Dr Terry Lynch Speaks Out Against Over-Use Of SSRI’s


http://www.herald.ie/news/antidepressants-the-real-story-behind-their-increase-in-use-and-the-sideeffects-31217269.html

Antidepressants: the real story behind their increase in use and the side-effects

Special Report

In Ireland it is estimated that as many as one in 10 people are on antidepressants at any time
In Ireland it is estimated that as many as one in 10 people are on antidepressants at any time

It’s 26 years since the antidepressant Prozac was launched on the Irish market. It was hailed as the “sunshine drug” and it heralded a medical – and cultural – revolution.

Depression wasn’t common parlance in Ireland prior to the launch of Prozac. Irish people were more inclined to say that they “suffered with their nerves” or concede that “Mammy had taken a turn”.

If they presented to a GP, they may have been prescribed a “first generation” antidepressant such as a TCA (Tricyclic Antidepressant) or an MAOI (Monoamine Oxidase Inhibitors).

In more serious cases, Lithium may have been prescribed for manic depression (now known as bipolar disorder).

These drugs were largely effective, but caused many unwelcome side-effects such as constipation, difficulty sleeping and shaking/trembling.

Prozac soon ushered in the “second generation” of antidepressants – along with a new generation of mass marketing.

This family are known as SSRIs (Selective Serotonin Reuptake Inhibitors). Today they are the most-widely used – and widely criticised – class of antidepressant, closely followed by the “third generation” SNRIs (Serotonin Norepinephrine Reuptake Inhibitors).

SNRIs were developed to be more effective than SSRIs, but empirical and anecdotal evidence doesn’t always bear this out. GPs also prescribe these classes of antidepressants for social anxiety disorder and post-traumatic stress.

Many more SSRI antidepressants have entered the ever-expanding market since the late Eighties.

According to the HSE PCRS report 2012, the top five most commonly prescribed in Ireland are Escitalopram (Lexapro), Citalopram (Celexa), Sertraline (Zoloft), Fluoxetine (Prozac) and Paroxetine (Paxil). And supply most definitely meets demand.

Prescription rates for SSRIs in Ireland have escalated to an alarming degree. The State spent almost €40m on 2.3 million prescriptions for the most popular SSRIs and anti-anxiety medications in 2012, covering 330,000 patients.

“In Ireland it is estimated that as many as one in 10 people are on antidepressants at any time (some estimates put this at one in five),” says Dr Charlotte Blease, an Irish Research Council Postdoctoral Fellow at the School of Philosophy, University College Dublin.

“In Northern Ireland things are even worse: they are one of the world’s leaders in prescription medication (twice as many people are prescribed these drugs compared to the rest of the UK).

“This is a serious issue,” she continues. “By 2020 the World Health Organisation estimates that depression will be the leading cause of disability in the world.”

This figure dovetails with Dr Blease’s more conservative estimate, though other reports show that prescription rates differ across geographical regions. In Limerick, for example, 10pc of the total population was prescribed anti-anxiety pills or anti-depressants, the highest percentage in the country, in 2012. The percentage was lowest in Dublin South at 4.3pc.

Are these drugs being over-prescribed?

Dr Terry Lynch.jpg
Dr Terry Lynch

“Antidepressants have a place, but they are over-used,” says psychotherapist and author Dr Terry Lynch.

“These issues are primarily emotional and psychological, so the first response should be emotional and psychological, with the proviso that medication is available if needed.

“While there are of course physical aspects to depression, what is diagnosed as depression is primarily a collection of emotional and psychological issues. A major concern of mine, at a more global level is how we as a society deal with emotional and psychological distress and how people’s experiences and behaviours are interpreted.

“I also have concerns about the level of understanding GPs have about these issues. I’m in the mental health field for 15 years and I was a GP for a further 12 years, and I’m not convinced that doctors understand what they are dealing with.”

Side-effects, contraindications and withdrawal processes also need to be better outlined.

READ MORE: Aine’s story: ‘I was placed in a psychiatric hospital without my consent’

“SSRIs need to be reduced slowly, in small increments,” continues Dr Lynch. “This process may need to take several months. Patients are likely to experience an increase in emotions and tearfulness. When a person stops, they may feel fine for a few weeks and then they feel the emotions beginning to come up.

“We generally advise people not to withdraw from antidepressants during stressful or emotional periods, or at uncertain times such as during a house move or a new job.”

The HPRA (formerly the Irish Medicines Board) “continually urges patients and caregivers to read the patient leaflet which accompanies their medicine as it contains important information on the safe use of that medicine, including what it treats, dosing information, storage information as well as pre-cautions and known side-effects”.

Dr Terry Lynch’s latest book, Depression Delusion Volume One: The Myth of the Brain Chemical Imbalance, will be available by September

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3 comments

  1. kiwi

    “SSRIs need to be reduced slowly, in small increments,” continues Dr Lynch. “This process may need to take several months. ”
    I applaud Dr Lynch for his voice on this topic.
    However it is clear that doctors still don’t get the obscene extent of the addictiveness of these drugs. I guess thats understandable because pharma have taken addiction to a whole new galaxy and lied about it!
    A several month taper may be ok for someone who has been on the drug for a month or two but the prison bars thicken with time on the drug and we are talking taper periods of years for many.
    A taper of 10% of previous dose per month is proving to be key. If one is taking 20 mg then 30 months is needed. I know of 2 people who are now in there 7th year of tapering! Such is the addiction. Why are they doing this because to trigger wdl is to trigger HELL.

  2. evidencer

    Yup, Kiwi, they mince words or quibble over addiction vs dependency. They outright say there is neither. Experts promoted as such the Science Media Center do it. Royal College of Psychiatry’s survey was a nice idea, but they checkboxes for how long withdrawal took only went up to 12 weeks.

  3. solo49

    I don’t know whether or not Dr Terry Lynch’s comment about withdrawal may have been
    taken off the cuff or otherwise out of context. However, I agree with the above respondents
    about drug withdrawal in the sense that it can take as long as it takes in individual cases..

    As an aside to this debate it may be worth noting that, currently, around 74% of the Republic
    of Ireland’s public water supply is fluoridated compared to hardly any fluoridation in Northern
    Ireland.. The notable effects of fluoridation (banned in most European countries) range from
    hyperactivity to lethargy.

    http://www.fluoridefreewater.ie/

    As for ‘sunshine wonder drugs’ such as SSRI’s, (not forgetting Benzodiazepine and Antipsychotic drug victims) they were first of all strategically ‘sold’ to the medical profession. In consequence, the medical profession should and must play a greater strategic part in sorting the mess that they themselves have all along helped to create, rather than leave it to more attentive and compassionate folk amongst their number such as Dr.Terry Lynch.

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