This week we present the second part of our podcast to join in the events for World Benzodiazepine Awareness Day 2020 (W-BAD). In part one, we interviewed Angela Peacock and talked about her experiences of taking and coming off benzodiazepines and also her involvement in the film Medicating Normal, which had a special screening and panel discussion on July the 11th at 1:00 PM EST.
And before we go on, I just wanted to say that these podcasts would not be possible without the efforts of W-BAD lead operations volunteer Nicole Lamberson, who goes above and beyond to make these interviews possible. Later in this episode, we will hear from Baylissa Frederick, who is a therapeutic coach and psychotherapist with over two decades’ experience working with clients affected by prescribed drug injury. But before we chat with Baylissa, I’m delighted to get the chance to talk with clinical pharmacologist Dr. Jim Wright.
Jim is Emeritus Professor in the Departments of Anesthesiology, Pharmacology, and Therapeutics in Medicine at the University of British Columbia. Jim obtained his MD from the University of Alberta in 1968, and his PhD in pharmacology from McGill University in 1976. He is a practicing specialist in internal medicine and clinical pharmacology. He is also Editor in Chief of the Therapeutics Letter and he sits on the editorial boards of PLoS One and the Cochrane Library. Dr. Wright’s research focuses on issues relating to the appropriate use of prescription drugs, clinical pharmacology, clinical trials, systematic review, meta-analysis, and knowledge translation.Read More
A 2018 article published in Ethical Human Psychology and Psychiatry argues that there are two primary false beliefs held by academic psychiatry related to the efficacy of antidepressants. The article was written by researchers with expertise on antidepressants and suicide risk, Michael Hengartner of Zurich University in Switzerland and Martin Plöderl of Paracelsus Medical University in Salzburg, Austria.
First, they explain that physicians often attribute antidepressant effects to pharmacological action rather than placebo effects. Second, academic psychiatry maintains that physical dependence on antidepressant drugs does not exist, and therefore any withdrawal or discontinuation symptoms are benign and affect only a small minority of users. These two remain pervasive within the field of psychiatry, despite a wealth of evidence suggesting that they are untrue. Hengartner and Plöderl point to the undue influence of the pharmaceutical industry as one of the forces maintaining the popularity of these misleading beliefs about antidepressants.
“The problem is presumably less with erroneous views expressed by patients and researchers critical of psychopharmacological drugs, but rather with false beliefs held by academic psychiatry and promoted by the pharmaceutical industry,” the authors write.Read More
In a new study published in JAMA Psychiatry, the use of antipsychotics (in this case, olanzapine) was associated with damage to the brain in multiple areas. The researchers used a randomized, controlled trial (RCT) design, which allows them to suggest that the drugs cause the observed effect on the brain. The researchers found “widespread” cortical thinning in those who took the drug versus those who took a placebo.
“Unlike uncontrolled studies, our randomized, double-blind placebo-controlled clinical trial design provides potential evidence for causation: olanzapine administration may cause a decrease in cortical thickness in humans,” the researchers write.
Exposure to olanzapine for just 36 weeks resulted in a loss of cortical thickness equal to up to four times the loss, on average, over the entire lifespan of someone who did not take the drug.Read More
In 2004, the US Food and Drug Administration (FDA) controversially issued a black box warning that antidepressants were associated with an increased risk of suicidal thoughts and behaviours in people aged under 18 years. In 2007, the warning was expanded to include young adults aged under 25 years. In 2005, the Australian Therapeutic Goods Administration responded to the FDA warning by requiring Product and Consumer Information leaflets to be updated to reflect the risk. However, there was considerable debate, and at times emotive backlash, in academic journals and the international media. Prominent US and Australian mental health organisations and psychiatrists challenged the FDA warning. They argued that, on balance, antidepressant use was likely to reduce the risk of suicide. Several ecological studies were cited misleadingly as evidence that decreasing antidepressant use increases suicide risk. From 2008 to 2018, Australian per-capita child, adolescent and young adult antidepressant dispensing (0–27 years of age) and suicide (0–24 years) rates have increased approximately 66% and 49%, respectively. In addition, there was a 98% increase in intentional poisonings among 5 to 19 year-olds in New South Wales and Victoria between 2006 and 2016, with substantial overlap between the most commonly dispensed psychotropics and the drugs most commonly used in self-poisoning. These results do not support claims that increased antidepressant use reduces youth suicide risk. They are more consistent with the FDA warning and the hypothesis that antidepressant use increases the risk of suicide and self-harm by young people. Causal relationships cannot be established with certainty until there is a vast improvement in post-marketing surveillance. However, there is clear evidence that more young Australians are taking antidepressants, and more young Australians are killing themselves and self-harming, often by intentionally overdosing on the very substances that are supposed to help them.
We also asked Peter Groot who helped develop the first Tapering Strips for Antidepressant withdrawal – who with colleagues has demonstrated that this can help many people – not all – unfortunately not all he would say.
Before answering the questions, all were asked, Peter offered some more general views that have been paraphrased here.Read More
There has been a recent rise in antidepressant prescriptions. After the episode for which it was prescribed, the patient should ideally be supported in withdrawing the medication. There is increasing evidence for withdrawal symptoms (sometimes called discontinuation symptoms) occurring on ceasing treatment, sometimes having severe or prolonged effects.
To identify and compare current knowledge, attitudes and practices of general practitioners (GPs) and psychiatrists in Cornwall, UK, concerning antidepressant withdrawal symptoms.Read More
H’s nightmare with Effexor withdrawal was laid out in last week’s post. Experts on antidepressant withdrawal were asked to comment – Will Hall, Altostrata, Peter C Groot, Bob Fiddaman, Josef Witt-Doerring have generously given time to do so. James Moore, Stevie Lewis and Ed White, administrator for a Facebook venlafaxine withdrawal group, who have substantial international profiles on withdrawal have also added comments to last week’s post.
Most of those commenting have had lives touched by withdrawal. I’ve designated them as experts but they would likely see themselves as ordinary people who have had to grapple with two awful problems – the effects of a drug and a betrayal by the medical profession and the pharmaceutical industry – and they would likely say to any readers going through similar problems that your motivation is more likely to lead to answers than waiting for expertise to ride to the rescue.
The issues in these posts apply to all SSRI and SNRI antidepressants, but also antipsychotics, gabapentinoids and other drugs. The withdrawal button beside the RxISK blog brings up 50+ posts on withdrawal issues with some on Sertraline and Prozac having hundreds of comments. RxISK also has a Complex Withdrawal panel with more information.Read More
As if the Covid-19 pandemic wasn’t enough, unprecedented numbers of people are suffering emotional fallout from isolation, money worries and fear of coronavirus infection, leaving Britain facing a tidal wave of anxiety and depression.
That’s the stark warning from the Royal College of Psychiatrists, with the organisation’s president, Professor Wendy Burn, declaring: ‘Our fear is that lockdown is storing up problems which could lead to a tsunami of referrals.’
The Royal College of Psychiatrists predicts that many of those affected will be people who have never before been diagnosed with depression or anxiety.Read More
The Guidance for Psychological Therapists: Enabling Conversations With Clients Taking or Withdrawing from Prescribed Psychiatric Drugs1 was published in December 2019. I was invited to play a small part in its production as I am a campaigner bringing to the attention of governments, the NHS, and the public the difficulties that some people have with severe and protracted physical symptoms when trying to withdraw from SSRI antidepressants.
We know from the advance research quoted at the beginning of the Guidance that 96.7% of therapists work with clients who take at least one psychiatric drug. Of the therapists surveyed, 93.1% reported they would find it either ‘useful’ or ‘very useful’ to have professional guidance to help them work more competently and confidently with such clients.1 This prompted the development of the Guidance as an accessible source of information for therapists about each class of psychiatric drug, how it works, what it is prescribed for, and what is known about its effects on the body and while it is exiting the body. Anything specifically written about a drug is referenced, and everything is evidence based.Read More
A new study compared intensive cognitive behavioral case management (CBCM) with and without antipsychotic use in young people diagnosed with first-episode psychosis. The researchers found that there was no difference in outcomes at the six-month endpoint. Both groups improved, and there was no added benefit to having taken antipsychotic medications. The study authors, writing in Schizophrenia Bulletin, explain:
“There was no discernible advantage to receiving antipsychotic medication from the start of the trial,” the researchers write.
The study was led by Shona M. Francey at Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia.Read More