Depression With Drugs example essay topic

The Over Diagnoses, Over Prescription and Low Efficacy of Anti-Depressants It is truly sad the way in which modern medicine deals with so called "depression", where doctors pass out pills without considering the long-term damage these powerful drugs can inflict upon the patients, that often times do not require such medication. Drug companies often have unhealthy relationship with doctors, giving them gifts and benefits, while of course handing out innumerable samples of these new, possibly unsafe drugs. There are also countless advertisements in magazines and on television that promote these drugs, regardless of their efficacy. It is fact that most anti-depressants reduce symptoms of depression to the extent as does placebo, meaning the drug does nothing but make the person think they are feeling better. Its seems strange to me that cigarette advertisements are banned, while anti-depressants advertisements are quite common.

These drugs can have side effects that rival that of nicotine, including fatal reactions, physical addiction and suicide upon discontinuation. These aspects are failed to be mentioned on anti-depressant advertisements. This is a multi-billion dollar industry, but are they really helping the afflicted? pg. 2 For a doctor to properly diagnose a patient as clinically depressed, they must meet certain guidelines. Clinical depression is roughly defined as a major depressive episode that generally interferes with ones daily functioning.

It should include at least four of the following symptoms: change of appetite, different sleep patterns, agitation, loss of interest in usual activities, decrease in sexual drive or functioning, feelings of guilt or worthlessness, fatigue, slowed thinking or impaired judgment, a suicide attempt or suicidal ideation. These symptoms should occur nearly everyday for at least two weeks in order to be diagnosed as clinically depressed. The problem I see with this diagnosis criteria, is that two weeks is too limited of a scope of time to really determine that an individual has a problem serious enough to be medicated. From personal experience, I have been to four different psychiatrists in regards to my own feelings of depression, and each time was never asked about the symptoms that are listed in the general guidelines that I previously mentioned. They were all very quick to affirm that I was in fact depressed, asking a few arbitrary questions about my allergies and health in general. Then came the samples.

Three out of the four doctors gave me Paxil, the last giving me Zoloft. Both of these drugs were heavily marketed on televison, periodicals and magazines. I followed the dosing directions, and immediately encountered some unwanted side effects, particularly from the Paxil. I can honestly say I never felt any anti-depressant effect from these drugs, although I did feel something. I would not categorize it as particularly pleasant, but not completely dysphoric. Most of these drugs take at least 2 weeks to start working, and by that time, pg. 3 ones feeling of depression could subside naturally, especially if there was no real clinical basis behind the depression, as so was in my case.

The main premise of clinical depression is characterized by a lack of a neurotransmitter called soratonin, and in some cases, norepinephrine. An imbalance of these chemicals is what leads to a serious depressive state, such as clinical depression. What is unfortunate, doctors can only guess if a patient is lacking these neurotransmitters, because to test for these chemicals would require a risky procedure called a "lumbar puncture" (aka spinal tap), where a large needle is inserted into the spine between the vertebrae and fluid is extracted. If the procedure is done incorrectly, the patient could easily be injured, paralyzed or even killed in the process. This extracted fluid is then analyzed to see if there are imbalances, but this is not always accurate. Because of the impracticality of a lumbar puncture, doctors have to instead guess if the patient has a chemical imbalance.

So, as you can see, this not a very accurate practice. The doctor has to rely on the patients complaints during the brief period of time they have with the client, and these feelings of depression are often transient, yet its is almost without a doubt that the patient will walk out with a prescription or some sort of sample. I do not believe that this "hit or miss" type of psychiatry is a valid way to treat a supposedly depressed patient, although it can work for those who have legitimate imbalances. There are a variety of reasons that doctors so freely hand out samples and casually write prescriptions for these drugs, which are often newly released and could be potentially dangerous. The clinical trials that the drug companies conduct in order to be pg. 4 accessed for FDA approval are supposed to determine all the flaws of the drugs, including its side effects, efficacy etc. The problem with these trials are that they are conducted by the drug company who's interest is in selling the drug and therefore the results may be somewhat biased.

Another more significant problem with the drug company clinic trials is that they are conducted over a relatively short period of time, so the long-term side effects may not manifest in the course of the trial. One of the psychiatrists I saw told me that the real clinical trials are on the patients that receive the drug after it has been approved by the FDA, and long-term side-effects only begin to appear after its been introduced into the general public. Another reason why new anti-depressants are so heavily marketed upon approval, is that the drug companies have a short window of time after a drug has been released to sell it solely under their own brand name, which can generate quite a bit money for that specific company. Once the formula is released to public domain, cheaper generics of the same drug is made and sold for an often substantially lower price. So when a drug company had just passed FDA approval for some new anti-depressant, drug companies very persistently market the drugs so they can reap their profits while the drug is still under their sole property. This leads to heavy marketing on media of all sorts, and more importantly, a relationship with individual doctors that seem to cross the lines of proper medical ethics.

Drug companies often shower doctors with gifts, "seminars" in exotic locations like Hawaii, and all sorts of benefits during the introduction of some newly FDA approved drug. And of course, the drug companies give the doctor many free samples of the new drug. There is a sort of pg. 5 silent understanding between drug makers and doctors, where the doctors prescribe these new drugs to keep the drug manufactures appeased, and keep their sales up. Essentially, drug companies could not exist without these doctors, and doctors could not exist without these companies as well. This leads me to believe that both the drug manufacturers and The table below shows the side effects of one of the most popular anti-depressants, Prozac (chemical name Fluoxetine). Notice the higher incidence of side-effects (then placebo) of symptoms that mimic depression, which Prozac is supposed to suppress, not induce.

It appears that insomnia, anxiety, nervousness and somnolence are more prevalent when taking Prozac, than placebo (sugar pill). TABLE 2 A Most Common Treatment-Emergent Adverse Events: Incidence In U.S. Depression Placebo-Controlled Clinical Trials Percentage of Patients Reporting Event Depression Body System / Adverse Event Fluoxetine HCl (N = 1728) Placebo (N = 975) Body as a Whole Asthenia 9 5 Flu syndrome 3 4 Cardiovascular System Vasodilation 3 2 Digestive System Nausea 21 9 Anorexia 11 2 Dry mouth 10 7 Dyspepsia 7 5 Nervous System Insomnia 16 9 Anxiety 12 7 Nervousness 14 9 Somnolence 13 6 pg. 6 Why does an anti-depressant such as Prozac induce the symptoms of depression that it is supposed to suppress? It is very possible that the people in that study were in fact not depressed in the clinical sense, and the drug worsened their depression rather than appeasing it. Guy Sapirstein wrote the following article found on the American Psychological Association website, regarding the inefficacy of such drugs: "The debate about treating depression with drugs, psychotherapy, or a combination of both drugs and psychotherapy has raged on over the years. But a recent analysis of 39 studies of 3,252 depressed patients, presented at the American Psychological Association's (APA) 104th annual convention, found that 50 percent of the drug effect is due to the placebo response. In other words, a patient taking antidepressant medication with a self-reported improvement rate of 10 points, can attribute half (.

5) of that improvement to the placebo effect. To determine the placebo effect of antidepressant medications, psychologist Guy Sapirstein, Ph. D., at the University of Connecticut, analyzed 39 studies of depressed patients from 1974 to 1995. The studies included patients with a primary diagnosis of depression, were randomized, and controlled for patients who received no treatment. Studies that measured the effects of antidepressant medications such as fluoxetine (Prozac), serta line (Zoloft) and paroxetine (Paxil) were included in the analysis. Dr. Sapirstein concluded that the pharmacologic and non pharmacologic effects of antidepressants indicates that while only 27 percent of the response to medication is due to the medication alone (a true pharmacologic effect), 50 percent is due to the psychological impact of administering the medication (placebo effect) and 23 percent is due to other 'nonspecific factors. ' 'People benefitting from drugs are benefitting because they think that taking the antidepressant medicine is working,' Dr. Sapirstein said.

'If we take these results and say that improvement is due to what the patients think, then how people think and its effect on how they feel are more powerful than the chemical substance,' he added. (Sapirstein 8) " Again, from this study, we can see the inadequacy of anti-depressants. With 50% of the anti-depressant effect accounted for as placebo, its clear that many of the patients taking these drugs are really putting themselves at risk for no significant pharmacological benefit. The problems that could arise from toying with medications that can permanently alter ones receptors and neurotransmitters is not worth the possible damage. Leave these pg. 7 medications to the seriously depressed, not to 15 year olds who broke up with their girlfriend or had their cat run over.

When taken with consistency, these drugs leave a permanent mark. They are physically addictive, and are difficult to get off of when taken for a long period of time. The risks outweigh the benefits, so before one goes to a doctor because they are feeling down, they should re-evaluate the risk-benefit ratio. If one can simply not function because of crippling depression, the risk may be worth it.

Doctors should be more straightforward, and be more aware of what they are doing by prescribing these drugs. I believe this is a serious problem, and the real dangers of these drugs will not be realized until it is too late. Final Proposal Thesis It is a truly sad state in which modern medicine deals with so called "depression", where doctors pass out pills without considering the long-term damage these powerful drugs can inflict on the patients that often times do not require such medication. This is a multi-billion dollar industry, but are they really helping the afflicted?

Bibliography

Appleton, William. Prozac and the New Antidepressants: What You Need to Know About Prozac, Zoloft, Paxil, Luvox, Wellbutrin, Effexor, Serzone, Vestra, Celexa, St. John's Wort, and Others. New York: Dutton Plume, 2000.
Bech, P. "Social aspects of treatment of depression". National Library of Medicine. PMID: 7622806 PubMed. Frederiksborg General Hospital, Psychiatric Institute, Hillerod, Denmark. 10 March 1995 Breggin, Peter.
The Anti-Depressant Fact Book. Massachusetts: Perseus Books Group, 2001.
Gilman, Charlotte Perkins. "The Yellow Wallpaper". Dreams and Inward Journeys. Ed. Marjorie, Jon Ford. Addison Wesley Longman Inc, 2001.
258-272. Styron, William. "The Roots of Depression". Ed. Majorie, Jon Ford. Addison Wesley Longman Inc, 2001.
248-252. Sapirstein, Guy. American Psychological Association. 1996.
21 July 2003.
Main Points Thesis defines argument: Over-diagnoses and overmedication for so-called "depressed" individual. Body Paragraphs Content: - A quick introduction about the pharmacology of depression, and the commonly used drugs to treat this disorder. Also including some of the figures of the drugs efficacy from clinical trials, showing that many have similar effects to sugar-pill (placebo). - The differentiation between temporary sadness, and clinical depression requiring medication. - Doctor inadequacy and lack of their negligent lack of knowledge in respect to these anti-depressants, and the practice of prescribing of drugs on a trial and error basis Many patients who claim to have depression may be suffering from other disorders, such as generalized anxiety disorder, obsessive-compulsive disorder, manic depression, and often their problems are psychosomatic. Doctors use these new anti-depressants as "cure-alls" for the myriad of problems of which their patients complain. First proposal Thesis It is a truly sad state in which modern medicine deals with so called "depression", where doctors pass out pills without considering the long-term damage these powerful drugs can inflict on the patients that often times do not require such medication. Works Sited Appleton, William. PMID: 7622806 PubMed. Ed. Marjorie, Jon Ford. Styron, William. Ed. Majorie, Jon Ford. PMID: 7622806 PubMed. Ed. Marjorie, Jon Ford. Sapirstein, Guy. 1996.