![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 34 to 58 of 78. Go back in thread:
Posted by jamestheyonger on December 10, 2005, at 22:58:46
In reply to Okay about autism and mercury.., posted by spriggy on December 10, 2005, at 22:33:33
Most vaccines no longer contain Thimerosal, the source of Mercury:
http://www.vaccinesafety.edu/thi-table.htm#1.
Given the huge number of people vaccinated in the past why do not more have autisim ? Common
contact lens solutions contain Thimerosal amoung other products. Many vaccines never contained Thimerosal and today most do not. There have been allergic reactions to Thimerosal.http://www.fda.gov/cber/vaccine/thimerosal.htm
There is a strong genetic link in Autisim, it seem there is a hig corralation to having some genes and Autisim:
Posted by willyee on December 10, 2005, at 23:32:22
In reply to *DON'T MISS THIS* - Listen to Dr. Tracy on SSRIs.., posted by ReadersLeaders on December 10, 2005, at 1:26:01
Its so easy to find flaws with the drugs we have,and so easy to make what your selling look like a miracle cure,BUT the reason we tolerate any of these drugs is because mostly everything else is snake oil,this group here is gonna catch anything effective,it wont last long without being discovered,thats why i pass by here.
Lets not forget these drugs are crossing into the brain and altering it,but we choose to accept this as it does benifit a lot of people.
Im sick of theorys,hers vs pro ssris,when i personaly feel the truth lays way deep in a part of the brain we just cant examine yet.We run test,and see all these imbalances of a depressed person to a non-depressed person,but ive seen imbalances of chemicals,nutrients,aminos nuerons ,brain wave activity and so on,.......i think all this leads us to is the finalaztion we all know,a depressed persons brain is not functioning at optimal levels,and does it surprise anyone that if examined the end result of that wont be a very ubalanced brain,inlcuding all various type of unbalances?
She isnt who she says,and that i dont think is fair,to imply her credittanials are more than they are to evoke scare tactics which is what she is doing,scare tactics to ever so lightly promote herself and products.
I have a lot of articles that show collegage studies done one after another showing MAJOR differecnes,imbalances of inhibitory amino acid ratios to stimulatory ones in depressed/non depressed people.Certain ones constantly showed up greatly imblanced,glutamtic acid,taurine etc .Anyone who really has a good clue on whats going on i believe the average person here will not even be able to talk to,they will talk real scieance and leave us scratching our head,not talk about serotion constantly,its already known ssris affect dopamine etc as well.
There are only a few peopl here i believe can have a true understanding of that kind of scieance,exlcuding myself and many people here we need to understand the brain is simply not simple,its complex and treating it is not gonna be easy ever.I dont know im ramling,but how many people have to try and steal from us when we are down and out,to make money off this disease u have to have a rotten black soul.
Posted by Larry Hoover on December 11, 2005, at 10:14:54
In reply to Re: What!, posted by linkadge on December 10, 2005, at 21:16:57
> For goodness sake. England thought enough of the data connecting SSRI's to suicidal behavior to make significant changes to their prescribing habits for SSRI's in children.
>
> LinkadgeThat was a precautionary act, due to lack of safety data. The recommendation was for closer monitoring, something I also have long advocated, both for adults and children.
Just last month, a major report was tabled.
Neuropsychopharmacology advance online publication 23 November 2005;
doi:10.1038/sj.npp.1300958ACNP Task Force Report on SSRIs and Suicidal Behavior in Youth
Conclusion:
The Task Force concluded that SSRIs and other new generation antidepressant drugs, in aggregate, are associated with a small increase in the risk of AE reports of suicidal thinking or suicide attempts in youth. The evidence for this comes from the FDA meta-analyses of all pediatric RCTs of antidepressants. This effect is quite variable across SSRIs and it is not clear if that variance is a measurement error or represents a real difference between medications. Systematic questionnaire data do not identify a risk for more suicidal ideation on SSRIs, raising concerns over ascertainment artifacts in the AE report method. Three other lines of evidence in youth, epidemiology, and autopsy studies, and recent cohort surveys (Valuck et al, 2004; Simon et al, 2005), do not support the hypothesis that SSRIs induce suicidal acts and suicide, instead indicating a possible beneficial effect, and that a negligible number of youth suicides are taking antidepressants at the time of death.
I did a similar review some months ago, and came to an identical set of conclusions. Adverse event reporting in clinical trials falsely suggested suicidal acts were occurring, due to systematic methodological deficiencies. Autopsy data do not support the theory that SSRIs contribute to youth suicide. In fact, net reductions have been clearly demonstrated.
Lar
Posted by Larry Hoover on December 11, 2005, at 10:44:52
In reply to Re: Dr. Tracy on SSRIs.., posted by linkadge on December 10, 2005, at 21:07:06
> >Excepting serotonin syndrome, no demonstrated >condition of excess serotonin is known.
> So I restate. Some research shows that high serotonin is implicated in certain disease states.
We're arguing a semantic distinction, about our interpretation of another person's words.
Localized serotinergic activation can be, on a relative scale, high or low. I am arguing against a global "elevated serotonin" state, as postulated by the under-educated Tracy.
> >MAO-A is not specific to serotonin. Flooding the >brain with free serotonin does not mimic any >known physiological process.
>
> Taking LSD, doesn't mimic any physiological process. I don't know what you are trying to say?We can mess with the brain, with drugs, and produce unnatural states. Tracy was implying an innate condition, "excess serotonin", or however she phrased it, was the underlying etiological factor in mental diseases of all sorts.
It is a preposterous theory, with no evidence.
> SSRI's simply mimic the antidepressant effects of sleep deprivation.Whether that's your theory or hers, I disagree. I don't think anyone knows the mechanism, but it most certainly won't be as simple as that.
> >?? What is premature aging?
>
> Lets not be difficult. I think there was an X-Files on it.It's a meaningless phrase. That's my point. It contributes nothing, except perhaps, hooking the naive mind.
> >I try to stay away from these mechanistic >arguments, because they require that you believe >the premise to believe the conclusion. Petitio >principii.
>
> It's quite simple. The higher the functional agonism at 5-ht2a receptors. The higher the probability of visual disturbances as a side effect.Which differs so substantially across the population it is more reasonably a genetic trait (susceptibility) than a drug effect.
Exceptional cases always occur. Sample enough population, and you're going to find outliers. How to treat those cases is a matter of opinion, and we shan't settle that by arguing.
I am an outlier. Me. I've had very bizarre drug effects, when compared to normalized data. My bizarre response to a drug demonstrates nothing, other than I should avoid the drug.
> >She doesn't make those arguments. You did.
>
> No, I didn't make that connection. She has made it her job to try and explain some of the behaviors that have resulted from the use of the drugs.She wants to blame the drug for all aberrant behaviour. And I'm still waiting for the explanation part.
> I am to suppose that her attemps to liken the effects of SSRI's to that of harsher drugs has no relavance to this?
Her generalizations amount to hyperbole without any reasonable support.
"If feeling depressed.....injecting one-quarter gram of PCP.....will have same effect on body and mind.....as Prozac."
That is false, bizarre, fear-mongering, meaningless.
> >In the very next breath, she argues that SSRIs >are prophecied in the Bible, and I just stopped >listening at that point.
>
> I would stop listening too.Oh, but you snipped the part about "the gummy gooey glossy substance". I thought that was so relevant.
> But that doesn't mean I would throw the baby out with the bathwater.
This woman makes what amount to emotional appeals. Her theories contain vague expressions which can be taken in many ways. There is a plausibilty to what she says. But nowhere, does she offer the data, the observations, the physical evidence, to support even her core allegations. What baby?
> It is too bad that the sensationalists are the only ones who get the attention.
As I said earlier, let the data speak for themselves.
> Goodness knows there are more sensable people saying the same thing.
No, not that I've seen.
> >Please try to separate from the emotional >appeals, with seemingly plausible arguments, >based on zero evidence. The woman scares me.
>
> Zero evidence?Would you kindly present her evidence? I've seen none. I am totally serious.
> Now that is kind of talk scares me.
> LinakdgePerhaps we should agree to disagree?
Lar
Posted by Larry Hoover on December 11, 2005, at 10:48:25
In reply to Re: What! Yes it was me! » linkadge, posted by spriggy on December 10, 2005, at 22:26:20
> I completely tripped/wigged out on SSRI. I doubt I WILL EVER try anything in that family again because of how bad my experience was.
I think that's an excellent conclusion to reach, based on your experience.
I experienced manic psychosis on Luvox. I've use other SSRIs since. With some caution.
Lar
Posted by Larry Hoover on December 11, 2005, at 11:03:53
In reply to Okay about autism and mercury.., posted by spriggy on December 10, 2005, at 22:33:33
> Sorry Lar, I appreciate you so much (and think you are wonderfuL). Although I will be the first to confess I don't know nearly half as much as you do..
Sprig, you don't need to qualify your remarks. I won't respect you less, or care about you less, no matter what might come from this discussion. No matter what you might think about what I think.
> I DO know for certain what I watched/saw with my own eyes happen to my own child.
I know you did.
> COMPLETELY normal child; all medical records show he was fine.
>
> Received his vaccines ( 5 in one day).I'm really interested in what he got. Do you want to email me?
> He ran 102 fever, chronic diarrhea, dehydrated, had to be hospitalized... He stopped speaking, waving, smiling.. in a nutshell my son stopped completely!
My heart goes out to you, watching that happen. Doing what a loving parent would do, to protect their child against serious disease. And then, powerless, watching this unfold.
> Found out through vaccine records that he received over 60 micrograms of mercury that day- he weighed 23 pounds. Do you think that is within the EPA's safety limit for exposure??
>
> Nope.You're absolutely correct.
>
> My son was bombarded with a neurotoxin before he turned 2.
>
> And oddly enough, when we began the process of removing mercury (chelation) he began to speak.
>
> Strange coincidence?No, I don't believe in coincidences.
Nor am I, in any way, suggesting that what happened to your son was not related to the vaccination process, and/or the Thimerosal preservative.
The evidence I presented was population data. It neither proves nor disproves individual cases.
I can only say that I cannot imagine having to see this happen to my own child. And how sad I am to learn that it happened to yours.
I'm an environmental toxicologist. I've spent many hours looking at this issue. But I would never use my training or my experience to disrespect another person's experience.
Lar
Posted by jay on December 11, 2005, at 11:45:56
In reply to Re: What! » linkadge, posted by Larry Hoover on December 11, 2005, at 10:14:54
FWIW...I would go as far to say that there may be a *good* chance SSRI's cause suicidal ideation in beginners of the med. But, it is definitely something that does not last! There are also some easy, simple remedies. I've been on and off both Prozac and Effexor for many years (plus all other SSRI's) , and only had problems with really bad anxiety when started. In fact, that anxiety is what led to 'suicidal ideation', et al. Very simply, stepping up a benzo dose and/or adding an antipsychotic has been shown to pretty much eliminate this problem. Once the person is adjusted to the SSRI/SNRI dose, they may be able to lower or even come off the other meds.
Quite simply, it's just taking a precaution by adding a counter-balancing med. The atypical antipsychotics have been shown to have anti-suicidal properties on their own.(I think clozapine is the 'gold standard'...but it translates to other atypicals as well.) Just look it up on Medline.
Just IMHO...
Jay
Posted by Phillipa on December 11, 2005, at 11:55:29
In reply to Re: Okay about autism and mercury.. » spriggy, posted by Larry Hoover on December 11, 2005, at 11:03:53
This is the best discussion to hit the board in a long time. Fondly, Phillipa ps I wish I had all your knowledge so I could participate more.
Posted by gibber on December 11, 2005, at 21:47:35
In reply to *DON'T MISS THIS* - Listen to Dr. Tracy on SSRIs.., posted by ReadersLeaders on December 10, 2005, at 1:26:01
This whole discussion strikes me as so similar to Dr. Breggin. Jamestheyonger posted a great link to an article about Breggin that I'll post below if you didn't catch it. I really wonder what motivates people (doctors?) like Tracy and Breggin. First of all it shows that they greatly misunderstand or deny the facts and are somehow afraid of simply the idea of pychiatric medications. I few years ago I may have taken people like this a little seriously and spent some time researching their remedies. Thanks to boards like this and my own research I can dismiss people like that. I recall reading about some doctor believed all mental illness was caused by bacterial infection. In some ways the people who challenge us just make us stronger, but these two doctors? don't help to reduce the lingering stigma of what I believe is a physiological condition, not to mention delaying the opportunity to find the right treatment.
Breggin article:
http://web.archive.org/web/20000105033326/chadd.org/Russ-review.htm
Posted by jamestheyonger on December 11, 2005, at 23:12:30
In reply to Tracy, Breggin, and other quacks..., posted by gibber on December 11, 2005, at 21:47:35
I read a study on what makes a sucessful hoax;
people seem to believe statements that are somewhat grandiose, like Prozac and PCP have the same effects or someone you do not know from Nigeria wants to give you lots of $$$ if they can use your bank account. Here is some more stuff:
http://www.columbia.edu/cu/21stC/issue-3.4/valhouli.html"Another reason people find pseudoscience plausible is a cognitive ability to "see" relationships that don't exist. "We have an adaptive reflex to make sense of the world, and there is a strong motivation to do this," says Lilienfeld. "We need this ability, because the world is such a complex and chaotic place, but sometimes it can backfire." This outgrowth of our normal capacity for pattern recognition accounts for the "face on Mars" (a group of rocks that allegedly resembles a face) or the belief that a full moon causes an increase in the crime rate. When people believe in something strongly--whether it is an image on Mars or a causal interpretation of a chronological association--they are unlikely to let it go, even if it has been repeatedly discounted"
Posted by spriggy on December 12, 2005, at 19:08:14
In reply to Gullibility, posted by jamestheyonger on December 11, 2005, at 23:12:30
You mean that's not true about letting someone from Nicarauga use my account and then they give me lots of money??????
NOW you tell me....
ROFL
Posted by jamestheyonger on December 12, 2005, at 19:33:26
In reply to Re: Gullibility WHAT?? » jamestheyonger, posted by spriggy on December 12, 2005, at 19:08:14
Somethimes the scammers get scammed:
Posted by mknight on December 14, 2005, at 19:13:04
In reply to Re: Gullibility WHAT??, posted by jamestheyonger on December 12, 2005, at 19:33:26
Eleven years ago I had a clouded right eye for 10 minutes and the next day the worst headache I have ever had. I have not been the same since. I feel like I am on marijuana or mild mescaline all of the time. Four years later, fatigue and exhaustion set in. Paxil was the first drug tried. It was to me exactly like taking LSD. I did not leave the house for 2 weeks. Other SSRIs like Zoloft, Prozac, and Celexa are not that bad but they do make me more stoned than I already feel. Supposedly halucinogenic drugs stimulate the 5HT2a receptor which some psychopharmacologists say SSRIs do also. So I tried a 5HT2a antagonist, Mirtazapine. Did not do that much and the sedation did not help my fatigue. Most drugs that antagonize 5HT2a are also sedating. Wellbutrin seems to pull me up from the stoned feeling a little and helps with the fatigue but then makes me angry, explosive, and aggressive. I have yet to try stimulants or APs. Any and all thoughts and ideas would be appreciated.
Posted by linkadge on December 14, 2005, at 20:17:49
In reply to Re: What! Yes it was me! » linkadge, posted by spriggy on December 10, 2005, at 22:26:20
Some people on this board wouldn't believe you. They might say something like, well the drug just triggered something.
I am in favor of people questioning the safety of these drugs. They may not be as safe as doctors suggest.
I, nor Dr. Tracy, are the first to compare antidepressants to recreational drugs.
Linkadge
Posted by linkadge on December 14, 2005, at 20:33:23
In reply to Re: What! » linkadge, posted by Larry Hoover on December 11, 2005, at 10:14:54
I don't think that a net reduction has been *clearly* demonstrated at all.
That is what has been argued for the past however many years.
Many authors have come to the conclusion that no such reduction has been demonstrated.http://biopsychiatry.com/suicide.html
There also exist studies that show the course of depression to be worsened by antidepressant use.
Current antidepressants reduce depression, and anxiety by creating emotional indifference.
The frontal lobe syndrome caused by SSRi's serves to disinhibit the user, making them more prone to impulsive behavior.
I don't doubt for a minaute that antidepressants can increase the likeyhood of suicide.
Dr. Tracy made a good point. The drug companies pay.
Linkadge
Posted by linkadge on December 14, 2005, at 22:05:08
In reply to Re: Dr. Tracy on SSRIs.. » linkadge, posted by Larry Hoover on December 11, 2005, at 10:44:52
>We're arguing a semantic distinction, about our >interpretation of another person's words
>Localized serotinergic activation can be, on a >relative scale, high or low. I am arguing >against a global "elevated serotonin" state, as >postulated by the under-educated Tracy.I see you did not read the link that I put up. The state that SSRI's induce would be very similar to that of an individual who posesses the double short varient of the serotonin transporter gene. Dr. Tracy argues that SSRI's cause depression and suicide. This link that I put up is research showing how lifetime depressive episodes correlate with the serotonin transporter gene. This research supports her theory that taking an SSRI (and thus lowering SERT activity) could cause depression, alcoholism etc.
>We can mess with the brain, with drugs, and >produce unnatural states. Tracy was implying an >innate condition, "excess serotonin", or however >she phrased it, was the underlying etiological >factor in mental diseases of all sorts.That may be. If we discovered the antidepressant effects of Tianeptine beofore that of SSRI's we might have the same hypothesis.
>Whether that's your theory or hers, I disagree. >I don't think anyone knows the mechanism, but it >most certainly won't be as simple as that.Many doctors think that the rem sleep depriving mechanisms are key force in their behavioral effects. Quite a few agents (for instance Surmontil) which have no effect on monoamine uptake, but do reduce REM sleep, are effective antidepressants.
>It's a meaningless phrase. That's my point. It >contributes nothing, except perhaps, hooking the >naive mind.If any drug were capable of mimicing some the catastrophic alterations in cognition an sentience that are evident in old age, I'd like to know about it. For instance, smoking will age you prematurely. Knowing that is not meaningless.
>Which differs so substantially across the >population it is more reasonably a genetic trait >(susceptibility) than a drug effect.I was not the first one to suggest the connection between the subjective effects of antidpressants and LSD. Many experienced LSD users have likened the effects of LSD to antidepressants. Studies show that fluoxetine potentiates the discrimintive stimulus effects of LSD.
See the abstract at:
http://www.antidepressantsfacts.com/prozac-lsd.htm
These reports are more than just coincidences. There are biochemical reasons that the drugs can produce similar states of mind. And that is important information, when faced with the task of sorting out some of the behavioral states that have been linked to SSRI use.
>I am an outlier. Me. I've had very bizarre drug >effects, when compared to normalized data. My >bizarre response to a drug demonstrates nothing,
>other than I should avoid the drug.But we are talking about experiences that have happened to more than just one person. We are also talking about experiences that may be partially explained by studies like the one above which show how these two agents can produce similar behavioral states.
>She wants to blame the drug for all aberrant >behaviour. And I'm still waiting for the >explanation part.And I am still waiting for the explaination for how antidepressants actually help depression. Since there is not much of a solid theory for that, I can't pick too many holes in arguing the
negation.>Her generalizations amount to hyperbole without >any reasonable support.
Hyperbole without any reasonable support? We've got two drugs. One inhibits the reuptake of serotonin, and the other increases the uptake of serotonin. Both are "effective antidepressants".
Vitamin C either prevents scurvey, cures scurvey, or neither.
>That is false, bizarre, fear-mongering, >meaningless.Fear mongering, maybe. I see it as a necessary counterballence, in a world of "pop this". After 8 months off of 100mg of zoloft, I am still relearning how to walk properly.
>Oh, but you snipped the part about "the gummy >gooey glossy substance". I thought that was so >relevant.
Like I said. I don't agree with everything she says. But I do agree with her main argument that SSRI's can sometimes induce abnormal and frankly dangerous states of mind.
>This woman makes what amount to emotional >appeals. Her theories contain vague expressions >which can be taken in many ways. There is a >plausibilty to what she says. But nowhere, does >she offer the data, the observations, the >physical evidence, to support even her core >allegations. What baby?Thats not true. For example, she talks about how the worker for Lilly ended up resigning due to her decision to make a firm stance against the safety of SSRI's.
She also referres to studies in which patients given SSRI's reported increased hostility and suicidal behavior.
If forget her name, but she referred to one of the key scientists who was involved in the idenficiation of the serotonin reuptake mechanism, who referred to the SSRI's as monster drugs. These are real people, with real credability who agree with her on different levels.
>As I said earlier, let the data speak for >themselves.Let it.
>No, not that I've seen.
Ok, maybe not the exact same things. But ther "are" very intellegent people who do not agree that these drugs cary the safety that is assumed by most doctors. There are intellegent people who believe that the drugs can induce suicidal thinking and behavior. Do you want to know who some of these people are? There are scientist out there right now who are developing animal models of antidepressant induced mania and rapid cylcing. Some of this research is on www.neuransmitter.net. While Dr. Tracy is extreme. I don't thing she is out of the ballpark.
>Would you kindly present her evidence? I've seen >none. I am totally serious.Well, for starters, she said that SSRI's can induce psychotic states. I mentioned above some information on researchers who are studing the propensity of SSRI's to induce mania. Researchers create links between some of the genes affected by stimulants, and antidepressants, to try and sort out some of the findings. These are obviously *very expensive* studies to undertake, and would not be done if there was indeed "no evidence"
>Perhaps we should agree to disagree?
I am happy with anyone who agrees that the safety of SSRI's is not a closed case.
Linkadge
Posted by linkadge on December 14, 2005, at 22:06:33
In reply to Re: What! Yes it was me! » spriggy, posted by Larry Hoover on December 11, 2005, at 10:48:25
Posted by linkadge on December 14, 2005, at 22:17:10
In reply to Tracy, Breggin, and other quacks..., posted by gibber on December 11, 2005, at 21:47:35
There was a time too when I would sit and defend any allegations made against the precious class of drugs.
But the more people I talk to, and the more information I read has made me cautious of anyone who referes to the drugs as wonder drugs, and who pays no attention to some of the studies that come out.
Med-Empowered and I were refering the other day to some of the studies that showed how mice exposed to SSRI's for exended periods of time developed "corkscrewed" serotonin receptors.
This is one of the studies refered to by Breggin.
People like to call him a quack, because if the studies he referrs to are true than that changes a lot.
A psychiatrist may infact believe the study and yet still not tell you this, mainly because he thinks its in your best interest not to know.
Referring to Breggin as a "quack" makes life easier...... for the time being
whoa ha ha ha ha ha ha ha ha ha......(sorry)
Linkadge
Posted by Emme on December 14, 2005, at 22:28:44
In reply to Re: What!, posted by linkadge on December 14, 2005, at 20:33:23
Hi Link,
Just a quick 2 cents on one particular point.
> Current antidepressants reduce depression, and anxiety by creating emotional indifference.
Ain't necessarily so! At least not in my personal experience. Yes, Lexapro definitely numbed me out. But when I had positive responses to Paxil and to Wellbutrin + Serzone, my emotions felt very much alive and I was able to experience pleasure again. And I still experienced some anxiety, but it was an *appropriate* amount of anxiety instead of being over the top. Like some nervousness for giving a talk, but not enough to be a real problem. So yeah, I think it's possible for ADs to work without turning you into a zombie.
emme
Posted by linkadge on December 14, 2005, at 22:37:29
In reply to Gullibility, posted by jamestheyonger on December 11, 2005, at 23:12:30
Listen folks. All I am saying is that the issue is not binary.
We want the information to be binary because it makes us feel confident about our decisions.
Take depakote.
It may help your mood. But it is a fact that it may damage your liver. It is a fact that my mother has a bad liver from years of depakote use.
There are some real dangers that may be associated with the use of certain drugs. That is a fact, not psudoscience. Just like antipsychotics can dammage certain areas of the brain. That is a fact. Psychiatrists know that. It's not just the Tom Cruises.
I am under the belief that a lot of information/dangers are withheald / played down because it is percieved that the best interest of the mentally ill.
It is not a black and white issue. I don't know why people try to make it into that.
Linkadge
Posted by linkadge on December 14, 2005, at 22:43:12
In reply to Re: What! » linkadge, posted by Emme on December 14, 2005, at 22:28:44
Ok. Its not true with every drug. But it seems that often SSRi's helped just by numbing me.
Linkadge
Posted by Larry Hoover on December 14, 2005, at 22:55:52
In reply to Re: What!, posted by linkadge on December 14, 2005, at 20:33:23
> I don't think that a net reduction has been *clearly* demonstrated at all.
Like I said before, I like to let the facts speak for themselves. I'm an empiricist. This is one of the most convincing studies I've come across, in years. The source data are completely independent (collected for other legitimate but reliable purposes) and show highly significant statistical relationships.
Arch Gen Psychiatry. 2003 Oct;60(10):978-82.
Relationship between antidepressant medication treatment and suicide in adolescents.Olfson M, Shaffer D, Marcus SC, Greenberg T.
Department of Psychiatry, New York State Psychiatric Institute, College of Physicians and Surgeons of Columbia University, New York 10032, USA. olfsonm@child.cpmc.columbia.edu
CONTEXT: A decade of increasing antidepressant medication treatment for adolescents and corresponding declines in suicide rates raise the possibility that antidepressants have helped prevent youth suicide. OBJECTIVE: To evaluate the relationship between regional changes in antidepressant medication treatment and suicide in adolescents from 1990 to 2000. DESIGN: Analysis of prescription data from the nation's largest pharmacy benefit management organization, national suicide mortality files, regional sociodemographic data from the 1990 and 2000 US Census, and regional data on physicians per capita. PARTICIPANTS: Youth aged 10 to 19 years who filled a prescription for antidepressant medication and same-aged completed suicides from 588 three-digit ZIP code regions in the United States. MAIN OUTCOME MEASURES: The relationship between regional change in antidepressant medication treatment and suicide rate stratified by sex, age group, regional median income, and regional racial composition. RESULTS: There was a significant adjusted negative relationship between regional change in antidepressant medication treatment and suicide during the study period. A 1% increase in adolescent use of antidepressants was associated with a decrease of 0.23 suicide per 100 000 adolescents per year (beta = -.023, t = -5.14, P<.001). In stratified adjusted analyses, significant inverse relationships were present among males (beta = -.032, t = -3.81, P<.001), youth aged 15 to 19 years (beta = -.029, t = -3.43, P<.001), and regions with lower family median incomes (beta = -.023, t = -3.73, P<.001). CONCLUSIONS: An inverse relationship between regional change in use of antidepressants and suicide raises the possibility of a role for using antidepressant treatment in youth suicide prevention efforts, especially for males, older adolescents, and adolescents who reside in lower-income regions.
> That is what has been argued for the past however many years.It's been argued, but from smaller samples. Type 1 error is the biggest issue for scientists to manage.
> Many authors have come to the conclusion that no such reduction has been demonstrated.
>
> http://biopsychiatry.com/suicide.htmlOr, there's this study, demonstrating a significant change in slope of the suicide rate coinciding with the introduction of SSRI meds. The only way to get a change in slope as described in this study is to have a change in the independent variable(s). It would be a big coincidence if it wasn't related to the introduction of SSRIs.
Pharmacoepidemiol Drug Saf. 2001 Oct-Nov;10(6):525-30.
Antidepressant medication and suicide in Sweden.
Carlsten A, Waern M, Ekedahl A, Ranstam J.
Department of Social Medicine, University of Goteborg, Sweden. anders.carlsten@telia.com
OBJECTIVE: To explore a possible temporal association between changes in antidepressant sales and suicide rates in different age groups. METHODS: A time series analysis using a two-slope model to compare suicide rates in Sweden before and after introduction of the selective serotonin reuptake inhibitors, SSRIs. RESULTS: Antidepressant sales increased between 1977-1979 and 1995-1997 in men from 4.2 defined daily doses per 1000 inhabitants and day (DDD/t.i.d) to 21.8 and in women from 8.8 to 42.4. Antidepressant sales were twice as high in the elderly as in the 25-44-year-olds and eight times that in the 15-24-year-olds. During the same time period suicide rates decreased in men from 48.2 to 33.3 per 10(5) inhabitants/year and in women from 20.3 to 13.4. There was significant change in the slope in suicide rates after the introduction of the SSRI, for both men and women, which corresponds to approximately 348 fewer suicides during 1990-1997. Half of these 'saved lives' occurred among young adults. CONCLUSION: We demonstrate a statistically significant change in slope in suicide rates in men and women that coincided with the introduction of the SSRI antidepressants in Sweden. This change preceded the exponential increase in antidepressant sales.
> There also exist studies that show the course of depression to be worsened by antidepressant use.True. But when large studies were done, as were just recently published, there is no such signal. You have to consider Type 1 error.
> Current antidepressants reduce depression, and anxiety by creating emotional indifference.
That's one possible outcome.
> The frontal lobe syndrome caused by SSRi's serves to disinhibit the user, making them more prone to impulsive behavior.
What is this frontal lobe syndrome?
> I don't doubt for a minaute that antidepressants can increase the likeyhood of suicide.
There is a brief increase in suicidal risk from SSRIs. When compared to that induction caused by tricyclics, it is a smaller risk. What has happened is that the SSRIs are getting bad press, that tricyclics, for example, never faced.
> Dr. Tracy made a good point. The drug companies pay.
>
>
> LinkadgeThat's where I disagree absolutely. Antidepressants are tools. When those tools are not properly managed, I would focus on the mismanagement. The idea that a potentially suicidal depressed patient is written a prescription for one of these drugs, and told to come back in three months (or whatever), is where the problem lies. Proper medical management requires much more than that. E.g. explicit warnings to the patient, to immediately report certain specific adverse effects; frequent reassessments by trained medical personnel; involvement of the family or close friends of the patient, for monitoring purposes; brief prescriptions initially, until the patient's response can be assessed.....so much more can be done, to make the use of these drugs safe.
The medications in question are powerful, complicated, and somewhat unpredictable. The treated patients are not inherently stable at the time of treatment. Complacency in management of these medications is the primary flaw, IMHO.
Lar
Posted by linkadge on December 14, 2005, at 23:48:14
In reply to Re: What! » linkadge, posted by Larry Hoover on December 14, 2005, at 22:55:52
I see no significant relationship.
I quote from a study in the Archives of General Psychiatry of all U.S. suicides between 96-98.
http://archpsyc.ama-assn.org/cgi/content/abstract/62/2/165
"The overall relationship between antidepressant medication prescription and suicide rate was not significant."
Most psychiatrists agree that the only agents that have demonstrated a clear effect on suicidiality are lithium and clozapine.
>It's been argued, but from smaller samples. Type >1 error is the biggest issue for scientists to >manage.
I don't see anything conclusive here.
Many of the Brittish records show an increased rate of suicide for during start up, but then little to no effect aftarwards.
>True. But when large studies were done, as were >just recently published, there is no such >signal. You have to consider Type 1 error.
No, I am referring to the whole course of the illness. Ie, how without antidepressants, most people recover from depression 8mos to a year. Some studies show that with treatement, it actually becomes a more chronic disorder.
>What is this frontal lobe syndrome?
http://www.antidepressantsfacts.com/frontal-lobe-syndrome.htm
>That's where I disagree absolutely. >Antidepressants are tools. When those tools are >not properly managed, I would focus on the >mismanagement. The idea that a potentially >suicidal depressed patient is written a >prescription for one of these drugs, and told to >come back in three months (or whatever), is >where the problem lies. Proper medical >management requires much more than that. E.g. >explicit warnings to the patient, to immediately >report certain specific adverse effects; >frequent reassessments by trained medical >personnel; involvement of the family or close >friends of the patient, for monitoring purposes; >brief prescriptions initially, until the >patient's response can be assessed.....so much >more can be done, to make the use of these drugs >safe.Even when the tools are used properly, bad things can happen. I am an example. I used the drugs properly.
>The medications in question are powerful, >complicated, and somewhat unpredictable. The >treated patients are not inherently stable at >the time of treatment. Complacency in management >of these medications is the primary flaw, IMHO.No arguments.
Posted by Larry Hoover on December 15, 2005, at 0:21:20
In reply to Re: Dr. Tracy on SSRIs.., posted by linkadge on December 14, 2005, at 22:05:08
> >We're arguing a semantic distinction, about our >interpretation of another person's words
> >Localized serotinergic activation can be, on a >relative scale, high or low. I am arguing >against a global "elevated serotonin" state, as >postulated by the under-educated Tracy.
>
> I see you did not read the link that I put up.I read it. There was no evidence presented that the pre-synaptic neuron would release identical amounts of serotonin under both transporter conditions, nor any evidence presented that COMT or MAO-A concentrations were the same.
> The state that SSRI's induce would be very similar to that of an individual who posesses the double short varient of the serotonin transporter gene.
There is no evidence to reach that conclusion. It is a conceivable hypothesis, but it has never been tested.
The only easily tested hypothesis which arises from this heterogeneity of SERT promoter regions is to determine if SSRI response is different under the three natural populations. It may well explain why SSRIs don't work for everybody. Or part of the why.
> Dr. Tracy argues that SSRI's cause depression and suicide.
SSRIs are depressogenic?
Suicide rates are falling.
http://www.afsp.org/statistics/USA.htmThere is one drug with extremely powerful suicidal potentiation. Alcohol. I won't waste space here, but I have all kinds of data on that.
There is no autopsy evidence for SSRI potentiation of suicide. But alcohol? Huge. Widely available, without a prescription.
> This link that I put up is research showing how lifetime depressive episodes correlate with the serotonin transporter gene. This research supports her theory that taking an SSRI (and thus lowering SERT activity) could cause depression, alcoholism etc.
No, it doesn't. It links a homozygous gene to those events. Not SSRIs.
>
> >We can mess with the brain, with drugs, and >produce unnatural states. Tracy was implying an >innate condition, "excess serotonin", or however >she phrased it, was the underlying etiological >factor in mental diseases of all sorts.
>
> That may be. If we discovered the antidepressant effects of Tianeptine beofore that of SSRI's we might have the same hypothesis.Or Tianeptine might work on homozygous short-short SERTs?
I strongly reiterate. There is no pathological excess serotonin state.
> >Whether that's your theory or hers, I disagree. >I don't think anyone knows the mechanism, but it >most certainly won't be as simple as that.
>
> Many doctors think that the rem sleep depriving mechanisms are key force in their behavioral effects. Quite a few agents (for instance Surmontil) which have no effect on monoamine uptake, but do reduce REM sleep, are effective antidepressants.In so many words, it's like trying to construct a platypus. These pieces, these analogies, do no demonstrate that SSRIs do or do not do similar things. Those are untested hypotheses. Having an hypothesis is proof of nothing. Tracy would have you believing her theory because of plausibility of its constituent hypotheses.
> >It's a meaningless phrase. That's my point. It >contributes nothing, except perhaps, hooking the >naive mind.
>
> If any drug were capable of mimicing some the catastrophic alterations in cognition an sentience that are evident in old age, I'd like to know about it. For instance, smoking will age you prematurely. Knowing that is not meaningless.Getting back to how this phrase came into our discussion, Tracy claims that this "excess serotonin" state causes premature aging. You seem to have just contradicted that, quite explicitly.
>
>
> >Which differs so substantially across the >population it is more reasonably a genetic trait >(susceptibility) than a drug effect.
>
> I was not the first one to suggest the connection between the subjective effects of antidpressants and LSD. Many experienced LSD users have likened the effects of LSD to antidepressants. Studies show that fluoxetine potentiates the discrimintive stimulus effects of LSD.
>
> See the abstract at:
>
> http://www.antidepressantsfacts.com/prozac-lsd.htmNo, not potentiation. "...all data were compatible with additivity of effects rather than true potentiation."
Like alcohol and benzos.
> These reports are more than just coincidences. There are biochemical reasons that the drugs can produce similar states of mind. And that is important information, when faced with the task of sorting out some of the behavioral states that have been linked to SSRI use.
>
> >I am an outlier. Me. I've had very bizarre drug >effects, when compared to normalized data. My >bizarre response to a drug demonstrates nothing,
> >other than I should avoid the drug.
>
> But we are talking about experiences that have happened to more than just one person. We are also talking about experiences that may be partially explained by studies like the one above which show how these two agents can produce similar behavioral states.The one above was about dogs. I wonder just what the dogs said to describe their experiences.
And, individual idiosyncratic reactions happen all the time. Read almost any monograph. "People with sensitivity to X class substances should not use this medication.", or such like. It's not an indictment of the drug. Or even the class of drugs. It's about being responsible about what you ingest.
> >She wants to blame the drug for all aberrant >behaviour. And I'm still waiting for the >explanation part.
>
> And I am still waiting for the explaination for how antidepressants actually help depression.How? Who the heck knows that?
> Since there is not much of a solid theory for that, I can't pick too many holes in arguing the
> negation.That's what I meant earlier about mechanistic arguments. They really are pointless.
Native peoples used to make a special tea from twigs of red willow, to relieve pain. Following a traditional prayer and invocation, the medicine man would administer the decoction, believing that he had facilitated the transfer of the willow spirit to the afflicted party. Often, the pain went away.
Other people, with different beliefs, discovered salicylic acid in willow bark, derived a synthetic form, and made a near-bankrupt German dye chemist named Bayer very rich.
Both were effective treatments, with entirely different mechanisms.
> >Her generalizations amount to hyperbole without >any reasonable support.
>
> Hyperbole without any reasonable support? We've got two drugs. One inhibits the reuptake of serotonin, and the other increases the uptake of serotonin. Both are "effective antidepressants".That's not hyperbole. And we don't know why. But we do know that they work. Empirical evidence.
> Vitamin C either prevents scurvey, cures scurvey, or neither.
In different circumstances, each phrase is true.
>
> >That is false, bizarre, fear-mongering, >meaningless.
>
> Fear mongering, maybe. I see it as a necessary counterballence, in a world of "pop this".How about promoting better medical management. More personal interaction with caregivers. Providing critical information for true informed consent. No fear-mongering required.
> After 8 months off of 100mg of zoloft, I am still relearning how to walk properly.
I'm sorry that is true for you. I must resort to logical analysis. Post hoc ergo propter hoc is a fallacious interpretation, a good part of the time.
You may have other medical concerns.
> >Oh, but you snipped the part about "the gummy >gooey glossy substance". I thought that was so >relevant.
>
> Like I said. I don't agree with everything she says. But I do agree with her main argument that SSRI's can sometimes induce abnormal and frankly dangerous states of mind.Sometimes, they do. And if appropriate precautions had been taken, and corrective action initiated at the first sign of trouble, I think that many of the most serious outcomes would simply never have happened.
When Szasz et al emptied the asylums, the enabling belief that permitted such a drastic change in medical management was that medication alone would suffice. But, what inevitably also happened was that contact with caregivers was totally disrupted. And this idea, that medicine through pharmacepia had reached a golden age, enveloped the entire culture. I remember Prozac hitting the front cover of Time magazine. I still have it, somewhere. Pure propaganda. Everyone bought into it. But nobody wants to take responsibility for it. That's how the Holocaust came about.
> >This woman makes what amount to emotional >appeals. Her theories contain vague expressions >which can be taken in many ways. There is a >plausibilty to what she says. But nowhere, does >she offer the data, the observations, the >physical evidence, to support even her core >allegations. What baby?
>
> Thats not true. For example, she talks about how the worker for Lilly ended up resigning due to her decision to make a firm stance against the safety of SSRI's.I didn't listen to the whole interview.
> She also referres to studies in which patients given SSRI's reported increased hostility and suicidal behavior.I have read through some of the complete clinical trial data for some of the SSRIs. We're talking reports of over 500 pages. The raw data. And I'm convinced, just as the recent task force was convinced, that methodological deficiencies in many studies are so profound, that concluding anything about suicidal induction during the studies is questionable. The studies were not designed to collect that sort of information. The way the information was extracted from the raw data was flawed. In one study I analyzed, which suggested a six-fold increase in suicidality in adolescents using Paxil, the detailed analysis revealed that there were no suicidal gestures attributable to Paxil, and the only true suicidal act was in the placebo group. If you want to see that, I'll dig it up and show it to you.
> If forget her name, but she referred to one of the key scientists who was involved in the idenficiation of the serotonin reuptake mechanism, who referred to the SSRI's as monster drugs. These are real people, with real credability who agree with her on different levels.I have no problems with people holding different opinions. I have problems with people making unfounded allegations, i.e. those without underlying evidence. I'm an empiricist. The data are the only truth we have. All else is interpretation.
> >As I said earlier, let the data speak for >themselves.
>
> Let it.Good. Agreed there.
> >No, not that I've seen.
>
> Ok, maybe not the exact same things. But ther "are" very intellegent people who do not agree that these drugs cary the safety that is assumed by most doctors. There are intellegent people who believe that the drugs can induce suicidal thinking and behavior. Do you want to know who some of these people are?Link, I have very closely followed the research. I read every study on this subject. The recent Healy and Martinez studies were rather compelling. If there is a suicidal signal, it is brief, early, and small. Medical management can handle these issues.
> There are scientist out there right now who are developing animal models of antidepressant induced mania and rapid cylcing. Some of this research is on www.neuransmitter.net. While Dr. Tracy is extreme. I don't thing she is out of the ballpark.
She's in the ballpark. She's the candy floss.
> >Would you kindly present her evidence? I've seen >none. I am totally serious.
>
> Well, for starters, she said that SSRI's can induce psychotic states. I mentioned above some information on researchers who are studing the propensity of SSRI's to induce mania.They can induce psychosis, yes. They can trigger mania, certainly.
> Researchers create links between some of the genes affected by stimulants, and antidepressants, to try and sort out some of the findings. These are obviously *very expensive* studies to undertake, and would not be done if there was indeed "no evidence"
I was meaning her evidence. Her hypotheses are not directly connected to evidence. I'm being generous. Myrrh oil? All mental illness is sugar related? (or something like that)
> >Perhaps we should agree to disagree?
>
> I am happy with anyone who agrees that the safety of SSRI's is not a closed case.
>
> LinkadgeIt's far from closed. And I am not trying to shut the door. I'm trying to lay a solid foundation of empirical evidence, and put to rest hyperbole and fear-mongering.
Lar
Posted by Larry Hoover on December 15, 2005, at 0:34:45
In reply to Re: Tracy, Breggin, and other quacks..., posted by linkadge on December 14, 2005, at 22:17:10
> Med-Empowered and I were refering the other day to some of the studies that showed how mice exposed to SSRI's for exended periods of time developed "corkscrewed" serotonin receptors.
Do you have any idea of the doses used in that study? Off the top of my head, I think it was 360 times the maximum human dose, maintained for 12 weeks (equivalent to 15 years of a human life span). And I think the hypothalamic dendrites were corkscrewed, not the receptors. I don't recall for sure.
> This is one of the studies refered to by Breggin.Who should have known better to simply generalize to people taking the drug as prescribed. There are toxic thresholds. Novel effects that only occur at or above certain concentrations. These are called toxicoses. There is no reasonable extrapolation from that mouse experiment to any human experience conceivable.
> People like to call him a quack, because if the studies he referrs to are true than that changes a lot.
He's a quack because he cherry-picks quotations from studies, reports secondary and tertiary references as if they were primary, reports data out of context, and ignores the published conclusions of the study authors. He also has been shown to fabricate the odd bit of data.
> A psychiatrist may infact believe the study and yet still not tell you this, mainly because he thinks its in your best interest not to know.
That's an easy straw man argument to raise.
> Referring to Breggin as a "quack" makes life easier...... for the time beingBreggin likes to sell books. He does not do primary research. He "mines" other peoples work, and creates a collage. Breggin is better at it than Tracy. He actually knows better, but does it anyway.
> whoa ha ha ha ha ha ha ha ha ha......(sorry)
>
>
> LinkadgeIf you've got the time, you can take Breggin apart, too.
I'm amazed I stayed up to post these. Enough. G'nite.
Lar
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