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Antonuccio, 2012 Relabeling the Medications We Call Antidepressants


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Antonuccio and Healy suggest antiaphrodisiacs, agitation enhancers, insomnia inducers, suicidality inducers, mania stimulators, or gas busters might be more accurate ways to describe the drugs.



Volume 2012 (2012), Article ID 965908, 6 pages

http://dx.doi.org/10.6064/2012/965908Review Article

Relabeling the Medications We Call Antidepressants

David Antonuccio and David Healy


Received 18 April 2012; Accepted 28 May 2012


Abstract and full text at http://www.scientifica.com/2012/965908/



This paper raises the question about whether the data on the medications we call antidepressants justify the label of antidepressant. The authors argue that a true antidepressant should be clearly superior to placebo, should offer a risk/benefit balance that exceeds that of alternative treatments, should not increase suicidality, should not increase anxiety and agitation, should not interfere with sexual functioning, and should not increase depression chronicity. Unfortunately, these medications appear to fall short on all of these dimensions. Many of the “side effects” of these medications have larger effect sizes than the antidepressant effect size. To call these medications antidepressants may make sense from a marketing standpoint but may be misleading from a scientific perspective. Consumers deserve a label that more accurately reflects the data on the largest effects and helps them understand the range of effects from these medications. In other words, it may make just as much sense to call these medications antiaphrodisiacs as antidepressants because the negative effects on libido and sexual functioning are so common. It can be argued that a misleading label may interfere with our commitment to informed consent. Therefore, it may be time to stop calling these medications antidepressants.


From the paper:


8. Conclusions

On all of the identified dimensions for what a medication should accomplish to be called an antidepressant, current medications we call antidepressants seem to fall short. They are not clearly superior to placebo for the vast majority of patients for whom they are prescribed. The risks appear to outweigh the benefits for many patients, risks that are serious enough to warrant black box warnings about increased suicidality for patients under the age of 25 issued by the FDA and other regulatory bodies. There is now worldwide consensus that these medications increase the risk of suicidality. They may even increase the chronicity of depression in some patients. Anxiety, agitation, gastrointestinal problems, and sexual dysfunction are the most common side effects. If we do not call these medications antidepressants, what are some alternative labels that may better fit the existing data? The effect sizes for many of the “side effects” are larger than the antidepressant effect sizes. Using labels like antiaphrodisiac medications, agitation enhancers, insomnia inducers, suicidality inducers, mania stimulators, or gas busters obviously would not offer the same marketing appeal. Though tongue in cheek, we consider these possible labels to be more accurate than the commonly used label of “antidepressant.” It could be argued that the outcomes with the largest effect sizes should be offered as the primary label for a medication. Though the data reviewed in this paper appear not to adequately support the label of antidepressant, as long as these medications continue to be called antidepressants, prescribers will feel a moral obligation to offer them to their patients who are suffering from depression. Of course, the drug industry does not have an incentive to change the label. However, we feel patients ought to be informed of these possible alternative labels because they may apply equally well if not better. The main point is that calling these medications antidepressants is a marketing decision that does not appear to be consistent with the scientific data.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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If we look at long term effects in addition to side effects:


Depression enhancers

Diabetes inducers

Cognitive disruptors

Motivation disruptors

Endocrine disruptors...


Pharmaceutical bottom line enhancers

Pristiq tapered over 8 months ending Spring 2011 after 18 years of polydrugging that began w/Zoloft for fatigue/general malaise (not mood). CURRENT: 1mg Klonopin qhs (SSRI bruxism), 75mg trazodone qhs, various hormonesLitigation for 11 years for Work-related injury, settled 2004. Involuntary medical retirement in 2001 (age 39). 2012 - brain MRI showing diffuse, chronic cerebrovascular damage/demyelination possibly vasculitis/cerebritis. Dx w/autoimmune polyendocrine failure.<p>2013 - Dx w/CNS Sjogren's Lupus (FANA antibodies first appeared in 1997 but missed by doc).

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