Why doctors are still "crazy" about antidepressants

I just received a wrenching email from a woman in North Carolina who was prescribed a SSRI antidepressant because she was having trouble eating due to a “horrible metallic taste” in her mouth. After her blood work came back negative, her doctor decided the problem must be “emotional” and prescribed the antidepressant. Now I’m not a doctor, but I know from personal experience that a metallic taste can be caused by any number of things, such as a reaction to surgery or another drug. Why this lady’s doctor would automatically link a bad taste in her mouth to depression is beyond me. Perhaps he decided that her real problem was anxiety and that an SSRI might ease that, I don’t know.

What I do know is that an inordinate number of women continue to be given antidepressants at the drop of a hat, as I’ve written about here. And indeed, the North Carolina woman writes:

I know so many women on SSRI antidepressants that it’s mind boggling! I hear friends talk about how they “need a little something” because they are feeling stressed out so they go to the doc and get a prescription.

Of course, this problem of overmedication is not limited to SSRI antidepressants or women, for that matter. As Philip Dawdy notes in Furious Seasons, 60 percent of antipsychotics prescribed in the VA system in 2007 were prescribed off-label for conditions such as post-traumatic stress disorder, depression and anxiety. This disturbing data comes from a new study in Psychiatric Services, in which the authors themselves conclude:

Given that these drugs are expensive, have potentially severe side effects, and have limited evidence supporting their effectiveness for off-label usage, they should be used with greater caution.

So why do so many doctors continue to prescribe such potent psychoactive drugs with limited efficacy and potentially dangerous side effects? Or as the North Carolina woman put it, why are so many doctors still “crazy about the SSRIs?” It all comes back to the aggressive marketing of these drugs by the drug industry and the reality that so many key opinion leaders in psychiatry are on the pharm companies’ dole. It also has a lot to do with the fact that an astonishing percentage of studies published in supposedly reputable medical journals are ghost-written, usually by paid writers for the drug industry. For example, as much as 10.9 percent of studies published in the prestigious New England Journal of Medicine were ghost-written, according to a new study released at an international meeting of journal editors in Vancouver and first reported in The New York Times.

This kind of disclosure doesn’t inspire much confidence in the way doctors get their medical information, does it?

This latest wrinkle on ghostwriting didn’t, of course, make much difference to my North Carolina pen pal; she had already taken matters into her own hands. After imbibing the prescribed antidepressant for a week and experiencing some weird side effects — bad mood swings and shaking — she went off the drug and is now working with her doctor to find another way to deal with her symptoms. Getting off the SSRI is a good start.

This entry was posted in Uncategorized. Bookmark the permalink.

4 Responses to Why doctors are still "crazy" about antidepressants

  1. Howard S. King, MD says:

Leave a Reply

Your email address will not be published. Required fields are marked *

*

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>