The FDA is charged with making sure that prescription drugs are both safe and effective. But questions have been raised about antidepressants and other drugs for mental illness. Exactly how effective are these medications to treat psychiatric conditions? Are they safe?

How Well Do Antidepressants Work?

Dr. Peter Gøtzsche, a founder of the nonprofit Cochrane Collaboration that evaluates the effectiveness of treatments has taken a hard look at antidepressants like fluoxetine (Prozac), sertraline (Zoloft) or venlafaxine (Effexor). He presents data showing that these drugs, on average, don’t treat depression well.

Side Effects from Drugs for Mental Illness:

We also speak with Thomas J. Moore, who has examined the reports of serious side effects that have been submitted to the FDA. He has found a number of alarming adverse reactions linked to antipsychotic medications and other drugs for mental illness. Some of these drugs are prescribed in addition to antidepressants when depression fails to respond.

What Can Be Done?

Do not despair! Dr. Samantha Boardman is a psychiatrist who has found a number of other ways to help people overcome their depression. Learn about non-drug approaches that can help improve mood and coping skills.

This Week’s Guests:

Peter Gøtzsche, MD, is professor of clinical research design and analysis at the University of Copenhagen. He co-founded the Cochrane Collaboration in 1993 and is currently director at the Nordic Cochrane Center in Copenhagen. Dr. Gøtzsche, a specialist in internal medicine, worked in clinical trials and regulatory affairs in the pharmaceutical industry between 1975 and 1983. He is a member of several groups publishing guidelines for good reporting of research and has co-authored CONSORT for randomized trials (www.consort-statement.org), STROBE for observational studies (www.strobe-statement.org), PRISMA for systematic reviews and meta-analyses (www.prisma-statement.org), and SPIRIT for trial protocols (www.spirit-statement.org). He is author of Deadly Medicines and Organised Crime as well as Deadly Psychiatry and Organised Denial. His website is http://www.deadlymedicines.dk/

Thomas J. Moore is a senior scientist at the Institute for Safe Medication Practices. He is project director for QuarterWatch, a publication that monitors FDA MedWatch reports. The ISMP website is http://www.ismp.org/ His recent publications can be found in Drug Safety (Jan. 2017) and JAMA Internal Medicine (Feb. 2017).

Samantha Boardman, MD, is a Clinical Instructor in Psychiatry and Assistant Attending Psychiatrist at Weill Cornell Medical College. She received her B.A. from Harvard University, an M.A. in Applied Positive Psychology from the University of Pennsylvania, and a medical degree from Cornell University Medical College, where she was awarded the Oskar Diethelm Prize for Excellence in Psychiatry. Dr. Boardman has published papers in journals including Translational Neuroscience, The American Journal of Psychiatry and The Journal of Clinical Psychiatry. Her blog, https://www.PositivePrescription.com, shares insights from the psychiatry and psychology community with readers, and explores the way psychology, culture and science intersect. Dr. Boardman lives and works in New York City. Other links: on Facebook https://www.facebook.com/positiveprescription  on Twitter @sambmd  and on Instagram https://www.instagram.com/positive_prescription/

Listen to the Podcast:

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  1. Sharon
    Solon, Ohio
    Reply

    My beautiful brilliant daughter’s five-year nightmare started the summer after she graduated from college. She was depressed and went to a psychiatrist from a local reputable medical facility. She was prescribed one antidepressant after another…every 6 weeks…but experienced near-constant nausea and vomiting, confusion, irritability, weeping and insomnia.

    She was given the diagnosis of “Treatment Resistant Depression”. After 18 months, she switched to a new psychiatrist who continued to prescribe one antidepressant after another. A year later, she had a “nervous breakdown”. Consumed with rage, convinced her co-workers and parents were the enemy…she tried to stab me with a knife!

    Her psych meds were discontinued, but my daughter was now a shadow of her former self, thin, pale, shaking, confused, impulsive with emotional swings ranging from sobbing to explosive rage. A blood test indicated she had mutations in her MTHFR gene. She began taking methylated supplements and her behavior improved somewhat, but she could no longer concentrate at work.

    Her psychiatrist prescribed a constant parade of mood stabilizers which caused sudden bouts of weeping, violent tantrums and impulsivity. She decided to move to California and later told me she was barely hanging on to sanity at that time. She had another “nervous breakdown” several months after moving and lost her job.

    She enrolled in a psychiatric partial hospitalization program. The doctors were appalled when they heard of her treatment at the hands of two supposedly therapeutic professionals. They told us the constant merry-go-round of antidepressants and mood stabilizers had taken their toll and damaged my daughters brain.

    My once-brilliant daughter is now taking Lithium and Respiradol and is struggling to stay employed. Her doctors believe these meds will allow her brain to heal and plan to wean her slowly after a year.

    Needless to say, I am not a fan of these new antidepressants. Over the past 5 years we have spent an inconceivable amount of money trying to put my precious daughter back together and undo the harm these supposedly competent professionals caused. I warn everyone I can not to get caught up in the antidepressant merry-go-round as my daughter did. The brain damage it can cause is very real and persistent.

  2. george
    New York
    Reply

    I noted that one of the speakers said that DEA has stated that drugs like Xanax can be habit forming. I not a professional but I think that belief should be amended to say that it could be habit forming for some people but not everybody.

    Years ago I took 0.25mg of Xanax for almost a year, 4 times a day for IBS. But when it turned out that my gallbladder was infected & removed, I stopped taking Xanax all together without any problems whatsoever.

    On the other hand a friend took Xanax for a sleep disorder & it definitely caused what appeared to be a long term withdrawal situation. So, I suspect it has something to do with whether someone has an addictive personality or not. Where the underlying cause of an addictive personality is due to brain chemistry & probably a certain synapse pattern but I’m just speculating on this last part.

  3. Sherry B.
    Texas
    Reply

    It is dangerous and foolish to tell people with mental illness that meds don’t help. Pls be careful with this topic.

  4. jackie
    Ohio
    Reply

    Xanax gave me back my life, and i only take a half of a ml. So little, but helps.

  5. Bev
    Texas
    Reply

    I looked at Samantha Boardman’s website (positive prescriptions) and found it very hokey. It’s just a little too “happy,” and for someone who’s already feeling depressed, it’s like reading a facebook post of your friend whose life is just a little too perfect. Her comments on the show were interesting, which is why I wanted to check out the website, but I do not recommend it.

  6. Danelle
    South Carolina
    Reply

    I found this programme very informative. Thank you, Joe and Terry, for being willing to swim upstream and risk the ire of drug companies by pointing out that these medications DO have side effects, sometimes serious. One thing I would add, though, is that a doctor is not always the best person to help with a taper. In my experience I have found a pharmacist at a local compounding pharmacy to be far more informed and helpful as to how much to taper, how often, etc. Doctors are involved with so many aspects of care that their expertise in this area can be quite narrow by comparison.

  7. Rich
    Houghton, MI
    Reply

    I was initially surprised that your speakers did not mention the strong placebo effect that the anti depressants have (in sugar pill form). We are conditioned all our life to equate going to a doctor and being given a prescription for a pill to recovering from an illness. Of course, the allopathic medical doctors you interviewed have been conditioned the same way. The placebo effect is just annoying static rather than proof that our mind can heal us. Fortunately there are doctors like Dr. Boardman who have a more open mind. I have a lot more faith in positive psychology, exercise and nature therapy to which I’ll add diet.

  8. Cindy M. Black
    Seattle, WA
    Reply

    Unfortunately almost all psych meds are central nervous system (CNS) inhibitors, and it is NOT a “surgical strike” but rather a blunt-force impact, damping down many good things with the bad. Basically CNS inhibitors are “old-person” drugs. They make you old before your time.

    Yes, some people absolutely need these meds; their lives would be even worse without them. But I worry that so many people who could improve their situation with some motivation and discipline are lured into taking meds instead. And of course they do, because everyone wants to find that silver bullet that’ll make everything OK. I worked in the mental health system for 30 years, and I can tell you that most doctors and “counselors” are fairly lazy and not very creative in helping people find alternative fixes, helping them understand how and why these fixes might help them. Because of budgetary and other constraints, meds are always the easiest way to go and always the very first thing caregivers turn to.

  9. Betty
    Miami, FL
    Reply

    I HAVE HAD problems since going off CYMBALTA. Neurologists and other Drs. do not believe this can happen!! My problem has been dyskensia. Does anyone else also have this repetitive movement? (Incidentally, mine is burning mouth syndrome, no diagnosis, cure or treatment, strange?)

  10. Ahmed
    TX
    Reply

    I have family members who have bipolar disorder and I know several others who have similar issues. Medications have helped them survive. I think its dangerous to make general statements like “antidepressants don’t work!” Of course, therapy should be used in conjunction with the medicines. And there is no single medicine that works for everyone. So there are risks but they need to be carefully monitored.

  11. Suzi
    Oshkosh
    Reply

    I hope someone with depression and now think the medications don’t work, pretend you never heard this discussion.
    Depression meds work! I know without my medication I would be dead.
    Do not go to your primary physician. Go to a therapist. Get a referral and go.

  12. Mary Beiter
    Hamburg NY
    Reply

    I also have a problem with the information on this show. It is surprising to me that the presentation is so one-sided against antidepressants. The mental health field was absolutely transformed with the introduction decades ago of antidepressant and antipsychotic medications. Lives have been saved, transformed, and people that had no hope beyond institutionalization today would be able to live productive lives. I know; I am one of them. Diagnosed with Major Depressive Disorder in 1989, Prozac changed my life. I no longer felt trapped by my cloud of depression and was able to finally have some sense of normalcy.
    Of course if these medications are taken by people who only have mild depressive symptoms, such as would be seen with what is clinically called Adjustment Disorder, they may do more harm than good. That would be the equivalent of starting someone with borderline type 2 Diabetes on an insulin pump instead of diet and lifestyle changes.
    This shows once again that mental health disorders are misunderstood and demeaned by the general population.

    • Beverly D.
      Texas
      Reply

      Good advice, Mary

  13. Maureane
    Durham, NC
    Reply

    I have a problem with Dr. Gøtzsche’s argument that antidepressants “don’t work”. He argues that when they are given to normal subjects they cause side effects. No duh!
    Every drug causes side effects. That’s why we don’t/shouldn’t give them to people who don’t have a condition that is worse than the potential side effects. That is also why the public at large and the regulatory agencies are misguided to expect drugs to have no significant side effects. It is always a risk-benefit calculation.

    Furthermore, the approach of the Cochrane Reviews can be terribly flawed in many cases. Just because a drug (or any other treatment) does not work for the majority of people, does not mean it doesn’t work for a subset of people. The effect for a selected group of individuals can be readily swamped out by a lack of effect for the entire group. It effect, the approach of pooling all the data on a treatment often results in the conclusion that “there is no evidence that the treatment is effective”. In effect, the Cochrane approach can result in throwing the baby out with the bathwater.

    I have not read the author’s books, only listened to the radio program. However, I have extensive experience with the Cochrane approach in general and know very well of cases where individuals not familiar with the particular field wrongly, in my opinion, concluded that an treatment is not effective when it actually is – when used for the right patients.

  14. Kj
    NC
    Reply

    This is an excellent show. Realistic, straight-forward, seems easily helpful with the wide range of helpful info and insights. Dr Samantha really ROCKS!

    • Gail
      Virginia
      Reply

      Add me to the list of people helped out of major depression by antidepressants. I also had psychotherapy, and I believe that both were necessary. I could not have benefitted from therapy without the relief given by the medications.

  15. Matthew
    Largo, FL
    Reply

    Question for Dr Gotsczche and for psychiatry in general, there are many people who have taken antidepressants successfully for depression, then “periodically reconsider use” and stop taking the medication; each time they go off the medication the depression re-emerges; when they go back on the antidepressant the depression diminishes.?
    From my experience, the “euphoria” that Dr G refers to is less common than he implies; in fact, it is common for antidepressant takers to experience it as “putting a floor on the depression” – antidepressant keeps people from the deeper despair, helplessness/hopelessness and suicidal thinking.

  16. Andy A.
    Gibsonville, NC
    Reply

    Hello Joe and Terry: I’ve been prescribed Lithium Carbonate, Bupropion, and Lamotrigine for over twenty years now to treat mono-polar depression and an accompanying mood disorder. These medications seem to be working fine with few side effects except for some thirstiness from the lithium. None of the other antidepressants ever worked for me. I expect to use these medications for the rest of my life because they have given me my life back.

  17. Ken
    Reply

    There are known unwanted effects from all medications. We routinely judge the hoped for benefits of a medication against the risk that it carries. In my role as a psychiatrist, I recently started a young man with schizophrenia on an injectable long term antipsychotic. Prior to being brought to our program he has three years of increasingly irritable aggression and violence against family and community with multiple arrests. Now after six months on meds, he has not been re- arrested, his parents have allowed him to move back into their home, and he is holding a part time job. That is a lot of benefit. How much risk should I accept in order to gain that much benefit? Is it reasonable to ask a person who has active thought disorder (as made evident by his behavior and thought process) to make that decision “for himself”? He may well develop diabetes in ten or eleven years on this medication. We know how to treat diabetes. His other real option is to be arrested and spend the next ten or eleven years in state prison for his action. Am I part of a conspiracy of organized denial to have made that decision?

  18. Susan
    Houston, TX
    Reply

    A very close friend was diagnosed with depression and put on medication. Instead of helping, the medication turned her depression into bipolar disorder. She is currently on medication that has completely curtailed her manic episodes, but not the depression. She is now experiencing shaking, a side effect of one of her medications. She has been unable to hold a job for many years and looks far older than her age. I far as I can tell, the medication has only succeeded in making my friend “easier to handle”. It is my personal opinion that my friend’s depression could have been managed with talk therapy when she was first diagnosed, but instead was immediately put on medication. Are Psychiatrists getting lazy? Is it easier to just hand out pills rather that actually talk to their patients?

  19. Patty
    Reply

    Tragically, recklessly, these Drugs have been pushed by Drug companies and prescribed by doctors to anyone in the general public as harmless as taking a vitamin. I am sure that they may be life savings for definitive, mental illnesses. People with psychosis. Instead they are marketed to anyone who is having a bad day or struggling with life setbacks. We can not, will not always win, be happy and have everything that we want in this life. Coping mechanism must be taught and learned. Pills do nothing to solve life issues. These drugs ruin lives. People become addicted. They end up unable to quit. They should not be taken long term for much issues. It’s all about profits not people. People lose their judgment, overdose and die. Large numbers of young people, and others under 50 yrs. old.

    • Sunny
      AK
      Reply

      Did her Dr. tell her these drugs shorten lives of user 20-25 years?

    • Gail
      Virginia
      Reply

      Insurance companies drive the “pill pushing.” For many years, my insurance would not cover “psychotherapy” but would cover “medication management,” i.e., a 10-minute visit. I have a friend who was my original psychiatrist who quit practicing partly because of the difficulties dealing with insurance.

    • Susan
      Reply

      Susan and Patty, I’ve suffered from Major Depressive Disorder for many years. This condition is much more serious than having a bad day or struggling with life issues. Not every drug will work for every person. Sometimes, there is trial and error in finding the right medication to treat mental illness. My psychiatrist and I have found a medication combination that works for me. My life hasn’t been ruined; it’s on track. I’m not addicted to anything. I don’t like some of the side effects, but I can tolerate them. I agree with the person who advised that patients get treated by a mental health professional, not the family doctor. My psychiatrist and I also talk. I feel very fortunate. Please, let’s not throw out the baby with the bathwater.

  20. Katie
    San Diego
    Reply

    I don’t see any link to the podcasts you mention. How do we listen?

  21. robert lannon
    95948
    Reply

    Clozapine, clozaril ….NO …Five black box medication…Agranulocytosis, heart, infarction… My daughter had all these symptoms after only three months with her provider …Robert

    • Mary
      Charleston SC
      Reply

      My daughter’s primary care doctor put her on Cymbalta for “gastric distress” and “neuromuscular pain.” She stayed on it about three months and tried to discontinue it, which caused her brain zaps and fearful discomfort for weeks, even though she stopped it very gradually. She said coming off Cymbalta was much worse than the problems she had before starting it. The experience has left her disillusioned with the medical profession and very suspicious of prescription meds, especially “new and improved” ones.

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