More Antidepressants Being Prescribed Without A Psychiatric Diagnosis: Are Undiagnosed Thyroid Problems a Key Cause?

[Patience]

Here's an article I found interesting. In my case, I felt unwell because I was overmedicated on thyroid pills (possibly even given the wrong diagnosis, but I'm currently investigating that). I added my two cents worth in the comments section after the article on the website.

 

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More Antidepressants Being Prescribed Without A Psychiatric Diagnosis: Are Undiagnosed Thyroid Problems a Key Cause?

 

By Mary Shomon, About.com Guide

August 15, 2011

 

http://thyroid.about.com/b/2011/08/15/antidepressants-thyroid-depression-shames.htm#comment-295736

 

... researchers found that in 1996, antidepressant prescriptions were written in about 4% of physician visits, going up to 9% in 2007. And the percentage of prescriptions that were written without a mental health diagnosis went from 60% to almost 75%.

 

Are Antidepressants Being Given for Undiagnosed Thyroid Problems?

 

Researchers have been discussing for years that a subset of people who are told they are suffering from depression may actually have undiagnosed hypothyroidism. Given the prevalence of undiagnosed and untreated hypothyroidism -- which can includes as symptoms fatigue, aches, pains, headaches, and other symptoms -- I wondered if some of the growth in antidepressant prescribing may be going to the community of undiagnosed thyroid patients.

 

I had an opportunity to do a brief Q&A with Dr. Richard Shames, one of the co-authors of the new book Thyroid Mind Power.

 

Mary Shomon: A new study is showing that a rapidly growing number of patients are being prescribed antidepressant medication without a psychiatric diagnosis. Do you suspect that some of these people are being given antidepressants, instead of the range of thyroid tests needed to properly diagnose hypothyroidism?

 

Richard Shames, MD: Absolutely. I know that a great many people with common, every day mental symptoms of physical illness, such as low thyroid, are being given antidepressants instead of thyroid tests. Frequently, they are being given antidepressants without any tests at all -- not a TSH test for thyroid imbalance, and not even a simple blood count for anemia, which is another very common cause of low energy and low mood.

 

...

 

Mary Shomon: Do you believe that this evidence of misdiagnosis?

 

Richard Shames, MD: Definitely. People with a treatable thyroid illness, who take antidepressants to feel better mentally, may end up feeling worse. Antidepressants have many side effects. Moreover, this improper treatment does not fix the thyroid imbalance, and costs patients and the healthcare system in terms of wasted resources. Meanwhile, years of neglecting the thyroid illness can worsen the problem.

 

In the end, treating just the "symptom" of an illness, and not treating the actual underlying cause, is woefully inefficient. Often, depression is a symptom of a physical illness like thyroid imbalance, and not a true diagnosis in and of itself. The antidepressant medicine may sometimes offer some relief, but in many instances of depression it does not address the root cause of the condition.

 

Mary Shomon: Why would some doctors tend to hand out a prescription for an antidepressant for symptoms like fatigue, aches, brain fog, and headaches, rather than run thyroid tests?

 

Richard Shames, MD: I believe that it is most often related to time and money. It is much quicker for doctors to write a prescription for an antidepressant medicine, than to question patients further about their health history, their family history, or to order thyroid blood tests and wait to see the results. Also, some doctors rely on the overrated TSH test alone, which is often "normal" in depressed people with mild hypothyroidism.

 

It doesn't make sense. Several good controlled studies have indicated that endocrine disorders in general, and thyroid imbalances in particular, are the most frequent medical conditions causing mental symptoms. Depression is the most common psychiatric condition in the general population. It also happens to be the most common mental symptom of widespread thyroid disease.

 

Mary Shomon: How can patients with these kinds of symptoms be taken seriously, rather than being automatically sent off with an antidepressant prescription?

 

Richard Shames, MD: The first thing depressed patients can do is to approach their medical office visit as any other business negotiation. Have a written list of the questions you want answered and a list of the testing panel you would like to have ordered. To check properly for thyroid imbalance, I recommend that patients insist on Free T4, Free T3, TSH, and TPO (thyroid peroxidase) antibody tests. Tell the doctor you want this more complete panel because of the severity of your thyroid-like symptoms, and, be sure to mention any family history with thyroid or diabetes or any rheumatoid/autoimmune illnesses, like migraine, colitis, lupus, multiple sclerosis, etc.

 

Mary Shomon: In your opinion, which is safer -- thyroid medication, or antidepressant medication?

 

Richard Shames, MD: Thyroid medicines are typically much safer than antidepressants. Antidepressants can have a wide range of both minor and serious side effects. The minor ones may be annoying, but the serious ones can be dangerous. For instance, some antidepressants have an increased risk of suicide in young men, and an increased risk of stroke in older women.

 

Thyroid treatment, on the other hand, is extremely safe. It is hardly ever involved in serious side effects. In standard doses, thyroid medicines are generally inexpensive, effective, and able to be safely taken for long periods of time.

 

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[Patience]

This is the comment I posted on the site:

 

NoAD4Me

 

I didn’t feel well after I was put on thyroid medication (Armour, then synthroid). After years of struggling, I went to a doctor to help me figure out why I didn’t feel well. He told me my thyroid had nothing to do with it and spent the rest of the appointment trying to convince me that I had a “disease” called depression. I had a hard time believing I was depressed, but if that’s what he called what I was feeling, I went along with it to get relief. He said if I take Prozac for only six months, I will be cured (yes, he said “cured”). I was concerned that the drug might be addictive, but he assured me it wasn’t and I could stop anytime I wanted. I spent the next 19 years struggling (think unrelenting white-hot anger and scared-out-of-your mind, shaking-all-over struggling) to get off antidepressant drugs (they all poop out and you have to take another one to avoid withdrawal symptoms). With knowledge and peer support from sites like survivingantidepressants dot org and ****** dot org, I was finally able to free myself three years ago. Antidepressants change the brain and create an imbalance where there wasn’t one before taking the drugs. Withdrawal symptoms, which include depression and a whole host of other weird symptoms, can persist for months or years, and many end up on disability as a result. This is often mistaken for a “return” of the previous depression, however, it’s usually much worse and more persistent than anything we experienced before taking the drugs. Read “Anatomy of an Epidemic” by Robert Whitaker for a better understanding of how these drugs “work”.