Antidepressants Are Popular — And Dangerous

Number 5 in the USA Today catalog of medical changes in the past 25 years is (imagine a drum roll playing – and CYMBAL CRASH!) — antidepressants are the most popular drugs.

They also have a warning about suicide.  Has anybody noticed?  Does anybody care? Yes, I remember the day when a morning news magazine first talked about fluoxetine — the generic name for Prozac — because I was half asleep, in an on-call room in a Kansas hospital.  I heard the TV (which I had used a few hours before to lull me to sleep) say something about a new antidepressant that would make people sexy and make them lose weight.  I thought I was dreaming, of course, but woke up enough to remember the company (Eli Lilly) and the drug name, and I told it to my chief at morning rounds. We had been running a clinical trial on it, and I had been working on it, and I had no idea where the morning news magazine got the junk they were feeding America.  I had a feeling it could have started with the drug company. Social Security made every patient who was on an antidepressant get a psych exam.  I did a bunch of them.  I tend to believe what patients say, especially when they are naive and confused and have no idea why someone gave them an antidepressant, or why they are on one. Many thought they were “nervous,” so the doctor gave them a nerve pill.  Or they complained of aches and pains they thought the doctor thought were fake or silly. I have been practicing long enough to remember that other drugs have been most popular prescriptions.  It was Valium for a while — “mother’s little helper.”  Sometimes it was antibiotics, but I want to believe that now at least some people know that inappropriate antibiotic prescriptions that are not particularly well considered can cause only strains resistant to that antibiotic to survive. 

We create “worse” infections. See number 13 on the USA today list linked to above. Antidepressants have a lot of side effects, including drug-drug interactions.  Oh yes, and there is suicide as a means of death, in young folks especially. Simple cognitive therapy may work as well as antidepressants in plenty of depression cases. So can fixing the problem —  whether it be loss of job, marital strife or something even more serious, like the loss of a loved one. People want pills, doctors give them, and nobody seems to learn very much.