Guest guest Posted September 16, 2004 Report Share Posted September 16, 2004 YESSSSSSSSSSSS This has come from Patrick Holford's September Newsletter. Is Prozac's Replacement More Dangerous? As the patent for Prozac's replacement runs out, manufacturer Eli Lilly has released a new anti-depressant drug in the US, Cymbalta, which is due for release in the UK early next near. It is part of a new class of anti-depressants called 'serotonin and noradrenalin re-uptake inhibitors' (SRNIs for short). Effexor is another drug in this class. Are these drugs going to solve the now well-established increased risk of suicide associated with several SSRI anti-depressants such as Prozac and Seroxat? I asked Dr David Healy, author of the excellent book Let Them Eat Prozac, for his view. Dr Healy is Visiting Professor at the University of Toronto and Reader in Psychological Medicine at the University of Wales. As an advisor to many pharmaceutical companies, he has first-hand experience of the manipulation of clinical trials behind today’s top-selling drugs. PH: How many people are on SSRIs like Prozac? DH: In the US about 28 to 30 million people have gone on Prozac. But at any one point in time, one in ten are on some kind of anti-depressant. PH: What percentage of people have adverse effects? DH: Around one in four in clinical trials of SSRIs become anxious. One in 20 people in trials get so anxious they have to drop out. One in 70 become suicidally anxious to the point where they actually try to harm themselves, and the number who kill themselves is about one in 500. PH: I understand Lilly isn’t really interested in promoting Prozac anymore and has come out with a new anti-depressant drug Duloxetine, marketed as Cymbalta. DH: Lilly lost the patent on Prozac in 2001 so they’re not really pushing it any more. They had wanted to bring out R-Prozac, a derivative of the parent molecule, but that ran into problems. It appeared that there were undesirable side-effects on the heart. Instead, they resurrected a compound called Duloxetine that was developed backed in the early ‘90’s. As I understood it, this had been shelved because it caused problems. It seems that the resurrection of this drug is really scraping the bottom of the barrel. PH: What confidence can we have that this drug will be safer than Prozac? DH: You can have absolutely no confidence at all. This will be an SRNI and the only other SRNI on the market is a drug called Venlafaxine (Effexor). At this stage this appears, from adverse event reports worldwide, to result in more people ending up dead compared to other anti-depressants. It seems to have just the same rates of people becoming suicidal as the SSRIs. Last February, in one of their healthy volunteer trials of Duloxetine, one of the healthy volunteers committed suicide. And this drug looks likely to pose significant withdrawal problems also. The expectation, therefore, would have to be that Duloxetine isn’t going to be that great a compound. However, Lilly and the other major companies have proven that the drug doesn’t have to be that good to make a profit. Marketing seems to be the big issue, rather than effectiveness. PH: Nutritional research is often disregarded in the absence of large-scale trials. It’s also very hard to get nutritional trials published. Some drug versus nutrient trials, funded by drug companies, come out unfavourably. How can we trust what we read in the mainstream medical journals? DH: I don’t think we can trust any clinical trials at all these days. The hunch has to be that they’ve all been manipulated. Many of these drugs are so weak in their effects that, to find an effect, you need a large-scale trial. It’s also very difficult to compare two treatments, so the company concerned has great scope to design the trial to get the result they want. When it comes to publishing trials, there’s only a handful of key journals and the editors have huge power. If the editor is oriented towards drugs, it’s very easy to kill off a competitive treatment through peer review. You just send it out to two peers who have that bias and the paper gets rejected. To read the full version of this interview, see my September 100% Health newsletter. You can also read a report about natural anti-depressants that work better without the side-effects. Quote Link to comment Share on other sites More sharing options...
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