A brief history of psychoactive drugs. Alternet, August 16, 2014

[Barbarannamated]

Psychotherapy Networker / By Mary Sykes Wylie

 

Falling in Love Again: The Amazing History, Marketing, and Wide Legal Use of Today's "Dangerous Drugs"

 

Full text: http://www.alternet.org/drugs/falling-love-again-amazing-history-marketing-and-wide-legal-use-todays-dangerous-drugs?page=0%2C8&akid=12137.1118080.2beFqz&rd=1&src=newsletter1015803&t=4&paging=off&current_page=1

 

Excerpt:

 

In the mid-’80s, there was a kind of existential void in the pharmaceutical feel-good market—but not for long. What would take the place of the tranquilizers, amphetamines, barbiturates, cocaine, and =opiates to help millions of people relieve the genuine, if often hard-to-define suffering of mind and body that seems such a perennial affliction of Western, certainly American, society? This brings us to the era of antidepressants, beginning with the totally unique, the unparalleled Prozac, which spawned many, many descendants—a psychotropic empire in full triumph and glory!

 

During its early, palmy years, Prozac seemed the answer to the depressed person’s prayers. There was a time during the early 19th century when the “melancholic” temperament was admired, at least in theory, as the mark of a sensitive, artistic soul, but in the 1980s, that time was past. Prozac was an all-American, 20th-century go-getter sort of drug. It made people feel the way they thought successful people felt: self-confident but not arrogant, cheerful but not manic, cognitively on the ball but not hyperintellectual. And unlike so many other psychoactive drugs, the shiny little green-and-white capsule didn’t make people feel drugged, didn’t sedate them or jolt them into hyperconsciousness, didn’t send them drifting off into dreamy euphoria. Undoubtedly, some people taking Prozac felt “better than well,” as Peter Kramer famously wrote in Listening to Prozac, but most seriously depressed people were probably thrilled just to feel “normal,” able to go about their day with more emotional equilibrium than they’d experienced in years, if ever.

 

By 2011, the rate of antidepressant use had increased nearly 400 percent since 1991. By 2013, more than 40 percent of Americans had used an antidepressant at least once, and 270 million prescriptions were being written annually. And why wouldn’t people want them? Here was a class of drugs promoted as completely safe, without serious side effects, and effective for the wide-ranging symptoms of depression and anxiety and, increasingly over the years, obsessive-compulsive disorder, alcoholism, narcotics withdrawal, ADHD, eating disorders, bipolar disorder, PTSD, hypochondria, and so forth, as well as a long miscellany of nonpsychiatric conditions, including snoring, chronic pain, various neuropathies, chronic fatigue, overactive bladder, and so on. By now, thanks to their prevalence and a flood of direct-to-consumer print and broadcast ads, antidepressants are deeply familiar even to people who don’t take them.

 

*But they’re not the benign, uncontroversial consumer product they might seem. Beginning a mere three years after Prozac’s introduction, negative side effects to the drug had already been noticed: intense agitation, tremor, mania, suicidal ideation. Not only that, there was already evidence for what came to be known as “Prozac poopout”: the drug often stopped working after a few weeks or months. Such worrying signs increased over the next two decades, becoming a steady cascade of possible side effects and WITHDRAWAL symptoms that ranged from the prosaic (headaches, rashes, insomnia, digestive problems, joint pain) to the more disturbing (dyskinesia, rigid or trembling limbs, loss of fine motor control, sexual side effects amounting to a virtual shutdown of erotic life) to the frankly dire (abnormal bleeding and the potential for stroke in older people, and self-harm and suicidal thinking in children and adolescents).

 

Even worse, during the ’90s and the first decade of the 21st century, a small flood of psychiatric papers and research studies argued that antidepressants didn’t work well in the first place. After a few weeks of improvement, depressed patients often returned to the status quo ante and had to have their dosage increased or supplemented with other drugs. When antidepressants did work, the results were often—particularly for milder and moderate forms of depression—little if any better than placebo.

 

**And what was described as a relapse in people who stopped taking the drugs—redoubled depression, anxiety, insomnia—might really be withdrawal symptoms. There was even evidence for the depressogenic effects of the drugs, which acted on brain chemistry all right, but in the wrong way, making some people even more depressed and turning what might have been a temporary depressive episode into a chronic condition.

 

One reason we know about these developments at all is because a dedicated little army of muckraking mental health experts has produced a steady stream of books, articles, blogs, and websites devoted to publicizing what they regard as the money-driven, ethically challenged “drug culture” perpetrated by Big Pharma in collusion with the much-compromised field of psychiatry. Books like The Emperor’s New Drugs: Exploding the Antidepressant Myth (2009) by Irving Kirsch, Let Them Eat Prozac: The Unhealthy Relationship Between the Pharmaceutical Companies and Depression (2004) by David Healy, Comfortably Numb: How Psychiatry is Medicating a Nation (2008) by Charles Barber, and Anatomy of an Epidemic: Psychiatric Drugs and the Astonishing Rise of Mental Illness in America (2011) by Robert Whitaker not only excoriate the societywide overuse of antidepressant and other psychotropic medications, but relentlessly dig up dirt about the research that presumably justified the drugs in the first place.

 

Besides the well-known charge that drug companies routinely publish more than twice as many of their positive findings as negative ones (hiding the trials that proved unfavorable to the drug), these detectives revealed they also produce meta-analyses that are themselves drawn from pools of successful trials (ignoring the unsuccessful ones). Drug companies, it turns out, ghost-write studies (designing and conducting them, then analyzing the data) and publish them under the names of prominent physicians, who are often paid consultants for the companies. Overall, because there’s so much dough riding on encouraging outcomes, drug companies—and even the National Institute of Mental Health—stand accused of routinely inflating positive findings, omitting or hiding relevant negative data, and gaming the numbers in ways that make the results look fishy, to say the least.

 

Thus, the evidence for the routine use of antidepressants has increasingly come to be seen as pretty feeble. Generally, antidepressants seem to work well for seriously depressed people, but not so much for the vaster, far less emotionally disabled population for whom they’re usually prescribed. Even in drug company trials, placebos relieved mild or moderate depression as well as antidepressants. In other words, for the kind of ordinary, scratchy unhappiness that Freud found characteristic of human existence (at least among the Viennese bourgeoisie) and that primary-care doctors see all the time in modern America, antidepressants were not measurably helpful.

 

 

Note: my apologies if this is not posted per forum guidelines. Please edit as necessary.