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Right & Left Brain
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Psychiatry versus Biology
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Is Stress Real?
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Antidepressant drugs have become a big business, the promotion of depression as an illness, treatable with drugs has become a scandalous enterprise with little merit. Antidepressants were a hard sell until recently. Although many drugs in this class modified the behavior of patients, their slow action and many side effects were negative features.
The introduction of a “new class” of antidepressants that increase serotonin activity, led by Prozac changed the market for psychotropic drugs. The effects of Prozac on “personality” were widely publicized and drug companies advertise indirectly and, more recently directly to the consumer, relegating physicians to the role of middleman. The patient now demands the prescription and the doctor complies. The consumer hopes that Prozac and related drugs can increase energy, confidence and assertiveness. “Shy” people were added to list of potential customers. Although writers such as psychiatrist Peter Kramer (Listening to Prozac) suggested that the patient's interest in personality changing drugs was a new market force, nothing new really happened; it is the same old interest in psychotropic drugs but the names, the players and the prices changed. Cocaine outsells Prozac, but the profitability of prescription antidepressant drugs is outstanding. In Canada, three similar antidepressants were among the top-selling drugs; these are Prozac, Paxil, and Zoloft..
Lauren Slater call Prozac the "Big Mac of Medicine" because of its popularity and the faddish consumer appeal based on the futile hope that a drug could resolve human suffering. She described the dramatic and brief benefits of taking Prozac: "those first few mornings were fairy tales, tall tales, replete with all the bent beauty of a New World." Her story is not simple, however and the long-term effects of taking the drug are mixture of benefits and negative effects. The initial recovery from depression is not sustained and a three or four phase sequence can often be discerned, beginning with an initial improvement that occurs in the first 2 to 4 weeks. The statement “the first time was the best time" applies to most, if not to all psychotropic drugs.
In Slater's experience, Prozac removed her sexual drive, blunted her creativity and reduced her appetite. The underlying problems are many and begin with the lack of specificity of the drug. Prozac blocks Serotonin re-uptake and in stage 1 of its activity, probably increases serotonin receptor activity in all areas of the brain. Serotonin synapses are not all conveniently arranged just to alleviate depression and a whole complex of unrelated functions are affected. The brain is not passive and changes to offset or accommodate the drug activity; the effects then shift to an adapted state, different from the initial drug-dependent state. The person taking the drug has also shifted in terms of behavior and learning and may be learning new skills and, at the same time, coping with new problems such increased anger, loss of libido and blunted feelings.
Goodman, Chair of the US Food and Drug Administration (FDA) Psychopharmacologic Drugs Advisory Committee made a public statement in 2006 that claims in drug monographs and advertising that selective serotonin reuptake inhibitor (SSRI) antidepressants work by normalizing serotonin levels are not based on scientific evidence and should be prohibited. Moynihan and Cassels described the drug industry's marketing tactics. "With obscene profits from drug sales; a drug company can afford to control the naming and perception of diseases by physicians, government, and consumers. They create drug demand by advertising to consumers and doctors at the same time. For example, Cohn & Wolfe Healthcare, SmithKline's PR firm created “social phobia disorder” treatable with Paxil, which became the world's best-selling antidepressant, earning US$3 billion annually."
Antidepressants are chemicals that are added to a dysfunctional chemical mix that caused dysfunction and dysphoria in the first place. Few patients make any effort to alter their disease-causing lifestyle and few physicians make any effort to investigate and improve the patient’s chemistry overall. Prozac is added, mindlessly to the dysfunctional chemical mix and its effects merge with other drugs, coffee, alcohol, the chemistry of food and contaminants, sugars, food allergy and airborne neurotoxins that act on the brain.
New problems added by the prescription chemical may suddenly emerge such as unexpected bursts of anger and aggression or increased tendency to have violent suicidal thoughts. One young woman reported to me that after taking Prozac for two weeks, she had threatened her live-in boyfriend with hammer, chased him into the bathroom and attacked the closed door, smashing holes in the door until she more or less recovered composure. Her boyfriend fled the apartment and never returned. The boyfriend was domineering and verbally abusive, as boyfriends sometimes are, but the pre-Prozac young woman was compliant and never had a violent temper. Her Prozac rage is an example of chemically triggered behavior.
Prozac may provoke agitated preoccupation with suicide or violence directed against others. The drug facilitates the rage response, as do most of the drugs that suppress appetite. Up to 73% of patients taking antidepressant report sexual dysfunction, such as diminished sexual desire, delayed sexual arousal, and muted or absent orgasm.
Fisher suggests that these drugs blunt emotions and interfere with forming and maintaining meaningful relationships. When men and women take serotonin-enhancing drugs and fail to achieve orgasm, an important feature of pair bonding fails. You would not be surprised to learn that a woman taking Prozac decided to divorce her husband, stating that she no longer loved him. After she stopped the drug, she loved him again and stayed married.
Colin Meek. SSRI ads questioned. CMAJ • March 14, 2006; 174 (6)
Ray Moynihan and Alan Cassels. Selling sickness: How the world's biggest pharmaceutical companies are turning us all into patients: Greystone Books, 2006 Toronto; ISBN 1-55365-131-6
Fisher, H.E. Do Sexual Side Effects of Most Antidepressants Jeopardize Romantic Love and Marriage? Sex, Sexuality, and Serotonin" symposium.
Many of the symptoms included under the title of “depression” are typical of common food-related diseases including diabetes, atherosclerosis, malnutrition, hormonal dysfunction and delayed pattern food allergy. All these problems require diet revision. We suggest that a prudent person suffering depression and body symptoms would be wise to pursue vigorous, thorough diet revision at the earliest opportunity. Because some brain dysfunction compromises judgment learning and motivation, family members, friends and professional advisors often have to provide the right direction and support.
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