Only Severely Depressed Benefit From Antidepressants

While popular antidepressants such as Prozac are widely prescribed for people with varying degrees of depression, the drugs are only effective for those with the most severe depression, a new study suggests. "Although patients get better when they take antidepressants, they also get better when they take a placebo, and the difference in improvement is not very great," lead researcher Irving Kirsch, a professor of psychology at the University of Hull in Great Britain, said in a prepared statement. "This means that depressed people can improve without chemical treatments," he added. . . . Based on these results, there appears to be little reason to prescribe these antidepressants to anyone but the most severely depressed patients, the study authors concluded.

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Antidepressant Discontinuation Syndrome

Steven Kazmierczak's bolt-from-the-blue shooting spree on Feb. 14 reignited a long-running debate over the benefits and risks of antidepressants -- taking them and discontinuing them."It's sad to watch this," says Ann Blake Tracy, executive director of the International Coalition for Drug Awareness and co-founder of a website, SSRI stories.com, that catalogs violent crimes like Kazmierczak's and links them to psychiatric drug use. "You find suicide, murder, rape, arson" -- all caused by drugs such as Prozac, she says. "How did they convince us that this is therapeutic?" Most in the psychiatric profession would counter that antidepressants overwhelmingly save lives, and salvage those hobbled by sadness and anxiety. They doubt that coming off these drugs -- especially Prozac, which Kazmierczak was reported to have taken -- led the Illinois gunman to kill. And they fret that depressed patients who believe the charges of critics like Tracy will turn their backs on medicine that can work wonders if taken -- and stopped -- correctly." When a story like this is brewing, people think, 'If this medication can possibly be related to a bad outcome, I'd better get off it now,' " says UCLA psychiatrist Andrew Leuchter. "We're talking about millions and millions of people who've been treated successfully with these drugs and stopped treatment without any kind of dramatic changes of behavior." At the center of the latest tempest over psychotropic drugs is a long-recognized phenomenon called Antidepressant Discontinuation Syndrome. First identified in psychiatric journals in the late 1990s, the condition is an assortment of symptoms that can plague patients for several weeks and, in a few cases on medical record, months after coming off a wide range of antidepressants. They include dizziness, headache, fatigue, changes in sleep patterns and appetite, vivid or disturbing dreams, agitation and anxiety. Some patients experience tingling or "electric zap" sensations passing through their extremities or head and, in rare cases, spasmodic jerking in the extremities, especially while sleeping.