High Antidepressant Use Calls for a "De-Prescribing" De-Escalation Policy

LOS ANGELES - Amzeal -- The Citizens Commission on Human Rights International, a mental health industry watchdog, says the U.S. government should adopt similar measures as that recently recommended in the United Kingdom—to "de-prescribe" or reduce antidepressant and other psychotropic drug use. The high patient numbers taking antidepressants in England prompted the All-Party Parliamentary Group (APPG), an informal cross-party of legislators that reviews concerning issues, to report in May on "Shifting the Balance Towards Social Interventions: A Call for an Overhaul of the Mental Health System." One of the report's key recommendations is the need for drug de-prescribing services, as well as a national withdrawal support helpline.[1]

Statistics CCHR obtained from IQ Via show 45.2 million Americans take antidepressants, of which 2.1 million are ages 0-17.[2] It highlights the $8.1 billion budget for the Substance Abuse and Mental Health Services Administration (SAMHSA), which allocates $601 million for suicide prevention services. However, mounting evidence suggests that antidepressants may actually increase the risk of suicide.

In May, the UK's Medicines and Healthcare Products Regulatory Agency (MHRA) announced it would review over 30 common antidepressants due to potential links to suicide and self-harm, with over 515 death alerts linked to these drugs since 2000.[3]

Australian psychiatrist Niall McLaren, part of the global Critical Psychiatry movement, supports the APPG report given the lack of effective results from antidepressants. He writes, "After spending the stupefying sum of nearly a quarter of a trillion pounds [about U.S. $318 billion] over the past 40 years or so, there's been no measurable improvement. One by one, [the APPG] list the many failings of the current approach to mental health." For example:

• While about 20% of British adults take antidepressants, the suicide rate is going up.
• The prevalence of mental disorder is the same or worse after 40 years, yet the rate of disability from mental health diagnoses has trebled.
• Modern psychiatric drugs are many times more expensive than the older, "first generation" of psychotropics yet they are no better in terms of outcome and have just as many serious to dangerous side effects.[4]

A 2024 study published in the American Academy of Pediatrics reported antidepressant prescriptions for young adults and teens between 2016 and 2022 increased by nearly 64% from 2020 onward.[5] Yet, the Food and Drug Administration has a black box high-risk warning against prescribing antidepressants to this age group because of the risk of inducing suicide.

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Peter C. Gøtzsche, a Danish physician and medical researcher, wrote, "Depression drugs kill many people," and the risk increases with polypharmacy, which he says, is common in psychiatry. It "increases the risk of dying. As an example, the Danish Board of Health has warned that adding a benzodiazepine [sedative] to a neuroleptic increases mortality by 50-65%."

Long-term antidepressant use can produce physical dependence and withdrawal symptoms, making it difficult, or nearly impossible, for patients to stop taking them. Research presented at this year's European Psychiatric Congress showed there are major problems related to withdrawal. Dr. Mark Horowitz, a Clinical Research Fellow in Psychiatry in England, explained how withdrawal effects can last for more than a few days or weeks after the drug is out of the system. "It's not the time taken for the drug to leave the system that determines the length of the effect. It's the time taken for the system to readapt to the drug not being there that explains how long withdrawal symptoms can last for."

Withdrawal symptoms include dizziness, insomnia, impaired concentration, fatigue, headache, tremor, tachycardia, nightmares, depressed mood, irritability, anxiety, and panic attacks.

A Lancet Psychiatry study published this month addresses these serious withdrawal effects that pharmaceutical companies prefer to call "discontinuation syndrome." A review of 79 studies covering 21,002 patients reveals that 15% suffered withdrawal effects. However, "some reviewers estimate this can occur in the majority of patients (56% [range 14–86%]), with almost half of cases classed as severe."[6]

Horowitz further explains: "We know that these are symptoms of withdrawal and not just relapse (a return of someone's underlying condition), because they have been found in studies of people who stopped antidepressants with no underlying mental health conditions."

A little-known side effect is akathisia, a movement disorder usually caused by a psychoactive substance in which the individual may experience an intense sensation of unease or inner restlessness. Dr. Horowitz says: "People are pacing, they feel agitated, they feel terror. A lot of them are talking about suicide because it is a state in which you get no rest and no calm, often for weeks and sometimes longer."[7]

To minimize withdrawal effects, he suggests gradually tapering off the drugs over months or sometimes years, at a rate that the individual user can tolerate. CCHR stresses this should be done under medical supervision.

Dr. Horowitz was one of the researchers of the groundbreaking July 2022 review of 17 studies that looked at the decades-old theory that depression is caused by low serotonin and found there was "no consistent evidence" of "an association between serotonin and depression."[8] For decades, the chemical imbalance myth propelled millions to take antidepressants, driving $15 billion a year in global antidepressant sales.[9]

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The APPG concluded that the failure of the mental health system is due to the near-universal reliance on the "biomedical model." Dr. McLaren writes: "The dominant biomedical model of mental health care has led to over-reliance on psychiatric drugs."[10]

In October 2023, the World Health Organization (WHO) and United Nations Office of the High Commissioner for Human Rights (OHCHR) issued a guidance on Mental Health, Human Rights, and Legislation, recommending that legislation "take a new direction away from the narrow traditional 'biomedical paradigm' that has contributed to coercive mental health services."[11] Governments must also provide services to help people withdraw safely from psychotropics.[12]

CCHR advocates that mental health funding be directed toward services that help individuals safely withdraw from antidepressants and other psychotropic prescription drugs. CCHR further asserts that the current biomedical approach, which includes potentially harmful methods like electroshock therapy, should be replaced with safe, non-coercive practices.

Sources:

[1] www.newstatesman.com/comment/2024/05/our-mental-health-crisis-wont-be-solved-by-pills-alone

[2] www.cchrint.org/psychiatric-drugs/people-taking-psychiatric-drugs/

[3] nz.news.yahoo.com/prozac-one-30-antidepressants-probed-150843143.html

[4] www.niallmclaren.com/p/beyond-pills; beyondpillsappg.org/wp-content/uploads/2024/05/Beyond-Pills-APPG-Shifting-the-Balance-Report-2024-1.pdf?utm_source=substack&utm_medium=email

[5] www.healthline.com/health-news/antidepressant-prescriptions-increasing-young-people

[6] www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(24)00133-0/fulltext

[7] europeantimes.news/2024/05/users-of-antidepressants-may-suffer-due-to-doctors-not-knowing-new-research-and-guidelines/

[8] www.cbc.ca/news/health/depression-antidepressants-review-serotonin-1.6548219

[9] www.cchrint.org/2024/03/01/overdosing-americas-youth-dangerous-trend-in-antidepressant-prescribing/, citing: www.dailymail.co.uk/news/article-11035903/Expert-says-psychiatrists-KNOW-theory-low-serotonin-levels-cause-depression-incomplete.html

[10] www.niallmclaren.com/p/beyond-pills; beyondpillsappg.org/wp-content/uploads/2024/05/Beyond-Pills-APPG-Shifting-the-Balance-Report-2024-1.pdf?utm_source=substack&utm_medium=email

[11] www.cchrint.org/2023/09/18/who-guideline-condemns-coercive-psychiatric-practices/; www.ohchr.org/sites/default/files/documents/publications/WHO-OHCHR-Mental-health-human-rights-and-legislation_web.pdf, p. xvii

[12] www.cchrint.org/2023/09/18/who-guideline-condemns-coercive-psychiatric-practices/; www.ohchr.org/sites/default/files/documents/publications/WHO-OHCHR-Mental-health-human-rights-and-legislation_web.pdf, pp. 57-58