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Dr Mariano, need your opinions about this study.
If you read all of this study you can see that anti-depressant drug perturb your brain function for life with a little bit of success
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3334530/pdf/fpsyg-03-00117.pdf
Here is the abstract.
Primum non nocere: an evolutionary analysis of whether antidepressants do more harm than good
PaulW.Andrews1,2*,J.AndersonThomsonJr.3,4,AnandaAmstadter2 andMichaelC.Neale2
1 Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, Canada
2 Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA 3 CounselingandPsychologicalServices,StudentHealth,UniversityofVirginia,Charlottesville,VA,USA
4 InstituteofLaw,PsychiatryandPublicPolicy,UniversityofVirginia,Charlottesville,VA,USAAntidepressant medications are the first-line treatment for people meeting current diag- nostic criteria for major depressive disorder. Most antidepressants are designed to perturb the mechanisms that regulate the neurotransmitter serotonin – an evolutionarily ancient biochemical found in plants, animals, and fungi. Many adaptive processes evolved to be reg- ulated by serotonin, including emotion, development, neuronal growth and death, platelet activation and the clotting process, attention, electrolyte balance, and reproduction. It is a principle of evolutionary medicine that the disruption of evolved adaptations will degrade biological functioning. Because serotonin regulates many adaptive processes, antidepres- sants could have many adverse health effects. For instance, while antidepressants are modestly effective in reducing depressive symptoms, they increase the brain’s suscepti- bility to future episodes after they have been discontinued. Contrary to a widely held belief in psychiatry, studies that purport to show that antidepressants promote neurogenesis are flawed because they all use a method that cannot, by itself, distinguish between neuro- genesis and neuronal death. In fact, antidepressants cause neuronal damage and mature neurons to revert to an immature state, both of which may explain why antidepressants also cause neurons to undergo apoptosis (programmed death). Antidepressants can also cause developmental problems, they have adverse effects on sexual and romantic life, and they increase the risk of hyponatremia (low sodium in the blood plasma), bleeding, stroke, and death in the elderly. Our review supports the conclusion that antidepressants generally do more harm than good by disrupting a number of adaptive processes regulated by serotonin. However, there may be specific conditions for which their use is warranted (e.g., cancer, recovery from stroke). We conclude that altered informed consent practices and greater caution in the prescription of antidepressants are warranted.
This is not an article that says to avoid antidepressant use.
Rather, this is a good article that reviews all of the possible side effects of altering serotonin signaling. And it urges better informed consent practices and risk management when using antidepressants which alter serotonin.
Do antidepressants do more harm than good? That depends on the patient.
For many patients with depression, antidepressants clearly high benefit with low risk for harm. For others, there can be a high risk.
For example, it is important to assess whether or not a patient is metabolically capable of producing adequate dopamine. If not, then there is much higher likelihood that an SSRI will cause suicidal behavior. To understand and to be capable of doing this assessment requires minimally the years of training to become a psychiatrist (including undergraduate science, medical school and psychiatric residency) with an understanding of the biochemistry and pharmacology involved – not the few months of medical training some psychologists and other providers such as primary care physicians receive.
It takes an expert to determine the benefit to risk ratio for any individual patient. Otherwise, the patient may be harmed.
if anything, this article is a warning to those who are lesser trained than psychiatrists. They are incapable of assessing the full risks of treatment.
The need to assess for the risk of harm before prescription is true of any medication or herbal product, by the way.
Every substance one gives medicinally has serious potential risks that an expert has to assess before giving to a patient.
Even aspirin has serious risks. You can’t simply give it to anyone at risk of a heart attack without considering the risks – including stroke, bleed, gout attack, risk of arrhythmia, etc.
Even water has serious risks. If I tell a patient to drink more water, I have to assess the risk for water toxicity. Even water can kill a patient under certain circumstances.
As an aside:
Treating major depressive disorder well can be very expensive since it is a serious and complex illness. Antidepressants are only a small component of the treatment and are simply not enough for the vast majority of patients with major depressive disorder. Additional treatments are needed. Any individual treatment of major depressive disorder alone, I think is insufficient. A multimodal approach is necessary.
Years ago, in a county where I work, we had an intensive dialectical behavioral therapy program in a partial hospitalization setting which required a patient to receive daily therapy lasting 6 hours for five days a week for several weeks from a team of specially trained therapists. We succeeded in having zero hospitalizations for the county for weeks at a time. And we stopped suicidal and self-mutilatory behavior for our patients. Obviously, doing intensive therapy means paying for the work of several therapists for an entire day’s worth of work for each patient and the work I did. But it is far less expensive than psychiatric hospitalization. And the patients retained the benefits of their therapy for years after psychotherapy ended. Clearly, it was an extremely effective program. Unfortunately, government funding was cut to $75 a day for the program and no health insurance would pay for the treatment. So we had to abandon the program. The Camelot we achieved unfortunately went away.
This is a problem today because there are many informations and misinformation’s.
Dr Mariano what do you think about functional medecine ? This is a new vogue a mediatic physician like Dr Hyman
This is a problem today because there are many informations and misinformation’s and many physicians have a simplest solution. I like your vision because I known if it’s the true. But the difficulty today is that doctor are not formed for this holistic vison
Dr Mariano what do you think about functional medecine ? This is a new vogue a mediatic physician like Dr Hyman. It’s interesting because there are more physiological comprehension of disease.
But but I don’t like the star system and show of this doctor. Some doctor like Dr Hyman have a big interest of supplement company and give a bad opinion about antidepressant drug.
I think in medecine there are not black and white, conspiracy Big pharma or the panacea of nutrition and supplement.@Jean 4956 wrote:
This is a problem today because there are many informations and misinformation’s and many physicians have a simplest solution. I like your vision because I known if it’s the true. But the difficulty today is that doctor are not formed for this holistic vison
Dr Mariano what do you think about functional medecine ? This is a new vogue a mediatic physician like Dr Hyman. It’s interesting because there are more physiological comprehension of disease.
But but I don’t like the star system and show of this doctor. Some doctor like Dr Hyman have a big interest of supplement company and give a bad opinion about antidepressant drug.
I think in medecine there are not black and white, conspiracy Big pharma or the panacea of nutrition and supplement.This is why you support the proper neurotransmitters with the proper precursors. Drugs have their place in medicine for sure. I prefer to use an intergrative approach with Drs by looking at the factors which are causing the issue in the first place. If you are not willing to commit to a dietary and lifestyle change, then you are not committed to getting well. The power of proper eating is so over looked it scary. The results I have seen just through slight dietary and little nutritional support in some instance out weight response to harsh drugs. You need to look towards motive. Dr Hyman is all about marketing. Its $1500 just to walk in the door to see him and then you get blasted with few $1,000 in blood test. By doing this you create a bad reputation. Dr OZ has fallen into this trap and medical professionals begin to lose respect for these people. I have several clients who have gone to Rothernberg, hyman, Gordon, ect only ending up with and an empty wallet. Its all about marketing. I prefer the silent, but humble approach works better. Other medical professionals will give you much desired respect.
@hardasnails1973 4982 wrote:
This is why you support the proper neurotransmitters with the proper precursors. Drugs have their place in medicine for sure. I prefer to use an intergrative approach with Drs by looking at the factors which are causing the issue in the first place. If you are not willing to commit to a dietary and lifestyle change, then you are not committed to getting well. The power of proper eating is so over looked it scary. The results I have seen just through slight dietary and little nutritional support in some instance out weight response to harsh drugs. You need to look towards motive. Dr Hyman is all about marketing. Its $1500 just to walk in the door to see him and then you get blasted with few $1,000 in blood test. By doing this you create a bad reputation. Dr OZ has fallen into this trap and medical professionals begin to lose respect for these people. I have several clients who have gone to Rothernberg, hyman, Gordon, ect only ending up with and an empty wallet. Its all about marketing. I prefer the silent, but humble approach works better. Other medical professionals will give you much desired respect.
Nice answer Hardasnails. But do you practice the same medicine of Jeffrey Bland, Dr Hyman, ect…. without the marketing of this doctors ?
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