freakoutcrazy

Blog des AK Psychiatriekritik der NFJ Berlin

Kategorie: SSRI

Antidepressants, Pregnancy, and Autism: Why Wouldn’t Antidepressant Chemicals Affect a Developing Baby’s Brain?

This week another study was published (Boukhris, 2015) showing that SSRI antidepressant use during pregnancy is associated with increased rates of autism in the children.  By my count, this is now the tenth study on this topic and it follows on the heels of previous studies by Croen, Eriksson, Rai, Harrington, Gidaya, El Marroun and others – all of which found links between SSRI antidepressant use in pregnancy and autism in the offspring.  Most of these studies were recently reviewed by Man, et al, who also concluded that SSRI antidepressant use during pregnancy is associated with autism in the children.

So we now have numerous studies in different human populations all showing a link between SSRI use in pregnancy and autism in the children.  Yet, much of the news and blogosphere focus on casting doubts about these findings.  What is going on here?

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Stopping SSRI Antidepressants Can Cause Long, Intense Withdrawal Problems

In the first systematic review of withdrawal problems that patients experience when trying to get off SSRI antidepressant medications, a team of American and Italian researchers found that withdrawing from SSRIs was in many ways comparable to trying to quit addictive benzodiazepine sedatives and barbiturates. Publishing in Psychotherapy and Psychosomatics, they also found that withdrawal symptoms can last months or even years, and entirely new, persistent psychiatric disorders can emerge from discontinuing SSRIs.

 

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SSRI ‘Indication Creep’ Relies on Negligent Doctors

A report on antidepressant consumption released on 18 February 2014 by the Organisation for Economic Cooperation and Development (OECD)[1] shows huge increases in prescribing of the drugs across most countries. According to the report a key factor driving this increase is the expansion of the off-label use of the drugs for a vastly increased number of indications. While this may not seem like news, I think it warrants some analysis because I think what we are seeing is something more complex than simple market expansion.

In my view what we are seeing is a strategic rebranding of antidepressants as treatments for non-psychiatric conditions which could only occur in an environment where doctors have a criminal disregard for patient safety while knowing they will not be held accountable for patient harm. While the development of a new product often entails sacrificing sales from an existing product, the willingness of doctors to prescribe off label in the absence of any evidence of their effectiveness or safety allows pharmaceutical companies to maintain and even expand their revenues from SSRIs while replacing them with newer drugs and biologics.

After a very long period in which the development of psychiatric drugs involved little in the way of identification of novel agents, pharmaceutical companies and leading universities are now publishing large numbers of studies and issuing media releases telling us they are working on developing, or have developed, a range of new treatments for depression. In a delicate balancing act, big pharma are highlighting the lack of efficacy of antidepressants as a way of promoting their new treatments but remaining silent on their adverse effects so as not to undermine their prescription for non-psychiatric conditions.

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Antidepressants, Pregnancy, and Autism: Time to Worry?

Does antidepressant use during pregnancy lead to autism in the exposed children?  This is a very important question, which new research is beginning to address—and the findings are concerning.

Prozac, the first of the SSRI (selective serotonin reuptake inhibitor) antidepressants, was launched in 1987 and sales have risen since then.  Women of childbearing age make up a large percentage of SSRI users.  Estimates are that up to 13% of US pregnancies are exposed (or around 500,000 US pregnancies per year.)  How the SSRIs affect pregnancy has been an area of increasing concern.  Current evidence suggests that antidepressant use during pregnancy is associated with miscarriage, birth defects, preterm birth, and newborn behavioral syndrome along with other pregnancy complications such as preeclampsia and low birth weight.  The SSRIs appear to be associated with pregnancy complications, but a major area of concern is what the effects are on the developing brain of embryos and fetuses exposed to these drugs.  Available scientific data from animal and human studies raise serious concerns that exposure to SSRIs during pregnancy damages the developing brain and may cause neurodevelopmental abnormalities—including autism.

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Playing the Odds: Antidepressant ‘Withdrawal’ and the Problem of Informed Consent

If I thought that it was possible, I would have opened a string of clinics all over the country to help get people off of antidepressants.  Unfortunately, the problems that sometimes occur when people try to stop an SSRI antidepressant are much more severe and long-lasting than the medical profession acknowledges, and there is no antidote to these problems.

Outside of using a benzodiazepine, I don’t have a lot of suggestions.  Reinstating the medications often does not help and sometimes there is a negative reaction. In the past I worked with SAM-e, thought to enhance neurotransmitter synthesis, and L-tryptophan, a precursor of serotonin.  It had placebo value, but was not an ‘antidote’ to the problem

The problem starts with nomenclature.  The citizen scientists of the Internet have labeled the problem ‘protracted withdrawal.’  To physicians, withdrawal is a phenomenon that starts when the blood level of a substance drops to near zero and persists for a week or two.  The concept of ‘protracted withdrawal’ is inconsistent with the very definition of withdrawal.  So when a patient tells their doctor that they have ‘protracted withdrawal’ the doctor draws a blank.

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