Items Tagged With Antidepressants

I've never been officially diagnosed with Generalized Anxiety Disorder (GAD), partly, I believe, because there have been so many other disorders for my doctors and I to focus on (depression, Obsessive Compulsive Disorder and Attention Deficit Disorder, anyone?). Looking at the description of GAD, though, I am pretty sure that I have had at least mild anxiety disorder most of my life. I'm definitely a worrier, although I've learned to control it to some extent, and I have had tension knots on my neck since I was a teenager. And I'm really, really bad at relaxing. It's almost impossible for me to relax unless I'm physically exhausted. I used to think that it had something to do with my ADHD, but I'm beginning to think that's not the culprit.

Another tipoff is my nail biting. I've bitten my nails as long as I can remember, down to the quick. I've tried to stop many times, and have even succeeded, sometimes for a year or more, but the majority of my life has been spent with virtually no nails. It took me a long time to figure out why I could stop sometimes and why I couldn't, but I think I've finally hit on it. I think that when I go through periods of heightened anxiety, I start biting my nails again. When I am going through those fairly rare periods of low anxiety, it's a snap to stop.

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Last week, leading psychiatric researchers linked a 2004 increase in the suicide rate for children and adolescents to a warning by the Food and Drug Administration about the use of antidepressants in minors. The F.D.A. warning, the researchers suggested, might have resulted in severely depressed teenagers going without needed treatment.

But the data in the study, which was published in The American Journal of Psychiatry and received widespread publicity, do not support that explanation, outside experts say.

While suicide rates for Americans ages 19 and under rose 14 percent in 2004, the number of prescriptions for antidepressants in that group was basically unchanged and did not drop substantially, according to data from the study. Prescription rates for minors did fall sharply a year later, but the suicide rates for 2005 are not yet available from the Centers for Disease Control and Prevention.

“There doesn’t seem to be any evidence of a statistically significant association between suicide rates and prescription rates provided in the paper” for the years after the F.D.A. warnings, said Thomas R. Ten Have, a professor of biostatistics at the University of Pennsylvania.

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I don't know what to make of it: the number one drug in the universe (Prozac) has now been relegated to nearly last place, while a drug that ten years ago was at the bottom of the atypical antispychotic playlist is now number one with a bullet.
Many people complain about pharmaceutical involvement in doctor prescribing practices, and while this certainly is an issue, what people don't seem to acknowledge is how doctors themselves, independent of Pharma, have prescribing drift. Doctors want to try the latest drugs and see if they're better; but even if they end up being the same and no better, they never drift back. That has nothing to do with Pharma. It's just a habit. Habits are comfortable.

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In a finding that is likely to revive a debate of many years about the safety of drugs prescribed for depression, health officials reported yesterday that the rate of suicide in Americans ages 10 to 24 increased 8 percent from 2003 to 2004, the largest jump in more than 15 years.

Some psychiatrists argue that the reason for the increase is the decline in prescriptions of antidepressant drugs like Prozac to young people since 2003, leaving more cases of serious depression untreated. Others say that it is impossible to know if the increase is linked to patterns of antidepressant prescriptions. The one-year spike in suicides could be a statistical fluctuation, they say, and not the start of a trend.

The increase was particularly sharp among adolescents, especially girls, according to the Centers for Disease Control and Prevention, which released the figures yesterday. The timing of the increase coincided with a public debate in the United States and overseas over whether the antidepressants increased the risk of suicide in a small percentage of young people who took them. In late 2004, after public hearings, the Food and Drug Administration called for drug makers to put a prominent “blackbox” warning on the drugs’ labels, cautioning about the possibility of increased suicide risk in minors.

A talking cure for depression called cognitive behavior therapy appears to cancel the risk of suicidal thinking or behavior associated with taking antidepressant medication, according to the most comprehensive and long-running study to date of depression treatment among adolescents.

The study, which followed for a year more than 600 adolescents being treated for chronic depression, found that four in five recovered entirely, or nearly so, when treated over nine months with medication, talk therapy or a combination of the two.

Patients taking medication showed significant signs of improvement up to six weeks earlier than those who received talk therapy alone, but were about twice as likely to report feeling suddenly suicidal. The combination of the two therapies, the authors found, produced the most rapid recovery and protected against sudden suicidal urges.

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