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The Antidepressant Dilemma (long read)
NY Times ^ | November 21, 2004 | JONATHAN MAHLER

Posted on 11/20/2004 7:07:55 PM PST by neverdem

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1 posted on 11/20/2004 7:07:56 PM PST by neverdem
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To: neverdem

Isn't it ironic that an anti-depressant killed someone?


2 posted on 11/20/2004 7:13:00 PM PST by Angry Republican (yvan eht nioj!)
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To: neverdem

prozac & paxil have many more horror stories on the internet than zoloft. I don't know why.


3 posted on 11/20/2004 7:22:05 PM PST by agitator (...And that no man might buy or sell, save he that had the mark)
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To: Angry Republican
"Isn't it ironic that an anti-depressant killed someone?"

On the surface, yes, but then if you know the science behind them you might get angry.

Serotonin, an important chemical produced in the brain, is considered essential for relaxation, concentration, sleep and calmness. Its lack or suppression can lead to severe mental disturbances and even violent behavior. To make serotonin the body requires adequate levels of magnesium, tryptophan and vitamin B-6, nutrients which the USDA says American diets are severely deficient in, but which medical doctors rarely run tests for -- even when they prescribe medications which affect serotonin levels (which includes "anti-depressants," and which is often!).

There are about 200,000 deaths a year because of prescription (legal) drugs, including the homicides and suicides from "serotonin re-uptake inhibiters" and other so-called anti-depressives (in contrast to about 20,000 deaths a year in the U.S. because of illegal drugs).

Most American medical doctors have taken no more than 5 hours of nutrition classes in medical school if any at all, but they are subjected to dozens and dozens of presentations by pharmaceutical company representatives on patent medications every year. So it should be no wonder why more and more people look elsewhere for advice on real nutrition.

4 posted on 11/20/2004 7:26:46 PM PST by FreeKeys ("There is always an easy solution to every human problem -- neat, plausible and wrong." -H.L.Mencken)
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To: neverdem

I all most hung myself trying to read that!


5 posted on 11/20/2004 7:33:05 PM PST by Boazo (From the mind of BOAZO)
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To: fourdeuce82d; El Gato; JudyB1938; Ernest_at_the_Beach; Robert A. Cook, PE; lepton; LadyDoc; jb6; ...

FReepmail me if you want on or off my health and science ping list.


6 posted on 11/20/2004 7:36:18 PM PST by neverdem (Xin loi min oi)
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To: neverdem

Bump


7 posted on 11/20/2004 7:36:22 PM PST by AnimalLover ((Are there special rules and regulations for the big guys?))
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To: FreeKeys

Very interesting. Thank you.


8 posted on 11/20/2004 7:46:11 PM PST by Canticle_of_Deborah
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To: FreeKeys

a nutritional deficiency would explain certain food cravings in depressed people and even women with PMS who are now offered repackaged antidepressants.


9 posted on 11/20/2004 7:48:00 PM PST by Canticle_of_Deborah
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To: FreeKeys
"To make serotonin the body requires adequate levels of magnesium, tryptophan and vitamin B-6, nutrients which the USDA says American diets are severely deficient in, but which medical doctors rarely run tests for -- even when they prescribe medications which affect serotonin levels (which includes "anti-depressants," and which is often!)."

-- and even when just taking supplements for those missing nutrients may have been all that is required.

Amendment X to the Constitution of the United States, together with Article I, Section 8, prohibits the U.S. Congress from involving itself in cabbage pricing, education, health care, personal safety, campaign financing, most criminal law, toilet capacity, the banning of amino acid supplements (specifically, tryptophan) and thousands of other things it has gotten away with (so far). (see http://lcweb2.loc.gov/const/constquery.html)

10 posted on 11/20/2004 7:52:50 PM PST by FreeKeys ("'Solve' and 'problems' are not in the Constitution." -- Doug Newman)
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To: FreeKeys

Do you have any reputable links?


11 posted on 11/20/2004 7:54:08 PM PST by neverdem (Xin loi min oi)
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To: neverdem

I lost my son, Jeff, (17) in Feb of 1999 due to major depression (suicide). He was on Zoloft, and it made it worse, I am certain. God, I miss my son! I wish the FDA would get it's act together regarding anti-depressants.


12 posted on 11/20/2004 8:03:37 PM PST by Highwayman53 (Behind Enemy Lines...)
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To: FreeKeys

I don't think these goofy MD's care. When I went to see my OBGYN he just gave me lexapro for post partum, Never bothered to see about lifestyle changes or therapy. and the crazy thing was that he knew the last thing I wanted was drugs and for the next 6 months I went through h***. Thank GOD I am off and doing well.


13 posted on 11/20/2004 8:04:36 PM PST by dahlena
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To: agitator
Since this is the New York Times we're talking about, let me pull out the nut graf for everyone:

Chad Brownel, Matt's only close friend at Harmony, said that Matt mentioned suicide ''hundreds of times'' during the six months that they'd known each other. And toward the end of the school year, when Roxana Rogers asked Matt about his plans for the summer, Matt said that if his parents sent him away to camp, he would kill them and then kill himself.

The simplest way to think about SSRIs is this: They give the patient back his energy before they give him back his mood. Many, many people who have both moderate to severe depression and suicidal ideation are literally too depressed to kill themselves. They want too, but they're too detatched to even be bothered to go through with an attempt. Once you start them on an SSRI, there is a short period of time, roughly one to six weeks, where they medication will be effective enough to give the patient some of his energy back, but not effective enough to relieve the underlying depression. Obviously, in those who are already thinking about suicide, this can be an extremely dangerous period of time, because it gives them a window in which they'll have both the desire to kill themselves and the wherewithall to go through with it.

The solution, however, is incredibly simple: All patients with even the slightest hint of suicidal ideation (like the subject of this article) should be monitored 24 hours per day for the first few weeks after being started on an SSRI. You don't have to lock them up for the duration, but you can't just toss the bottle of pills at your kid and continue with your daily routine during this time.

Assuming this article is telling the truth about what occurred (a giant if, given the source), the doctor should have made this very clear to the parents. But in any case, for all the bloviating in the MSM about this issue over the last few months, the reality is that doctors and scientists have known that SSRIs act this way for pretty much as long as they've been in existence. The only reason these medications are getting black box warnings is because there are so many doctors and parents out there that simply don't want to take any responsibility any more.

14 posted on 11/20/2004 8:25:12 PM PST by Dont Mention the War (How important a Senator can you be if Dick Cheney's never told you to "go [bleep] yourself"?)
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To: Angry Republican
Isn't it ironic that an anti-depressant killed someone?

No. They sometimes have devastationg effects on some people even in small doses. Most of them require a weaning-on period. Sometimes they throw you into a severe agitated state which I can only describe as a preview of hell.

Some depressed people cannot tolerate anti-depressants. Sometimes if you have anxiety or comorbidity, a transquillizer works better. Take care of the anxiety and the depression lifts because you are able to get out and do more things comfortably.

I will never take another drug without doing extensive research on the anxiety/panic/depression newsgroups to see the various reactions people have towards them.

We have a tendency to trust doctors which is fine (to a point) with psyiological drugs but can be deadly when dealing with brain chemistry altering drugs.

People going on anti-depressants should be watched carefully for increased anxiety/agitation/tremors/behavorial changes. If you have a negative reaction, it sometimes takes quite a while to resolve. A lot of people cannot articulate what they are feeling. Outwardly they seem better because they seem to have more energy and "sound" better but inwardly they are in terrible danger.

Some people can almost effortlessly go on to anti-depressants and when get the chemicals built up with positive transformative effects. For others it is a recipe for disaster. I would imagine it is even worse for younger people who are more volatile anyway and don't know what to expect and trust their doctors because things like antibiotics work in such a life-saving manner. It is not the same with psychological meds.

They used to put you in the hospital and monitor your reactions, blood pressure etc. Now they write you a script and send you out the door and tell you to come back in a month or so. In the meantime, anything can happen.

15 posted on 11/20/2004 8:28:51 PM PST by Aliska
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To: Angry Republican
Isn't it ironic that an anti-depressant killed someone?

Yes it is.

16 posted on 11/20/2004 8:30:33 PM PST by EGPWS
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To: neverdem

The list of what the USDA has said is depleted in the food supply is in one of my many bookshelves, and I don't know where it is right off, and I'm tired. I do recall that they said magnesium barely meets the RDA's (but various nutritionists claim the RDA's are ridiculously low in this, in B-6 and in some other nutrients).

FWIW, I do respect the Life Extension people and their obsession with data ( http://www.lef.org/ ). Some people say their research should be discounted since they have products to sell. I say anything funded by government and universities should therefore be doubly-discounted since they have tyranny to sell and tenure to buy. In any case, let the buyer beware, ESPECIALLY when anyone claims to be unbiased.


17 posted on 11/20/2004 8:30:49 PM PST by FreeKeys ("'Solve' and 'problems' are not in the Constitution." -- Doug Newman)
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To: neverdem

Does anyone know if Zoloft has a similar affect on adults?


18 posted on 11/20/2004 8:31:54 PM PST by ChocChipCookie (Really! I'm just a nice little stay-at-home mom!)
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To: Highwayman53

Prayer for the both of you. Condolences.


19 posted on 11/20/2004 8:31:59 PM PST by John Robertson
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To: Aliska
I will never take another drug without doing extensive research on the anxiety/panic/depression newsgroups to see the various reactions people have towards them.

Where did your lack of trust in Doctors first originate to place such trust in the Internet?

20 posted on 11/20/2004 8:34:08 PM PST by EGPWS
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To: EGPWS
Where did your lack of trust in Doctors first originate to place such trust in the Internet?

Because they made so many mistakes in my treatment over the years. They just have to make an educated guess about what might work for you. Can you say "guinea pig"? They don't really know and just start trying a drug and switching to another or a combo until they find something that seems to work. Sometimes if you are on a drug long-term, it quits working. Sometimes a drug only does half the job but it is better than not being able to function at all.

I was once put on a drug (mao inhibitor). I woke up about 8 times a night, felt like laying down in the park and finally lost control of my bladder. I had to threaten to get a lawyer if I had to take any more of that. How many sick people have the courage to take on a powerful doctor? They have the power to throw you in a state hospital if you don't cooperate in taking your meds and the courts back them up.

It depends on the illness. People with schizophrenia are particularly at the mercy of their doctors.

I suffer with anxiety/depression with some ocd behavior which is difficult to treat.

In the beginning, I took whatever they dished out without questioning any of it. Neither did my family because everyone is frightened of and for a family member who suffers from psychological disorders. And everybody trusts doctors.

I shudder to think what they are doing to some helpless people who are unable to articulate what is going on inside or are in nursing homes, etc. People should *always* have a second or third opinion and *never* trust one primary care giver, even if there can be some conflict over professional turf in the process.

21 posted on 11/20/2004 8:48:25 PM PST by Aliska
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To: neverdem

My apologies. I'm so tired I'm not thinking (not that tiredness has that much to do with it). Nomatter whether the USDA is basing their assumptions on Americans eating 5 servings of fresh fruits and vegetables a day or not, and nomatter whether my recollection of what they had to say is accurate or not, the point really is: MD's SHOULD test each referenced patient for those nutrients from which serotonin is made BEFORE they make THEIR hurried decisions, whether they are to prescribe nutrient supplements, prescription meds or whatever.

As far as which nutrients the body needs to actually synthesize serotonin is concerned, I'm sure a minimal amount of Googling will get you there. Sorry to be so brusk (before my head hits the keyboard!).


22 posted on 11/20/2004 8:56:42 PM PST by FreeKeys ("'Solve' and 'problems' are not in the Constitution." -- Doug Newman)
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To: neverdem

Did anybody give thought that these people might be killing themselves caused they ARE depressed?


23 posted on 11/20/2004 8:59:27 PM PST by TwoBear (Go Big Orange!)
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To: neverdem
In 2002, 11 million antidepressant prescriptions were written for children and adolescents in the United States.

For anyone on antidepressants, ritalin, or other psycotropic drugs, or if considering taking them please visit www.breggin.com

24 posted on 11/20/2004 9:00:04 PM PST by tutstar ( <{{--->< http://ripe4change.4-all.org Violations of Florida Statutes ongoing!)
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To: Highwayman53

I'm sorry about your loss.
I've been on anti-depressents for many years myself and it's hard to decide if I'm better off on the meds than off them.


25 posted on 11/20/2004 9:03:24 PM PST by MeekMom (When are the Hollyweirds moving to Canada/France?)
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To: neverdem
This is criminal. The parents should have sued the doctor as well, who was getting tens of thousands of dollars yearly as a shill for these drugs.

As long as parents are "looking for a miracle" (as the parents in the article put it), and as long as doctors are making quick & easy profits, no one has any motivation to look into the *behavioral* and *alternative* treatments for depression available. Of course, as the article also says, many of the things which *cause* teenagers to be depressed are considered "unchangeable" (when in actuality they are NOT.)

26 posted on 11/20/2004 9:08:21 PM PST by valkyrieanne (card-carrying South Park Republican)
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To: ChocChipCookie
Does anyone know if Zoloft has a similar affect on adults?

I just checked the precautions for a number of SSRIs. All of their precautions included watching for suicidal tendencies or suicidal ideation. The distinction between adolescence and adulthood is somewhat arbitrary. Suicide is the worst outcome of untreated depression. I would be wary for about the first 6 weeks that someone started taking a SSRI to be on the safe side. I'm always leary about adverse drug reactions.

27 posted on 11/20/2004 9:10:17 PM PST by neverdem (Xin loi min oi)
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To: Dont Mention the War; Aliska

Both of you make excellent points - the key here seems to be that these drugs for many people may be *too dangerous* in the first month or so without hospitalization. But insurance companies won't pay for 4-6 weeks of hospitalization (they usually provide only 10 days or so.) Obviously for some it's not enough.


28 posted on 11/20/2004 9:12:02 PM PST by valkyrieanne (card-carrying South Park Republican)
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To: TwoBear
Did anybody give thought that these people might be killing themselves caused they ARE depressed?

Perhaps. But my son was prescribed paxil for anxiety and tried to kill himself. He wasn't depressed.

The particular side effect of restlessness/agitation seems to be the precursor.

29 posted on 11/20/2004 9:16:24 PM PST by Dianna
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To: Aliska
Because they made so many mistakes in my treatment over the years.

Doctors make mistakes so the Internet is more appealing to you?

Personally I am taking Paxil, because I explained to my Doctor that I have been having trouble sleeping since my aortic dissection surgery.

I felt that the 20mgs was too strong for me and I self medicated to 10mgs and with the approval of my Doctor all is well.

Point being, if you are dissatisfied with treatment by your doctor, why would you go to the Internet for comfort in knowing that your treatment would be better?

Unless of course, for some personal reason you have a distaste for proved medical service I would recommend that you seek another Doctor before going to the Internet when it is your health that is at stake.

30 posted on 11/20/2004 9:19:15 PM PST by EGPWS
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To: valkyrieanne
Both of you make excellent points - the key here seems to be that these drugs for many people may be *too dangerous* in the first month or so without hospitalization. But insurance companies won't pay for 4-6 weeks of hospitalization (they usually provide only 10 days or so.) Obviously for some it's not enough.

I'd be happy if Dr's would mention that restlessness/agitation is a MAJOR warning sign. I was told about insomnia, I was told about appetite problems. No one mentioned restlessness.

I was still trying to find out from my child's teacher what she meant by "having difficulty controlling himself, physically" meant when my son tried to kill himself in her classroom.

31 posted on 11/20/2004 9:19:55 PM PST by Dianna
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To: neverdem

Someone realy ought to redo "Bowling for Columbine" exposing the real reason those boys did what they did. Moore goes to such bizarre lengths to prove America is a violent culture and guns are evil and Charlton Heston is the devil. the truth is much simpler: The 2 Columbine boys were on a combanation of Prozac and Ritalin, which has been proven in a Cornell study to produce feelings of rage, persecution and paranoia, with violent tendencies at a rate 100x that of Prozac or Ritalin alone.


32 posted on 11/20/2004 9:26:05 PM PST by montag813
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To: MeekMom

There is a good story though...Lexapro has changed my life for the better and the lives of others I know.


33 posted on 11/20/2004 9:53:22 PM PST by nonliberal (Up the feces tributary without a means of locomotion.)
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To: neverdem

Was there some studies showing that the number of suicide has steadily decreased since SSRI as introduced?


34 posted on 11/20/2004 10:18:02 PM PST by Fishing-guy
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To: Fishing-guy
Was there some studies showing that the number of suicide has steadily decreased since SSRI as introduced?

From the article:

Studies have shown that areas in which antidepressant use among young people is widespread have experienced a dip in teenage suicide rates; according to Dr. John Mann, a suicide expert at Columbia University, fewer than 20 percent of the 4,000 adolescents who commit suicide in America each year are taking or have ever taken antidepressants. ''It would be ludicrous to think that antidepressants could actually contribute to suicide in the United States in any kind of significant way,'' Mann told me. ''The vast majority of teen suicides are actually committed in the absence of antidepressants.''

35 posted on 11/20/2004 10:34:15 PM PST by neverdem (Xin loi min oi)
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To: neverdem
Both of them took a month off from work.

Little bit late there with that, aren't you, bow-tie daddy and soft-bowed-blouse mommy?

36 posted on 11/20/2004 11:05:49 PM PST by fire_eye (Socialism is the opiate of academia.)
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To: neverdem

Sounds strange that the suicide is attributed to merely one week of medication. It is counterintuitive: one would think that much greater exposure would be needed for serious side effects. Seems like the case was worse than garden variety depression.


37 posted on 11/20/2004 11:32:00 PM PST by GSlob
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To: neverdem

Currently using Wellbutrin, which doesn't have the side effects that Zoluft has, but has done nothing but make me amgry and irritable.


38 posted on 11/21/2004 2:36:25 AM PST by Clemenza (Gabba Gabba Hey!)
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To: neverdem

I will bet that the good Dr. was getting rewards (kickbacks) for the number of scripts per week!


39 posted on 11/21/2004 3:30:14 AM PST by stockpirate (Not we must take our mandate and do the deed.)
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To: neverdem

Not a word in the article about dopamine - and interactions w/ sleep, dopamine, and these drugs.

Should be.

Incredible read.


40 posted on 11/21/2004 5:32:16 AM PST by gobucks (http://oncampus.richmond.edu/academics/classics/students/Ribeiro/laocoon.htm)
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To: EGPWS
Doctors make mistakes so the Internet is more appealing to you?

Not at all. I wouldn't self-medicate from the internet. I sought out discussion groups because I have known a lot of people with problems and mine is different from anyone I have ever known until I found the internet discussion groups and found out that people who have both depression and anxiety can have serious problems going on anti-depressants. I never knew that before and no doctor ever told me that specifically.

I wouldn't have said anything at all in this discussion, but I kind of wanted to warn readers that some drugs that work great for some people are disasters for others, and the doctors don't know for sure until they try them on you.

I shouldn't have said doctors make mistakes. It is a trial and error process in most cases with these meds, and most doctors do the best they can.

The only reason I said anything at all is that I don't want anyone else to go through some of the things I have been through. Sometimes you have to assert yourself with your doctors and stop taking things that are affecting you adversely and look for something more suitable.

Sometimes tranquillizers will get you over the hump, but they are really pushing the SSRI's right now for some reason. You cannot go off them cold turkey but have to taper off.

41 posted on 11/21/2004 9:09:37 AM PST by Aliska
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To: montag813
Interesting. Two questions:

a) Sources for this?
b) What is Prozac prescribed for IN TEENAGERS anyway?

42 posted on 11/21/2004 11:53:30 AM PST by grey_whiskers (The opinions are solely those of the author and are subject to change without notice.)
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To: Highwayman53
God, I miss my son! I wish the FDA would get it's act together regarding anti-depressants.

My heart goes out to you. Having two little girls I can't comprehend how you feel.

However that doesn't matter to these people. There is too much money in it for them to worry about little things - like your son. These bastards in the FDA are setting themselves up for cushy jobs at Eli-Lilly etc after they oversee the drugs the same companies put out. A personal experience with a surgical tool company opened my eyes to the fact that there are people who will sit in an office and let people get blinded, maimed or killed for a decent salary. It was an ugly revelation.

Trial lawyers and punitive damages do have a place. The corporate veil for some circumstances has to be limited.

God Bless You.

43 posted on 11/22/2004 12:35:29 PM PST by Nov3 ("This is the best election night in history." --DNC chair Terry McAuliffe Nov. 2,2004 8p.m.)
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To: Al B.

No one has accused anyone of being a Scientologist yet


44 posted on 11/22/2004 12:36:40 PM PST by Nov3 ("This is the best election night in history." --DNC chair Terry McAuliffe Nov. 2,2004 8p.m.)
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To: neverdem
''The vast majority of teen suicides are actually committed in the absence of antidepressants.''

Actually that stat is meaningless. It is the relative rate that is an issue. Children who take antidepressant do kill themselves at a higher rate. It has been argued and denied for years. Now the major drug companies are putting warnings on their product. Irrational and homocidal behavior is next.

45 posted on 11/22/2004 12:43:25 PM PST by Nov3 ("This is the best election night in history." --DNC chair Terry McAuliffe Nov. 2,2004 8p.m.)
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To: GSlob

Absolutely true.

When I was on Zoloft, my doc told me the effects wouldn't kick in until the 4th week or so. It sounds as if the "therapy" session, followed by girlfriend issues, pushed him over.

My concern with these drugs are side effects that are not listed. Both Zoloft and Prozac can cause huge weight gain. The argument is that it happens to such a small percentage of people, that the companies don't need to list it. I put on almost 100 pounds in only 2 1/2 years before they attributed it to the Zoloft (my thyroid quit at the same time, so I was doubly hit) I went off Zoloft and lost 30lbs in 3 weeks!!! Since then, everyone I speak to mentions that they gained weight while on these drugs as well. (BTW, I'm still losing the weight. About 30 lbs to go. I'm in year 3 of taking off. I DO NOT RECOMMEND THIS DRUG TO ANYONE!!! It's weird, but acupuncture did wonders for me)

This is still not a recognized side effect.


46 posted on 11/22/2004 12:56:50 PM PST by Hoodlum91
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To: neverdem

Re: Your quote from the article from Dr. John Mann:

In the interest of full disclosure, Dr. Joseph John Mann of Columbia is a paid consultant and expert witness in court cases for both Glaxo and Pfizer. Dr. Mann testified on behalf of Glaxo in the Schell case mentioned in this article. It's the only case lost at trial over this issue.

Dr. Mann has also received funding from Eli Lilly to promote the safety of antidepressants.


47 posted on 11/22/2004 2:02:26 PM PST by Al B.
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To: Al B.
In the interest of full disclosure, Dr. Joseph John Mann of Columbia is a paid consultant and expert witness in court cases for both Glaxo and Pfizer. Dr. Mann testified on behalf of Glaxo in the Schell case mentioned in this article. It's the only case lost at trial over this issue.

I find that quite interesting because I have an irrational, inherent distrust of folks who don't like their first, given name.

Before you made that statement, overall, I thought the article was pretty good, balanced and comprehensive. Now, I'm wondering.

48 posted on 11/22/2004 4:31:14 PM PST by neverdem (Xin loi min oi)
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To: neverdem
Now, I'm wondering.

I'm glad you are.  In reading your comments in the threads you've put up on this issue, including our exchange on a recent thread, I've sensed that you're struggling with this. Good luck in your journey.

Although I'm sure most will laud this article as balanced, there's plenty wrong with it IMO....mainly factual omissions such as the one I pointed out.

49 posted on 11/22/2004 5:33:35 PM PST by Al B.
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To: Al B.

Please address any omissions that you find.

I thought the struggle was obvious. Primum, non nocere. Translate Latin. First, do no harm.

Any corrections are always appreciated.


50 posted on 11/22/2004 6:28:37 PM PST by neverdem (Xin loi min oi)
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