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http://www.steelhorsemag.com/SSRI.htm

 

THE ASSASSINATION OF OUR YOUTH

 

SSRIs, or selective serotonin reuptake inhibitors, are

the pharmaceutical companies latest cash cows. Their

use has skyrocketed in the last ten years. Nicknamed

" Chemical Babysitters " and designated anti

depressants, they are causing dozens of murders,

thousands of psychoses and are altering the minds of

millions of users. All but a very few of the latest

" Mass Murderers " have been on these drugs. Schools

encourage parents to put their children on these drugs

for the smallest signs of " non conformity " . Schools

receive more money for " disabled " students.

 

Here is one of the most informative articles on SSRIs

I've found by Dr. Julian Whitaker MD:

 

The Scourge of Prozac

 

When I first heard about the Columbine High School

massacre, my initial thought was, " Lord help us, were

they taking Prozac? " Nine days later, it was reported

that Eric Harris, one of the shooters, was taking

Luvox, which, like Prozac, Zoloft and Paxil, belongs

to the class of drugs known as selective serotonin

reuptake inhibitors (SSRIs). In one out of every 25

children taking it, Luvox causes mania, " a psychosis

characterized by exalted feelings, delusions of

grandeur…and overproduction of ideas. "

 

Guns Are Blamed, but What About Prescription Drugs?

Likely due to pressure from the pharmaceutical

industry-heavy advertisers in all media-the national

debate on the epidemic of teen violence has ignored

the widespread use of prescription drugs in teens and

particularly those who have committed monstrous acts.

However, the drug-violence link is frighteningly

common. Fifteen-year-old Shawn Cooper of Notus, Idaho,

fired a shotgun at students and school staff.

According to his stepfather, he had been taking an

SSRI. Thirteen-year-old Chris Fetters of Iowa killed

her favorite aunt. She was taking Prozac. Kip Kinkel,

a 15-year-old youth, went on a rampage in Oregon. He

first shot and killed his parents, spent the night

with the bodies (characteristic of the dissociative

reaction these drugs often cause), then killed two and

wounded 22 of his fellow students at Thurston High

School. He was taking Prozac.

 

SSRI Drugs Can Turn People Into Monsters

Look, folks, these are the acts of monsters. The

accessibility of guns and violent movies alone does

not create monsters out of children. But prescription

drugs that markedly alter brain chemistry can-and do!

Particularly drugs like Prozac, which are, in my

opinion, the chemical equivalent of a ghoulish Stephen

King monster hiding in the closet. A few people have

tried to warn the neighborhood, but no one is

listening. And SSRIs don't backfire in children only.

In November 1991, 66-year-old Barbara Mortenson

attacked her 81-year-old mother, biting her more than

20 times and leaving chunks of flesh strewn on the

floor. Barbara had been taking Prozac for the previous

two weeks. Kristine Marie Cushing, age 39, had been

separated from her husband for several months. In

October 1991, she took a .38-caliber pistol and shot

and killed both of her children, Elizabeth age 8, and

Stephanie Marie, age 4, while they lay sleeping in

their beds, then shot herself, inflicting a non-fatal

wound. Prosecutors stated that they " couldn't find one

iota of information to show that she was anything but

a very giving, caring and sweet human being. " After a

plea of insanity, she was committed to a mental

institution. What made her snap? She had been taking

Prozac. Ann Blake Tracy, Ph.D., author of Prozac:

Panacea or Pandora?, has been studying the violent,

dark side of SSRI drugs for ten years. She has

researched 32 murder/suicides that involved women and

their children. By interviewing their families and

studying autopsy reports, news accounts and medical

histories, she has determined that in 24 of these 32

cases, the women were taking Prozac or another SSRI.

 

These Drugs Alter Normal Brain Function

The explosive nature of these drugs is predictable.

Studies show that they can cause a condition known as

akathisia. Akathisia comes from the Greek word meaning

" can't sit still, " and refers to significant physical

and mental agitation. Akathisia is to violence what a

match is to gasoline. This condition has been reported

in one out of 16 Prozac users, but its incidence is

likely under-reported because Prozac also produces

mania, hypomania, anxiety and restlessness, which are

first cousins of akathisia. The defenders of Prozac

say that millions are being helped by it, but this

claim is spurious. In the clinical trials submitted to

the FDA for registration, Eli Lilly studied the drug

in less than 300 people and for only four or six

weeks. However, one out of every seven participants

dropped out of the study because of side effects of

the drug. In fact, in a recent evaluation of the usage

of Prozac and other SSRIs, it was found that nearly

70% of those who are prescribed the drug do not take

it as prescribed, probably due to its undesirable side

effects. Imagine that, for a drug touted to make

people feel better! Furthermore, there are no studies

demonstrating that taking any antidepressant prevents

suicide or violent behavior. In fact, according to

Peter Breggin, M.D., author of Your Drug May Be Your

Problem, " there is substantial evidence that many

classes of psychiatric drugs-including

antidepressants, such as SSRIs-can cause or exacerbate

depression, suicide, paranoia and violence. " Did you

know that one out of every 12 patients (and this

figure, too, is likely under-reported) admitted to

mental hospitals for psychosis is taking SSRIs?

 

Even the Bright Side of SSRIs Is Dark

As Dr. Breggin points out in his earlier book, Talking

Back to Prozac, these drugs rob people of their

humanity-they lose their capacity for empathy. " A lot

of what we are seeing is individuals losing their

feeling for the people in their lives. They stop

caring about their husbands or wives or children. They

stop caring about God. " Though zombie-like numbness

may initially be felt to be an improvement by someone

with depression, it can hardly be considered healthy,

or even desirable. It is this loss of empathy in my

opinion, that allowed Kip Kinkel to kill both of his

parents, then spend the night in the same room before

heading out to shoot his classmates in Oregon. It is

precisely why Eric Harris could wander around shooting

his classmates in Columbine High School, even kids he

liked, and laugh about it. It's beyond my

comprehension how any doctor could knowingly prescribe

a drug that may generate violence and numb the

individual to its consequences!

 

We Are the Drug Companies' Guinea Pigs

This is not the first time Eli Lilly and other large

drug companies have polluted our culture with

mind-altering, hallucinogenic drugs. Did you know that

Eli Lilly first produced and marketed LSD as a legal

drug in the 1950s, promoting it as an aid to

psychoanalysis, a cure for alcoholism and a way to

clear up mental illness? Did you know that PCP, often

referred to as angel dust-one of the most dangerous

street drugs because it produces irrational, violent

behavior-was once legally marketed as an analgesic and

painkiller by Parke-Davis? Did you know that both LSD

and angel dust act by increasing serotonin levels in

the brain, precisely the same mechanism of SSRIs? Dr.

Tracy reports that people who have taken LSD in the

past sometimes have LSD flashbacks when given Prozac

or a similar drug. These drugs are not helping people.

At best, they blunt your experience of both the joys

and the sorrows of the human experience. At worst,

they are our most frightening nightmare.

 

More SSRI-induced Tragedies

Two years ago, Matthew Miller had achieved every

13-year-old boy's dream-he had reached 100 pounds. He

had also changed schools and was a little melancholy.

He saw a psychiatrist, who gave him some samples of

Zoloft, an SSRI, with the instructions to " give it a

try for a week. " His parents were happy and trusting,

though a little perplexed that it all seemed so easy

and that no other form of therapy was even mentioned

to help Matthew with what they felt was a common

adjustment reaction for a child his age. The drug

produced akathisia in Matthew. His sister complained

that he was being loud and bothering her more than

normal. His grandmother noted that Matthew " could

hardly sit still through our Sunday brunch. " In the

early morning hours of his seventh day on Zoloft,

Matthew committed suicide. He hanged himself in his

closet. His father, now painfully aware of what these

drugs can do, wrote: " There was no cry for help. No

scream. Nothing…but that single, fateful, horrifying

and irreversible act. For a bright, healthy and loved

young man, Matt had every reason to live. Yet under

the power of this debilitating drug, he found a way to

die. We know it was not our Matt who took his own

life. This was a Matt 'high' on a legalized pill.

Reality and nightmares became indistinguishable for

him. The universe that was his chemically stimulated,

serotonin-enriched, emotionally tortured brain came

crashing down around him with such ferocity, he had no

way out. "

 

We Must Get the Word Out

Drug companies are pushing to sell more and more

SSRIs, thereby drugging larger segments of our

population. Believe it or not, it's reported that many

children under the age of three have already been

given Prozac, and it will soon be made in flavored

form for children! Folks, you must educate yourself

and others on this issue. There are at least two

current lawsuits against Pfizer, the manufacturer of

Zoloft. The family of the late television actor Phil

Hartman claims that Brynn Hartman, Phil's wife and the

mother of their two children, aged 9 and 7, was under

the influence of Zoloft when she shot and killed her

husband while he was sleeping, then killed herself.

Another SSRI murder-suicide. The family of Matthew

Miller is also suing the company over the fatal

consequences of this drug in their son. As evidence

like this mounts, the tide is bound to turn against

these dangerous drugs and, just like LSD and PCP, I

believe they will ultimately be taken off the market.

It's just a question of how much human suffering must

be endured before that occurs.

 

Let's Get Rid of These Drugs

I urge you to state your views on this important

matter in a letter to Jane Henney, M.D., Commissioner,

Food and Drug Administration, 5600 Fishers Lane, Room

1471, Rockville, MD 20857. Send copies of your letter

to your Senators and Congressman, and the

International Coalition for Drug Awareness at P.O. Box

1044, West Jordan, UT 84-84 (www.drugawareness.org).

 

Want to Know More?

Three books I strongly recommend are Ann Blake Tracy's

Prozac: Panacea or Pandora? (which may be ordered by

calling 800/280-0730) and Peter R. Breggin's Your Drug

May Be Your Problem and Talking Back to Prozac (both

available in bookstores). Jon Rappoport's in-depth

analysis of teen violence, Why Did They Do It? An

Inquiry into the School Shootings in America may be

downloaded from his web site

http://home.earthlink.net/~alto/.

 

Two other excellent web sites for obtaining detailed

information on the human tragedies and the dark side

of " happiness in a bottle " are Dr. Tracy's

International Coalition for Drug Awareness at

drugawareness.org and the Prozac Survivor's Support

Group at pssg.org.

 

This is the warning given when SSRIs are prescribed:

Dropping " cold turkey " off any medication, most

especially mind altering medications, can often be

more dangerous than staying on the drugs. Tapering off

very, very, very slowly--over months, not just

weeks!-- has proven the safest and most effective

method of withdrawal from this type of medication,

thereby giving the body time to readjust its own

chemical levels.

 

Here are the psychosis warnings for the following

drugs from the warning labels of each:

 

Prozac, Mania/Hypomania:

During premarketing clinical trials in a patient

population comprised primarily of unipolar

depressives, hypomania or mania occurred in

approximately 1% of fluoxetine treated patients. The

incidence in a general patient population which might

also include bipolar depressives is unknown. The

likelihood of hypomanic or manic episodes may be

increased at the higher dosage levels. Such reactions

require a reduction in dosage or discontinuation of

the drug.

 

Zoloft, Activation of Mania/Hypomania:

During clinical testing in depressed patients,

hypomania or mania occurred in approximately 0.6% of

sertraline-treated patients. Activation of

mania/hypomania has also been reported in a small

proportion of patients with Major Affective Disorder

treated with other marketed antidepressants.

 

Effexor, Activation of Mania/Hypomania:

During Phase II and III trials, mania or hypomania

occurred in 0.5% of venlafaxine-treated patients.

Activation of mania/hypomania has also been reported

in a small proportion of patients with major affective

disorder who were treated with other marketed

antidepressants. As with all antidepressants,

venlafaxine should be used cautiously in patients with

a history of mania.

 

Paxil, Activation of Mania/Hypomania:

During clinical testing in depressed patients,

approximately 1% of paroxetine treated patients

experienced manic reactions. When bipolar patients

were considered as a sub-group the incidence of mania

was 2%. As with other Selective Serotonin Reuptake

Inhibitors (SSRIs), paroxetine should be used with

caution in patients with a history of mania.

 

Serzone, Activation of Mania/Hypomania:

As with most antidepressant agents, activation of

mania/hypomania has been reported rarely in patients

with Major Affective Disorder treated Brim nefazodone.

In unipolar depressed patients in clinical trials,

hypomania or mania occurred in 0.4%, 0.3%, and 0.5% of

patients treated with nefazodone, tricyclic

antidepressants and placebo, respectively. In bipolar

patients included In these studies, the corresponding

rates of occurrence were 3.1%, 10%, and 0% for

nefazodone, tricyclic antidepressants and placebo.

 

Anafranil Psychosis, Mania-Hypomania, and other

Neuropsychiatric Phenomena:

In patients treated with tricyclic antidepressants,

activation of latent schizophrenia or aggravation of

existing psychotic manifestations in schizophrenic

patients may occur; patients with manic-depressive

tendencies may experience hypomanic or manic shifts;

and hyperactive or agitated patients may become

over-stimulated. A reduction in dose or

discontinuation of clomipramine should be considered

under these circumstances.

 

All of the above drugs contain the following

disclosure results in testing:

 

Suicide:

The possibility of a suicide attempt is inherent in

depression with or without obsessive-compulsive

disorder. These patients should be carefully

supervised during treatment with clomipramine, and

hospitalization or concomitant electroconvulsive

therapy may be required. To minimize the risk of an

intentional overdose by a depressed patient,

prescriptions should be written for the smallest

possible quantity of the drug consistent with good

patient management.

 

During testing an average of 11.5% of patients

showed some adverse reactions to the drugs.

 

Peter Jennings ABC News: September 15, 1999

 

Peter Jennings: " Just when is the drug actually making

a difference?

 

Antidepressants are very popular these days: sales are

up 17% from just last year. Millions and millions of

prescriptions now are being written to battle

depression and mood swings. Tonight, are these drugs

really doing everything that people think they are?

Here's ABC's Deborah Amos "

 

Deborah Amos: " These depression fighting pills are 60

- 70% effective in bringing relief according to the

medical literature. But Thomas Moore, who studies

drugs at George Washington University, says the

numbers are misleading "

 

Thomas Moore: " Millions of Americans believe that the

benefits of these drugs are much greater than they

are "

 

Deborah Amos: " To investigate, Moore analyzed all drug

company tests on five major drugs submitted to the FDA

prior to market approval: for Paxil, Zoloft, Effexor,

Serzone and Prozac. The effectiveness of the drug was

measured against a placebo or sugar pill. "

 

Thomas Moore: " The effect of antidepressants drugs on

depression is only very little different than the

effect of a completely inactive placebo. "

 

Deborah Amos: " The highlight of Moore's finding is the

case of Prozac with more than $2 billion dollars in

U.S. Sales. About 90% of Prozac's overall

effectiveness is about the same as patients taking

nothing stronger than a sugar pill. But the label for

antidepressant drugs, the prescribing detail for

doctors, usually do not spell out the small overall

differences between the drug and the placebos. "

 

Thomas Moore: " At the very least the FDA product

labeling should include a more balanced picture of all

the information they have received about the drug, -

about all the clinical trials. "

 

Deborah Amos: " " The FDA says it does not put that kind

of detail on the label because it is not helpful in

predicting individual outcomes. So what does it all

mean for patients, when a placebo can have almost the

same benefits as a dug, and particularly, when a drug

can have unpleasant side-effects.

 

(a psychologist from the University of Conn., who has

teamed up with Thomas Moore.)

 

" It suggests that the frontline of treatment for

depression should be psychological rather than

chemical. "

 

Deborah Ames: " The problem is that good therapy is

expensive and not always available. Pills are cheaper

and more easily available. Deborah Ames, ABC News, New

York. "

 

Grieving father warns of drug dangers:

Wife, mother who took lives of their

two young children was under treatment

 

By DENNIS STANLEY

 

 

Nearly six weeks after his wife took the life of their

two children and then her own at a scenic overlook to

Center Hill Lake, Robert Kirkwood of Lebanon wants the

public to be made aware of the dangerous side effects

of anti-depressant medications such as Prozac, Effexor

and Zoloft.

 

Kirkwood believes his wife’s medication played a role

in her decision to shoot their two young children and

then turn the gun on herself.

 

" That’s the only reason I’m calling, so this will not

happen to someone else, " he said in a telephone

interview Monday. " This is such a deep, dark hole,

such a pain in a person’s heart. Nobody should have to

go through this. "

 

It was early the morning of July 16 when State Trooper

Sherry Beaty was called to investigate a parked

vehicle at the scenic overlook to Center Hill Lake on

Highway 56 near the DeKalb-Putnam County line.

 

When she arrived, Beaty found four-year-old Kelly

Diane Kirkwood and her brother, three-year-old Kyle,

shot to death in the back seat of a Jeep Cherokee.

Dead in the driver’s seat was the mother, Rosemarie

Kirkwood.

 

Following an investigation, authorities revealed Mrs.

Kirkwood was taking anti-depressant medicine and beer

was also found in the vehicle.

 

Robert Kirkwood said he " was given no advance warning,

no instructions from anybody on what to look for or to

know about what might or could happen " to his wife,

who at one time was taking 15 different medications

between those prescribed by her primary care physician

and her psychologist.

 

He said Monday his wife started taking Zoloft about a

year ago and then some six months later was prescribed

Effexor, a medication he said is often described as

" Prozac with a kick. "

 

Dr. Ann Blake Tracy, Director of the International

Coalition For Drug Awareness and a Doctor of

Psychology and Medical Sciences, said Prozac, Zoloft,

Paxil, Luvox, Serzone, Effexor, and Anafranil increase

serotonin, the same brain chemical that LSD, PCP and

other psychedelic drugs mimic in order to produce

hallucinogenic effects.

 

According to the coalition’s website, side effects to

increased serotonin include: vivid and violent dreams,

inability to feel guilt or cry, breathing or lung

problems, cravings for alcohol, confusion, mood

swings, altered personality, symptoms of mania,

inability to see any alternatives in situations;

aggressive or violent behavior, impulsive behavior

with no concern about consequences, paranoia, feeling

" possessed " or that something evil is inside; self

destructive behavior and suicidal ideation; and

suicide attempts.

 

Kirkwood said he talked to his wife’s psychologist

after she had 15 pills of medication but was given

little relief and was told " it would take about a year

to help her out. "

 

He said he has obtained a pharmacy prescription list

" that is six feet long. "

 

" I’d say one-third of it is 1998-99 (prescriptions), "

Kirkwood said, adding that the psychologist’s name

appears " 34 times straight times for medication in an

8 to 10 week period. "

 

" In no way in God’s name should that be going on, " he

said Monday. " There’s no way to chemically alter a

person’s make-up. "

 

Now, Kirkwood said his efforts to educate the public

on the side effects of prescribed medication is " what

keeps me going. "

 

" I spend 70 percent of my time in front of the

computer trying to educate myself and other people to

become aware of alternative herbal and natural ways to

prevent depression before that happens, prevent mania

episodes from these type of medications, " he said.

" That’s all I got left right now. That’s what keeps me

going. I’ve been passing out information to the

sheriff’s departments in Gallatin and Lebanon. They re

the ones who have to see all of this happening. "

 

He said he also attends Titans football games because

his wife had talked him into buying private seat

licenses.

 

" I know she would have really enjoyed them (games), "

said Kirkwood, an industrial sheet metal worker who

often worked out of town. " I go and take a couple of

friends every now and then. they had some great

firework shows and I know my little girl would have

loved that because every time I’d come in from out of

town I’d buy fireworks and make like a celebration

when dad came home from working. She’d always call me

up and say ‘daddy, you got enough money for fireworks

yet.’ "

 

Kirkwood said he forgives his wife, " even in my anger

for what has happened. "

 

In an e-mail to the Smithville Review, he said it has

taken five to six weeks " nearly 8-12 hours a day to

find all that I have learned about just one

medication " adding, " I must be under the grace of God

for I could have been buried with them. This must be

why I am still here, to tell others that you can be

deceived by what you think is supposed to help you. If

I knew a few months ago what I know today, I would not

be telling you this now. Please be educated and not

just by or on a doctor’s advice. They are very busy

and they may not even be told the whole truth. "

 

Kirkwood also said he appreciated Trooper Beaty’s

" prayers for my children and for the mercy upon my

wife’s soul. I often say the same thing. I still love

my wife and kids very much. "

 

For more information about anti-depressants and other

medications, Kirkwood recommends the following

Internet sites: www.drugawareness.org; www.pssg.org;

and www.breggin.org.

 

(Next week: Comments from Dr. Tracy on the dangers of

anti-depressant medications.)

 

Reader Submitted Opinions:

 

By: Diane on 1999-09-19

The loss Mr. Kirkwood has experienced is devastating,

and unfortunately is quickly becoming common. I have

been researching these drugs myself and am painfully

aware of the adverse affects. My sister has been

taking Paxil for about a year. At first she did real

well on them. Now she is little more than a zombie.

Doesn't care about her responsibilities, family or

friends. She has been drinking a lot and is rapidly

going down hill. Her children are neglected and are in

dire need of a mother. Unfortunately their father has

his own vice of alcohol and also neglects. I trust my

14yr old niece to watch my 7yr old daughter before her

mother. I am scared for our whole family because of

these drugs. We have just recently approached her

about taking these things and seems to be paying

attention, however I have little faith in her ability

to think clearly. She is seeing the Dr. on Thurs and

my fingers are crossed. I have little faith in a

positive outcome as doctors rarely see beyond the

financial rewards from the pharmaceutical companies.

 

Please seek alternatives to these SSRI drugs, they are

very dangerous! During my research I have found what

seems a good alternative (natural) called SAMe

(pronounced Sammy)It can be found in health food

stores and many web sights. I can only suggest you do

research and learn from Mr. Kirkwood' unfortunate

experience.

 

By: Curlysing on 1999-09-20

Please do not be fooled by anyone who says that

psychiatric drugs such as Prozac, Zoloft, Luvox, and

other similar drugs are safe. They are not!! Due to a

family tragedy of my own, I have done a huge amount of

research on these drugs. Prozac had over 28,000 severe

adverse reactions reported to the FDA several years

ago, yet no action was taken. There are doctors who

" vote " at the FDA who are on the payroll of the large

pharmaceutical companies. Apparently, all they're

interested in is lining their pocket-books. I also

discovered that 94% of all " mental illness " is always

caused by an actual physical problem which has been

overlooked by doctors. Most psychologists and

psychiatrists don't even bother to do physical

examinations of their patients.

 

You should also know that EVERY one of the recent

shootings in schools was done by a child who was on

one or more psychiatric drugs. This is documented

truth. Please take heed. Don't let your life be

destroyed! Refuse to allow yourself or any member of

your family to take ANY type of psychiatric drug. They

ALL have documented horrible side effects! There are

natural remedies which can handle any emotional

problem without resorting to drugs that kill.

 

By: eponio on 1999-09-21

Most of tragedies today are because of this

drugs,-Criminal children in Colorado School was under

a psyche drug.

-Few days after that event in Atlanta other child

create a similar scene. This child was also under

psyche drug.

-Princess Diana's driver was under Prozac based drug.

I have no doubt that psyche drugs and psychiatrist (or

sociologist) are the hidden responsible behind crime,

social decadency and materialism.

 

From Clinical Psychiatry News

SSRI Prescribing in Primary Care Draws Fire Todd

Zwillich, Senior Writer

[Clinical Psychiatry News 27(6):34, 1999. © 1999

International Medical News Group.]

 

------

More primary care physicians are prescribing

antidepressants, but some observers worry that

patients aren't being evaluated closely enough for

potential adverse reactions or monitored appropriately

while taking the drugs.

 

Research is beginning to show that " large numbers " of

prescriptions for selective serotonin reuptake

inhibitors (SSRIs) aren't accompanied by a diagnosis

of depression or any other mental condition, said

Stephen Crystal, Ph.D., a researcher who studies

prescribing trends at Rutgers University in New

Brunswick, N.J.

 

" We have a massive uncontrolled experiment going on

out there, " he said.

 

The number of doctor office visits including an

antidepressant prescription more than doubled between

1985 and 1994 to more than 24 million, according to

data from the National Ambulatory Medical Care Survey

(NAMCS). Researchers attribute the rise to the

popularity of SSRIs.

 

While an estimated 11 million psychiatrist

appointments included an antidepressant prescription

in 1994, more than 10 million other antidepressant

prescriptions were written by primary care doctors.

Preliminary analysis of survey data extending through

1996 shows that antidepressant prescriptions are now

more common in primary care offices than in

psychiatrists' practices, according to Dr. Crystal.

 

Managed care is at least partly responsible for the

trend. Primary care physicians acting as gatekeepers

in HMOs have been encouraged to treat potentially

depressed patients rather than refer them to

specialists. At the same time, primary care doctors

are becoming more comfortable with the newer SSRIs

because they are relatively easy to use.

 

Toxicity and overdoses are rare, and potential drug

interactions are far less common than with other drug

classes. The drugs may also provide a convenient way

to treat somatizing patients who have a few depressive

symptoms without a full-blown depressive episode.

 

But relatively few data exist to support SSRIs'

efficacy in treating the " sub threshold " patients

often seen in primary care. Many of those patients may

get SSRIs without any official diagnosis, according to

Dr. Harold Pincus, who last year published a study on

psychotropic prescribing using NAMCS data.

 

Office-based psychiatry practices tend to aggregate

around more affluent and better-educated patients in

medium and large cities. Most observers agree that

primary care's new dominance in antidepressant

prescribing makes the drugs available to a wider range

of patients.

 

" Those who are under served by specialists are

nonwhite and not wealthy. They are the ones who

benefit most from primary care physician prescribing, "

said Dr. Gregory Simon, a psychiatrist who studies

prescribing patterns at Group Health Cooperative of

Puget Sound in Seattle.

 

The American Psychiatric Association recommends in its

depression treatment guidelines that patients continue

their SSRI prescription for 4-5 months after complete

remission of their symptoms. But data from Group

Health Cooperative--an HMO that emphasizes primary

care treatment of mental conditions--show that only

34% of patients on SSRIs refill their prescriptions

often enough to suggest continuous use.

 

At the same time, new data from the Rutgers group show

that Medicare patients treated in primary care are

more than twice as likely as similar patients treated

in psychiatric settings to fill their SSRI

prescriptions only once, Dr. Crystal commented.

 

Others worry that physicians are not paying enough

attention to patient factors that could make

initiation of SSRIs dangerous. Dr. Malcolm B. Bowers

Jr., a psychiatrist at Yale University in New Haven,

told CLINICAL PSYCHIATRY NEWS that SSRI-induced

psychosis has accounted for 8% of all general hospital

psychiatric admissions over a recent 14-month period.

[emphasis added]

 

The pattern suggests that while SSRIs are a help to

the majority of patients who take them, more needs to

be done to make sure that doctors prescribing the

drugs evaluate patients for psychotic predisposition

vulnerable to SSRIs. Such patients may include those

with a history of psychotic illness or early signs of

mania.

 

" What is surprising is that this particular group of

side effects is really underplayed, " Dr. Bowers said.

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