Knowing Too Little

As time goes on, the widespread use of antidepressants may come under more scrutiny, which I would personally welcome. I have too many friends taking them. Some days it feels like the people on “serotonin reuptake inhibitors” significantly outnumber those of us who chose to suffer our demons.

Antidepressants are now, in fact, the most widely prescribed drugs in the world.

I am not “against” antidepressants. There are people who desperately need them, both for their own well-being and the well-being of those around them. But I know of too many cases of pharmaceutical shopping – “if you won’t prescribe it, I’ll go to somebody who will” – in hopes of scoring this latest wonder drug. (Unless painkillers have now taken over the top slot on the drug shopping list.)

In a column in today’s New York Times, Dr. Richard Friedman, professor of psychiatry at Weill Cornell Medical College, brought out two points about antidepressants that further unnerved me.

First, the fact that antidepressants – because they emerged during the 1980s – have not been subjected to long-term testing and nobody knows the effects of people using antidepressants for major portions of their lives. The longest maintenance study so far of one of these drugs, in this case Effexor, lasted two years “and showed the drug to be superior to a placebo in preventing relapses of depression.”

It’s true that Congress has reauthorized the Prescription Drug User Fee Act expanding the FDA’s drug surveillance. But that points to the second fact Dr. Friedman mentioned that’s scariest of all: The suppression of negative clinical information about antidepressants.

A study in January’s New England Journal of Medicine pointed out that of 74 clinical trials of a dozen antidepressants, 97 percent of the studies with positive findings got published. Only 12 percent of the studies with negative findings have ever been published.

Put simply, bad news about antidepressants seldom sees the light of day.