Pharmacologically Enhanced Psychotropic Pharmaceuticals

In the 1930s, physicians approached the mental illness of depression a bit

differently that we do today. While acknowledging typically the etiology for their
patients is likely due to some great misfortune in their individual lives, the physician
focused on what was known as a complex.

A complex is the disturbances of ideas and impulses that are the cause of
consistent habitual patterns of thought, feelings, and behavior.

An example of this state of mind of one who is depressed is one who

experiences an exaggerated or obsessive concern or fear. And the etiology for this
mental disorder was often undefined. People react differently to life stressors in
their life, so depression cannot be empirically determined.

Also in the 1930s, at times, behavioral or cognitive therapy was

recommended for treating the depressed patient, and not pharmacological
treatment, overall. Also considered for the depressed patient was positive lifestyle
changes that maylessen the pain that the depression was causing them.

Try and be grateful, they would tell their patient, as well as thankful and
appreciative for whatever good may be in their life, and normally the depressed
patient would eventually recover.

Times have changed since then.

Presently, serotonin-enhancing drugs are the therapeutic regimens for those

who are suspect of having a depressed state or mood disorder. Patients believing
they have such cognitive issues often ask for such medications. The drugs are
known as SSRIs, or SRNIs.

What is remarkable is that the mood disorders which will be discussed are
subject to debate that progresses in its intensity as the more of these certain types
of drugs are used in others

Such disorders, presuming they exist at all,have been brought to the

attention to so many others through disease awareness campaigns by the makers
of these classes of drugs. So mental flaws claimed to be relieved by SSRI drugs
may not be entirely accurate. Disease mongering takes many forms- including
front groups wearing a mask.

With depression, the most severe cognitive and behavioral malfunctions are
expressed in what is called a major depressive disorder, as well as clinical
depression or major depression. Depression is thought to affect twice as many
women than men.
 Symptoms of this type of depression, which is the most concerning to health
care providers in particular due to its severity, include decreased or flat affect,
decreased interest in activities once enjoyable, self perceptions of worthiness, guilt,
regret, helplessness, and hopeless by the sufferer, to name a few of the diagnostic
features that may be present with one who has such a major depressive disorder.

The disease has a vexing insistence on staying with the victim for a lengthy
period of time- often continuing to progress symptomatically in severity and
discomfort. This disease is very disabling, and cannot be lifted by one’s will, so all
health care professionals likely agree that depression is a potentially serious
condition with their patients. Suicidal ideation and attempts are associated with
major depression. Treatment, it appears, is reasonable and necessary for the
depressed patient.

These SSRI drugs mentioned earlier are known by some health care providers
as third generation anti-depressants. Such drugs, drugs that affect the mind, are
called psychotropic medications.

SSRIs also include a few drugs in this class that include the addition of a
norepinephrine uptake inhibitor added to the SSRI in one capsule, and these drugs
are referred to as SNRI medications. The combination of two different drugs has
made them the top class of prescriptions for those suspected of psychological
misalignment.

There are several available SSRIs presently, and a few SRNIs. Both classes of
medications are prescribed for similar mental conditions.

Some consider these classes of meds, the serotonin enhancers in these

medications, to be the next generation mood enhancers- after the benzodiazepine
hype decades ago, which was followed by what were called trycyclic drugs for
depression for some time as well, it is believed.

Furthermore, regarding SNRIs, adding the additional agent of norepinepherine

is presumed to increase the effectiveness of SSRIs by some, yet not everyone
claims relief from these types of drugs included in the SRNI class.

Some Definitions:

Serotonin is a neurotransmitter thought to be associated with mood. The

hypothesis was first suggested in the mid 1960s that this neurotransmitter may
play a role in moods and emotions in humans. Yet to this day, the serotonin
correlation with such behavioral and mental conditions is only theoretical.

In fact, the psychiatrist’s bible, which is known as the DSM, states that the
definite etiology of depression remains a mystery and remains unknown with
complete certainty. So a chemical imbalance in the brain is not proven to be the
cause of mood disorders, it is only suspected as a result of limited scientific
evidence.
 Diagnosing mental diseases such as depression is based on subjective
assessment only, as interpreted by the prescriber, so one can examine the accuracy
of such diagnoses.

Norepinepherine is a stress hormone, which many believe help those who

have such mood disorders as depression. Basically, with the theory that by adding
this hormone, the SSRI will be more efficacious for a patient prescribed such a med,
as suggested earlier.

And the depressive state of a patient certainly can be aggravated by another

mood disorder at the same time with some patients. Anxiety usually exists with one
who has a major depressive disorder. An objective diagnosis of such a mental
condition is rather impossible to assess objectively. Therefore any diagnosis made
for a mental abnormality lacks complete accuracy and assurance.

So such speculated mental illnesses can only be assessed conceptually. As a

result, the diagnosis or impression concluded by the patient’s health care provider is
dependent on subjective criteria expressed by the suspected patient that is
presumed to be not mentally sound.

At times, there have been screening programs that have been used for
identifying depressed patients have proven to be largely ineffective.

A social patient history is uncertain and tricky as well, some have said, yet is
obtained often from such patients. There is no objective diagnostic testing for any
mental malfunction to validate as to whether or not such a disease is present- just
the perception of the health care provider, and survey questions related to a
particular mental disorder.

A health care provider has to assess as to whether certain non-verbal or

vocalized features are present with a patient in order to conclude confidently that
one may have in fact some degree or level of depression or any other mental
disorder.

To assess a suspected depressed patient is further complicated by the fact

that the exact cause of major depression is unknown. Research says that there is a
strong genetic component to this illness, however.

The diagnosis of depression as well as mood disorders that may exist within
patients has increased quite a bit over the past few decades. Some have asked
themselves, as well as others- actually how many people are really and actually
depressed, or affected by any other mental disorder?

What is believed is that if one determined to be cognitively impaired from a

mental paradigm, then this may be in fact major depression. If this mental disorder
is determined by a health care provider, it is possible that pharmacological therapy
may be considered reasonable and necessary, as well as psychotherapy either
suggested to be performed with or in place of medicinal therapy.
 Studies show that both therapies working together may be of most benefit for
the depressive patient, yet it is not a guaranteed protocol for treatment in this way.

It has been reported that around 10 percent of the U.S. population will at
some point be affected by an episode of what may be a major depressive disorder.
This is much greater in number than just a few decades ago.

Perhaps media sources are to blame to some degree for the progressive
increase in diagnosing mental disorders by suggesting to the public that they may
have such disorders. So the diagnosis and medicinal treatment have clearly
increased in a relatively short period of time in the United States.

Of course, the expansion of those claimed and determined to be depressed

does not sadden the makers of these drugs used to treat this mental disorder one
bit, it is safe to say.

Some have said that so many more people seek treatment now for what they
believe is a major depressive disorder they are experiencing, when in fact it may be
possibly intense sadness, perhaps, due to a loss of some sort in their lives. There is
a difference, and health care providers should have the appropriate tools and
knowledge to discriminate between the two states of mental conditions.

Sadness is not a medical problem. Symptoms associated with an unfavorable

mental state need to be excessive and chronic to be considered to have in fact the
medical problem of a major depressive disorder, as stated by others.

In Time magazine’s June 16th 2008 cover story, it was reported that the
military personnel in the Iraq war are pounding down SSRIs often. Every time there
is a new war, there is a new drug, it seems. Yet the story may illustrate the frequent
usage of these types of medications in a variety of different areas for different
reasons.

Some reasons may be valid and appropriate, yet others perhaps may not be
reasonable for such medicinal therapy. However, as illustrated in this situation, they
appear to be accepted as a treatment option without reservation.

In regards to those pharmaceutical companies who make and market such

psychotropic drugs in the manner that their manufacturers do is largely unknown to
others, such as with screenings performed essentially by front groups, and so forth.

However, what is known is that the psychiatry specialty, as they often treats
and manages depressed patients, is the one specialty that receives the most
monetary funding that is paid to them by these certain pharmaceutical companies
for ultimately what they hope will be continued and additional support of the
psychotropic meds that they currently promote to these doctors.

Needless to say, the desire and the aspect of the pharmaceutical industry
clearly is primarily concerned with encouraging as much use out of their products as
possible- with both doctors and patients being the route of that increased use they
desperately hope will occur.

Regardless, SSRIs and SRNIs are the preferred treatment methods if

depression or other mood disorders that are suspected and determined by the
health care providers who treat such patients. Yet these drugs discussed clearly are
not the only treatments, medicinally or otherwise, for depression and other related
and suspected mental disease states, moods, or disorders.

Patients should be aware of this fact as well as caregivers. And they may not
be aware of the options available to them.

For example, tens of millions of prescriptions are written by health care

providers for these types of medications for their patients.

These drugs are not inexpensive, either, as it is not unusual for a patient to
pay greater than one hundred dollars to have their prescription filled for only a
month’s worth of these particular drugs.

Presently, there are about ten different SSRI/SRNI meds available, many of
which are now generic, yet essentially, they appear to be similar in regards to their
efficacy and adverse events.

The newest one, a SNRI called Pristiq, was approved in 2008, and is believed
to be launched as a treatment for menopause.

The first one of these SSRI meds was Prozac, which was available in 1988,
and the drug was greatly praised for its ability to transform the lives of those who
consumed this medication in the years that followed. Some termed Prozac, ‘the
happy pill’.

In addition, as the years went by and more drugs in this class became
available, Prozac was the one of preference for many doctors for children. A
favorable book was published specifically regarding this medication soon after it
became so popular with others.

Furthermore, these meds have received upon request of their makers to the
FDA to have additional indications besides depression for these types of drugs they
produce and market, and the indications they have received are for some really
questionable conditions, such as social phobia and premenstrual syndrome.

Also included with indications that now exist with these types of medications
are the quite devastating conditions of what may be mild anxiety and shyness, yet
the makers of these drugs consider such patients as having chronic anxiety with
severe anxiety disorder, which others have said is rather obsurd.
 And it gets worse with the indications received for these types of drugs,
which now include Obsessive-Compulsive Disorder, Panic Disorder, Agoraphobia,
Post Traumatic Stress Disorder, Bulimia, and any form of stress disorders in general.
I understand they are seeking indications for pain management as well with these
SSRI or SRNI pharmaceuticals.

Likely, they will get the indication for their drugs to treat such creative
cognitive states apparently others have in great numbers.

With some of these indications for these classes of drugs, I question as to

whether or not they are actual and treatable disease states or medical problems.
Yet with additional indications for particular drugs in these classes of medications,
one can be assured that the market for these drugs will continue to grow- as more
are prescribed to those patients who are progressively asking for them specifically
for relief they anticipate they will receive from taking these drugs.

What such patients are not aware of is that studies have shown that this class
of medications is only effective in roughly half of those who take them. And some of
the indications granted to drugs in these classes of medications may be considered
disease mongering tacitly performed by the makers and marketers of these drugs to
again grow the market share for particular drugs of this type.

This is combined with drug companies who make these types of meds either
forming or creating front groups in order to have more diagnosed with various
medical problems that may not exist so their medication can be utilized more.

And as mentioned earlier, such pharmaceutical companies have been known

to either create or support front groups to ultimately encourage who may be normal
people to get evaluated for the diseases indicated with these medications. Of
course, such tactics implemented by such pharmaceutical companies are deceptive,
inappropriate, unreasonable, unnecessary, and potentially if not actually dangerous
to others.

Perhaps of greater concern and danger with these particular psychotropic

medications involve the adverse effects associated with these types of drugs, which
include suicidal thoughts and actions, violence- including acts of homicide, and
aggression- and this is only to name a few. Such events are devastating and have
been demonstrated by those who have or are taking these types of drugs.

It has been reported that the makers of such drugs are suspected to have
known about these toxic and dangerous effects of their drugs and did not share
them with the public in a timely and critical manner until forced to do so.

While most SSRIs and SNRIs are approved for use in adults only, prescribing
these meds to children and adolescents has drawn the most attention and debate
with others for understandable reasons, which have included those in the medical
profession as well as citizen watchdog groups.
 The reasons for this attention are due to the potential off-label use of these
meds in this population of children, yet what may be most shocking is the fact that
some of the makers of these meds did not release clinical study information about
the risks of suicide as well as the other adverse events related to such populations,
combined with the true decreased efficacy of SSRIs in general, which is believed to
be only less than 10 percent more effective than a placebo.

The makers of Paxil caught the attention of the government regarding this
issue of data suppression some time ago, this hiding of such important information-
Elliot Spitzer specifically was the catalyst for this awareness, as I recall.

Furthermore, that drug is in the spotlight once again years later. Some
believe the drug maker knew about possible risk to the youth as early as 1991. Yet
did not disclose such danger associated with their drug to the public or the FDA, and
this was done with intent.

And there are very serious questions about the use of SSRIs in children and
adolescents regarding the possible damaging effects of these meds on them as they
get older- these children and teenagers who are prescribed these drugs. Others are
asking if this is really necessary- and are these drugs doing more harm than good
for their children.

For example, do the SSRIs correct or create brain states considered not within
normal limits, which in effect would possibly cause harm rather than benefit a
patient on such a drug? Are adolescents really depressed, or just experiencing what
was once considered normal teenage angst?

Do SSRIs have an effect on the brain development and their self identity of
such young people? Do adolescents in particular become dangerous or bizarre due
to SSRIs interfering with the myelination occurring within their still developing
brains?

No one seems to know the correct answer to such questions, yet the danger
associated with the use of SSRIs does in fact exist, as demonstrated by others. It is
observed in some who take such drugs, but not all who take these drugs.

Yet health care providers possibly should be much more aware of these
possibilities, possibly, along with the black box warning now on SSRI prescribing
information for the youth that has existed since 1994. There are other medications
health care providers could prescribe for such patients that have no less benefit for
them then the serotonin drugs discussed.

Finally, if SSRIs or SNRIs are discontinued by a patient rapidly, abruptly, and

without medical supervision, withdrawals experienced by many of these patients
are believed to be quite brutal that follow soon after this drug is not taken anymore
by a former patient. This in itself may be a catalyst for one to consider or attempt
suicide, others have suggested.

Many are aware and understand that discontinuing these SSRIs and SSNIs
leaves the brain in a state of neurochemical instability for some great length of time
as the neurons need to recalibrate after existing in a brain over-saturated with
serotonin and neuron alteration.

This occurs to some degree with any psychotropic medication, yet the
withdrawals can reach a state of danger for the victim in some classes of meds such
as SSRIs and SNRIs, it is believed. And this seems to concern many, yet does not
inhibit health care providers for continuing to select such therapy with these drugs
for their patients.

SSRIs and SRNIs have been claimed by doctors as well as patients to be

extremely beneficial for the patient’s well -being regarding their apparent mental
issues that resolve in time. Yet overall, the factors associated with this class of
medications may outweigh any perceived benefit for the patient taking such a drug
that can harm themselves and others.

Before these medications mentioned were developed, doctors praised

trycyclics, another class of anti-depressants mentioned earlier, in a similar manner
since their advent in the 1950.

Considering the lack of efficacy that has been demonstrated objectively with
these new serotonin specific psychotropics, along with the deadly adverse events
with these SSRI and SSNI meds only recently brought to the attention of others,
other pharmacological and non- pharmacological treatment options should probably
be considered, but that is up to the discretion of the prescriber.

And the perception of the benefits derived by these types of drugs may be
flawed, as there has been no decrease in incidences of suicide or remission of
depression since these drugs have been available, many have concluded.

Yet antidepressants in general have been considered by others to create

amotivational syndrome, which is a lack of interest in various activities, as well as
creating a state of flat affect of users of antidepressants.

Furthermore, recent studies have suggested that the supplement, St. John’s
Wart, has shown to be as effective as medicine for major depression. Deficiencies
in vitamins B12 and Folate have been suggested as a cause for depression as well.
One study showed that a small jog performed by a depressed patient offered similar
if not greater relief than a SSRI drug.

It is my hope that such a prescriber rules out possible other etiologies for
their patients’ mental conditions before they conclude that such a patient is
suffering from true mental illness requiring the medications mentioned earlier, such
as asking their patients about life stressors and other medications these patients
have taken or are presently taking. Because at times, a doctor can in fact do harm
without intent.

“I use to care, but now I take a pill for that.” ---

Author unknown*

www.nmha.org

www.nami.org

Dan Abshear