At 6:21 AM -0500 12/14/06, Allen Esterson wrote:
On 13 December 2006 Paul Brandon wrote [snip]:
And to increase the anxiety a bit more ....
The Associated Press
Wednesday, December 13, 2006; 6:17 PM
WASHINGTON -- Antidepressants increase the risk of suicidal behavior
for people up to age 24, the government said Wednesday. It plans new
warning labels, and says users of all ages should be closely
monitored.
The Food and Drug Administration presented its plan to update the
drug labels at a meeting of outside advisers on the issue. They
endorsed the plan.
The FDA also stressed that patients of all ages should continue to be
carefully monitored for signs of suicidal tendencies when they are
beginning treatment on the drugs.
Hey, Paul, haven't I had enough to deal with from TIPSters whose knowledge
of the extensive literature on the efficacy of antidepressants appears to
extend little beyond whichever articles are highlighted in the New York
Times? -:) Not to mention dotty claims that Freud's theories of hysterical
conversion have been "validated" by brain scans!
Sorry Allen -- I wasn't aiming this at you specifically.
Just thought it was apropos given the list's interest in antidepressants.
Overall, I think that the situation is the same
in the USofA: most psychiatric drugs being
prescribed by primary care physicians (mostly
internists, OB/GYNs and family care physicians).
A lot of marketing pressure (obligatory link to
John B. Watson and advertising) directly from
drug companies to physicians as well as
direct-to-consumer marketing (seems to be a
peculiarly American perversion ;-) resulting in
unnecessary and often off-label prescriptions, as
well as inadequate monitoring and followup.
Writing from recollections of the fairly recent discussion of this issue
in the UK, the concerns at the time were mostly in relation to the effects
of one drug (Prozac?) on children under 18 ñ though in fact the
information about its use by the manufacturers had specifically excluded
children. There was also a one-sided documentary on BBC TV that made
anecdotally-based claims that Seroxat induced suicidal feelings among some
adult users (of which there have now been millions of people).
I can't begin to go into this now, as I simply don't have enough
information. I can only remark that in relation to the UK debate it was
pointed out that for many of the very large numbers of people taking
Prozac or Seroxat, suicidal feelings were part of the symptomatology for
the problems for which they were being treated, and this must be taken
into account. Also, in some cases at least, adverse responses occurred
when patients took themselves off the drug suddenly, instead of phasing
out its use over a period of time. And, as with all drugs, the relatively
rare severe adverse responses out of millions of users should be balanced
against the potential positive benefits for disorders for which suicidal
inclinations are one of the symptoms for many people. (Speaking personally
again, it certainly has been the case for me.)
As I say, I don't know the evidence on which the FDA warning is based, and
of course it is important that both patients and practitioners are aware
of possible adverse effects of this nature, but the matter has to be
considered in the round, taking into account *everything* that is
relevant. For quite a lot of people the psychiatric disorder itself,
untreated, is a potential cause of suicidal inclinations.
I would also add that there is little doubt that in the UK antidepressants
are over-prescribed by GPs, under heavy pressure from overloaded patient
lists and with insufficient time to deal adequately with patients
presenting with time-consuming psychological/emotional/psychiatric
problems. I'm sure (possibly for different reasons, such as medics being
influenced by exaggerated claims in manufacturers' publicity literature ñ
also a factor in the UK) this is also the case in the States. If the FDA
warning helps to encourage more discriminating targeting of the patient
population, and more careful monitoring, that can only be a good thing.
Allen Esterson
Former lecturer, Science Department
Southwark College, London
http://www.esterson.org/
--------------------------------------------------------------
Wed, 13 Dec 2006 18:57:15 -0600
Author: Paul Brandon <[EMAIL PROTECTED]>
Subject: Re: SSRIs and depression and anxiety
And to increase the anxiety a bit more ....
FDA May Expand Antidepressant Warning
By ANDREW BRIDGES
The Associated Press
Wednesday, December 13, 2006; 6:17 PM
WASHINGTON -- Antidepressants increase the risk of suicidal behavior
for people up to age 24, the government said Wednesday. It plans new
warning labels, and says users of all ages should be closely
monitored.
The Food and Drug Administration presented its plan to update the
drug labels at a meeting of outside advisers on the issue. They
endorsed the plan.
The FDA also stressed that patients of all ages should continue to be
carefully monitored for signs of suicidal tendencies when they are
beginning treatment on the drugs.
--
* PAUL K. BRANDON [EMAIL PROTECTED] *
* Psychology Department 507-389-6217 *
* 23 Armstrong Hall Minnesota State University, Mankato *
* http://krypton.mnsu.edu/%7Epkbrando/ *
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--
The best argument against Intelligent Design is that fact that
people believe in it.
* PAUL K. BRANDON [EMAIL PROTECTED] *
* Psychology Dept Minnesota State University *
* 23 Armstrong Hall, Mankato, MN 56001 ph 507-389-6217 *
* http://krypton.mnsu.edu/~pkbrando/ *
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