us all to DO something, particularly in the memory of those who have died, to aid the recovery of the still-living damaged ones, and thus give us a purpose to carry on. Big Pharma cannot hide away in denial of their crimes forever. If they came to terms with this, put their hands up to the damage they’ve caused and genuinely attempted reparation with all of us, listening to our ideas on how to do it, the world could be a much safer place for everyone. Then maybe some of the hate they’ve attracted could be dissipated (it can’t be doing them much good) and their ways of working could change, to benefit us all by producing safe medicines and affordable effective treatments, not driven by profit, cover ups, lies, fudged trials etc, but by honourable, dare it say, ‘spiritually inspired’ brilliance in what they produce, and the inevitable universal acclaim for it.
While emotional blunting with SSRI’s does occur, often a patient will get it with one of them as a side effect but not with another. If a patient gets ANY problematic side effect with one – such as agitation or akisthesia that is likely the cause of any suicidal ideation – you can switch them to another one. This of course requires close follow up, which is rapidly disappearing in the practices of American psychiatrists.
Anyone out there tried giving Kegel exercises to men and women with SSRI-induced sexual dysfunction? About half of the patients I suggested it to report that it helps, although I have no idea how often or regularly they are doing the exercise. I’m surprised no one has done a study on that.
I agree that they haven’t been shown to work in “depressed” adolescents, but that is because most adolescents do NOT meet the actual DSM criteria for major depression (as is the case with many adults as well), and the drugs are completely useless for chronic unhappiness due to stress, trauma, family chaos, chronic invalidation and a host of other environmental factors that are not even asked asked about by a lot of clinicians.
However, if an adolescent has clear-cut and significant OCD, the drugs work quite well. Again, if they get agitated with one, they can be switched to another.