![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 106. This is the beginning of the thread.
Posted by Hello321 on September 15, 2015, at 21:57:16
This seems about right considering Antidepressants have already been shown to decrease the concern for ones own wellbeing. And when one is less concerned about themselves, surely theyre likely to be less concerned about the wellbeing of others.
Posted by Tomatheus on September 15, 2015, at 23:35:36
In reply to Young people on SSRI's commit more crimes?, posted by Hello321 on September 15, 2015, at 21:57:16
Hello321,
Thank you for posting this article. Even though the article stated that the study in question didn't prove that SSRIs are responsible for the observed increase in criminal violence among young people, the information in the article is definitely cause for concern.
Regarding what you said:
> This seems about right considering Antidepressants have already been shown to decrease the concern for ones own wellbeing.
Has this been shown? I'd be interested in knowing more about this.
Tomatheus
Posted by SLS on September 16, 2015, at 0:02:50
In reply to Young people on SSRI's commit more crimes?, posted by Hello321 on September 15, 2015, at 21:57:16
The study being referred to in this article seems to be very well-done, although it must be interpreted carefully. There are many variables and scenarios to be considered. I don't doubt the validity of the numbers, but I think they need to be clarified and placed into context. I wish I had a background in statistics.
http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001875
> This seems about right considering Antidepressants have already been shown to decrease the concern for ones own wellbeing.
I didn't know that. Is this SSRIs only?
> And when one is less concerned about themselves, surely theyre likely to be less concerned about the wellbeing of others.
You might be right. However, it might also have to do with a reduced ability to process risks and suppress impulses, even though one remains concerned with their wellbeing. I had thought that the explanation for this related to an underdeveloped prefrontal cortex in adolescence, but it seems to be more complicated than that.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2475802/
There is little doubt in my mind that antidepressants affect young people with developing brains differently than they do adults. I guess the question then becomes how many young people are saved by antidepressants compared to those being hurt by them. Can those who would be hurt by them be managed closely enough by their doctors in order to prevent deleterious behaviors?
It is unfortunate that antidepressants can induce suicidal and violent effects in some people - both adults and children. Statistical risks versus statistical benefits? It has been my impression over the years that the statistics indicate that the benefits far outweigh the risks, and that the risks can be minimized if doctors would explain the risks and see their patients once a week early in treatment.
- Scott
Posted by SLS on September 16, 2015, at 0:09:39
In reply to Re: Young people on SSRI's commit more crimes? » Hello321, posted by Tomatheus on September 15, 2015, at 23:35:36
> Hello321,
>
> Thank you for posting this article. Even though the article stated that the study in question didn't prove that SSRIs are responsible for the observed increase in criminal violence among young people, the information in the article is definitely cause for concern.
>
> Regarding what you said:
>
> > This seems about right considering Antidepressants have already been shown to decrease the concern for ones own wellbeing.
>
> Has this been shown? I'd be interested in knowing more about this.
>
> TomatheusI take better care of myself when I am responding to an antidepressant than when I am not taking anything at all.
Perhaps the apathy and amotivation that is sometimes produced by SSRIs enters the equation.
- Scott
Posted by SLS on September 16, 2015, at 7:44:19
In reply to Young people on SSRI's commit more crimes?, posted by Hello321 on September 15, 2015, at 21:57:16
Antidepressant-induced suicide and violence.
I wrote this in 2000 despite much resistance:
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Getting back to antidepressant-induced suicide and violence...
That this occurs is so manifestly true.
I don't think it makes sense to begin a discourse as to the phenomenology of the psychobiological substrate for spontaneous suicidal states (as opposed to a cerebral decision making process) and for that of violence. There is a plethora of personal descriptions on this board to demonstrate conclusively that this is indeed the case.
Check out the posts that are on the board right now!
Serzone-induced anger. What's this all about? Prozac-induced agitation. Wellbutrin-induced rage?
I experienced reboxetine-induced suicidality. Unfortunately, this was not a manifestation of an improvement of depression. It is significant that my suicidal state was dose-dependant. At 4mg., I experienced anxiety, dysphoria, and some catastrophic thinking. At 8mg., these things became quite severe, and suicidal ideation became prominent. I called my parents and told them that I wanted to begin getting my affairs in order. I wanted to hide my savings so that I could bequeath it to family and friends, leaving the state to pay for my burial. Suicidality vanished within 36 hours of my last dose of reboxetine.
What about violent rage produced by benzodiazepine-induced disinhibition? Alcohol?
Of course, psychotropics are not the only drugs capable of exerting a psychotropic effect resulting in depression, aggression, or psychosis. Prednisone, Dianabol, testosterone, Inderal, reserpine, digoxin, l-dopa - Cam, help me out here.
These are just things that can happen when only *one* drug is used. What about combinations of drugs?
Suicidal or violent psychological profile + drug-induced biological perturbation = Suicide and Murder.
This stuff is so obvious, regardless of the statistical rate of occurrence.
If we don't take our heads out of the sand with this one, more people will get hurt.
Drug-induced depression, aggression, rage, psychosis, and suicidality should all be regarded simply as being the adverse side effects and reactions that they are. Just like any other set of drug side effects, they must be screened for through appropriate monitoring. Patients should be educated to the potential of these reactions and be encouraged to report them.
* Does Prozac cause suicide? Yes.
Balance.
- Scott
--------------------------------------------------------: Biol Psychiatry 2000 May 1;47(9):804-12 Related Articles, Books
Lactate-induced rage and panic in a select group of subjects who perpetrate acts of domestic violence.George DT, Hibbeln JR, Ragan PW, Umhau JC, Phillips MJ, Doty L, Hommer D, Rawlings RR
Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland 20892-1610, USA.
[Medline record in process]
BACKGROUND: Perpetrators of domestic violence frequently report symptoms of autonomic arousal and a sense of fear and/or loss of control at the time of the violence. Since many of these symptoms are also associated with panic attacks, we hypothesized that perpetrators of domestic violence and patients with panic attacks may share similar exaggerated fear-related behaviors. To test this hypothesis, we employed the panicogenic agent sodium lactate to examine the response of perpetrators to anxiety fear induced by a chemical agent. METHODS: Using a double-blind, placebo-controlled design, we infused 0.5 mol/L sodium lactate or placebo over 20 min on separate days to a select group of subjects who perpetrate acts of domestic violence and two nonviolent comparison groups. We compared their behavioral, neuroendocrine, and physiologic responses. RESULTS: Lactate administration elicited intense emotional responses in the perpetrators of domestic violence. Perpetrators evidenced more lactate-induced rage and panic and showed greater changes in speech, breathing, and motor activity than did nonviolent control subjects. There were no significant differences between the groups for any neuroendocrine or physiologic measure. CONCLUSIONS: These results are consistent with our hypothesis that some perpetrators of domestic violence have exaggerated fear-related behavioral responses.
PMID: 10812039, UI: 20277614
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1 : Harv Rev Psychiatry 1998 Jan-Feb;5(5):239-46 Related Articles, Books, LinkOut
Mood symptoms during corticosteroid therapy: a review.Brown ES, Suppes T
Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas 75235-9070, USA.
Corticosteroids such as prednisone are commonly prescribed for a variety of illnesses mediated by the immune system. This paper reviews the available literature on mood symptoms during corticosteroid treatment. Few studies have used well-recognized measures of symptoms or clearly defined diagnostic criteria to characterize such mood changes. The limited data available suggest that symptoms of hypomania, mania, depression, and psychosis are common during therapy. Symptoms appear to be dose dependent and generally begin during the first few weeks of treatment. Risk factors for the development of mood instability or psychosis are not known. The similarities of the psychiatric symptoms resulting from corticosteroid treatment to the symptoms of bipolar disorder are discussed.
Publication Types:
Review
Review, tutorialPMID: 9493946, UI: 98152965
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: J Med Assoc Thai 1998 Jul;81(7):551-4 Related Articles, Books, LinkOut
Drug-induced akathisia and suicidal tendencies in psychotic patients.Kasantikul D
Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Five patients, while being treated with high potency antipsychotic drugs developed akathisia and tended towards committing suicide as a consequence of the inner agitation and restlessness they were suffering. Upon discontinuation of the respective medication or switching to low potency drugs, as well as addition of anti-parkinson drugs or benzodiazepines, the akathisia and suicidal tendencies abated. Clinicians ought to be aware of suicidal impulses emerging in patients suffering from akathisia. By prompt recognition and treatment of akathisia such suicidal tendencies and attempts can be prevented.
PMID: 9676095, UI: 98340746
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17 : Int J Clin Pract 1997 Jul-Aug;51(5):330-1 Related Articles, Books, LinkOut
Suicide attempt due to metoclopramide-induced akathisia.Chow LY, Chung D, Leung V, Leung TF, Leung CM
Department of Psychiatry, Chinese University of Hong Kong.
Akathisia as a side-effect of metoclopramide has received increasing attention in consultation-liaison psychiatry in recent years. A case of metoclopramide-induced akathisia resulting in a suicide attempt is reported in order to highlight the suffering of such patients and the factors that lead to misdiagnosis.
PMID: 9489098, UI: 98150356
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Drugs Aging 1997 May;10(5):367-83 Related Articles, Books
Neuropsychiatric adverse effects of antiparkinsonian drugs. Characteristics, evaluation and treatment.Young BK, Camicioli R, Ganzini L
Mental Health Division, Portland Veterans Affairs Medical Center, Oregon, USA.
Parkinson's disease (PD) is a progressive neurological condition that causes considerable disability in the elderly. Drugs used to treat PD, such as levodopa, offer symptomatic relief but often have neuropsychiatric adverse effects, most prominently psychosis and delirium. Aged patients and those with dementia are particularly vulnerable to these adverse effects. Evaluating PD patients with drug-induced neuropsychiatric adverse effects is made difficult by their complex clinical presentations. The treatment of drug-induced psychosis and delirium begins with manipulating the antiparkinsonian drug regimen, but this frequently worsens motor function. Atypical antipsychotics such as clozapine have been successfully employed to treat the psychosis without worsening the motor disability. Patient intolerance of clozapine therapy has prompted open-label studies with newer agents such as risperidone, remoxipride, zotepine, mianserin and ondansetron.
Publication Types:
Review
Review, tutorialPMID: 9143857, UI: 97288925
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29 : J Emerg Med 1994 Sep-Oct;12(5):685-7 Related Articles, Books, LinkOut
Revisiting fluoxetine (Proxac) and suicidal preoccupations.Tueth MJ
Department of Psychiatry, University of Florida, Gainesville 32608.
Several reports were published in the psychiatric literature in 1990 and 1991 documenting fluoxetine (Prozac) causing patients to consider or attempt suicide. During the following 2 years, retrospective studies appeared in the medical literature that seemed to indicate that suicidal preoccupation was not related to the antidepressant fluoxetine (Prozac) but was probably a symptom of the depressive illness. Recent studies have suggested, however, that fluoxetine (Prozac) may in fact lead to suicidal behavior because the drug appears to adversely affect serotonergic neuronal discharge and induce an akathisia-like extrapyramidal reaction. While fluoxetine (Prozac) has a very favorable side effect profile compared to the tricyclic antidepressants, it may cause akathisia and induce a small subset of patients to consider or attempt suicide.
PMID: 7989697, UI: 95081530
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50 : J Clin Psychiatry 1991 Dec;52(12):491-3 Related Articles, Books, LinkOut
Reexposure to fluoxetine after serious suicide attempts by three patients: the role of akathisia.Rothschild AJ, Locke CA
McLean Hospital, Department of Psychiatry, Harvard Medical School, Belmont, MA 02178.
Considerable controversy exists regarding the relationship between fluoxetine and the emergence of suicidal ideation. Three cases are presented of patients who were reexposed to fluoxetine after having previously made a serious suicide attempt during fluoxetine treatment. All three patients developed severe akathisia during retreatment with fluoxetine and stated that the development of the akathisia made them feel suicidal and that it had precipitated their prior suicide attempts. The akathisia and suicidal thinking abated upon the discontinuation of the fluoxetine or the addition of propranolol. The emergence of suicidal ideation during treatment with fluoxetine may be secondary to the development of akathisia. Gradual increments of fluoxetine dose and the prompt recognition and treatment of akathisia may reduce further the rare occurrence of suicidal ideation during fluoxetine treatment.
Comments:
Comment in: J Clin Psychiatry 1992 Jul;53(7):256-7
Comment in: J Clin Psychiatry 1993 Nov;54(11):439PMID: 1752848, UI: 92091324
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J Clin Psychopharmacol 1993 Aug;13(4):235-42 Related Articles, Books
Postmarketing surveillance by patient self-monitoring: trazodone versus fluoxetine.Fisher S, Bryant SG, Kent TA
Department of Psychiatry and Behavioral Sciences, University of Texas Medical Branch, Galveston 77555.
This article presents incidence estimates and relative risks for a number of adverse clinical events reported by outpatients being treated with either trazodone or fluoxetine. Data were collected via an innovative method of patient self-monitoring. Many of the suggested differences between the two drugs are quite consistent with expected adverse drug reactions documented in both the package insert data for outpatients and with reports in the literature. Findings not so readily anticipated for trazodone, however, include higher relative frequencies for muscle weakness or soreness, skin swelling, and urinary complaints compared with fluoxetine; for fluoxetine, data are presented indicating a higher incidence of various psychologic/psychiatric adverse clinical events, including delusions and hallucinations, aggression, and suicidal ideation. Other possible interpretations of the results are discussed.
PMID: 8376610, UI: 93388901
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Posted by Tomatheus on September 16, 2015, at 12:09:17
In reply to Re: Young people on SSRI's commit more crimes?, posted by SLS on September 16, 2015, at 0:09:39
> > Hello321,
> >
> > Thank you for posting this article. Even though the article stated that the study in question didn't prove that SSRIs are responsible for the observed increase in criminal violence among young people, the information in the article is definitely cause for concern.
> >
> > Regarding what you said:
> >
> > > This seems about right considering Antidepressants have already been shown to decrease the concern for ones own wellbeing.
> >
> > Has this been shown? I'd be interested in knowing more about this.
> >
> > Tomatheus
>
> I take better care of myself when I am responding to an antidepressant than when I am not taking anything at all.
>
> Perhaps the apathy and amotivation that is sometimes produced by SSRIs enters the equation.
>
>
> - Scott
>Yes, Scott, I too would suspect that to the extent that antidepressant medications might decrease concern for one's own well-being that the apathy and amotivation that some antidepressant users report would play a role in this. There most definitely seem to be some individual differences in the ways that patients with depression and other disorders are affected by antidepressant medications, and even though I'd naturally expect the medications to increase concern for one's own well-being given that decreased attention to well-being could be a sign of depression, I'm not discounting the possibility that some who take antidepressant medications might show less concern for their well-being while on the medications. I'm just wondering if there is any relationship between the use of antidepressant medications and concern for one's well-being that's been demonstrated scientifically.
Tomatheus
Posted by baseball55 on September 16, 2015, at 19:06:41
In reply to Young people on SSRI's commit more crimes?, posted by Hello321 on September 15, 2015, at 21:57:16
> This seems about right considering Antidepressants have already been shown to decrease the concern for ones own wellbeing. And when one is less concerned about themselves, surely theyre likely to be less concerned about the wellbeing of others.
Where have anti-depressants been shown to decrease concern for one's well-being. Certainly, depression decreases concern for one's well-being, so much so that people contemplate, attempt and complete suicide. Maybe whatever studies you are referring to are measuring lack of concern on the part of those who HAVEN'T RESPONDED to AD's - apparently more that half of those prescribed ADs'. I know that I have little concern for my own well-being when depressed, virtually none, in fact. When drugs work, I start working out, engaging in activities, meditating, calling friends.
I'd like to see the source for your statement.
Posted by Hello321 on September 16, 2015, at 20:36:18
In reply to Re: Young people on SSRI's commit more crimes? » Hello321, posted by baseball55 on September 16, 2015, at 19:06:41
The possible effect of an antidepressant causing lack of concern for ones wellbeing im referring to has been warned about by every governing agency. It is written about clearly on every medication guide handed out to the patient. Im referring to the possibility of the prescription that has been prescribed by a well-meaning prescriber causing the taker to feel a strong/stronger desire to end their life. I consider this a very extreme lack of concern for ones wellbeing. No, these meds dont have this effect on the majority that take them. But it does happen and those who have a strong enough suicidal urge induced by the treatment simply arent here to post about it.
Its awesome when something like Celexa works as intended it increases the takers wellbeing, as some of you experienced. But what happens when someone experiences a worsening of their depression because of a medication like Celexa? What if their hopelessness, irritability and impulsiveness become worse because of the effect the med is having on their brain function? Sometimes these symptoms can get so bad that the one taking the med that feels the world is against them and that there is no way out. Am i wrong? And what can feeling like this lead to?
Posted by Hello321 on September 16, 2015, at 20:50:46
In reply to Re: Young people on SSRI's commit more crimes?, posted by Hello321 on September 16, 2015, at 20:36:18
In the cases where a patients depression is increased because of the antidepressant working against the healthier brain functioning before this patient had before starting the treatment, why should it be expected that in each case this patient will continue to have the same level of concern for their wellbeing as when their depression wasnt as severe?
Sometimes the wrong treatment for ones mood can be like treating a skin cancer patient with ultraviolet rays.
Posted by Tomatheus on September 16, 2015, at 21:59:48
In reply to Re: Young people on SSRI's commit more crimes?, posted by Hello321 on September 16, 2015, at 20:36:18
> The possible effect of an antidepressant causing lack of concern for ones wellbeing im referring to has been warned about by every governing agency. It is written about clearly on every medication guide handed out to the patient. Im referring to the possibility of the prescription that has been prescribed by a well-meaning prescriber causing the taker to feel a strong/stronger desire to end their life. I consider this a very extreme lack of concern for ones wellbeing. No, these meds dont have this effect on the majority that take them. But it does happen and those who have a strong enough suicidal urge induced by the treatment simply arent here to post about it.
>
> Its awesome when something like Celexa works as intended it increases the takers wellbeing, as some of you experienced. But what happens when someone experiences a worsening of their depression because of a medication like Celexa? What if their hopelessness, irritability and impulsiveness become worse because of the effect the med is having on their brain function? Sometimes these symptoms can get so bad that the one taking the med that feels the world is against them and that there is no way out. Am i wrong? And what can feeling like this lead to?Thank you for your explanation, Hello321. Yes, there are indeed warnings stating that antidepressant medications "may increase suicidal thoughts or actions in children, teenagers, and young adults within the first few months of treatment." And I most certainly agree with you that having suicidal thoughts and especially engaging in suicidal actions represent some of the most extreme forms of showing a lack of concern for one's well-being. The warnings about antidepressants and suicidal thoughts and actions also point out that depression and other serious mental illnesses can also cause suicidal thinking and/or behaviors, which does of course raise the question as to whether suicidal actions taken while taking antidepressant medications should be attributed to the medications or to the illness that the medications were prescribed to treat. I think that you'd probably agree with me that the answers to the question that was just raised aren't clear-cut. Antidepressant medications in many cases likely reduce suicidal thoughts and actions (and other instances of reduced concern for one's well-being) by treating the illness that gives rise to such thoughts and actions, but there might also be cases where the medications increase the likelihood that some patients will have suicidal thoughts or engage in suicidal actions. I think that concerns about both the consequences of leaving a depressive disorder untreated and about the consequences of doctors prescribing the wrong medication to the wrong patient are valid, and I think that more needs to be done to address both sets of concerns.
Tomatheus
Posted by europerep on September 17, 2015, at 5:53:26
In reply to Re: Young people on SSRI's commit more crimes?, posted by Hello321 on September 16, 2015, at 20:36:18
> The possible effect of an antidepressant causing lack of concern for ones wellbeing im referring to has been warned about by every governing agency.
The DMV? The EPA? The NOAA Fisheries? Ok, I don't want to be overly disingenuous here, I just want to point out the absurdity of your statement.
> It is written about clearly on every medication guide handed out to the patient. Im referring to the possibility of the prescription that has been prescribed by a well-meaning prescriber causing the taker to feel a strong/stronger desire to end their life.Are you talking about the black box warnings on SSRIs? In that case you should limit your claim to SSRIs, rather than antidepressants as a whole. Or are you referring to the fact that in rare cases, when mood brightening takes longer to kick in than an increase in motivation in patients already harboring suicidal thoughts, these patients may experience increased suicidality and then possibly commit suicide? This can indeed happen, but it requires a lot of very specific circumstances (plus possibly errors on behalf of the prescriber), so making a statement as general and clear-cut as you made in your initial post is most certainly problematic.
> But it does happen and those who have a strong enough suicidal urge induced by the treatment simply arent here to post about it.Actually, a lot of people, including me, have reported experiencing a worsening of depression on certain drugs on this board. Yes, none of us did actually proceed to commit suicide in those circumstances, but the phenomenon is certainly not unknown.
> Its awesome when something like Celexa works as intended it increases the takers wellbeing, as some of you experienced. But what happens when someone experiences a worsening of their depression because of a medication like Celexa? What if their hopelessness, irritability and impulsiveness become worse because of the effect the med is having on their brain function? Sometimes these symptoms can get so bad that the one taking the med that feels the world is against them and that there is no way out. Am i wrong? And what can feeling like this lead to?You're not necessarily wrong, but what should be the conclusion? That we do not prescribe antidepressants at all anymore until we fully understand the (patho)physiology of the human brain? I really don't get your point in making all these claims about psychiatric drugs. I think there is much much more evidence (including on this board) for the terrible, devastating and life-threatening effects of untreated depression than there is for serious, irreversible or possibly fatal effects or side-effects. If you want to change our views on that, you really need more than absurd statements like the above that can be so easily disproven.
Posted by Hello321 on September 17, 2015, at 11:42:50
In reply to Re: Young people on SSRI's commit more crimes? » Hello321, posted by europerep on September 17, 2015, at 5:53:26
> The DMV? The EPA? The NOAA Fisheries? Ok, I don't want to be overly disingenuous here, I just want to point out the absurdity of your statement.
>
> the only absurd part is you not being able to recognize that im referring to every governing agency that monitors/controls antidepressant use.
Youre not going to get anywhere by nitpicking words to the point of absurdity.Every medication guide that has been handed to me at the pharmacy for an antidepressanr from any class, SSRI, NDRI, MAOI SNRI has had a warning about the possibility of taking it leading to inducing new or worsening suicidal thoughts. If it is only the SSRI class that is 100% officially recognized as doing this, and if that leads to you ONLY recognizing SSRI's as causing that effect (even adter all your experience of using these meds) then thats just fantastic.
>> Actually, a lot of people, including me, have reported experiencing a worsening of depression on certain drugs on this board. Yes, none of us did actually proceed to commit suicide in those circumstances, but the phenomenon is certainly not unknown.
>
> nice we agree that it does happen.> > Its awesome when something like Celexa works as intended it increases the takers wellbeing, as some of you experienced. But what happens when someone experiences a worsening of their depression because of a medication like Celexa? What if their hopelessness, irritability and impulsiveness become worse because of the effect the med is having on their brain function? Sometimes these symptoms can get so bad that the one taking the med that feels the world is against them and that there is no way out. Am i wrong? And what can feeling like this lead to?
>
> You're not necessarily wrong,I know this. And you ask me what should be done, and im not going to pretend i have the answer to every question. I could make suggestions that im certain some would like to nitpick to the point of absurdity. One suggestion is that every governing agency (that governs psychiatric meds) be as open and transparrent as possible with the public.
>
Posted by europerep on September 17, 2015, at 15:48:53
In reply to Re: Young people on SSRI's commit more crimes?, posted by Hello321 on September 17, 2015, at 11:42:50
> Youre not going to get anywhere by nitpicking words to the point of absurdity.
My point is that you artificially inflate your claims to make them more convincing and less susceptible to criticism. Who, after all, would possible disagree with "every governing agency"? If you don't want "nitpicking", don't make claims that are patently false.
> If it is only the SSRI class that is 100% officially recognized as doing this, and if that leads to you ONLY recognizing SSRI's as causing that effect (even adter all your experience of using these meds) then thats just fantastic.Again, my point is that we need to look at the facts. As far as I know, in the US, only SSRIs have the black box warning about possible suicidality in teenagers as a side-effect. That other drugs (for me, tranylcypromine) can worsen depression is a different phenomenon. And by the by, I actually think there is something encouraging in this fact: if it worsens my depression, it does at least seem to hit the spot in my brain where depression is "happening", it just does the wrong thing there. Shows that we're not completely off the mark with today's treatments for depression.
> > nice we agree that it does happen.We *all* agree that it is happening. That is precisely why you get those warnings on the package inserts. So yes you are right here, but your point is completely trivial.
> One suggestion is that every governing agency (that governs psychiatric meds) be as open and transparrent as possible with the public.Sounds good, I don't think that many people would object. But posting outlandish claims is not going to get you there. If you want others to stay with the facts, you should do the same.
Posted by Christ_empowered on September 17, 2015, at 16:31:40
In reply to Re: Young people on SSRI's commit more crimes? » Hello321, posted by europerep on September 17, 2015, at 15:48:53
I think all ADs in the US have the black box. Even the atypicals sometimes used for depression have to have the warning.
Posted by Tomatheus on September 17, 2015, at 16:50:02
In reply to Re: Young people on SSRI's commit more crimes? » Hello321, posted by europerep on September 17, 2015, at 15:48:53
> Again, my point is that we need to look at the facts. As far as I know, in the US, only SSRIs have the black box warning about possible suicidality in teenagers as a side-effect. That other drugs (for me, tranylcypromine) can worsen depression is a different phenomenon. And by the by, I actually think there is something encouraging in this fact: if it worsens my depression, it does at least seem to hit the spot in my brain where depression is "happening", it just does the wrong thing there. Shows that we're not completely off the mark with today's treatments for depression.
Europerep,
As far as I can tell, the black box warning regarding suicidal thinking and behavior applies to all antidepressant medications.
Here is a page on the U.S. Food and Drug Administration's Web site listing the antidepressant medications that the warning applied to as of May 2007:
http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/UCM096273
Also, as far as I can tell, it seems that the black box warning is even included in the information that comes with medications that are used in the add-on treatment of depression, given that the Abilify that I get from my pharmacy each month comes with the warning.
I haven't looked at all of the studies that have been conducted on the association between antidepressant use and suicidality. It may very well be the case that only SSRIs, or perhaps only the newer antidepressant medications in general, have been found to increase the risk of suicidal thoughts and behaviors in children, adolescents, and young adults. Nevertheless, it seems that the FDA's warning applies to all antidepressant medications, at least if the information I'm looking at is correct.
Tomatheus
Posted by europerep on September 17, 2015, at 17:32:12
In reply to Re: Young people on SSRI's commit more crimes? » europerep, posted by Tomatheus on September 17, 2015, at 16:50:02
Ok, I stand corrected on that point, thanks to Tomatheus and C_E for pointing it out.
Still, this hardly justifies Hello's general statement that "antidepressants have already been shown to decrease the concern for ones own wellbeing". For very few patients in certain age brackets antidepressants can (temporarily?) increase suicidality. Plus, the fact that the FDA mandates those warnings actually is a sign of openness and transparency.
So I think my larger point still stands.
Posted by baseball55 on September 17, 2015, at 18:42:46
In reply to Re: Young people on SSRI's commit more crimes?, posted by europerep on September 17, 2015, at 17:32:12
A child psychiatrist I know believes some AD's increase suicide attempts in early treatment with teens because the AD's reduce vegetative symptoms before boosting mood, leading to a situation where people have the energy to carry out suicidal plans.
This is not at all the same as "reduced concern for one's well-being." Probably lots of people lie around thinking of suicide, but lack the energy and motivation to carry it through. It's possible that AD's allow people to get up and carry it through.
Posted by Hello321 on September 17, 2015, at 20:00:50
In reply to Re: Young people on SSRI's commit more crimes?, posted by baseball55 on September 17, 2015, at 18:42:46
The depression each human being experiences is as unique as this persons brain. Im sure suicidal thoughts, or a worsening of ones current suicidal thoughts are caused by different experiences each person has when taking the medication. In some cases a suicide might very well be completed simply because the patient has enough energy induced by the med to follow through with it. Other cases it might be the worsening of depression a patient experiences as a result of the med not being right for them. I can see Sexual Dysfunction caused by the treatment resulting in suicide. Not being able to perform for a partner can have very negative effects in ones wellbeing. A healthy libido is a major part of a happy life for many in their "mating years". And in the rare cases sexual dysfunction persists long after an antidepressant is stopped, im sure this can
Be a terrible thing to experience.But to sum up, im thinking there are many reasons why one is pushed to take their life as a result of taking an antidepressant.
This is from Drugs.com:Antidepressants may have a role in inducing worsening of depression and the emergence of suicidality in certain patients during the early phases of treatment. An increased risk of suicidal thinking and behavior in children, adolescents, and young adults (aged 18 to 24 years) with major depressive disorder (MDD) and other psychiatric disorders has been reported with short-term use of antidepressant drugs.
Adult and pediatric patients receiving antidepressants for MDD, as well as for psychiatric and nonpsychiatric indications, have reported symptoms that may be precursors to emerging suicidality, including anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia, hypomania, and mania. Causality has not been established
Posted by SLS on September 17, 2015, at 20:15:24
In reply to Re: Young people on SSRI's commit more crimes?, posted by baseball55 on September 17, 2015, at 18:42:46
> A child psychiatrist I know believes some AD's increase suicide attempts in early treatment with teens because the AD's reduce vegetative symptoms before boosting mood, leading to a situation where people have the energy to carry out suicidal plans.
>
> This is not at all the same as "reduced concern for one's well-being." Probably lots of people lie around thinking of suicide, but lack the energy and motivation to carry it through. It's possible that AD's allow people to get up and carry it through.EXACTLY!
- Scott
Posted by Hello321 on September 17, 2015, at 20:26:34
In reply to Re: Young people on SSRI's commit more crimes?, posted by Hello321 on September 17, 2015, at 20:00:50
But really, hot damn this has gotten way past the point of being mundane. I just dont know why some are so unacceptable of any suggestion that a chemical designed to alter the fundamental functions of the brain that lead to a change in their outlook, thoughts and actions can indeed lead to the worst of scenarios, at least in a certain fraction of those who take it.
Everything these meds/chemicals do to tbe brain is unnatural. It is as artificial as it gets. Sometimes
they function as an amazing artificial crutch that greatly improves the life of the person taking it. But sometimes they work like an artificial "bat" that worsens the life of the person taking it and beats them down when theyre in need of help. Then there are times they are just mildly helpful or mildly harmful. They in no way function like an essential nutrient that is needed when a sick person is low on that nutrient. Maybe one day we will have medications that work tbat effeciciently, but unfortunately at this time we do not. So dont give ourselves more credit than we deserve. We have to recognize any problem before we can fix it.
Posted by europerep on September 18, 2015, at 4:55:40
In reply to Re: Young people on SSRI's commit more crimes?, posted by baseball55 on September 17, 2015, at 18:42:46
> A child psychiatrist I know believes some AD's increase suicide attempts in early treatment with teens because the AD's reduce vegetative symptoms before boosting mood, leading to a situation where people have the energy to carry out suicidal plans.
>
> This is not at all the same as "reduced concern for one's well-being." Probably lots of people lie around thinking of suicide, but lack the energy and motivation to carry it through. It's possible that AD's allow people to get up and carry it through.Yes, that is indeed exactly what I had in mind when I wrote this:
"Or are you referring to the fact that in rare cases, when mood brightening takes longer to kick in than an increase in motivation in patients already harboring suicidal thoughts, these patients may experience increased suicidality and then possibly commit suicide? This can indeed happen, but it requires a lot of very specific circumstances (plus possibly errors on behalf of the prescriber), so making a statement as general and clear-cut as you made in your initial post is most certainly problematic."
Posted by europerep on September 18, 2015, at 5:07:00
In reply to Re: Young people on SSRI's commit more crimes?, posted by Hello321 on September 17, 2015, at 20:26:34
> I just dont know why some are so unacceptable of any suggestion that a chemical designed to alter the fundamental functions of the brain that lead to a change in their outlook, thoughts and actions can indeed lead to the worst of scenarios, at least in a certain fraction of those who take it.
Do you actually read the replies to the things you post? In one of the first replies from Scott he linked to an earlier post of his where he described his own experience with reboxetine and made exactly that point, backed up with scientific references for various drugs. I, too, explicitly acknowledged the phenomenon of worsening depression and suicidality as a rare but possible effect of antidepressants, not the least because I have experienced it myself. And noone here calls into question the black box warnings on antidepressants.
So, if you actually read the posts here you will find that we are by no means "unacceptable" to this. I just object to your dramatizations, misrepresentations and exaggerations.
I also strongly disagree with your qualification of a working antidepressant as an "amazing artificial crutch", but that's for a different thread I guess.
Posted by SLS on September 18, 2015, at 5:59:47
In reply to Re: Young people on SSRI's commit more crimes?, posted by Hello321 on September 17, 2015, at 20:26:34
I understand your argument that antidepressants can have clinical effects that are negative instead of positive. I agree with this. However, one cannot make the argument that an antidepressant can cause someone to begin practicing limbo dancing obsessively without scientific evidence. I don't think that the issue here is whether or not antidepressants can have negative effects on mood and cognition. However, I think you have been challenged to produce sources of information to validate your claim:
"Antidepressants have already been shown to decrease the concern for ones own wellbeing."
Perhaps you could be more specific as to what are the components to "wellbeing" that you are referring to.
- Scott
Posted by SLS on September 18, 2015, at 6:05:51
In reply to Re: Young people on SSRI's commit more crimes? » Hello321, posted by europerep on September 18, 2015, at 5:07:00
> I also strongly disagree with your qualification of a working antidepressant as an "amazing artificial crutch", but that's for a different thread I guess.
Don't get me started!
:-)
- Scott
Posted by Hello321 on September 18, 2015, at 15:42:11
In reply to Re: Young people on SSRI's commit more crimes? » Hello321, posted by SLS on September 18, 2015, at 5:59:47
http://www.drugs.com/sfx/lexapro-side-effects.html
Scott, i honestly thought negative effects on ones mood and cognition were already well recognized possibilities of taking antidepressants. In the link from Drugs.com i posted above, there are many possible side effects listed that affect mood and cognition. And many of them seem like they can be pretty severe.
From the artocle:
"Antidepressants may have a role in inducing worsening of depression and the emergence of suicidality in certain patients during the early phases of treatment. An increased risk of suicidal thinking and behavior in children, adolescents, and young adults (aged 18 to 24 years) with major depressive disorder (MDD) and other psychiatric disorders has been reported with short-term use of antidepressant drugs.Adult and pediatric patients receiving antidepressants for MDD, as well as for psychiatric and nonpsychiatric indications, have reported symptoms that may be precursors to emerging suicidality, including anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia, hypomania, and mania. Causality has not been established.[Ref]
"Very common (10% or more): Insomnia
Common (1% to 10%): Abnormal dreams, agitation, anxiety, nervousness, restlessness
Uncommon (0.1% to 1%): Abnormal thinking, aggravated depression, aggressive reaction, aggravated restlessness, alcohol problem, apathy, bruxism, confusion, confusional state, depersonalization, depression, emotional lability, excitability, feeling unreal, forgetfulness, hallucination, hypomania, irritability, jitteriness, obsessive-compulsive disorder, panic reaction, paroniria, sleep disorder, suicide attempt, tics
Frequency not reported: Mania, suicidal ideation
Postmarketing reports: Acute psychosis, anger, delirium, delusion, disorientation, non-accidental overdose, mood swings, nightmare, psychotic disorder, withdrawal syndrome"These side effects dont just affect the life of the person taking the med. They dont just end at the front door. They can very well have effects on the wellbeing of the patient. I am not understanding what more info people are insisting they need? Are they simply waiting for the FDA or who ever to tell them what the deal is before they make up their mind? I have my own anecdotal experience with such severe effects from various psychiatric meds, and ive mentioned it on this forum before. And im sure that has helped me to understand these severe reactions more easily. But i think theyre listed right there in front of us. And i feel some want to make it as techhnical as Bill Clinton when discussing what the meaning of the word "is" is.
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