Bottom Line Health
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| And self-help strategies, such as exercise, diet and natural remedies, don't help
"Antidepressants now carry a warning label because research shows increased suicidal thoughts (not actual suicides) in children and adolescents who are taking these drugs. When taking an antidepressant, call your doctor if you experience agitation, physical restlessness or have suicidal thoughts. everyone. For many people who are depressed, medication offers the best hope for relief.
New: Drugs that relieve depression but do not cause intolerable side effects are now available.
DO YOU NEED AN ANTIDEPRESSANT? |
| In October 2004, the FDA directed manufacturers of SSRIs, which include (citalopram) Celexa, (paroxetine) Paxil, (fluoxetine) Prozac and Zoloft, to put a special "black-box" warning on the drugs' labels to alert health-care providers of an increased risk of suicidal thoughts and behaviors in children and teens who are using the medications.
In July 2005, the FDA issued a public health advisory saying that this same risk may also apply to adults taking SSRIs, after several studies pointed to that possibility.
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Gerald E. Markle and Frances B. McCrea
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 One more point: TADS reported suicidal thoughts in 7% who took Prozac compared with 4% in the placebo group.
The authors concluded (perhaps a bit defensively) that: "despite calls to restrict access to medications, medical management of [major depression] with Prozac, including careful monitoring for adverse events, should be made widely available, not discouraged.38 This conclusion received a cautious endorsement—"as is usually the case with good research, the study provides not only important answers, but also raises several important questions"—from a JAMA editorial in the same issue. |
Craig Pepin-Donat
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 We take them to the doctor and put them on drugs proven to cause suicidal thoughts and behavior. This is lunacy.
A Healthy and Fit Government does the government tax health club memberships? When you pay taxes on a fitness membership you are paying the government to improve youo health. Joining a quality fitness center is a proactive, preventive way to increase your vitality, health and well-being. Since most quality clubs offer weight management programs they are a good first line of defense in the quest for optimal health. Diets alone do not work! They never have, and they never will. |
| According to MedWatch, a large study, combined with the results of 24 different smaller studies, suggested an increased risk of suicidal thoughts and behavior in users, especially at the beginning of treatment or when dosages were changed. According to the drug companies, there were no suicides in any of their drug trials. On closer examination of the initial reports, it was unclear whether the behaviors reported in these studies represented actual suicide attempts or other self-injurious behaviors that were not suicide-related. |
Bottom Line Health
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| Though much of the previous research had focused on users' suicidal thoughts and actions, this study "focused on things that are at the far more severe end of the spectrum— kids coming into the emergency room following suicide attempts and those who actually die," says Dr. Mark Olfson, lead author of the study and a professor of clinical psychiatry at the New York State Psychiatric Institute at Columbia University Medical Center in New York City. "These are things that are many, many times less common, thankfully, than the sorts of things that have been studied. |
| When taking an antidepressant, call your doctor if you experience agitation, physical restlessness or have suicidal thoughts. everyone. For many people who are depressed, medication offers the best hope for relief.
New: Drugs that relieve depression but do not cause intolerable side effects are now available.
DO YOU NEED AN ANTIDEPRESSANT?
Depression affects both the mind and the body. Emotionally, you feel sad or "numb" much of the time. You may no longer enjoy things that once pleased you (including hobbies, seeing friends and shopping).. you feel unmotivated. . . |
Jack Challem
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 Occasionally, taking these drugs will lead to an increase in suicidal thoughts and behavior.
St. John's wort is widely used to treat depression in Europe, where herbs have been used medicinally for at least two thousand years, but the U.S. pharmaceutical industry has convinced most American physicians that its higher-priced drugs are superior. The herb can also help to alleviate symptoms of premenstrual syndrome, including anxiety, depression, nervous tension, confusion, and crying.
Dosage: The chemical constituents of St. |
Steven V. Joyal
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 Guilt: believing you "just can't do anything right" or that you are a burden to others
?Suicidal thoughts or attempts
Cognitive-behavioral therapy is based on the idea that your thoughts—and not external factors such as people or events?drive your behaviors and feelings. Therefore, you can change the way you think so that you will feel and behave better. |
Bottom Line Health
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| IMPLICATIONS
It is likely that the differences in suicidal thoughts and behaviors among children were, in fact, due to the drugs they were taking, Olfson surmises.
"In order to be due to the depression, there would have to be differences in depression between groups," Olfson explains. "I can't completely exclude that possibility—and those that are more severely ill get more medications—but I think if depression were responsible, we would expect to find the same kind of relationships in adults. The fact that we see it with kids should raise our concern about this risk. |
John J. Ratey, MD
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 Now SSRIs carry a warning that they may increase the risk of suicidal thoughts and actions in children and adolescents, a finding that is still in question. And stories are coming out about the difficulty of withdrawing from this class of drugs, especially from venlafaxine (Effexor).
Recently, I started treating a successful entrepreneur whose life was a mess. He and his wife were separated because he'd had an affair, and he'd also lost his business. He came to me to find out more about an issue that had cropped up in couple's therapy, where it became clear that he suffered from ADHD. |
Dr. Arthur Janov
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 The tendency toward depression, and often suicidal thoughts, continues until we explore the deep, remote past and relive it. It is that reliving that normalizes both chemistry and behavior. Reliving means hurtling through time to a timeless state where the present and past merge into one. One is the past, then current behavior becomes clear: "I have migraines because there was so little oxygen at birth." Or, "I drink because there was no mother for weeks right after I was born." No insights necessary. The unconscious explains it all. |
Mike Adams, the Health Ranger
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 These drugs, we now know, cause suicidal thoughts and violent behavior, especially in young boys. They imbalance brain chemistry and even alter the body's metabolism of sugar, promoting diabetes and leading to rapid weight gain. These drugs are so dangerous that feeding them to children should be considered a crime. Every single school shooting involving a child in the United States in the last 15 years has been linked to antidepressant drug use. Need I say more?
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Bottom Line Health
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| Although rare, antidepressants have been known to induce suicidal thoughts. (For more information on the link between antidepressants and suicide, see page 118.) When you start taking a new antidepressant, you should follow up with your doctor consistently.
•How depressed do you need to be for treatment to make sense—and how do you gauge this? Many more people should be evaluated for depression than currently are. Minor, or low-level, depression is just like major depression but with less intensity. |
Shannon Brownlee
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 In the letter, Wyeth warned health care professionals that clinical studies had found a heightened risk of hostility and suicidal thoughts in children and teenagers taking its drug. The company wrote, "You should be alert to signs of suicidal ideation in children and adolescent patients prescribed Effexor." Extreme agitation was one of those signs. In October 2004, a little more than three years after Justin died, the Food and Drug Administration issued a warning to health professionals and the public. |
| The industry also had internal documents and data suggesting the drugs could trigger agitation, along with suicidal thoughts and behavior, yet the published literature said SSRIs were "effective" in children and adolescents and "well-tolerated," medical-speak for safe.t Even Justin's mother, a trained health care provider, hadn't a clue that her son's agitation might be a devastating side effect that could provoke him to suicide, until she received the "Dear Doctor" letter from Wyeth. "The medical community thinks these drugs are safe and effective," she says. |
| For others, SSRIs can trigger akathisia and suicidal thoughts. t Eli Lilly, the maker of Prozac, has data showing that 38 percent of people who take the drug become "activated," a term that includes varying degrees of agitation. But those data are considered "proprietary," and they have surfaced only once during a court case before a judge ordered them sealed. pediatric prescriptions for antipsychotics, powerful drugs that were developed to treat such serious psychiatric conditions as schizophrenia, mania, and bipolar disorder. |
Charles Barber
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 Five of the six ghost-written articles that concerned pediatric psychopharmacology failed to mention that 9 percent of the children in trials experienced suicidal thoughts or took an action toward suicide.85
All of which is to say that the industry has invaded the academy, and the academy has only been too happy to let them in. The New England Journal of Medicine has a sensible policy requiring its authors to list their financial relationship with the drug companies. The only problem is that the policy can be somewhat impractical. |
Connie Bennett, C.H.H.C. with Stephen T. Sinatra, M.D.
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 PMS, nightmares, heart palpitations, mental confusion, muscle pains, blurred vision, temper outbursts, suicidal thoughts, and more. Ultimately, this insidious roller-coaster effect, which occurs whenever you eat lots of sweets and quickie carbs, hampers sufferers' ability to function at full or even half throttle. warnings I'd heard years earlier when I first learned about hypoglycemia and the "sugar blues," as author William Dufty calls it. |
Mark Sircus
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 Never did I think that things could go so wrong with my biochemistry that it would cause me to have suicidal thoughts and tendencies. How wrong I was. I had been taking Zoloft (an antidepressant) since 1987 which seemed to take care of my depression. I lived on Zoloft, but by September of 1999, it stopped working ?and I knew that something was really wrong. |
| Despite a dramatic increase in treatment of psychiatric disorders during the past 10 years, there has been no decrease in the rate of suicidal thoughts and behavior among adults, according to a federal study primarily funded by the National Institute of Mental Health.
The Washington Post
June, 2005
Though it is a complex matrix of causes that cuts across physical, emotional, mental, and spiritual levels of being - it's arguable that a significant portion of the blame for violence and depression can be laid on nutritional causes which are the easiest to correct. |
| A few weeks before I was hospitalized in January of 2000, I had very low energy, mental fogginess, depression with strange suicidal thoughts and I was under enormous stress.
"Now, I can recognize these "mental" symptoms as symptoms of magnesium deficiency and/or calcium toxicity. I was put on nearly every antidepressant drug known and had severe side effects to all of them and felt sicker and sicker. None worked. I lost a lot of weight, and I was extremely constipated. I also had a cardiac arrhythmia.
"On April 12, 2000,1 looked like I was dying to several people important in my life. |
Peter J. Whitehouse and Daniel George
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 Clearly when brain aging hits earlier than we expect it to, and especially when it features prominent behavioral symptoms such as aggressiveness and suicidal thoughts, it is impossible to call a person's situation normal. Statistically speaking, it is not normal to be so demented at sixty-six, whereas the onset of some dementia in one's eighties, nineties, or beyond is more or less the normal expectation. |
| Some people come to me holding this extreme position, because the AD label has a way of driving suicidal thoughts. In this woman's case, and in each such instance I encounter in my practice, I attempted to persuade her to think more positively about the trajectory of her condition, and emphasized the variability of the clinical course of brain aging. I reminded her that even if the worst-case scenario played out and she declined quickly, she might become more serene and at peace with her condition, losing the desire to commit suicide in the process. |
Gary Null and Amy McDonald
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 The Cassidys' lawsuit, filed in federal court in Pittsburgh, charged that Diane Cassidy's doctor prescribed the antidepressant Prozac to her for weight loss and that the drug caused suicidal thoughts that led her to slash her wrists and overdose on a painkiller. She suffered intracranial bleeding from the painkiller, which left her paralyzed on one side and mentally impaired, according to the lawsuit, which sought $4.84 million in tangible damages.
The Cassidys were represented by Houston trial lawyer Andy Vickery, who has negotiated settlements of several Prozac cases against Lilly. |
| The symptoms of depression in older adults may include agitation, anxiety, memory problems, social withdrawal, decreased appetite, confusion, loss of l63 interest in normally pleasurable activities, prolonged grief, reduced energy, and suicidal thoughts. Because these symptoms are present in many other conditions, accurate diagnosis is difficult.
Among other mental health problems in older adults are anxiety, and alcohol and substance abuse. In a given year, more than 11 percent of people aged fifty-five and older meet the criteria for an anxiety disorder. Phobias are the most common type. |
J. Douglas Bremner
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 Another disturbing trend that came from this analysis was the change in suicidal thoughts over time. In the U.S. there are 24.5 million doctor visits for depression per year, a 70% increase from fifteen years ago. Sixty-nine percent of these visits result in a prescription for an antidepressant. The analysis showed that the risk of suicidal thinking and suicide itself has been gradually increasing over the years. It is unclear whether this is the result of an increase in the number of antidepressant prescriptions by primary-care physicians or other causes. |
| A recent meta-analysis of studies of adults taking SSRIs showed no increase in suicidal thoughts or attempts, while there was a 57% increase in nonfatal self-harm with SSRIs that was of borderline statistical significance. However, another metaanalysis showed a greater than twofold increase in fatal and nonfatal suicide attempts in patients on SSRI vs. placebo, and in those on SSRIs compared to other nonmedication treatments. The risk was 5.6 per 1,000 patient years (the number of years people take the drug times the number of patients). |
| If you do take SSRIs, start out at half the dose that the manufacturer recommends, and increase and decrease the dose in very small increments to avoid the mood swings and suicidal thoughts that seem to be associated with overly rapid changes in medication. Atypical antidepressants like Wellbutrin can overcome those sexual side effects.
The MAOIs work well, especially for atypical depression (increased sleep and appetite), but most people don't like the fact that while taking them it is necessary to avoid wine and cheese. |
| Andrew Mosholder, a psychiatrist at the FDA who reviewed data collected from SSRI trials in childhood depression, became concerned about an increase in suicidal thoughts, but was specifically excluded by his superiors at the FDA from attending an FDA advisory panel meeting on drug treatment of childhood depression. As described in The Lancet (April 24, 2004, "Depressing Research"), after reviewing the evidence from clinical trials conducted by the drug companies, the Medicines and Healthcare Products Regulatory Agency (MHRA) of the United Kingdom (U.K. |
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