17.3 million American adults (7.1% of the adult U.S. population) and 3.2 million adolescents (13.3% of U.S. population aged 12 to 17) suffered at least one major depressive episode in 2017. Antidepressant drugs, the most widely used therapy for depression, are also among the least effective, and often make the situation worse, especially in the long term. Studies have repeatedly shown antidepressants work no better than placebo for mild to moderate depression. A 2017 systematic review of 131 placebo-controlled studies found that “all trials were at high risk of bias” and that clinical significance was questionable. Antidepressants are neurotoxic and possible side effects include worsening depression, self-harm, violence and suicide, increased risk for diabetes, heart disease, heart attack, stroke and dementia, and depletion of various nutrients (depending on the type of drug you take).
Depression can interfere with personal and work relationships, reduce work or academic performance and affect physical health by impairing your ability to properly care for yourself and make good health decisions, including decisions about nutrition and sleep. Imbalances in nutrition, weight fluctuations and poor sleep habits may in turn compromise your immune function.2
The condition can also be lethal, as depression is a contributing factor in up to 70 percent of all suicides.3 In 2016, 44,965 Americans committed suicide.4 Depression can also lead to self-harming behaviors such as drug or alcohol abuse,5 and 90 percent of people who struggle with suicidal thoughts experience a combination of depression and substance abuse.6
Unfortunately, antidepressant drugs — the most widely used therapy for depression — are also among the least effective. In fact, statistics suggest that far from being helpful, psychiatric drugs are making the situation worse.
According to research7,8 published in February 2017, 16.7 percent of the 242 million U.S. adults (aged 18 to 85) included in the survey reported filling at least one prescription for a psychiatric drug in 2013.
Twelve percent reported using an antidepressant; 8.3 percent used anxiolytics, sedatives and hypnotics; and 1.6 percent used antipsychotics. With nearly 17 percent of the adult population in the U.S. taking psychiatric drugs, it would be prudent to evaluate the larger ramifications of these types of medications. Sadly, statistics overwhelmingly fail to support their use, yet they continue to be the leading form of treatment.
In a March 2019 segment of Full Measure (above), award-winning investigative journalist Sharyl Attkisson interviewed psychiatrist and director of the International Center for Patient-Oriented Psychiatry, Dr. Peter Breggin. He is known to many as “the conscience of psychiatry,” as he was instrumental in preventing the return of lobotomy as a psychiatric treatment in the early 1970s.
Breggin is also the author of “Medication Madness,” in which he details the many hazards of psychiatric drugs. In his 50 years of practice, he has never placed a patient on drugs. In fact, he specializes in getting people off them, and wrote a book on psychiatric drug withdrawal, “Psychiatric Drug Withdrawal: A Guide for Prescribers, Therapists, Patients and Their Families.”9
When asked what he thinks people don’t know about psychiatric treatment, and ought to, Breggin responds, “They don’t know that all psychiatric drugs are neurotoxins. They don’t know that they aren’t correcting biochemical imbalances, they are causing biochemical imbalances.”
Prozac was the first selective serotonin reuptake inhibitor (SSRI), approved by the U.S. Food and Drug Administration (FDA) in 1987.10 Over the years, Prozac became the target of a number of lawsuits, as patients suffered all sorts of ill effects, from birth defects to suicide and serotonin syndrome, a condition caused by excess serotonin in the brain, leading to agitation, confusion, high blood pressure and more.11
Already by 1996, 35,000 complaints about the drug had been lodged with the FDA.12 In the early 1990s, Breggin was appointed by a federal court as the medical and scientific expert for the plaintiffs in all combined lawsuits facing Eli Lilly with regard to Prozac, a role that gave him access to corporate records.13 Breggin tells Attkisson:14
“Prozac … had amphetamine affects. The chief investigators said and wrote, ‘this drug has amphetamine like effects. We need to put this into the label. It can make depression worse, can make people agitated, make them angry, might increase the suicide rate,’ but the FDA wouldn’t allow onto the label what it’s chief investigator into adverse effects was telling them.
So, from the beginning, it was all a house of cards. And, as for it’s being useful, I looked it over, carefully analyzed the statistics and said the drug actually doesn’t work. It’s about as good as placebo.
Now, placebo will help anywhere between 40 and 80 percent of people, so it’s a huge effect and that especially with depression, because depression is not about a biochemical imbalance. It’s about hopelessness. Depression is part of the human experience.”
In Breggin’s view, “There is no promising medical treatment and probably there never can be,” for the simple reason that depression is primarily rooted in the complexity of human emotions and experiences. He believes one needs to avoid numbing and escapist behaviors such as drug and alcohol use, and implement strategies to support healthy brain function instead, in order to “be able to deal with your issues.”
In 2010, Dr. Mercola interviewed medical journalist and Pulitzer Prize nominee Robert Whitaker about the use of psychiatric drugs, as he has written two books on this topic. I’ve included that interview again for your convenience. In it, Whitaker details the science showing antidepressants don’t work — and what actually does.
The available science has also brought Jacob Stegenga, a philosophy of science lecturer at the University of Cambridge and author of “Medical Nihilism,” to the same conclusion. In a recent essay, he notes:15
“Diving into the details of how antidepressant data are generated, analyzed and reported tells us that these drugs are barely effective, if at all … The best evidence about the effectiveness of antidepressants comes from randomized trials and meta-analyses of these trials.
The vast majority of these studies are funded and controlled by the manufacturers of antidepressants, which is an obvious conflict of interest. These trials often last only weeks — far less than the duration that most people are on antidepressants.
The subjects in these trials are selected carefully, typically excluding patients who are elderly, who have other diseases, or who are on several other drugs — in other words, the very kinds of people who are often prescribed antidepressants — which means that extrapolating the evidence from these trials to real patients is unreliable.
To give one prominent example, in 2012 the U.K. pharmaceutical company GlaxoSmithKline pleaded guilty to criminal charges for promoting the use of its antidepressant Paxil in children (there was no evidence that it was effective in children), and for misreporting trial data … When analyzed properly, the best evidence indicates that antidepressants are not clinically beneficial.
What Does the ‘Best Evidence’ Say About Antidepressants?
According to a 2022 British study by the University College London, depression is not a chemical imbalance in the brain. While all prescribed medications act by maintaining serotonin levels, the study suggests low serotonin levels do not cause depression. Instead, the study suggests depression may be more strongly correlated with adverse life events, which lower mood. Since the 1990s, antidepressant use has grown alongside the theory that drugs establish correct levels of chemicals in the brain. However, researchers say that is unfounded.1
“I think we can safely say that after a vast amount of research conducted over several decades, there is no convincing evidence that depression is caused by serotonin abnormalities, particularly by lower levels or reduced activity of serotonin,” said Joanna Moncrieff, a professor of psychiatry at UCL who authored the study.
“Many people take antidepressants because they have been led to believe their depression has a biochemical cause, but this research suggests this belief is not grounded in evidence,” she noted. “The popularity of the ‘chemical imbalance theory of depression has coincided with a huge increase in the use of antidepressants,” she continued.
Moncrieff also pointed out that “thousands of people suffer from side-effects of antidepressants, including the severe withdrawal effects that can occur when people try to stop them, yet prescription rates continue to rise.”
“We believe this situation has been driven partly by the false belief that depression is due to a chemical imbalance.”
Moncreiff then said, “It is high time to inform the public that this belief is not grounded in science.”
Researchers in the report reviewed studies regarding serotonin and depression and found no difference in levels between thousands of people diagnosed with the condition and healthy control participants. They also looked at studies where serotonin levels were artificially lowered in hundreds of people by depriving their diets of the amino acid required to make serotonin. The study surprisingly found that it did not make them depressed.
The researchers say that patients should not be told a chemical imbalance causes depression. They also noted that patients should not be informed that SSRIs can correct the problem. However, antidepressants can work but must do so through a different route. It is worth noting that experts have warned people against stopping their medication. (TGP)
While some psychiatric drugs may be helpful for a small minority of people with very severe mental health problems, such as schizophrenia, it’s quite clear that a vast majority of people using these drugs do not suffer from the type of psychiatric illnesses that might warrant their prudent use.
Most are struggling with sadness, grief, anxiety, “the blues” and depression, which are in many ways part of your body’s communication system, revealing nutritional or sunlight deficiencies and/or spiritual disconnect, for example.
The underlying reasons for these kinds of troubles are manifold, but you can be sure that, whatever the cause, an antidepressant will not correct it. In fact, as noted by Breggin, studies16,17,18 have repeatedly shown antidepressants work no better than placebo for mild to moderate depression.
Irving Kirsch, associate director of the Program in Placebo Studies at Harvard Medical School, has conducted several meta-analyses of antidepressants in comparison to placebo, concluding there’s virtually no difference in their effectiveness. According to Kirsch, “The difference is so small, it’s not of any clinical importance.”19 For example:
|In a 1998 meta-analysis20 that looked at 19 double-blind studies, Kirsch and colleagues noted that:
|Research published in 2008 found major discrepancies between published and unpublished research makes antidepressants appear far more beneficial and effective than the sum total of the research actually reveals them to be. Of 74 FDA-registered studies, 31 percent were never published.
As noted by the authors, “According to the published literature, it appeared that 94 percent of the trials conducted were positive. By contrast, the FDA analysis showed that 51 percent were positive … Selective reporting of clinical trial results may have adverse consequences for researchers, study participants, health care professionals and patients.”
|A 2010 meta-analysis21 concluded that “The magnitude of benefit of antidepressant medication compared with placebo increases with severity of depression symptoms and may be minimal or nonexistent, on average, in patients with mild or moderate symptoms.”|
|In a 2011 paper,22 Kirsch notes that six-week trials have a higher success rate than eight-week trials — 55 versus 42 percent — which suggests long-term use of antidepressants is likely ineffective.|
|In a 2014 paper,23 Kirsch notes that “analyses of the published data and the unpublished data that were hidden by drug companies reveals that most (if not all) of the benefits are due to the placebo effect.” In this paper, he notes that two of his earlier meta-analyses24,25 actually revealed that when both published and unpublished trials were included, the placebo response accounted for a whopping 82 percent of the beneficial response to antidepressants.
A major benefit of evaluating FDA trial data was that all of the trials used the same primary measure of depression, which made the drug-to-placebo effects very easy to identify and compare. The primary measure of depression used in these studies was the Hamilton depression scale, a 17-item scale with a possible score of 0 to 53 points.
The higher your score, the more severe your depression. Importantly, the mean difference between antidepressants and placebo was less than 2 points (1.8) on this scale. To illustrate just how insignificant of a difference this is, you can score a 6-point difference simply by changing sleep patterns without any reported change in other depressive symptoms.
Simply fidgeting less results in a 4-point decrease in your depression score, so as noted by Stegenga in his essay,26 “a drug that simply made people sleep better and fidget less could lower one’s depression score by 10 points.”
What’s more, clinical guidelines in the U.K. require antidepressants to lower depression scores by a mere 3 points, 27 and this too reveals why and how the benefits of antidepressants have been overestimated and oversold.
|Most recently, a 2017 systematic review with meta-analysis and trial sequential analysis of 131 placebo-controlled studies found that “all trials were at high risk of bias and the clinical significance seems questionable. SSRIs significantly increase the risk of both serious and non-serious adverse events. The potential small beneficial effects seem to be outweighed by harmful effects.”
None of the trials, even when reporting a positive result, met the threshold for clinical significance of 3 points on the depression score.
Long-Term, Antidepressant Users Fare Much Worse
What’s more, research has shown that patients who do not take antidepressants fare better in the long term compared to those taking drugs,28 and research29 comparing exercise and drug treatment for depression suggests those not taking drugs have a lower risk of relapse. This risk is also addressed in Kirsch’s 2014 paper30 on antidepressants and the placebo effect.
“The serotonin theory is as close as any theory in the history of science to having been proved wrong. Instead of curing depression, popular antidepressants may induce a biological vulnerability making people more likely to become depressed in the future,” Kirsch writes.
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