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”Medical Conspiracy?” Part 1

Published: April 8, 2014

A recent JAMA study notes 49 percent of Americans believe in one or more (of six) medical “conspiracy theories”. We agree with convicted Watergate conspirator John Dean who once told the author that he “only believed in the conspiracy theories that were real”. Might some be real?

We can agree that are no flying saucers at Area 51and no conspiracy to vaccinate children “even though the vaccines cause autism”. That was one of the six. The other five were of variable craziness, however.

They were: that the CIA deliberately infected blacks with HIV, the FDA covers up “natural cures for cancer, cellphones cause cancer (but nobody is stopping them), fluoridation is dumping mining waste in public water, and genetically modified foods are part of an effort to shrink the world’s population.

There are many reasons to doubt the wisdom of “round-up ready” plants and licensing practices to promote seed monopolies, but I have never heard anyone associating genetically modified organisms (GMOs) with population control. Who tacked that on?

While the jury is out on the negative health effects of cell phones would it not be foolish to assume that they have no health risks? Any cancer connections should be monitored. Fluoride? It helps with dental cavities, but studies should continue for health risks. To do otherwise would be irresponsible. But who labelled it a way to dispose of mining waste? The way this story was framed in JAMA implies that people concerned about phones, fluoride & GMOs phones must be propeller heads. It is quite unfair. Much junk science has gone into silly claims about vaccines. As a result measles and whooping cough have made a comeback. Charlatans selling “natural cures” for cancer have a financial stake in their snake oil. Still, one must not lump all suspicions about medicine in one pile of craziness!

Some “conspiracies”, for lack of a more precise word, seem to have skewed the practice of medicine in America. Case in point: the overuse of anti-depressant medications.

Case in point number two (addressed in our next post) is  an extension of the item laid out previously e.g.  that despite millions being diagnosed yearly with erectile dysfunction only a quarter of such patients are given ANY treatment. In some cases no treatment with a prescription is appropriate. The common cold has no “cure” that a doctor can write a prescription for, but this is hardly the case for erectile dysfunction. Despite the proven efficacy of PDE5 inhibitors and Trimix these interventions are often not offered? But let us return to the use of anti-depressants.

The jury has been in on antidepressants for some time now. They are lousy meds. From the drug companies own information – in some cases pried out by Freedom of Information Act requests – is a clear that for people with mild to moderate depression they are not significantly better than placebo. Only a few studies show a mild effect superior to dummy pills. Many other studies fail to show even a minimal advantage over placebo.

After review of these grim statistics the British National Health Service has decided to stop treating mild to moderate depression with pills, and instead direct patients to exercise.

In America the drug companies are marketing their products directly to the public. The public in turn has increasingly bought the idea that sadness should be treated with pills. Insurance companies evidently prefer paying for pills than for talking therapy. Psychiatrists, meanwhile, take the view that if their prescriptions help one perhaps patient in ten (which is about what studies suggest) then they are doing the public a service. Primary care physicians? They want to make their patients happy. If the patient says they feel bad it is easy to write for a prescription drug.

The SSRIs – selective serotonin reuptake inhibitors – are safer than the drugs which dominated the field a generation ago.  Yet normal grief reactions are a different beast than pathological bereavement. Drugs might be appropriate for the latter, but not for the former.

In April 2013 the journal Psychotherapy and Psychosomatics published a study showing that two-thirds of a sample of 5,000 patients given a diagnosis of “major depressive episode” (the category for which anti-depressants are felt to be most effective) actually failed to meet the criteria for this condition per psychiatry’s bible the Diagnostic and Statistical Manual of Mental Disorders.

The majority of patients diagnosed thusly were then, rightly or wrongly (most often wrongly), treated with an antidepressant. ONLY the severely depressed seem to benefit from these drugs. Those who fail to meet the criteria of major depression, and are nevertheless treated, have not been well served.

The numbers here are pretty remarkable.

Antidepressants represent the third most common type of prescription medicine in America.

According to the CDC 11% of Americans over the age of 12 are on them!

Between the 1990s and the 2000s their use increased 400%

About one in 25 children aged 12-17 uses antidepressants, more than one student for every classroom.

America’s doctors have 23% of America’s women in their 40s and 50s on antidepressants.

Having saturated the market for human beings the drug companies are medicating our pets. In 2007 Lily launched a chewable Prozac to treat “separation anxiety” in dogs.

In our experience patients get put on these drugs – often inappropriately – and stay on them for years without re-evaluating their usefulness. And this is not even the worst aspect of antidepressant use. While these drugs are of limited effectiveness their side-effects can be long-lasting, or permanent. We do not think that decreased libido, erectile dysfunction and difficulty with orgasm are trivial matters when they are not temporary.

If the SSRIs had a better track record one might be willing to put up with a small percentage of sexual dysfunction as a side-effect. Their track record is very weak, however, and the number of people who experience side effects is very large.

A graph in November’s The Journal of Family Medicine. Patients on placebo reported a rate of sexual dysfunction (arousal, desire or orgasm issues) of 12.4%. This reflects the rate of the general population.

Patients actually on SSRIs showed much higher rates:

Citalopram (Celexa) – 78.6%

Fluoxetine (Prozac) – 70.6%

Escitalopram (Lexapro) – 37.0%

Parozetine (Paxil) – 71.5%

Sertraline (Zoloft) – 80.3%

Even the best drug charted; Fluvoxamine (Luvox) still has a rate of sexual dysfunction of 25.8%

Related meds, the SNRIs (norepinephrine-dopamine reuptake inhibitors) also had high rates:

Venlafaxine (Effexor) – 79.8%

Dulxetine (Cymbalta) – 41.6%

The older, more dangerous antidepressants, as exemplified by Imipramine, also showed a high sexual dysfunction rate. In this case – 44.4%.

Evidence continues to mount from patient reports and studies that the sexual side effects associated with the antidepressants continue indefinitely after taking the drugs.

Amazingly, they are actually being used to supposedly help men with sexual dysfunction Dapoxetine (Priligy) is now alleged to help men with premature ejaculation even though the average time to ejaculate cited was just three minutes – compared to two minutes for placebo.

Medications with a 10% chance of helping – compared to a 70% chance of hurting – are long overdue for a re-think in our opinion.

Anyone on antidepressant medications should visit their doctor with some pointed questions about how they might benefit from coming off of them.