Debate Over Antidepressants – Letters NYT

Debate Over Antidepressants – Letters NYT

Mon, 11 Aug 2003

The New York Times published 5 letters re: “Debate Resumes on the Safety of Depression’s Wonder Drugs.” One letter from someone who experienced “a minor depressive episode” and was prescribed Celexa, one of the SSRI antidepressants. He describes experiencing “extreme, almost manic tendencies” during the first month which he says, “could give depressed people the energy to carry through with a suicide plan.” His experience validates our assertions about these drugs’ underlying, serious, undisclosed risks.

The one letter to focus on the underlying problems that arise from biased clinical trial reports is by Dr. David Cohen, a member of the board of AHRP.

The Times does not identify potential conflict of interests by some of the other letter writers. Following the 5 published letters is one I submitted today.

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THE NEW YORK TIMES
August 11, 2003
The Debate Over Antidepressants (5 Letters)

To the Editor:

Re “Debate Resumes on the Safety of Depression’s Wonder Drugs” (front page, Aug. 7):

Suicide will always be a risk for people living with depression until more effective treatments are found for this highly disabling illness. While raising awareness of the risk of suicide and the effectiveness of current available treatments is newsworthy, we are concerned that this news might cause patients and parents to discontinue medication without consulting their physicians.

The risk of suicide for those who are not being treated is far greater than it is for those who are taking these antidepressants.

LYDIA LEWIS
President, Depression and Bipolar
Support Alliance
Chicago, Aug. 7, 2003


To the Editor:

The recent debate over the safety of certain antidepressants (front page, Aug. 7) should take into consideration how improper diagnosis may affect outcome. There is growing evidence that bipolar disorder (“manic- depressive illness”) is both underdiagnosed and inappropriately treated in this country. Some of these individuals may have serious adverse reactions to antidepressants, including irritability, aggression and mania. These patients are more appropriately treated with mood stabilizers.

Suicidal behavior is a complex phenomenon with genetic, biochemical and psychosocial components. But if the diagnosis is wrong in the first place, treatment is bound to be misguided.

RONALD PIES, M.D.
Lexington, Mass., Aug. 7, 2003
The writer is a clinical professor of psychiatry, Tufts University.


To the Editor:

Re “Debate Resumes on the Safety of Depression’s Wonder Drugs” (front page, Aug. 7):

A number of years ago I experienced a minor depressive episode. I was put on a serotonin inhibitor called Celexa. I had never had suicidal thoughts before the drug therapy, nor did I begin to have them during the course of treatment. But during the first month, I experienced extreme, almost manic tendencies. My mind raced, I was restless, I couldn’t sleep. Eventually that restlessness subsided.

That manic stage during the first month could give depressed people the energy to carry through with a suicide plan. The first month’s antidepressant therapy should be watched extremely closely, but I found the drug’s overall effectiveness to be revolutionarily good. Drug companies have nothing to hide. They need new dosing and treatment strategies to counteract the manic effect, but should not run from these drugs.

STEVE MATICS
Rochester, Aug. 7, 2003


To the Editor:

The controversy over the effects of antidepressants (front page, Aug. 7) illustrates a problem resulting from the intense commercialization of medical research – publication bias. When huge financial gains hinge on showing success for a drug in a clinical trial, negative findings may be withheld from publication.

Your article confirms that clinicians who rely only on published reports to make treatment decisions increase the risk of harm to their patients. Worse, many physicians rely solely on digests provided to them by pharmaceutical companies, which are even less likely to present drugs’ effects objectively. Patients beware.

DAVID COHEN
Miami, Aug. 7, 2003
The writer is a professor at Florida International University’s School of Social Work.


To the Editor:

The antidepressants cited in your Aug. 7 front-page article are a safe, dependable therapy when prescribed by psychiatrists to appropriate patients. Unfortunately, with mass marketing by pharmaceutical companies to physicians who are not psychiatrists, these medications are often dispensed to individuals who should avoid them. The serotonin inhibitors, while not perfect, have allowed thousands of individuals to lead longer, happier, more productive lives.

PETER KUDLER, M.D.
New York, Aug. 7, 2003
The writer is a psychiatrist.

Copyright 2003

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The New York Times
Letter to the Editor:

Re: Debate Over Antidepressants, letters. (Aug. 11)

The debate about antidepressants and the risk of suicide had been suppressed until now thanks to the ubiquitous influence of industry. The Times would serve its readers better if it adopted a financial disclosure policy. Those whose opinions are cited and Times contributors – including letter writers – should be required to disclose any financial ties to pharmaceutical companies.

For example, readers should be informed that Lynda Lewis’ organization, Depression and Bipolar Support Alliance, is funded almost entirely by pharmaceutical companies that manufacture antidepressants. See: http://www.dbsalliance.org/PDF/01AnnRpt.pdf

Vera Sharav
President, Alliance for Human Research Protection (AHRP)
New York City

212-595-8974

Declaration: AHRP receives absolutely no funding from pharmaceutical companies.