(Science News) – As public health officials tackle opioid addiction and overdoses, another class of prescription drugs has been contributing to a growing number of deaths across the United States.
Benzodiazepines, such as Valium and Xanax, are commonly prescribed for anxiety and insomnia. The drugs are also highly addictive and can be fatal, especially when combined with alcohol or opioids. In the latest sign of the drug’s impact, the number of overdose deaths involving “benzos” rose from 0.54 per 100,000 in 1999 to 5.02 per 100,000 in 2017 among women aged 30 to 64, researchers report January 11 in the Morbidity and Mortality Weekly Report. That’s a spike of 830 percent, surpassed only by increases seen in overdose deaths involving synthetic opioids or heroin.
Overall, there were 10,684 overdose deaths involving benzodiazepines in the United States in 2016, according to the National Institute on Drug Abuse. In 1999, the total was 1,135.
Benzodiazepines have a sedating effect, and are particularly dangerous when used with other drugs that slow breathing, such as opioids and alcohol. In combination, the substances can “cause people to fall asleep and essentially never wake up again,” says Anna Lembke, an addiction psychiatrist at Stanford University School of Medicine. Benzos and opioids are often prescribed together, and opioids contribute to 75 percent of overdose deaths involving benzos.
The rising number of deaths involving benzos hasn’t stopped the flow of prescriptions. The number of U.S. adults who filled a prescription for benzos rose from 8.1 million in 1996 to 13.5 million in 2013, a jump of 67 percent, a study in the American Journal of Public Health in 2016 found. The quantity of benzos acquired more than tripled over the same time.Read More
(CEPUK.org) – For those still interested in the recent antidepressant withdrawal debate, here is a new and important installment.
Before we get to the essential part, let us first recall that our systematic review in Addictive Behaviors (2018) showed, among other things, that around half of people who stop antidepressants experience withdrawal. This conclusion was critiqued in a blog by Joseph Hayes and Sameer Jauhar, to which we responded by pointing out the blog’s many serious errors and misrepresentations (see our response here: http://cepuk.org/2018/11/05/antidepressant-withdrawal-review-authors-respond-mental-elf-critique/
Our response to that blog, however, did not deal with one of Hayes and Jauhar’s core criticisms: that our systematic review had failed to include five randomised control trials (RTCs) [i]. They alleged that these five trials, while primarily focusing on the effectiveness of antidepressants, also contained data on the ‘incidence’ of withdrawal – that is, on how common withdrawal actually is. Had we included this data in our review, Hayes and Jauhar contended, the number of people suffering antidepressant withdrawal would have been lower than we reported, perhaps by around 10% [ii]. It was therefore either remiss or dishonest of us, they implied, not to include data from these studies.
Today, we would like to deal briefly with this particular blog criticism, not merely to show how groundless it is, but more importantly because, by doing so, we gain crucial insight into how shadowy and ethically suspect antidepressant withdrawal research can get when viewed up close.Read More
(Yahoo! Lifestyle) – When Sheila Wojciechowski was 21 years old and fresh out of college, she found that her new job — working at a school for kids with autism — made her feel increasingly depressed and anxious.
“I would go home and cry, and feel like I was no good at the job,” she says now, at 35, of her quick spiral downward. “I slowly became less and less functional. I couldn’t get out of bed.” After seeing several psychotherapists and “not clicking” with any, she was taken by her parents, with whom she lived at the time, to a psychiatrist.
“I went in, and after, like, 10 minutes, he said, ‘Clearly, you have major depression disorder with anxiety disorder,” Wojciechowski, of Queens, N.Y., tells Yahoo Lifestyle. The doctor, who was citing an official diagnosis, then wrote her a prescription for the antidepressant Lexapro, a selective serotonin reuptake inhibitor (SSRI). Sensing her wariness, he asked her, “If you had a headache, wouldn’t you take an Advil?”
To that, Wojciechowski recalls, “I said yes. It made sense, and I tried it — reluctantly. … I knew it was not right from that first pill, but you do what you can with the information you have at the time.”Read More
Editorial Note: Aberystwyth on the West Coast of Wales is one of the best places in the world to see starlings murmurate. Clive King from the Computer Science Department there also organises TedX talks and on November 24 convened a panel of speakers to talk about murmurating swallows, ambivalent motherhood and making medicines safer among other things.Read More
(The Guardian) – The health secretary is under pressure to respond to growing concerns about the use of a controversial antipsychotic drug linked to deaths of psychiatric patients. Following claims by family members that two people died after being prescribed clozapine, coroners have written to Matt Hancock asking how he intends to ensure the drug does not claim more lives.
Julia MacPherson, 54, died while under the care of Oxleas NHS Foundation Trust in May 2016 after being put on a trial of clozapine, even though she did not have psychosis and begged not to be put on the medication. MacPherson had addiction problems, borderline personality disorder and was distraught after her marriage ended, but her family was shocked at the drug’s side-effects.
“She looked different, sounded different, had lost her sense of humour, cognitive function, coordination; she couldn’t eat properly, dress or wash. It was horrendous to see,” said her sister, Sarah MacPherson. “She was an attractive, intelligent person but on clozapine she was unrecognisable.”Read More
(The Washington Post) – All medications have the potential to cause unwanted side effects, and depression is among them. One-third of Americans are now taking meds that can cause this mood disorder, according to a study published in the Journal of the American Medical Association in June. Other research has had similar findings, but this is the largest review on the topic to date.
The study authors found that about 200 prescription drugs, including some often used by older adults — such as proton-pump inhibitors (PPIs) to treat acid reflux and beta blockers for hypertension — can lead to depression.
But doctors may not know this. “Many physicians may not be aware that several commonly prescribed medications are associated with an increased risk of this disorder,” says study author Mark Olfson, professor of psychiatry and epidemiology at the Columbia University Irving Medical Center in New York.Read More
(Medscape) – More than 30 million US adults, or roughly 1 in 8 people age 18 and above, used benzodiazepines in the past year — with over 5 million reporting misuse, new research reports.
Investigators analyzed 2015-2016 data from the National Survey on Drug Use and Health (NSDUH) and found that almost 13% of respondents reported past-year use of benzodiazepine, with only 10% using these agents as prescribed and 2% reporting misuse.
Misuse accounted for almost one fifth of overall use.
The highest prevalence of use was found in adults ages 50 to 64 years, while the highest prevalence of misuse was found in those aged 18 to 25 years.
“The focus has been on the badness of benzodiazepine, specifically in older adults, but with growing use in midlife superimposed on the opioid epidemic, this problem is not going away,” lead author Donovan Maust, MD, assistant professor of psychiatry, University of Michigan and research scientist, Center for Clinical Management Research, VA Ann Arbor Healthcare System, told Medscape Medical News.
“To our knowledge, this is the first national estimate of benzodiazepine misuse among older adults — a surprisingly data-free area,” he said.
The findings were published online December 17 in Psychiatric Services.Read More
(MadInAmerica.com) – An international group of researchers, including several with financial ties to manufacturers of antidepressants, explores possible explanations for why long-term users of antidepressants become chronically depressed.
The lead author on the paper is Michele Fornaroa at the University School of Medicine Federico II, Naples, Italy. The article is published online ahead of print in the journal Pharmacological Research. Fornaroa’s conservative estimate, based on previous literature, is that up to a third of people taking antidepressants find them ineffective or find that they increase depressive symptoms.
Mad in America has previously reported on studies that have found that antidepressant efficacy is overestimated, that antidepressant use is associated with worse outcomes, regardless of initial depression severity, and that severe withdrawal symptoms are common after discontinuation—particularly after long-term use.Read More
(RxISK.org) – Last week a seminar on dependence on and withdrawal from antidepressants took place in the Welsh Senedd, overlooking Cardiff Bay.
It was the initiative of and organised by Aled Jones of Prescription Drug Awareness, Support and Treatment, under the auspices of Mark Drakeford – the First Minister. The Senedd building was a stunning setting for the event.
(JAMA Psychiatry) – The introduction of second-generation antipsychotics led to a marked increase in antipsychotic medication prescribing for children and youths. In 2010, more than 1.3 million individuals receiving anti psychotics aged 24 years or younger filled 7 million antipsychotic medication prescriptions. The most common diagnoses associated with the antipsychotic prescriptions for these children and young adults were attention-deficit/hyperactivity disorder (ADHD), disruptive behavior disorder, and depression. However, antipsychotics are often an off-label or secondary therapeutic choice for these diagnoses, given the other well-defined therapeutic interventions available with potentially fewer adverse effects. Antipsychotics also are frequently prescribed to children and adolescents for bipolar disorder or mood instability, although there often are alternative treatments available.
Studies of older adults linking antipsychotics with increased risk of cardiovascular and total mortality raise the concern that receipt of antipsychotics may be associated with increased mortality in younger populations.Read More