Moreover, as this story makes clear, the available legal drugs are not effective for everyone and often have unpleasant side-effects. This is precisely what is reported by many medical marijuana users. When prohibitionists claim that medical marijuana is not necessary because of all of the wonderful new pharmaceuticals, keep this study in mind.)

September 6, 1998
From Chicago Tribune
tribletter@aol.com
http://www.chicago.tribune.com/

By Bob Condor

Section: Woman News

NOTION OF PROZAC-DEPENDENT NATION RELIES ON HEAVY DOSE OF MYTH

Whether Americans take too many anti-depressant medications is less clear-cut than some might think.

Data show anti-depressants are underprescribed for patients with severe clinical depression, said Laura Miller, psychiatrist and chief of the Women’s Services clinic at the University of Illinois at Chicago Medical Center. Yet too many women with mild depression and life problems are helping to make best sellers of anti-depressants such as Prozac, Zoloft, Paxil and Luvox.

Even as researchers work to eliminate these contradictions, they find many explanations for them.

For those who perhaps should be taking anti-depressants but aren’t, a likely reason is that people simply don’t get medical attention for their problem. "There is a stigma attached to seeing a psychiatrist," Miller said.

Doctors also may undertreat depression because many stick to the belief that people can lift themselves out of it without drugs.

Complicating matters is that anti-depressants don’t work for everyone—about 30 to 40 percent of patients don’t respond to them, said Eva Redei, researcher and associate professor in the psychiatry and behavioral sciences department at Northwestern University Medical School. If the medication is effective—which requires two weeks to two months to find out—the patient should stay on the regimen for at least 6 to 12 months to reduce the risk of the depression returning.

Even if the drugs do help with the depression, they can affect the body in other undesired ways. Common side effects (affecting about 10 to 25 percent of patients) include nausea, diarrhea and sexual dysfunction.
(Ed. note: Altogether, this is an enormous failure rate. It is clear from this study that cannabis might help a huge number of people, but it is never mentioned, nor, for that matter, are St. John’s Wort and other herbal anti-depressants even hinted at.)

The drugs also can seem to erase feelings altogether rather than help patients to modify behavior and emotions.

"Lots of women eventually complain about feeling flat when using anti-depressants," Redei said.

Women represent about two-thirds of patients who are diagnosed with depression, estimated to affect more than 17 million Americans. Theories that more women are diagnosed because of willingness to consult doctors have not been confirmed in recent studies. There also are hypotheses that today’s U.S. women are stretched emotionally by work and family roles. A landmark cross-cultural research project, however, showed similar gender ratios for depression across ethnic groups and among 10 industrial nations.

To help determine whether anti-depressants are necessary, Miller said women need to distinguish between depression and normal life problems. Midlife can create a series of new challenges for women, especially hormonal fluctuations and role changes in the family.

"Anti-depressants are not intended as a way to make more friends or address an unhappy or unfulfilled life," Miller said. "Women should insist on a thorough evaluation (from a psychiatrist) and maybe even allow a spouse or loved ones to be interviewed."

Any physician seemingly too quick to write a prescription for anti-depressants should be suspect. Miller said depressive illness has numerous variations that are difficult to analyze in a short visit.

"For someone whose depression can be traced to stress or a traumatic event, psychotherapy will typically be more effective than medications," Miller said. "But if the depression is chronic, a course of anti-depressants might prove beneficial."

A recent meta-analysis of 19 anti-depressant studies published in New Scientist magazine showed that the placebo effect plays a greater role in treatment results than drug companies report.

Industry-sponsored studies show anti-depressants result in 40 percent greater relief of symptoms (decreased energy level, sleep disruption, appetite changes), while researchers Irving Kirsch of the University of Connecticut and Guy Sapirstein of Westwood Lodge Hospital in Needham, Mass., reported the drugs were 25 percent better than dummy pills.