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Wednesday, January 27, 2021
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Antidepressants Are Prescribed for More than Depression

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Antidepressants Are Prescribed for More than Depression

More than 10 percent of all adult Americans use antidepressants, but to add to that now-not-so-surprising fact, they’re prescribed for more than just depression. A study showed approximately 45 percent of all antidepressants are prescribed for anxiety, insomnia, and pain.

A Canadian study published this Tuesday in the Journal of the American Medical Association reported almost three out of ten antidepressants prescribed in Quebec, Canada between the years 2006 and 2015 were under conditions unapproved by the U.S. Food and Drug Administration (FDA).

The reason the FDA has not approved this medicine for conditions different than depression is a simple financial one. It’s a very costly process to have the agency evaluate the new indication for a certain drug. But the common practice of recommending off-label meds is legal and apparently wide spread, possibly much more than the findings of the Canadian study.

These prescriptions were being written when patients complained of problems remotely resembling depression. Practitioners treated insomnia, pain, migraines and menopausal symptoms such as attention deficit, hyperactivity and digestive system problems, all with antidepressants. Anxiety and panic disorders pushed the prescriptions for reasons other than depression to a remarkable 45 percent.

These conditions are considered variants of depression and a significant range of antidepressant medicine has been confirmed safe and effective for treating them. But the study’s authors say it’s not enough for physicians to send off patients having symptoms of generalized distress with an antidepressant remedy.

The authors also conclude there is a need to study carefully the effectiveness and safety of using this medicine for more than just depression.

The study’s design was based on a pop-up query addressed to 158 physicians whose electronic medical record showed antidepressants prescriptions. The query asked what condition prompted their decision.

Out of 101,759 prescriptions, 55.2% were for depression, 18.5% were for anxiety, and the rest was covered by conditions like insomnia, pain, panic, Fibromyalgia, OCD disorder, sexual dysfunctions, nicotine dependence, and digestive system disorders.

In a 2011 study, researchers noted that 56 percent of antidepressants given throughout a twelve years period leading to the year 2007, were not prescribed by psychiatrists.

Mark Olfson, Columbia University psychiatrist and one of the authors of the 2011 study suggested an antidepressant is a much safer bet than heart attacking or dependency causing medicine.

Image courtesy of Carsten Schertzer

Antidepressants May Up Risk of Suicide, Aggression

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The largest review paper on antidepressants to date found that the drug may promote suicidal behavior among patients.

A comprehensive review, which has sifted through data from 70 trials of the most popular drugs for the treatment of depression, shows that antidepressants may up risk of suicide, aggression. Study authors also found that big pharmas often fail to report critical side-effects of their products along with drug-related deaths.

The review found that antidepressants may make underage patients more prone to adopt an aggressive behavior. Still, no such side-effect was found in adults, though researchers suspect that some trial data may be misreported.

Nevertheless, researchers have suspected for years that antidepressants may boost risk of suicide as families have often complained that the drugs were behind their loved ones’ tragic end. But antidepressant makers and doctors have dismissed such claims because no comprehensive study has ever found a link between the two.

The research review which comprises data on more than 18,000 patients is considered the largest to date. It was carried out by a team at the Nordic Cochrane Center in Denmark, and reviewed by University College London in the U.K.

After analyzing trial data and comparing it to reports submitted by families of people who committed suicide, researchers found that the companies who funded the trials have often misclassified the deaths to their products’ benefit.

Study authors were startled and ‘deeply worried’ by the unprecedented situation.

“It is absolutely horrendous that they have such disregard for human lives.”

said Prof. Peter Gotzsche, lead author of the research and mental heart expert with the Copenhagen-based Nordic Cochrane Center.

In the U.S., antidepressant use saw a tremendous rise in just two decades. Currently, one in ten people take antidepressants on prescription, while one in four middle-aged women take the drugs.

But this doesn’t mean that the U.S. was hit by a tidal wave of depression in recent years. In fact, doctors often prescribe the drugs for off-label uses such as dependence, ADHD and autism in children, anxiety, and eating disorders.

Nordic Cochrane Centre researchers found that at least four deaths by suicide were misreported by a pharmaceutical company. In one case, a patient tried to kill himself after taking venlafaxine, but since he died days later in a hospital his death was no longer considered to having occured during the trial. Suicidal attempts were often mislabeled as a sign of either emotional instability or depression.

The review also found that though antidepressants do not seem to work on children they do boost their risk of suicide. This is why, study authors believe that it is better to follow alternative courses of actions including psychotherapy, art therapy, and exercise before resorting to medications.

Image Source: Flickr

Binge Eating, Depression Sometimes Go Hand in Hand with Bariatric Surgery

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Researchers found an association between bariatric surgery and higher prevalence of depression and binge eating in weight-loss surgery patients.

A new research suggests that binge eating, depression sometimes go hand in hand with bariatric surgery especially in the severely obese.

After they have sifted through nearly 70 studies on the topic, researchers at University of California found that nearly 25 percent of patients who had underwent bariatric surgery reported mood changes and emotional instability. Another 17 percent said that they developed binge-eating disorder after the procedure.

The findings were published Tuesday in the Journal of the American Medical Association.

Bariatric surgery, also known as weight-loss surgery, is usually recommended to people that are severely obese, or are over 100 pounds, and all efforts to shed the extra pounds through dieting and exercise had failed.

Dr. Aaron Dawes, lead author of the study, said that the severely overweight often display mental health symptoms such as binge eating and depression, but in patients who underwent obesity surgery those symptoms were twice more likely to occur than in the general public.

Yet, there is also a piece of good news: the depressive symptoms and other mental health symptoms did not seem to hinder weight loss in the wake of the medical procedure.

Bariatric surgery has multiple versions but the final goal is to help patients lose weight by limiting the quantity of food they can ingest. Additionally, after the surgery patients are recommended to change their diets to help them lose weight without falling ill.

This is why, researchers suspect that the mood of surgery patients could be affected by the changes they need to make after surgery. Dawes noted that the new findings underscore the significance of these patients’ mental health, which is often overlooked.

Study authors recommend doctors to keep an eye o their patients post surgery and prescribe them a treatment if mental health symptoms are visible. Currently, obese patients only need to undergo mental health screening before surgery.

If a professional concludes that they aren’t mentally fit to be referred to weight-loss surgery, they are barred from the procedure. And since mental health issues often affect severely obese patients, constant evaluation is critical.

Yet, depression is not a reason to ban the patient from obesity surgery. Doctors should evaluate the severity of the depression in each particular case and take the best decision. Additionally, people diagnosed with binge-eating disorder before surgery are not at risk of being excluded. Although these patients could find it harder than other obese patients to restrict their food intake, binge eating did not hider them from losing weight after obesity surgery.
Image Source: Flickr

Depression Could Be Lethal For Heart Failure Patients

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Depression has be found to significantly increase the risk of death in the case of heart failure patients, a new study announced.

Heart failure patients whom suffer from moderate to severe depression had a five fold increased risk of death than those with no depression or just a mild form of the disease, researchers say.

“We know that depression is common in heart failure and affects 20 to 40 percent of patients,” explained study author John Cleland, a professor of cardiology at Imperial College London and the University of Hull in England.

The scientists studied 154 patients studied, 27 of whom had mild depression while 24 had been suffering from moderate to severe depression. The research followed the patients on an average of 302 days. In this period, 27 patients died.

The increased risk of death linked to moderate and severe depression was isolated from other health issue, and also from the severity of heart failure, the scientists added.

The research was revealed Saturday at the annual meeting of the Heart Failure Association of the European Society of Cardiology which took place in Seville, Spain. Studies that are presented at meetings are usually considered preliminary until their results are published in a medical journal.

Heart failure happens when the heart can’t pump blood as efficient as it should.

“About one-quarter of patients hospitalized with heart failure are readmitted for a variety of reasons within one month. Within one year, most patients will have had one or more readmissions and almost half will have died,” Cleland mentioned in its adress.

“Our results show that depression is strongly associated with death during the year following discharge from hospital after an admission for the exacerbation of heart failure; we expect that the link persists beyond one year,” Cleland explained.

The research did not offer definitie proof that depression is linked to an increase in death risk in heart failure patients.

Depression is usually connected to loss of motivation, sleep disturbances, loss of interest in everyday activities and change in appetite which then causes weight changes. According to the scientist, this fact could be an explanation for the association the scientists found between depression and mortality.

Despite the discovery, Cleland is not recommending prescribing antidepressants to heart failure patients who suffer from depression. He said that studies point to the fact that they are not effective in cutting down depression in patients with heart failure. “Clinicians should consider referring patients affected by depression for counseling,” he recommended.

Image Source: Salon

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