Professor Peter Gøtzsche, Dr Joanna Moncrieff and Dr James Davies today responded to a letter sent to The Times last week by Professor David Nutt, Professor Sir Simon Wessely and other senior psychiatrists entitled ‘In defence of antidepressants’. The response is copied below and can be seen in The Times here; the original letter from Nutt & others is also below and can be found here.
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Published at 5:51PM, May 6 2014
Sir, Further to the letter from Professor David Nutt and others, whatever the evidence on the efficacy of antidepressants – and the effects are weak even in severe depression – there is no doubt these drugs are being widely overprescribed, and not enough attention is being paid to the harms they can cause. We do not accept that reducing antidepressant prescribing will increase the number of suicides. Antidepressants have not been shown in reliable studies to reduce suicide, indeed they increase the risk of suicide in young people. There is also evidence that antidepressants may increase a whole range of adverse events in the elderly, including falls and fractures, and are associated with increased mortality.
Given these factors and the tendency of many psychiatrists to downplay the harms of overprescribing such medications, we invite Professor Nutt and his colleagues to a public debate where these views can be properly aired.
Professor Peter Gøtzsche, Nordic Cochrane Centre
Dr Joanna Moncrieff, University College London
Dr James Davies, University of Roehampton
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Published at 12:01AM, May 2 2014
Sir, Depression can be a debilitating and lethal illness. Medication is a vital part of the treatment of the severest cases. Successful treatment with antidepressants definitely does not do “more harm than good” as you report (Apr 30).
We do not dispute that these drugs are of potentially less value for mild depression, but their effectiveness is maintained as the severity of the depression increases. Is that true of psychological treatment or exercise?
Depression is serious: 6,500 people commit suicide each year in the UK. Many of them are never offered antidepressants, and the blanket condemnation of antidepressants by Professor Peter Gøtzsche and colleagues will increase that proportion.
Professor David Nutt, Neuropsychopharmacology Unit, ICL
Professor Stephen Lawrie, Division of Psychiatry, Edinburgh
Professor Sir Simon Wessely, Royal College of Psychiatrists
Dr Seena Fazel, University of Oxford
Professor Guy Goodwin, European College of Neuropsychopharmacology
Professor Dinesh Bhugra, World Psychiatric Association
“Depression is serious: 6,500 people commit suicide each year in the UK.”
That is indeed a scary number. Even more so when one considers the study done in Leicester University.
On Oct 4th 2011, in a radio programme ‘All in the Mind’, Dr Alex Mitchell of Leicester University, points out that deaths in the mentally ill resulting from drug side effects outnumber suicide deaths by 4:1.
http://www2.le.ac.uk/offices/press/press-releases/2011/august/psychiatrists-failing-to-adequately-monitor-patients-for-metabolic-side-effects-of-prescribed-drugs
Psychiatrists failing to adequately monitor patients for metabolic side effects of prescribed drugs. People treated in psychiatric settings are receiving inadequate medical monitoring following high-risk antipsychotic medication.
Issued by University of Leicester Press Office on 10 August 2011
And where can you get the P450 Cytochrome tests done – these should be readily available and GPs/Psychiatrists should know about them – instead many prescribe drugs in such a way as to seriously harm someone’s physical health without any thought whatsoever that there could be a physical underlying health problem/injury. Thank God there is an organisation called CEP where there are psychiatrists who are knowledgeable. It is no wonder why the acute wards are overflowing if the drugs do not work and patients forced to take them – it is not in the slightest bit surprising. When someone is “treatment resistant” ie poor or non metaboliser then they should not be on the drug and a diagnosis of PTSD SHOULD be recognised as there is plenty of research relating to this and underlying physical health problems. CTOs and enforced drugging are abuse and the complaints procedures are a shambles and I do not have anything good to say for the legal profession either after what I have seen. Unlicensed drugs, enforced drugging, never ending sections, manipulation of MH law and playing on capacity/confidentiality. I have never seen so much dishonesty allowed to go on, together with bullying, exclusion and threats of displacement as Nearest Relative if you dare to complain. There is no communication between GP and Psychiatrists and lack of knowledge as I have proven. Nothing is done properly as regards withdrawal and there are no facilities and not everyone can be happy on an acute ward – there needs to be choice. Also the acute wards are lacking when it comes to nutrition and that applies to placements in the community. Anti-depressants have caused mood swings that range from suicide to aggression and I have personally seen this with my daughter who I wish had never been given these highly dangerous drugs (Cipralex) – this should be banned.
Magician James Randi laid down a reward of $1 million if psychics could prove evidence of any paranormal event. Same reward should be offered to the field of psychiatry to prove that antidepressants correct a chemical imbalance.
Well, what else would you expect from leading members of the bankrupt psychiatric establishment whose opinions have no scientific basis and whose vested interests allied with the drug manufacturing companies have crippled many victims of psychiatric services here in the UK and elsewhere.
If these ‘leading’ members of the psychiatric profession would read the Patient Information Leaflet for their favoured ‘anti-depressants’, they would read that suicidality is listed there.
And yes, talk therapy aimed at severe past trauma works fast and well, even with the most severs psychosis, provided there’s sufficient expertise – and did so in 1796-1850.
As long as neurological psychiatry holds sway over socialising psychiatry, then these advances in talk therapy are going to be minimised by people who neglect them.
The wider public debate, including the iniquitous CTOs, is urgently needed – bring it on.
Dr Bob Johnson, MRCPsych. PhD.
Depression IS serious; nobody can deny that. Too many doctors, particularly here in the United States lean toward medicatoin as a first response to any symptoms of depression, Symptoms can range from mild to severe and they reach for medication first in situations where: a young girl breaks up with her boyfriend or a single person grieves over the loss of a parent.
If can be extremely difficult for some to come off of these drugs even when given small doses. We need more responsibility among health care professionals today.
For my depression let me talk with the health care professional that exhausts attempts at therapy, wholesome food and a restricted diet, fresh air, encouraging a patient to donate their time and love to charitable causes and plenty of excercise first before they start passing out the chemicals. Of couse, success with such treatment probably doesn’t help the practice much. Thank God nobody out there puts their practice in front of the needs of their patients.
In 2004 I was put on 1 MG of lorazapam,after the death of a sister. As the years passed it was increased to 8 MG . I was falling regularly ,once leaving my neurologists office,twice downstairs,and dozens of times home and away. I have an artificial shoulder that is frozen,a splice on my arm keeping the elbow from straight ing,and several cracks in my skull. Finally when I blacked out while I was sitting on a park bench,cracking my head right above my eye ,I told him I wanted off the benzo. He took me off in about 30 days with a crossover to Valium.a week after I was off I went to the ER for chest pains that were not caused by a heart problem,and the doctor there gave me Klonipin and said it was not addictive.2 weeks later I went into the hospital where they did a 4 day detox.now 14 months later I am still sitting in my recliner as I have for 14 months.my muscles are so contracted when I try to stand I can’t walk. Has been a nightmare and still is . Any suggestions ? My doctor has sent me over a dozen medications and they all had a negative effect.no where to turn.i am 76 and don’t know how long this nightmare is going to go on.My doctor is a waste of time as with extreme difficulty I saw him and he said I have to give it time? How much as 14 moths off I am worse ,suggestions ????
Arnold knutsen, have u researched protracted withdrawal syndrome? There is a good support group on facebook called “PWS from Benzodiazepines and Anti-depressants). I myself, am a member as I am just over 3.5 years off klonopin. I have also discontinued Ativan and lorazepam prior in addition to an entire slew of medications. The number of people that have been adversely affected by psychotropic medications, including benzodiazepines and anti-depressants is alarming. I am one of many, that can bear witness to the harm they cause. I can only hope that medical professionals will educate themselves and inform their patients of the potential side effects and withdrawal symptoms of such medications prior to the prescribing. A thorough review of side effects and withdrawal symptoms should be discussed with each patient prior to prescribing. The leaflet provided with the tablets, once the script if filled, is helpful, but not adequate. Although psychotropic medications may help and be necessary for a small few, although I strongly question their efficacy at all, alternative methods of treatment are a far better option (cognitive behavioral therapy, group therapy, diet, exercise, yoga, learning coping strategies, and much more.
Medical professionals that also need to educate themselves on proper tapering schedules as most advise patients to taper way to fast leading to even more serious and prolonged withdrawal symptoms. In addition, when a patient presents with symptoms, they must ask themselves if there is any possibility that the medication itself may be the cause of symptoms instead of presuming that the symptoms are indications of a mental illness, leading to the prescribing of yet additional potentially harmful medications. Please Dr’s! I plead with you to listen to your patients, ask lots of questions, complete a thorough evaluation before prescribing medications. I encourage you to try alternative forms of treatments prior to medication. Before anti-depressants and benzodiazepines, I was a protductive member of society with a successful career for 20 years. Now, after having been on psychotropic medications, I am disabled, collect social security disability income and I am unable to work. I have experienced serotonin syndrome, tolerance from benzo’s, inter-dose withdrawal from benzo’s, and am still enduring disabling symptoms from protracted withdrawal, all of which was never disclosed to me by a medical professional, but discovered in doing my own research and speaking to the thousands like me who have been on these medications, discontinued the medications because they found themselves more sick on them than they were before them, and also those that continue to be sick with a whole new set of symptoms because their medications were discontinued too quickly.
I would also like to add that I have had 2 suicide attempts. Both occurred while on psychotropic medication. None occurred prior to the use or after the use of psychotropic medication. I stand firm, with no doubt in my mind, that the medication I was prescribed led to these incidents.
I hope others will learn from your experiences with these meds and their dangers. While working with several hundred injured warriors, those who didn’t take meds recovered from their severe injuries of their whole being, those on the cocktails continued to suffer from all of symptoms reported and continue to suffer. As you suggest, receiving intensive and extensive integrative and holistic health services offers recovery, restoration and resilience. Our website introduces many of these options and results.
I love that a duo has been called. A showdown is well overdue. I’m with you Kim, I had one suicide attempt in my life and that was while doped up on 4 psychotropic medications including anti-depressants. The entire field is a huge farce causing death to hundred’s of thousands of innocent folks, world wide, every single year. They have not a single leg to stand on. We can also point the finger at anti-depressants causing homicides.
Arnold, I’m sorry that this travesty also happened to you. You are crying out for help. Unfortunately there isn’t any. You just have to keep going until your body clears itself of the poisons and the damage they have done. Stay strong every second until the healing comes. On behalf of the doctors that put you on these drugs and ripped you off of them so fast, I’m very, very sorry. They may be unable to weep at the damage they’ve caused humanity, I only hope they can open their minds and hearts to reality and change their ways.
I developed extremes of “highs” and “lows”, mania and “psychosis” after taking these mind altering drugs. Specifically Citalopram. I now know that claims that these SSRIs “rebalance neurotransmitters” is a marketing myth. Not forgetting the placebo effect which Irving Kirsch in Harvard University studied in detail.
I believe in informed consent and I wasn’t aware of the high risks that go with taking an “anti-depressant” (which I was prescribed for panic attacks). No one ever told me the truth. Instead I was pumped with several other potentially dangerous drugs. I am now off most prescribed drugs nearly 3 years. It is taking a number of years for the damage done by the drugs to subside. As there can be relapses. Especially in the first 2 years.
I now know that there is no pill that cures LIFE and that mental / physical health requires daily work. It is disheartening to see the number of people that have been fooled into believing the “chemical imbalance” theory. Yes we all have a biochemistry, but keeping it in check involves working on the basics eg diet/lifestyle, exercise, hydration, relaxation, stress management etc And sometimes going for therapy to address any trauma.
The biggest trauma I experienced was my treatment after I had an adverse reaction to “anti-depressants”. I would see it as Post Traumatic Stress. It has taken years to come to terms with the misinformation and the withholding of information eg that SSRIs can cause mania and that a person should not be given the label “Bipolar” when on SSRIs (as outlined in DSM-IV-TR). There has to be a better way in this Capitalist system. People in distress or suffering need empathy and SUPPORT not exploitation. Not forgetting the stigma and discrimination that goes with having been through mental health issues. Something I experience regularly.
Yale study ~ Antidepressant-associated mania and psychosis resulting in psychiatric admissions ~ http://www.ncbi.nlm.nih.gov/pubmed/11235925