Serotonin and Depression: A Disconnect between the Advertisements and the Scientific Literature

PLOS Medicine - Public Library of Science - a peer reviewed open access journal ^ | Nov. 8, 2005 | Jeffrey R. Lacasse, Jonathan Leo

[apackof2]

thanks, hey I will FRMail you sometime soon but its crunch time with some homework....still :>(

[LaineyDee]

That's cool. I've just finished a test and only have one more in each class. Yahoooooooey!!! Take your time, study hard and break in those boots! *chuckle*

[Jenny Hatch]

"If I would have listened to the scientologists, I would have never gotten well."

Do you even know what the scientologists recomend???

How can you say you "would have never gotten well" if you have not tried what they teach?

I'm not the only one who has serious issues with screening for mental illness.

Many articles have been written questioning the wisdom of this move - World Net Daily has been proactive in sharing alternative views.

http://www.worldnetdaily.com/news/printer-friendly.asp?ARTICLE_ID=45935

Lawmakers are concerned...

Bill prohibits coerced drugging of kids
Withholds funds from states that don't institute protections

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Posted: August 24, 2005
1:00 a.m. Eastern

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© 2005 WorldNetDaily.com
An education political action committee is promoting a bill in Congress that would withhold federal school funds from states that do not prohibit the forced drugging of students with psychotropic medications.

The bill, H.R. 1790, sponsored by Rep. John Kline, R-Minn., requires that states establish policies and procedures that prohibit school personnel from requiring a child take the popular behavior-modification drugs.


Titled the "Child Medication Safety Act of 2005," the legislation currently has 23 co-sponsors.

According to EdAction.org, psychotropic drugs are "over-prescribed," and parents oftentimes are forced by school personnel to have their children take the medication if they are to stay in school.

"Many studies, some of them kept from physicians and the public for years, have shown that these medications are not at all effective in the long term," said a statement from the organization.

EdAction asserts such medication has deleterious effects on children:

"The psychotropic medications, both on and off the controlled substances list, are far from benign; their side effects are rarely adequately explained to parents; and there are no studies defining their effects on the developing nervous systems of growing children, especially those under the age of 5 years."

The political action committee also is pushing a bill sponsored by Rep. Ron Paul, R-Texas, H.R. 181, which would prohibit any federal funds from being used to establish or implement any universal or mandatory mental health screening program. The bill also would require that a parent's refusal to consent to mental health screening programs could not be a basis of a charge of child abuse or education neglect.

http://www.worldnetdaily.com/news/article.asp?ARTICLE_ID=39078

http://www.worldnetdaily.com/news/article.asp?ARTICLE_ID=40384

Critics of the plan say it is a thinly veiled attempt by drug companies to provide a wider market for high-priced antidepressants and antipsychotic medication, and puts government in areas of Americans' lives where it does not belong.


http://www.worldnetdaily.com/news/article.asp?ARTICLE_ID=41511

The congressman, who is known for his strict adherence to the Constitution, wrote in a letter to his colleagues before the September vote: "As you know, psychotropic drugs are increasingly prescribed for children who show nothing more than children's typical rambunctious behavior. Many children have suffered harmful effects from these drugs. Yet some parents have even been charged with child abuse for refusing to drug their children. The federal government should not promote national mental-health screening programs that will force the use of these psychotropic drugs such as Ritalin."


http://www.worldnetdaily.com/news/article.asp?ARTICLE_ID=41606

"We believe the drug companies and the psychiatric establishment convinced Sens. Arlen Specter and Bill Frist to block it," said Kent Snyder, executive director of the Paul-founded Liberty Committee. "We are extremely disappointed that the conference committee ultimately rejected Dr. Paul's language and that it was not added to the omnibus spending bill."

Blogger,

As I said before, if you do not see these moves as a problem, we really don't have anything to talk about.

I would challenge you to do some research on Orthomolecular medicine http://www.orthomed.org/

This is the form of medicine I used to restore my brain after suffering from debilitation mental illness for two years.

The principles espoused by Scientology are sound, and if you will just relax your own prejudice and do some research I believe you will be amazed at the wellness that can come from using these nourishing principles for mental illness.

You claimed that I was misleading on the intentions of the pharma companies plans to screen the whole US for mental illness. I am not, keep reading, open up your mind to the idea that SSRI ANTI-d's are just a marketing ploy and they have been peddling LSD to the masses for the past seventeen years all under the umbrella of a chemical imbalance theory that has no basis in science or fact.

These people are brilliant marketers, and they have reaped a bounteous harvest off the misery and suffering of the American people.

It is time to expose the lies, propaganda, and conspiracies.

You claim I have an agenda? I do. I would like to see families encouraged in optimal health by teaching them correct principles of health and letting them govern themselves. I also would love nothing more than for Big Pharma to be taken down the way Big Tobacco was a couple years ago. It's time.

Jenny

[Blogger]

I didn't need to try what quack scientology teaches. The meds worked.

Scientology is not a medical profession. They are a dangerous cult. Please do not promote the trash they teach.

[Jenny Hatch]

"They are a dangerous cult. Please do not promote the trash they teach."

As I said, do you even know WHAT they teach, promote and use to help the mental ill? I would suggest that you do not.

As far as dangerous cults go, the medical profession is one of the most deadly dangerous cults around, and if you would read through some of the information I have posted, and lose your fixation on scientology, AND open your mind to the idea that you have been duped by an advertising ploy with absolutely no merit in scientific study and research, then I think we could come to a meeting of the minds.

But, if not, I'm not the one to convince....I have simply tried to make the case and share the information I have found which backs up my assertion that there is a serious dissconnect between what the drugs companies claim in their advertising and what is known in the scientific literature and research.

You have claimed symptom relief with your words, "the meds worked". OK, you felt better. Well, so do people who take illegal drugs or drink alcohol to turn off emotional pain. Those methods of symptom relief also "work".

My point is that there is no proof of chemical imbalance being "cured" by taking anti-depressants. And their is much evidence that taking anti-depressants causes a variety of problems, most notably, REM sleep disorder.

Here is a link to a new documentary that has been produced on the effect of anti-depressants on teens. http://www.prescriptionsuicide.com/interviewfm.html

Did you hear that congress put a black box warning on the drugs for teens???

This is the final step before a drug is pulled from the market. I predict that in a couple years antidepressants will go down the same path that Eli Lillys LSD went. First touted as the cure all for humanity, then eventually pulled from the market to become a street drug. And who gets lost in the cross hairs of this deception and fraud??

Only the millions of people taking the dope, I was one of them. I became suicidal on Prozac, and was hospitalized for five days. I give God all the glory for helping me through that time. But some people have gone ahead and ended it all...For what??? cha ching cha ching...

open your eyes

Jenny

[Blogger]

You are completely clueless as to the CULT Scientology, which if you are not a part of, you are certainly party to its damnable ways. Yes, I know a bit about the cult. I study cults, among other things. But, far from having a "fixation" on the cult, I do recognize its work immediately and proved that out by a simple "GOOGLE SEARCH" of the first doctor on your list. It was as I suspected.

You see, I do have an open mind. But I also know how to think critically and recognize certain attributes of what a certain cult has been preaching when I see them. I was right about the source you provided. I'm also right about the SSRIs. THEY DO WORK, and not just for symptom relief but in fixing the problem.

What I am not "duped by" is that there are sometimes chemical imbalances in the brain. After a time of particular prolonged stress, I, who had never had such an episode in my entire life, nor have I had sense, fell into clinical depression and anxiety. For weeks on end, I could not escape it. I couldn't think straight. The mind that earned me two masters degrees was thinking very irrationally and I couldn't make it stop.

I went a good 6 months going down hill trying anything short of meds to provide relief from the despair which gripped me. I could think nothing but depression and fearful thoughts. I knew that things were not as they were seeming but was powerless to stop my mind - to which I was a prisoner. I was prescribed Paxil, and almost IMMEDIATELY I began to feel better. The DRUG saved my life, I have no doubt. Within a few months on the drug, I was me again and did not need to continue the medication. I have been off of the drug for some time now and am still me. I had no ill effects in taking the drug, only good. Yes, it is overprescribed. Sometimes counseling helps. Sometimes natural supplements help. With me and millions of others, only the medication helped. You, Mrs. Hatch, are trying to deny people a life-saving medication by using literature published by a CULT. Yes, they are a cult, created by a science fiction writer with a huge ego and a less than admirable life. If you are a part of them, I am sad. I pray your mind will be able to see them for what they are.

Regarding the drugs and the idea that there is "absolutely no merit in scientific study and research" where is your medical degree? On what authority do you sit there and type that these drugs are only symptom relief? Your own opinion? Sorry, that isn't good enough. The articles you site? Already are made suspect by who wrote them. I'm sure there are plenty of people who will agree with the Scientologists on this subject, even if they don't suscribe to some of the tenets of their faith system. Does that make them right? No.

Is there really no proof? I'm living proof lady that the chemicals in the brain are made right by SSRIs. I know of another lady who has been helped by Prozac when nothing else would help. Another lady was on Xanax, same deal. It isn't some drug company's literature I'm believing. It is my own mind that was sick and is now well - when absolutely NOTHING else worked- an SSRI did.

Do I believe SSRIs are the answer to all depression. Hardly. Are they overprescribed? In all likelihood, yes.
Can they have bad side effects? I first tried Zoloft and my anxiety immediately doubled - so yes. But people are different and what doesn't work for me may work for another. I don't know what will work for everyone, but when you are in a mind that just wants to die, a little "symptom relief" is not a bad thing.

As to the comparison with drug abuse - that was just a hateful and spiteful comment. Drug abuse can mask pain, but just because one is taking a medication does not in any way equate with abusing drugs.

SSRIs, and other anti-depressants, have their place. Don't shut the door if they genuinely help people get their lives back.

[Jenny Hatch]

As I said in the original post and will continue to say. Please provide links to scientific studies that prove a chemical imbalance theory.

Nobody has done it yet on this thread, and nobody will be able to do it because none exist.

If you can prove that they exist I would be very happy to read the factual information you supply.

If you are unable to provide the information I request, then I would suggest that all that happened in your brain was a chemical lobotomy - which does in fact turn "off" symptoms - but in no way fixes any sort of chemical "imbalance".

I don't have to have a medical degree in order to request factual information.

Jenny

[Blogger]

SSRIs stand alone in treating pediatric depression
Low-Dose SSRI Is Promising in Treatment of Major Depressive Episodes - selective serotonin reuptake inhibitors
Effexor Beats Depression - Brief Article
Serotonin Activity Weight-Restored Anorexics
Understanding Depression Today

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Here are a few. There is a plethora of articles on the internet, but I'm sure you already know that.

Now, please stop with your cultic philosophy. You are literally putting lives at risk.

[Jenny Hatch]

Blogger,

It's like you have your hands over your ears and and yelling "I can't hear you" every time you post. As I said in the first post on this thread, and the whole point of the original essay that I linked to....

THERE IS A DISCONNECT BETWEEN ANTI-D ADVERTISING AND the SCIENTIFIC LITERATURE!!!

I know it makes you feel better to post links to some studies that have been funded by Big Pharma and sound all convincing and scientific...sort of a "GOTCHA" type of response, but what I and many other researchers are looking for is PROOF that a chemical imblance exists in the brain, one that is verifiable by a test - like a blood or urine test, and PROOF that anti-depressants cure those imbalances...

You linked to this article which said (And was typical of those you posted)-

Study investigators report that escitalopram, the isomer of citalopram (Celexa), was significantly more effective than citalopram relative to placebo across all study measures at a lower dose than indicated for any current selective serotonin reuptake inhibitors (SSRIs) in the treatment of patients with major depressive disorder, suggesting that escitalopram shows promise as a first-line treatment for this disorder. A total of 491 patients between 18 and 65 years of age with ongoing episodes of major depression were evaluated in a randomized, double-blind, placebo-controlled, multicenter study and were randomized for eight weeks to one of four trial arms: placebo, citalopram and two different dosages of escitalopram. The Montgomery-Asbert Depression Rating Scale (MADRs) was the prospective defined primary end point; other outcome measures included the Hamilton Depression Rating (HAMD) and HAMD item 1 scales, and the Clinical Global Impression (CGI) scale. At all time points throughout the study, patients randomized to the escitalopram trial arm showed significant improvement in the primary end point compared to the other trial arms. The investigators noted a low discontinuation rate due to adverse events, which they attributed to escitalopram's high tolerability.--WILLIAM BURKE, M.D., ET AL., University of Nebraska Medical School, Omaha, Nebraska

OK, so they had SYMPTOM relief, as did you, and so many people who take these drugs. Well, symptom relief is NOT fixing that big ol serotonin imbalance that everyone seems to be so educated and knowledgeable about.

I would like to see what the original essay wants to see (Quote from the essay)

"However, in addition to what these authors say about serotonin, it is also important to look at what is not said in the scientific literature. To our knowledge, there is not a single peer-reviewed article that can be accurately cited to directly support claims of serotonin deficiency in any mental disorder, while there are many articles that present counterevidence. Furthermore, the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is published by the American Psychiatric Association and contains the definitions of all psychiatric diagnoses, does not list serotonin as a cause of any mental disorder."


And because you seem to have missed reading the original essay, and more importantly the point of the essay, and because the authors have graciously offered it to be reproduced if it is sourced....here is the whole essay. Please read it, and then go find your scientific peer reviewed scientific literature....(Which as I said before DOES NOT EXIST!!!)

"In the United States, selective serotonin reuptake inhibitor (SSRI) antidepressants are advertised directly to consumers [1]. These highly successful direct-to-consumer advertising (DTCA) campaigns have largely revolved around the claim that SSRIs correct a chemical imbalance caused by a lack of serotonin (see Tables 1 and 2). For instance, sertraline (Zoloft) was the sixth best-selling medication in the US in 2004, with over $3 billion in sales [2] likely due, at least in part, to the widely disseminated advertising campaign starring Zoloft's miserably depressed ovoid creature. Research has demonstrated that class-wide SSRI advertising has expanded the size of the antidepressant market [3], and SSRIs are now among the best-selling drugs in medical practice [2].


Table 1. Selected Quotations Regarding Serotonin and Antidepressants

Table 2. Selected Consumer Advertisements from SSRIs from Print, Television, and the World Wide Web
Given the multifactorial nature of depression and anxiety, and the ambiguities inherent in psychiatric diagnosis and treatment, some have questioned whether the mass provision of SSRIs is the result of an over-medicalized society. These sentiments were voiced by Lord Warner, United Kingdom Health Minister, at a recent hearing: “…I have some concerns that sometimes we do, as a society, wish to put labels on things which are just part and parcel of the human condition”[4]. He went on to say, “Particularly in the area of depression we did ask the National Institute for Clinical Excellence [an independent health organisation that provides national guidance on treatment and prevention] to look into this particular area and their guideline on depression did advise non-pharmacological treatment for mild depression” [4]. Sentiments such as Lord Warner's, about over-medicalization, are exactly what some pharmaceutical companies have sought to overcome with their advertising campaigns. For example, Pfizer's television advertisement for the antidepressant sertraline (Zoloft) stated that depression is a serious medical condition that may be due to a chemical imbalance, and that “Zoloft works to correct this imbalance” [5]. Other SSRI advertising campaigns have also claimed that depression is linked with an imbalance of the neurotransmitter serotonin, and that SSRIs can correct this imbalance (see Table 2). The pertinent question is: are the claims made in SSRI advertising congruent with the scientific evidence?

The Serotonin Hypothesis
In 1965, Joseph Schildkraut put forth the hypothesis that depression was associated with low levels of norepinephrine [6], and later researchers theorized that serotonin was the neurotransmitter of interest [7]. In subsequent years, there were numerous attempts to identify reproducible neurochemical alterations in the nervous systems of patients diagnosed with depression. For instance, researchers compared levels of serotonin metabolites in the cerebrospinal fluid of clinically depressed suicidal patients to controls, but the primary literature is mixed and plagued with methodological difficulties such as very small sample sizes and uncontrolled confounding variables. In a recent review of these studies, the chairman of the German Medical Board and colleagues stated, “Reported associations of subgroups of suicidal behavior (e.g. violent suicide attempts) with low CSF–5HIAA [serotonin] concentrations are likely to represent somewhat premature translations of findings from studies that have flaws in methodology” [8]. Attempts were also made to induce depression by depleting serotonin levels, but these experiments reaped no consistent results [9]. Likewise, researchers found that huge increases in brain serotonin, arrived at by administering high-dose L-tryptophan, were ineffective at relieving depression [10].


(Illustration: Margaret Shear, Public Library of Science)
Contemporary neuroscience research has failed to confirm any serotonergic lesion in any mental disorder, and has in fact provided significant counterevidence to the explanation of a simple neurotransmitter deficiency. Modern neuroscience has instead shown that the brain is vastly complex and poorly understood [11]. While neuroscience is a rapidly advancing field, to propose that researchers can objectively identify a “chemical imbalance” at the molecular level is not compatible with the extant science. In fact, there is no scientifically established ideal “chemical balance” of serotonin, let alone an identifiable pathological imbalance. To equate the impressive recent achievements of neuroscience with support for the serotonin hypothesis is a mistake.

With direct proof of serotonin deficiency in any mental disorder lacking, the claimed efficacy of SSRIs is often cited as indirect support for the serotonin hypothesis. Yet, this ex juvantibus line of reasoning (i.e., reasoning “backwards” to make assumptions about disease causation based on the response of the disease to a treatment) is logically problematic—the fact that aspirin cures headaches does not prove that headaches are due to low levels of aspirin in the brain. Serotonin researchers from the US National Institute of Mental Health Laboratory of Clinical Science clearly state, “[T]he demonstrated efficacy of selective serotonin reuptake inhibitors…cannot be used as primary evidence for serotonergic dysfunction in the pathophysiology of these disorders” [12].

Reasoning backwards, from SSRI efficacy to presumed serotonin deficiency, is thus highly contested. The validity of this reasoning becomes even more unlikely when one considers recent studies that even call into question the very efficacy of the SSRIs. Irving Kirsch and colleagues, using the Freedom of Information Act, gained access to all clinical trials of antidepressants submitted to the Food and Drug Administration (FDA) by the pharmaceutical companies for medication approval. When the published and unpublished trials were pooled, the placebo duplicated about 80% of the antidepressant response [13]; 57% of these pharmaceutical company–funded trials failed to show a statistically significant difference between antidepressant and inert placebo [14]. A recent Cochrane review suggests that these results are inflated as compared to trials that use an active placebo [15]. This modest efficacy and extremely high rate of placebo response are not seen in the treatment of well-studied imbalances such as insulin deficiency, and casts doubt on the serotonin hypothesis.

Also problematic for the serotonin hypothesis is the growing body of research comparing SSRIs to interventions that do not target serotonin specifically. For instance, a Cochrane systematic review found no major difference in efficacy between SSRIs and tricyclic antidepressants [16]. In addition, in randomized controlled trials, buproprion [17] and reboxetine [18] were just as effective as the SSRIs in the treatment of depression, yet neither affects serotonin to any significant degree. St. John's Wort [19] and placebo [20] have outperformed SSRIs in recent randomized controlled trials. Exercise was found to be as effective as the SSRI sertraline in a randomized controlled trial [21]. The research and development activities of pharmaceutical companies also illustrate a diminishing role for serotonergic intervention—Eli Lilly, the company that produced fluoxetine (Prozac), recently released duloxetine, an antidepressant designed to impact norepinephrine as well as serotonin. The evidence presented above thus seems incompatible with a specific serotonergic lesion in depression.

Although SSRIs are considered “antidepressants,” they are FDA-approved treatments for eight separate psychiatric diagnoses, ranging from social anxiety disorder to obsessive-compulsive disorder to premenstrual dysphoric disorder. Some consumer advertisements (such as the Zoloft and Paxil Web sites) promote the serotonin hypothesis, not just for depression, but also for some of these other diagnostic categories [22,23]. Thus, for the serotonin hypothesis to be correct as currently presented, serotonin regulation would need to be the cause (and remedy) of each of these disorders [24]. This is improbable, and no one has yet proposed a cogent theory explaining how a singular putative neurochemical abnormality could result in so many wildly differing behavioral manifestations.

In short, there exists no rigorous corroboration of the serotonin theory, and a significant body of contradictory evidence. Far from being a radical line of thought, doubts about the serotonin hypothesis are well acknowledged by many researchers, including frank statements from prominent psychiatrists, some of whom are even enthusiastic proponents of SSRI medications (see Table 1).

However, in addition to what these authors say about serotonin, it is also important to look at what is not said in the scientific literature. To our knowledge, there is not a single peer-reviewed article that can be accurately cited to directly support claims of serotonin deficiency in any mental disorder, while there are many articles that present counterevidence. Furthermore, the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is published by the American Psychiatric Association and contains the definitions of all psychiatric diagnoses, does not list serotonin as a cause of any mental disorder. The American Psychiatric Press Textbook of Clinical Psychiatry addresses serotonin deficiency as an unconfirmed hypothesis, stating, “Additional experience has not confirmed the monoamine depletion hypothesis” [25].

Consumer Advertisements of Antidepressants
Contrary to what many people believe, the FDA does not require preapproval of advertisements. Instead, the FDA monitors the advertisements once they are in print or on the air [26]. Misleading content is frequently found in various DTCA campaigns [27]; hence, it is valuable to compare SSRI advertisements to the scientific evidence reviewed above. These SSRI ads are widely promulgated; hundreds of millions of dollars have been spent disseminating these advertisements, and one study found that over 70% of surveyed patients reported exposure to antidepressant DTCA [28].

The Role of the FDA
In the US, the FDA monitors and regulates DTCA. The FDA requires that advertisements “cannot be false or misleading” and “must present information that is not inconsistent with the product label” [27]. Pharmaceutical companies that disseminate advertising incompatible with these requirements can receive warning letters and can be sanctioned. The Irish equivalent of the FDA, the Irish Medical Board, recently banned GlaxoSmithKline from claiming that paroxetine corrects a chemical imbalance even in their patient information leaflets [29]. Should the FDA take similar action against consumer advertisements of SSRIs?

As just one example, the prescribing information for paroxetine, which is typical of the SSRI-class drugs, states, “The efficacy of paroxetine in the treatment of major depressive disorder, social anxiety disorder, obsessive-compulsive disorder (OCD), panic disorder (PD), generalized anxiety disorder (GAD), and post-traumatic stress disorder (PTSD) is presumed to be linked to potentiation of serotonergic activity in the central nervous system resulting from inhibition of neuronal reuptake of serotonin. Studies at clinically relevant doses in humans have demonstrated that paroxetine blocks the uptake of serotonin into human platelets” [30].

In other words, the mechanism of action of paroxetine has not been definitively established, and remains unconfirmed and presumptive (the prescribing information states that the efficacy of the drug “is presumed to be linked to potentiation of serotonergic activity” ([30], our italics added). Although there is evidence that paroxetine inhibits the reuptake of serotonin, the significance of this phenomenon in the amelioration of psychiatric symptoms is unknown, and continually debated [12,31]. Most importantly, the prescribing information does not mention a serotonin deficiency in those administered paroxetine, nor does it claim that paroxetine corrects an imbalance of serotonin. In contrast, the consumer advertisements for paroxetine present claims that are not found in this FDA-approved product labeling.

In order to determine whether these advertisements actually comply with FDA regulations, it is useful to consult the Code of Federal Regulations under which DTCA is regulated. The regulations state that an advertisement may be cited as false or misleading if it “[c]ontains claims concerning the mechanism or site of drug action that are not generally regarded as established by scientific evidence by experts qualified by scientific training and experience without disclosing that the claims are not established and the limitations of the supporting evidence…” ([32], our emphasis added]).

Stating that depression may be due to a serotonin deficiency is seemingly allowed, but, as stated in the regulations, only if the limitations of the supporting evidence are provided. In our examination of SSRI advertisements, we did not locate a single advertisement that presented any such information. Instead, the serotonin hypothesis is typically presented as a collective scientific belief, as in the Zoloft advertisement, which states that regarding depression, “Scientists believe that it could be linked with an imbalance of a chemical in the brain called serotonin” [33]. Consumers viewing such advertisements remain uninformed regarding the limitations of the serotonin hypothesis (reviewed above).

According to federal regulations, advertisements are also proscribed from including content that “contains favorable information or opinions about a drug previously regarded as valid but which have been rendered invalid by contrary and more credible recent information” [32].

This means that a disconnect between the evolving peer-reviewed literature and advertisements is not permitted. Regarding SSRIs, there is a growing body of medical literature casting doubt on the serotonin hypothesis, and this body is not reflected in the consumer advertisements. In particular, many SSRI advertisements continue to claim that the mechanism of action of SSRIs is that of correcting a chemical imbalance, such as a paroxetine advertisement, which states, “With continued treatment, Paxil can help restore the balance of serotonin…” [22]. Yet, as previously mentioned, there is no such thing as a scientifically established correct “balance” of serotonin. The take-home message for consumers viewing SSRI advertisements is probably that SSRIs work by normalizing neurotransmitters that have gone awry. This was a hopeful notion 30 years ago, but is not an accurate reflection of present-day scientific evidence.

The FDA has sent ten warning letters to antidepressant manufacturers since 1997 [34–43], but has never cited a pharmaceutical company for the issues covered here. The reasons for their inaction are unclear but seem to result from a deliberate decision at some level of the FDA, rather than an oversight. Since 2002, the first author (JRL) has repeatedly contacted the FDA regarding these issues. The only substantive response was an E-mail received from a regulatory reviewer at the FDA: “Your concern regarding direct-to-consumer advertising raises an interesting issue regarding the validity of reductionistic statements. These statements are used in an attempt to describe the putative mechanisms of neurotransmitter action(s) to the fraction of the public that functions at no higher than a 6th grade reading level” (personal communication, 2002 April 11).

It is curious that these advertisements are rationalized as being appropriate for those with poor reading skills. If the issues surrounding antidepressants are too complex to explain accurately to the general public, one wonders why it is imperative that DTCA of antidepressants be permitted at all. However, contrary to what the FDA seems to be implying, truth and simplicity are not mutually exclusive. Consider the medical textbook, Essential Psychopharmacology, which states, “So far, there is no clear and convincing evidence that monoamine deficiency accounts for depression; that is, there is no ‘real’ monoamine deficit” [44]. Like the pharmaceutical company advertisements, this explanation is very easy to understand, yet it paints a very different picture about the serotonin hypothesis.

Conclusion
The impact of the widespread promotion of the serotonin hypothesis should not be underestimated. Antidepressant advertisements are ubiquitous in American media, and there is emerging evidence that these advertisements have the potential to confound the doctor–patient relationship. A recent study by Kravitz et al. found that pseudopatients (actors who were trained to behave as patients) presenting with symptoms of adjustment disorder (a condition for which antidepressants are not usually prescribed) were frequently prescribed paroxetine (Paxil) by their physicians if they inquired specifically about Paxil [45]; such enquiries from actual patients could be prompted by DTCA [45].

What remains unmeasured, though, is how many patients seek help from their doctor because antidepressant advertisements have convinced them that they are suffering from a serotonin deficiency. These advertisements present a seductive concept, and the fact that patients are now presenting with a self-described “chemical imbalance” [46] shows that the DTCA is having its intended effect: the medical marketplace is being shaped in a way that is advantageous to the pharmaceutical companies. Recently, it has been alleged that the FDA is more responsive to the concerns of the pharmaceutical industry than to their mission of protecting US consumers, and that enforcement efforts are being relaxed [47]. Patients who are convinced they are suffering from a neurotransmitter defect are likely to request a prescription for antidepressants, and may be skeptical of physicians who suggest other interventions, such as cognitive-behavioral therapy [48], evidence-based or not. Like other vulnerable populations, anxious and depressed patients “are probably more susceptible to the controlling influence of advertisements” [49].

In 1998, at the dawn of consumer advertising of SSRIs, Professor Emeritus of Neuroscience Elliot Valenstein summarized the scientific data by concluding, “What physicians and the public are reading about mental illness is by no means a neutral reflection of all the information that is available” [50]. The current state of affairs has only confirmed the veracity of this conclusion. The incongruence between the scientific literature and the claims made in FDA-regulated SSRI advertisements is remarkable, and possibly unparalleled."

Jenny

[Blogger]

I stopped reading your reply after the second sentence. You could care less about the scientific research. "Funded by Big Pharma?" As opposed to "funded by scientology?" You aren't interested in truth. I just pray that you have zero affect in people who need help and can be helped by these drugs. My conversation with you is over.

[Coleus]

Health Experts Warn of Antidepressant Dangers for Children, Teens

[Coleus]

Child Medication Bill Passes House

The U.S. House of Representatives approved H.R. 1790, the Child Medication Safety Act (CMSA) of 2005 by a 407-12 vote on November 16. The CMSA would prohibit school personnel from requiring parents to obtain prescriptions for controlled substances in order for children to attend school "under any program or activity administered by the Secretary of Education."

Funding for schools would be contingent upon compliance. Section 4 also calls for the General Accounting Office to conduct a review of what medications are used to treat children in public schools.

The lead sponsor of H.R. 1790, Congressman John Kline (R-MN), speaking in support of the bill, said that as more children are diagnosed with Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD), and treated with medication, such as Ritalin or Adderall, the drugs "have the potential for serious harm and abuse, especially for children who do not need the medications. . . . in some instances, school personnel freely offer diagnoses for ADD and ADHD disorders and urge parents to obtain drug treatment for their child. Parents should never be forced to medicate their child against their will and better judgment in order to ensure their child will receive educational services."

Psychiatrist Dr. Peter Breggin, founder of the Center for the Study of Psychiatry and Psychology, and author of Talking Back to Ritalin, stated in a PBS interview on May 3, 2000: "I believe that there is no scientific reason or justification for giving psychoactive agents to children."

Dr. Breggin has helped many children withdraw from medication, including Paul Johnston, who experienced drug-induced psychosis and institutionalization. See Education Reporter of June, 2002 article, "A Parent's Nightmare: Losing a Child to Drug-Induced Psychosis."

Dr. Karen R. Effrem, a pediatrician, board member of both Ed Watch and the Alliance for Human Research Protection (AHRP), and advisory council member of ICSPP, has testified about the subjectivity of diagnosing ADD, ADHD, and other mental illnesses; the extremely dangerous side effects; and lack of research involving young children and the implications for their nervous systems, with the use of psychotropic medications.

In her testimony before the House of Representatives in 2003, Dr. Effrem cited numerous cases of severe problems with medications, safety issues, and parents who were coerced and threatened with charges of educational neglect and child abuse if they didn't comply.

In the last Congress, the CMSA was passed by the House, but stalled in the Senate through lack of action in the Health, Education, Labor and Pensions (HELP) Committee, primarily due to the efforts of Senator Edward Kennedy (D-MA). On November 17, the CMSA was read in the Senate and referred to the HELP Committee. Senators on the Committee are listed at http://help.senate.gov/committee_members.html

[KYGrandma]

I have fibromyalgia and with out anti-depressants I would not be able to function. The pain would be disabling. Each case should be decided on it's own and generalizing anti-depressants avoided.

[Jenny Hatch]

Coleus,

Thanks for the link to your previous thread, and to this information. I like to think that these drugs being more controlled will shift us in the right direction, but I heard Ann Blake Tracy, author of Prozac, Pandora or Panacea speak in Denver a couple years ago, and she said many of the big pharma companies were putting huge efforts into their new lines of anti-psychotics.

They have road the anti-depressant band wagon for twenty years, they have known from the beginning that anti-d's cause psychosis, and I believe they are lining themselves up to profit from the mass psychosis that will result when many many people, especially teens, come off their drugs too quick, and go psychotic.

http://www.freerepublic.com/focus/f-chat/1220966/posts

Wish I could say that I was optimistic, but I'm not. I see them controlling the mental health fields for a long time to come. And when Codex fully kicks in in 2007 and they have complete control of the supplement industries...it is going to be all out war between big pharma and natural healing.

http://herballure.com/Special/WeBecomeSilent/WindowsMedia.html


Thanks anyway for the info. It is nice to know we have some legislaters who are willing to fight for what is right.

Jenny Hatch

[ghitma]

You just opened up a new options for me. Thanks!

[dynoman]

.

[Cogadh na Sith]

Everyone who has a mental illness is B-vitamin deficient.

You're a kook.

[Cogadh na Sith]

Drugawareness.org is a Scientology front site.

[185JHP]

BTTT