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Clayon on SSRIs

Interesting thoughts here. I think there are a few things we’ll look back on in 50 years with horror. One of them is drugging an entire generation of jittery boys with amphetamines instead of dealing with the problem through proper discipline, and the other is over-prescribing of anti-depressants. I think these drugs can help some people, but these days doctors I think are too keen on making problems go away with drugs than with taking the time to deal with the underlying problem a patient might be having. I don’t blame them, because family doctors aren’t therapists. But the idea that SSRIs don’t come with any downside I think is a fanciful. Clayton’s observation is interesting:

In addition, the warning information on SSRI antidepressants now includes the very real hazard that a person who is severely depressed, once taking the antidepressant, may now have enough energy to plan and carry out a suicide.

Could be. We don’t really know a whole lot about how the brain works, which is why I’m skeptical about tinkering with brain chemicals in new ways and expecting that every issue is going to come out in clinical trials. It’s a lot more complicated than treating other well-defined medical problems.

14 Responses to “Clayon on SSRIs”

  1. Chas says:

    Socialism destroys people’s souls. It gives them a sense of despair and helplessness because it takes control of their lives away from them. It’s evil like that.

  2. McThag says:

    That a depressed person can gain the energy to kill themselves is not really new information. We covered that in Psych 101 way back in 92.

    Them admitting it on the warning label…

    Lots was written about easing the patient through this area. I wonder if the dependence on using drugs has cost the psychological professionals a valuable skill set.

  3. Bracky Rx says:

    I am a pharmacist by trade and I very much agree with this post. We know little to nothing about the long term effects of SSRIs and ADHD medications. These medications are altering and effecting the very essence of brain chemistry. They seem to be treated lightly but they should not be so carelessly used. I very much believe they have medical need for many people but not nearly as many people that use them regularly. Medicating a generation of boys is another issue entirely. Some children certainly have a need for these medications however it does appear in many situations we are trying to “drug” the boy out of the boy. Gone are the days of running outside until you drop. We want our boys to sit in classrooms and not have the chance to run, shoot, jump and play. I believe we will see and are already seeing the long lasting effects of these choices. All in all, I would love to see the use of these medication classes decrease and become more restrained.

  4. Watchman says:

    FWIW I have relatives who are professional Ritalin peddlers, but seem to honestly believe in what they are doing. They prescribe if for everyone from nine to ninety-nine (no centenarians in the family yet) for practically any affliction you can think of. I’m pretty sure they medicate themselves.

    I’m just throwing that in because sometimes we tend to regard these practices as cynical profiteering without doing any real work — which it is. But there are a lot of professionals who, never having known any tool but their hammer, really do see the whole world as made up of nails.

    • Of course, some of these drugs are very effective at improving the lives of a majority. That doesn’t mean that they are always the right choice, but once you have seen a dramatic transformation in someone’s life, it is very easy to see everyone has a nail.

      I have a relative who was disabled and crazy (to the point where his doctors could not determine if he was bipolar or schizophrenic) for more than a decade. Within five days of starting Welbutrin, he was able to again work and be a reasonably sane person.

      I have another relative for whom the various bipolar medications did essentially nothing. Within five days of starting lithium, her bipolar disorder calmed enough to have rational discussions. Today, she is well.

      These are powerful drugs, with enormous potential for good. But also, as with any powerful weapon, enormous potential for harm.

  5. david says:

    The human central nervous system is not fully myelinated until the mid-20s so up until that point it is a “work in progress.” It is not clear what the effects will be when a still-developing brain is exposed chronically to mind altering chemicals – which connections between neurons will not be made, and which connections that shouldn’t be made will be made. There are sound biological reasons to fear this won’t turn out well.

  6. Matthew says:

    A general practitioner MD has no business having the legal authority to dispense psychotropic drugs.

  7. scrotus says:

    Maybe if Clayton Cramer started taking an SSRI he would gain sufficient energy and motivation to realize how unqualified he is to speak on this subject.

  8. Bryan S. says:

    We’ve also had 40 years of children developing and growing up in a world filled with birth control hormones. Add all the soy in our diets 9very high in plant estrogen) and no wonder there are so many things out of wack in people today.

    And its a shame that it is effecting animal and fish as well.

    • Watchman says:

      I don’t know enough to blame anything in particular, but I have long wondered if some major health changes in our society may be a result of things other than what they are quickly and easily blamed on; e.g., the way the “diabetes epidemic” is easily blamed on the “obesity epidemic” which is easily blamed on just lack of exercise, as opposed to massively changed diet habits. (E.g., is it legal to eat anything that doesn’t contain pasta anymore?)

      Just stuff at random: I cringe at the way parents pour Tylenol down little kids’ throats these days, where, when I was a kid, we took an aspirin once in a blue moon, and I don’t think I took a Tylenol tablet until I was almost thirty. Maybe that’s OK, but how many other things do we do, that may not manifest themselves with health changes for forty years?

      • Harold says:

        Hmmm, I don’t doubt it’s being overused, but acetaminophen (Tylenol) is an amazingly safe drug as long as you don’t exceed the recommended dosages (as long as the liver can synthesize at a sufficient rate a necessary chemical that’s part of the pathway in breaking it down). It’s not anti-inflammatory, though.

        Asprin, like all nonsteroidal anti-inflammatory drugs (NSAID) is an acid and can have bad effect on the gut, has a bunch of effects and in general is a drug that demands a lot more respect. And as long as we’re discussing SSRIs, they interfere a bit with blood clotting, as do the NSAIDs, it’s best to avoid taking both at the same time if you can.

  9. dustydog says:

    Worth noting that anti-depressants are actually depressants. Their mechanism of action is to further depress the negative-feedback loop, so that endogenous signaling is increased, pushing the brain out of depression. An analogy would be putting an ice pack on the thermostat, to get the furnace to kick on.

    Drugs should be 5th line therapy. First – cut out the sugar, to avoid insulin spikes. Second – get less sleep (for most depressed people) or more sleep (for insomniacs). Third – more sunlight (mechanism of fighting depression unknown). Fourth – exercise (which helps with the insulin, but also has independent benefits).

    Next – run through the antidepressants in order based on which side-effects you want to avoid, then try ketamine, lithium, et al.

    If pharmaceutical companies ever make a safe anti-fat pill, or a safe & effective muscle-gain pill, those will probably be prescribed before SSRIs.

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