Saturday, August 09, 2008

SSRIs - how they work, side effects and other problems - from Charles Medawar Socialaudit

This is back on 2004. The person who used "ANON" as a nick raises important issues. Notice that he claims that the starting dose of Prozac was designed to be 5 mg not 20 mg as it's prescribed.

Dear Arek,

The SSRIs are not selective for anything except that they act on all serotonin in the body.

Only 5% of this is in the brain. Five per cent. The other 95% is found throughout the body with large amounts being found in: the digestive system (stomach movement); the cardiovascular system (blood flow); blood cells (clotting); reproductive system (genitals); hormonal system (widespread effects on lots of physiological processes). All of which is acted upon by the drug. All of it.

Increasing the serotonin produces a secondary action - it reduces the dopamine (by approx 50%). Dopamine being a second neurotransmitter. The longer you are exposed to a drug which reduces dopamine, and boosts serotonin way beyond the normal biological norm... The phrase 'silent brain damage' is a term commonly associated with those discussing the likely future. The body is having to cope with levels of a neurotransmitter way, way above anything it is designed to cope with. Hyperstimulation. Drugs causing dopamine drops are well known to cause dangerous side-effects, just like those now seen with the SSRIs. This damage is generally related to cumulative exposure to the drug. i.e. the longer you are on it, the greater the propensity for damage. So, in 20 years time we may well be seeing the first mass discoveries of early dementia and alzheimers. In the meantime there are the many instances of individuals already having to live with the tics, short-term memory loss, widespread cognitive damage, confusion, apathy, aggressive impulses, suicidal impulses, zombie-dom, tiredness and the like... all of which ties in neatly (but nastily) with the permanant damage theory. Perhaps these are only the 'unfortunate few', perhaps not. Perhaps they are only the exceptionally physiologically sensitive few, who are experiencing the aftermath in advance of the majority.

The tics, unsteadiness of gait, yawns, jaw pain, extreme tiredness, and a whole host of other neurological adverse effects relate to a scrambling of the involuntary motor system, deep, deep within the brain. Earlier classes of drugs which caused these effects... well they are 'the dread side effect' in psychiatry. And, of course the serotonin nerves originate in the deepest, oldest part of the brain - the brain stem.

Serotonin (by itself) is implicated in sleep, aggression, sexual behaviour, appetite, learning, memory... dysfunction of all of which are commonly associated with uses of SSRIs or damage to the nerve fibres.

There is NO known depression centre in the brain, and the drugs which boost serotonin have vast effects throughout the body, affecting pretty much everything. Selective? This was a term adopted by the drug companies because it sounded good. There is absolutely no selectivity involved in the action of these drugs beyond the fact that they act on all serotonin regardless of location, within the body.

There is also absolutely no proof that the root cause of depression is a serotonin deficiency. None. It is simply a theory that the drug companies sold as fact, in order to market the product. To huge success.

The prescribing guidelines are for only those suffering from severe depression. Ideally for six-twelve months. Not years.

The prozac trials were based on a dose of 5mg. FIVE. Even at this level a hefty percentage of participants were secondarily drugged to suppress the anxiety/agitation. Yet the starting dose was 20mg. TWENTY. With many people routinely immediately shifted up to 40mg and 60mg. So 10mg could be considered a 200% dose... when dose increases are usually looked at in terms of small percentages. Once this is taken into account, then 10mg could be considered a double-dose and 5mg a standard dose. Not a low dose.

Most people do get through withdrawal. A minority do not, physiologically cannot. Some get through the process but do not emerge with a good life. After all, the commonest lasting effects on healthy volunteers were depression and anxiety. Hardly surprising considering that the drug has a stimulant rather than classic anti-depressant action.

So the worst case scenario could be painted rather differently than that of living life to the full. It could, alternatively, encompass dopamine receptor damage/destruction (often connected to the sexual side-effects, plus lots of other nasties), constricted blood vessels (increase in strokes), osteoporosis (SSRIs double the amount of cortisol - the 'stress' hormone), heart attacks (SSRIs can treble the triglycerides), diabetes (SSRIs can cause blood sugar irregularities), liver damage (they can saturate the liver), alzheimers and premature senility (cumulative neuronal damage) and so on and so forth...

I'm glad that, in your personal experience, you have nothing but positive words.

However, many of your views on the safety of long-term usage are not universally shared; although 10mg doesn't sound a lot, it could be considered so when compared to the original prozac trial dose; and the drugs much touted 'serotonin specificity' is a double-edged sword... by acting on pretty much everything, it affects pretty much everything.

Best Wishes.
By ANON on Wednesday, January 7, 2004 - 13:54 pm:

It's quite clear to me that what Anon states is by far more acurate and PROVED than Arek argumentation.
If you assure that alcohol can damage the brain, for it has been on the market since the begginning of times, why is it so difficult to understand that SSRIs cannot affect our brains in a long period of time like 30-40 year of use?
Fotunatelly people suffer from so many side effects that they realize that they have to stop the drug in about one year or two. So the possibility of damage decreases. Few people stay on these drugs for more than 3, 4 or 8 years.
I believe that it's a very important that the long term use is more likely to promote the chemical lobotomy.
I believe you should not only rely on a single doctors point of view.
Your argumentation is very poor and does not reflect the testimonies of patients. One decade in medicine does not mean too much. But if you search on this site you can see that the harm SSRIs are provoking are quite hard to endure.
I'm sorry but you look like a KOL for me. You need serious argumentation.
You said "Of course I don't suffer from the same thing as other people here so perhaps my perspective is different but wondering how a drug that helps millions could damage you is hardly productive to the sufferer and probably not worth worrying about. The problem is that the drug is being used to treat depressed people and depending on how severe this is then it is not too surprising that aggression, anger and suicidal tendencies accompany it. Can this really be blamed on the drug? I don't think it is as clear cut as that. "
MY GOD... How many times will this argument be used?
You really should try to take a high dose off Seroxat or Efexor for six months and withdraw to understand what is the difference of a REAL suicide IDEATION and the CHEMICAL SUICIDE IDEATION.
THe review of the Paliament "The Influence of Pharmaceuthical Industry" have already made the distinction between the two.

"“5. Problems with Seroxat and other SSRIs Prozac and Seroxat are the best-known examples of SSRI and related antidepressants, but others are widely used. The introduction of SSRIs led to a threefold increase in antidepressant prescriptions between 1990 and 2000. Prescriptions for antidepressants now match those of the benzodiazepine tranquillisers at their peak, 25 years ago. Almost from the outset, there was concern about two main problems with SSRIs. First, there was suspicion (initially centred on Prozac) that these drugs could induce suicidal and violent behaviour – infrequently, but independently of the suicidal thoughts that are linked to depression itself. There was also concern (centred on Seroxat) about a risk of dependence; some users found it impossible to stop taking SSRIs because of severe withdrawal symptoms. The MCA/CSM formally reviewed these problems on several occasions. The suicidality problem was first investigated in 1990/1; withdrawal reactions were investigated in 1993, 1996 and 1998. In 2002, the MCA organised a further intensive review of both problems. This review was abandoned in April 2003, following criticism about conflicts of interest involving key figures on the review team.”"
There are many issues in this review. The above, and remember that the conflict of interest was due to half off the members were shareholders of the very Laboratories companies that they were researching, alert about the CHEMICAL SUICIDAL IDEATION.
I have suffered it. It does not come from your heart. Your life is great but something that we do not understand tell us to take our lifes is the only meaninfull thing to do.
Trust me. It is not me REAL SELF that I have to face when this feeling strikes me. I'm gladly cleaning the dishes and all off a sudden I start thinking about killing myself.
If you search, here, only here you will find many testimonies about "being a kind person and now I'm aggressive towards my loved ones"...
I'm tired of explaning this.
It seems to me that people...
Please Arek, refer yourself to the literature ANon gave you and search this site.
By Anonymous on Thursday, January 8, 2004 - 09:30 pm:

Arek, We really have different points of view.
"Additionally it would seem women who take the pill for decades again do more harm than an ssri according to the evidence we have. " I did not understand this argument It seems to me that you are comparing tomatos with avocatos here. You claim it is an evidence? Evidence of what?
"The problem is that the drug is being used to treat depressed people and depending on how severe this is then it is not too surprising that aggression, anger "
Again, the CHEMICAL agression is totally different from the natural aggression. We loose our senses in such a way that you can do things totally against your predisposition. I almost was beaten by a giant man for when the aggression side appears under these drugs you become totally possessed. I forgot I was 1,60, 50 kg and the man was a giant for me. Can you imagine if the other person is also under CHEMICAL AGRESSION?
"and so are used in fibromyalgia ". Strange. In the directions of some antidepressants it is reported that it can CAUSE fibromyalgia.
By Anonymous on Thursday, January 8, 2004 - 10:54 pm:


Truthman30 said...

If SSRI antidepressants "appear" to work in some people, it is because they are designed to numb the individuals emotions and feelings. For a large number of people they cause more problems than they help. One such drug is Seroxat (Or Paxil as it is called in the US) I myself was prescribed this defective and dangerous poison and I am lucky to have lived to tell the tale. Seroxat has become synonymous with increses in suicide, aggression and abnormal behavior. The risks do not outweigh any so called "benefits". It is an absolute disgrace that this drug is still on the market. The negative press it has received over the past 10 years is staggering, from reports of suicides induced by the drug to horrific withdrawal effects to birth defects in babies. Most of these risks are admitted now by the manufacturer, GSK , but still all the data about Seroxat has not been released into the public domain. This drug needs to be pulled from the market immediately. It is absolutely lethal .

For more information on the horrible dangers of Seroxat, please check out my blog :


Ana said...

I know your blog truthman30.
Thank you for the informations. I agree with you and I know what SSRI's can do. I was prescribed Seroxat (Aropax in Brazil) and it was changed to Effexor.
I admire your work and the other campaigners against this dreadful drug for, as it has already been said many times, this is one of the hardest to withdraw.
However, according to my experience that is described on this blog, it took me 2 years to withdraw 225 mg of Effexor and I suffered the hell to finally, suicidal and violent behavior included, and I had to take the drug again for could not stand withdrawal symptoms.
There are many testimonies about Effexor withdrawal hell as well as side effects. As far as side effects are concerned SSRIs tend to promote the same.
And there are also testimonies on Cymbalta...
Prozac problems is described on the "Prozac Backlash" but it surely easier to withdraw.
I hope that with all the job you, Fidddy and others are doing some justice is done to Seroxat Sufferers.
Perhaps that could lead other SSRIs sufferers do the same.
I'll put your blog on my bloglist.
Yours truly,

Ana said...

I forgot to say that I'm the "Anonymous" in Socialaudit.
I had already written a lot so I decided to go on anonymously.
I used a lot the expression Chemical Sucide Ideation and the that excerpt from the "The Influence of Pharmaceutical Industry" I have already copied I don't know how many times. I have even translated it into Portuguese. The use of relicenses is also an indicator of my style.
Of course numerous English mistakes.