Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Friday, January 06, 2017

Pill-Popping Ourselves Into Mental Oblivion

Matt Rourke / Associated Press
Matt Rourke / Associated Press    Antidepressants may be doubling the risk of developing Alzheimer's.
"They're being prescribed 'off label', meaning for non-depression related situations. They're being prescribed to very young children and to the very old."
"They're almost becoming the antibiotic of this century:'If you've got a disease, take an SSRI. It's going to help you in one way, shape or form'."
"They certainly do benefit some people. But we do find this association [with dementia] and, if nothing else, I think the discussion needs to begin."
"All of these anti-depressants act on these monoamines. It was just a logical step to look into what these drugs might be doing."
Dr. Darrell Mousseau, professor of psychiatry, University of Saskatchewan

"...There is something to this association [between SSRIs -- Selective serotonin reuptake inhibitors -- and dementia], even if it is not clear what it means."
"Replicability [where more than an initial study should produce similar results in multiple subsequent trials] is a crisis in medical research. My own benchmark is to wait until there is enough [published literature reflecting a mass of studies] for a [larger] meta-analysis."
Dr. Joel Paris, past chair of psychiatry, McGill University, Montreal
In this Jan. 11, 2008 file photo, a bottle of Eli Lilly & Co.'s Prozac is pictured at a company facility in Plainfield, Ind. Scientists say most antidepressants don’t work for children or teenagers with major depression and that some may even be unsafe, in the biggest analysis yet conducted of previously published studies. In a review of 14 common antidepressants, researchers found that only one seemed to be actually effective. “We now have a hierarchy of pharmaceutical treatments and the only one that is better than placebo and other drugs is Prozac,” said Dr. Andrea Cipriani of the University of Oxford, one of the study authors.
A bottle of Eli Lilly & Co.'s Prozac is pictured at a company facility in Plainfield, Ind.   AP Photo/Darron Cummings

A new Canadian research finding has been published in the journal Depression and Anxiety, which concludes that drugs classified as SSRIs; selective serotonin reuptake inhibitors, such as Prozac, along with other antidepressions are linked with a notable increase in the development of some type of dementia, including the most well-known, Alzheimer's. Canadians are known to use antidepressants in quantities outstripping their use elsewhere in the world.

In Canada, over 50 million prescriptions were dispensed in 2015. And it is these antidepressants that have now been flagged as contributing to brain-destroying dementias, according to the research headed by Dr. Mousseau, as lead author. Dr. Mousseau holds a research chair specializing in Alzheimer's and related brain disease, which is funded jointly by the Saskatchewan Health Research Foundation and the Alzheimer's Society of Saskatchewan.

His scientific interest resides in a molecule class called monoamines. Neurotransmitters serotonin and noradrenaline, ('brain messengers') thought to be involved in depression, are among the class of monoamines that Dr. Mousseau studies. Society is bedevilled by the rising incidence of Alzheimer's and other frontal lobe types of dementia and the search for risk factors has been intense over the years. Depression has been flagged as one predictor.

"Still, not everyone who has depression gets Alzheimer's disease, and not everyone who has Alzheimer's has had depression", observed Dr. Mousseau. So he felt it imperative to continue to search through other avenues not hitherto explored. With the knowledge that the cells that make serotonin and nonadrenaline happen to be among the first cell clusters that die in the brain changes that lead to Alzheimer's.

So his research team sifted through the medical literature for studies relevant to their research, and from a pool of over four thousand papers, five were selected that met their criteria. Within which a total of almost 1.5-million people were represented by the five studies alone. And the pooled estimates pointed to people with dementia being twice as likely to have been exposed to an antidepressant in comparison to people not suffering dementia.

For people under age 65 the risk of acquiring dementia appeared threefold; reflective it was assumed, of longer use of the drugs, given age involvement. Older antidepressant formulas turned out to have the weakest link, whereas the SSRIs provided the strongest. The details surrounding dosage and duration could not be clarified from the studies, so it was unclear whether the length of time an individual took an antidepressant made a difference to acquiring dementia.

But there was another study published in 2015, when researchers in Taiwan also found SSRIs to be linked with an increased risk of dementia. Though two years earlier an American research team reported that the SSRI citalopram [Celexa] appeared to reduce production of the deadly brain plaques tied to Alzheimer's. Nonetheless, researchers are left with the definite impression that a link exists between antidepressants and Alzheimer's, and that the impression is "biologically plausible".

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