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Common prescription drugs linked to increased dementia risk

We wish it wasn’t the case but, unfortunately, memory loss is a hot topic. People have countless questions about brain diseases such as Alzheimer’s and dementia. What really causes it? Will there ever be a cure? Are there any natural preventatives? How do my other medications that I’m taking affect my risk of such problems?

Many prescriptions have been linked to memory loss! We hope to answer these questions and more below. So, if you or a loved one is worried about or currently living with this problem, please keep reading…

 

How Common Is Alzheimer’s Disease?

Most people associate Alzheimer’s with memory loss, one of first and most common symptoms of the disease. On average, the progressive (and currently) irreversible brain disorder starts affecting people after 60 years of age. [1] However, there are many factors that contribute to an individual’s experience such as their genes, diet, lifestyle habits, and more.

According to Alzheimers.net, there are 44 million people who have Alzheimer’s or a related dementia, approximately 5,700,000 of whom are American. Health officials expect that number to rise to 16 million by 2050. And because it’s the sixth leading cause of death in America – the only one in the top 10 that cannot be cured, prevented, or slowed – it demands everyone’s attention. [1,2]

 

10 Early Warning Signs and Symptoms of Alzheimer’s

  • Memory loss
  • Inability to plan things or solve problems
  • Difficulty completing simple tasks
  • Getting confused about times, dates, and places
  • Inability to understand spatial relationships and visuals
  • New problems when it comes to speaking or writing
  • Forgetting where you put stuff and being unable to retrace steps
  • Increasingly poor judgement
  • Growing less and less social
  • Uncharacteristic changes in mood and personality

How About Dementia?

Not unlike Alzheimer’s disease, the most common form of dementia, general dementia is also a progressive syndrome that impairs your cognitive function. That is, your ability to think, reason, remember, and behave properly (if at all). Many of the symptoms actually overlap with those of Alzheimer’s disease. [1]

Growing by 10 million new cases per year, there are around 50 million people worldwide currently living with dementia… According to the World Health Organization, that’s a figure that we expect to hit 82,000,000 by 2030 and 152,000,000. [4]

Although these numbers are alarming, there are numerous ways to decrease your risk of development Alzheimer’s disease or other forms of dementia – naturally and otherwise. But the possibility of keeping the number of dementia cases to a minimum seems unlikely when so many people are on medications that can increase the likelihood of getting it.

 

Common Drugs Like Benadryl Linked to Increased Dementia Risk

In March 2015, researchers published a prospective cohort study in JAMA Internal Medicine called “Cumulative Use of Strong Anticholinergics and Incident Dementia.” The University of Washington and Seattle healthcare system, Group Health, conducted the long-term study which tracked 3,434 men and women who were aged 65 and up, and had no dementia when the study began. [5]

The team accessed every participant’s history of drug use for the previous decade, including both over-the-counter and prescription drugs. Over a 7-year timeline, they followed up with all the participants every two years, during which 797 participants developed dementia (637 of whom developed Alzheimer’s disease).

As researchers looked back on what those 797 individuals took, anticholinergic drugsbecame the main suspect. The most common anticholinergics participants used were tricyclic antidepressants, first-generation antihistamines, and bladder antimuscarinics. Compared to those who didn’t take anticholinergic drugs, people who did for as little as three years were 54% more likely to develop dementia.

What Are Anticholinergics?

Usually, these types of drugs are prescribed to treat problems including urinary incontinence, Parkinson’s disease, and chronic obstructive pulmonary disorder (COPD). Anticholinergic drugs’ main purpose is to block the actions and effects of acetylcholine, a neurotransmitter which causes muscles to contract, activates pain responses and regulates endocrine and REM sleep functions. [6]

It’s just a natural fact of life – as we age, our bodies’ ability to produce acetylcholine decreases. [7] Since the brain actually contains many acetylcholine-producing cells, as Harvard editor Beverly Merz highlights, “blocking its effects can deliver a double whammy to older people.” [8]

If you want to keep your head clear and brain functioning as highly as possible, steering clear of anticholinergic drugs seems ideal. However, it is important to recognize that the long-term study revealed only a small portion of drugs was interfering with cognitive function. So, please discuss with your doctor if you’re thinking of getting off any prescribed medications.

 

Experiencing Memory Loss? It’s Not Necessarily Alzheimer’s

There are reversible dementias that, although worrisome, people can treat and even overcome. Some of these problems might surprise you: [9]

1) Delirium

Although this condition seems similar to dementia, the mental changes that occur in delirium happen within days in comparison to months or years. Another key distinction between these two problems is that with dementia, you maintain consciousness; with delirium, you don’t.

2) Depression

People with depression have likely experienced moments of forgetfulness and disorientation. A simple way to tell the difference between depression and dementia is looking at the timeline… Depressed people become depressed first and experience memory-related symptoms later, whereas people with dementia become depressed as a result of their declining cognitive function.

3) Vitamin B12 Deficiency

This crucial deficiency can lead to pernicious anemia, a rare condition associated with confusion, slowness, apathy, and irritability. If you suspect this is the case, see your doctor as soon as possible to make sure your body can even absorb vitamin B12 properly.

4) Thyroid Disease

Individuals with hypothyroidism will likely exhibit dementia-like symptoms. One of the best things you can do is get a thyroid hormone blood test to determine the best possible treatment.

5) Alcoholism

People who are alcoholic can suffer bouts of confusion and amnesia which can mimic the same experiences as someone with Alzheimer’s disease. Although alcoholism can deteriorate the ability to remember and orientate oneself, abstinence and overcoming addiction can help reverse dementia.

 

Sources: 
theheartysoul.com

[2] Alzheimer’s Statistics. (n.d.). Retrieved from https://www.alzheimers.net/resources/alzheimers-statistics/

[3] 10 Early Signs and Symptoms of Alzheimer’s. (n.d.). Retrieved from https://www.alz.org/alzheimers-dementia/10_signs

[4] Dementia. (n.d.). Retrieved from http://www.who.int/news-room/fact-sheets/detail/dementia

[5] Gray, S. L. (2015, March 01). Strong Anticholinergics and Incident Dementia. Retrieved from https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2091745

[6] Anticholinergics: List, Side Effects, and More. (n.d.). Retrieved from https://www.healthline.com/health/anticholinergics

[7] Acetylcholine (ACh). (n.d.). Retrieved from http://memorylossonline.com/glossary/acetylcholine.html

[8] Merz, B. (2017, May 23). Common anticholinergic drugs like Benadryl linked to increased dementia risk. Retrieved from https://www.health.harvard.edu/blog/common-anticholinergic-drugs-like-benadryl-linked-increased-dementia-risk-201501287667

[9] What’s Causing Your Memory Loss? (n.d.). Retrieved from https://www.helpguide.org/harvard/whats-causing-your-memory-loss.htm#top

[1] Alzheimer’s Disease Fact Sheet. (n.d.). Retrieved from https://www.nia.nih.gov/health/alzheimers-disease-fact-sheet

Full article: https://realfarmacy.com/drug-dementia/

 

Heath Ledger – awareness

Overdose awareness Day!

Heath Ledger, Prescription drugs and overdose.

‘It was [10] years ago … but to me it’s like it was yesterday.’

These are the words of Kim Ledger as he recalled the loss of his son Heath to an opioid overdose in January 2008.

The 28-year-old actor had been caught up in a punishing production schedule, flying between three different countries and filming scenes at night in the bitter cold. He contracted a chest infection that developed into pneumonia, and experienced insomnia.

Heath visited a variety of doctors on his travels to help deal with these problems, collecting a veritable cornucopia of prescription medications, including opioids and sleeping pills.

In combination, the opioids, sleeping pills and the chest infection itself had a depressing effect on Heath’s respiratory system, causing it to shut down. This made him a high-profile casualty of what was emerging as a prescription opioid epidemic, which includes the use of legal drugs such as codeine, fentanyl and oxycodone.

This phenomenon has claimed thousands of lives in Australia and around the world.

While Heath’s death was the result of a medication mix he didn’t realise would exact such a heavy toll, other opioid users have a more long-term relationship with these types of drugs, often becoming unexpectedly addicted after using them as a treatment for chronic non-malignant pain.

‘The accidental addict. In a very short space of time, people can become addicted to oxycodone and products like that,’ Kim said.

Such was the case of 30-year-old nurse and mother of two, Katie Howman, found dead following a fentanyl overdose in her Toowoomba home just before Christmas in 2013. Investigations revealed she had visited 20 different doctors and 15 different pharmacies over the previous 13 months in her search for opioids.

Opioids – a category that includes pharmaceuticals such as oxycodone and fentanyl, as well as illicit versions such as heroin – remain the main cause of accidental overdose death in Australia. Opioid-related deaths hovered at around 450 per year at the turn of the century, but these numbers have risen sharply since 2006 to hit over 1100 per year since 2014.

What has led us to this epidemic, and what can GPs do to help curb it?

Too good to be true
In the late 1990s, prescription opioids seemed like an ideal answer to the often-difficult problem of chronic, non-malignant pain.

‘There was an increased demand to treat chronic pain. There were very few options and very little research that had been done on this problem,’ Dr Evan Ackermann, a GP with a special interest in opioids, told the RACGP.

‘This was mixed with a situation of some fairly aggressive drug company marketing of opioids and a change of clinical attitude towards pain. Normally, pain would be part of the healing process, but people started to say we should be looking at pain as the “fifth sign” and treating it aggressively.

‘It was a cultural shift across the healthcare sector, across the board, from pharmacy right through to general practice, specialists and hospitals.’…………….
‘There is a sense out there sometimes that it’s just people choosing to do this, that there’s a dichotomy between the genuine-pain patient and the bad drug user,’ she said. ‘My experience is that they’re the same group of people.

‘Opioids interact with us as a species in a particular way; all of us are at risk of side-effects and one of those major side-effects is dependency and addiction.’

………….

full story

Exerpt from:https://www.racgp.org.au/newsGP/Clinical/Agony-and-ecstasy-Prescription-drugs-and-overdose

Withdrawal – What we Know and Don’t Know

Antidepressant Withdrawal – What we Know and Don’t Know

My Doctor/Psychiatrist told me that I have to take an antidepressant to correct a
chemical imbalance in my brain, is this true?

No, it is a myth, we cannot test or measure the state of neurotransmitters in your brain, the
American Psychiatric Association disavowed this myth in 2011(1). It is a pharmaceutical
company invention (2).

How many people experience withdrawal effects?

It varies according to which drug is used, at what dosage, and for how long. Recent
studies (3) are showing the number affected to be greater than 50% of those taking the
drugs. The UK Royal College of Psychiatrists did their own survey (4) (now removed) which
showed that 63% reported withdrawal effects.

Why does my doctor/psychiatrist keep saying ‘discontinuation syndrome’ when I
mention withdrawal?

Discontinuation syndrome is an invented term (5) which minimises the role of the drug in the
harm caused and steers users away from addiction terminology. While dependence and
withdrawal have some features in common with addiction, they are not accurately
described using just this approach. What you are experiencing is an effect of withdrawing
from a drug, not of discontinuing treatment.

Why does my doctor insist that ‘once the drug is out of my system’ I will be fine?

Because not all doctors understand the effects of antidepressant drugs on the brain (6). A
heavy drinker or smoker may suddenly stop drinking/smoking, but the effects on their brain
and nervous system continue to be felt long after they have quit. Antidepressant drugs
change the brain in ways we don’t currently understand. These adaptations (7) to the drug
are responsible for withdrawal effects.

What does withdrawal feel like?

It’s a highly variable experience ranging from mild symptoms which pass quickly, to
profound symptoms that sometimes persist for many years. In a 2017 survey (8), 46% of
those reporting withdrawal symptoms described them as ‘severe’. Most common reported
symptoms (9) are insomnia, dizziness, fatigue, digestive problems, anxiety, panic,
depression, agitation. Withdrawal symptoms can sometimes mimic depressive or anxious states but should not be confused with relapse (10).

I am worried about dependence, what should I do?

The most important thing is never stop your drugs suddenly, this can be dangerous. Talk to
your doctor but be prepared as many doctors do not have the information to be able to
help. Withdrawal is a unique experience, with no fixed rules.

There are some excellent and
reliable online sources for help including:
• theinnercompass.org
• madinamerica.com/drug-withdrawal-resources
• survivingantidepressants.org
www.jfmoore.co.uk August, 2018
Antidepressant Withdrawal – What we Know and Don’t Know

References (to read these online visit www.jfmoore.co.uk/ltw.html)
1. http://www.psychiatrictimes.com/blogs/couch-crisis/psychiatry-new-brain-mind-andlegend-chemical-imbalance
2. https://www.scientificamerican.com/article/is-depression-just-bad-chemistry/
3. http://roar.uel.ac.uk/7402/
4. RCPsych survey (now deleted)
5. https://www.psychologytoday.com/gb/blog/side-effects/201107/antidepressantwithdrawal-syndrome
6. http://time.com/3399344/antidepressant-changes-the-brain-study-finds/
7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4118946/
8. http://roar.uel.ac.uk/7402/
9. https://www.karger.com/Article/FullText/370338
10.http://www.stacommunications.com/journals/diagnosis/2006/Diagnosis_sep_06/DS.pdf
www.jfmoore.co.uk August, 2018

What we know about antidepressant withdrawal V1

James Moore

“Eminem – About The Dependency he had” – YouTube

https://youtu.be/9bpvT3VjOiU

Are All Psychiatric Drugs Too Unsafe to Take?

An interesting article found at
http://mindfreedom.uk/psychiatric-drugs-unsafe-take/

Psychiatric drugs are more dangerous than you have ever imagined. If you haven’t been prescribed one yet, you are among the lucky few. If you or a loved one are taking psychiatric drugs, there is hope; but you need to understand the dangers and how to minimize the risk.

The following overview focuses on longer-term psychiatric drug hazards, although most of them can begin to develop within weeks. They are scientifically documented in my recent book Psychiatric Drug Withdrawal and my medical text Brain-Disabling Treatments in Psychiatry, Second Edition.

Newer or atypical antipsychotic drugs: Risperdal, Invega, Zyprexa, Abilify, Geodon, Seroquel, Latuda, Fanapt and Saphris

Antipsychotic drugs, including both older and newer ones, cause shrinkage (atrophy) of the brain in many human brain scan studies and in animal autopsy studies. The newer atypicals especially cause a well-documented metabolic syndrome including elevated blood sugar, diabetes, increased cholesterol, obesity and hypertension. They also produce dangerous cardiac arrhythmias and unexplained sudden death, and they significantly reduce longevity. In addition, they cause all the problems of the older drugs, such as Thorazine and Haldol, including tardive dyskinesia, a largely permanent and sometimes disabling and painful movement disorder caused by brain damage and biochemical disruptions.

Risperdal in particular but others as well cause potentially permanent breast enlargement in young boys and girls. The overall risk of harmful long-term effects from antipsychotic drugs exceeds the capacity of this review. Withdrawal from antipsychotic drugs can cause overwhelming emotional and neurological suffering, as well as psychosis in both children and adults, making complete cessation at times very difficult or impossible.

Despite their enormous risks, the newer antipsychotic drugs are now frequently used off-label to treat anything from anxiety and depression to insomnia and behavior problems in children. Two older antipsychotic drugs, Reglan and Compazine, are used for gastrointestinal problems, and despite small or short-term dosing, they too can cause problems, including tardive dyskinesia.

Antipsychotic drugs masquerading as sleep aids: Seroquel, Abilify, Zyprexa and others

Nowadays, many patients are given medications for insomnia without being told that they are in fact receiving very dangerous antipsychotic drugs. This can happen with any antipsychotic but most frequently occurs with Seroquel, Abilify and Zyprexa. The patient is unwittingly exposed to all the hazards of antipsychotic drugs.

Antipsychotic drugs masquerading as antidepressant and bipolar drugs: Seroquel, Abilify, Zyprexa and others

The FDA has approved some antipsychotic drugs as augmentation for treating depression along with antidepressants. As a result, patients are often misinformed that they are getting an “antidepressant” when they are in fact getting one of the newer antipsychotic drugs, with all of their potentially disastrous adverse effects. Patients are similarly misled by being told that they are getting a “bipolar” drug when it is an antipsychotic drug.

Antidepressants: SSRIs such as Prozac, Paxil, Zoloft, Celexa, Lexapro and Viibyrd, as well as Effexor, Pristiq, Wellbutrin, Cymbalta and Vivalan

The SSRIs are probably the most fully studied antidepressants, but the following observations apply to most or all antidepressants. These drugs produce long-term apathy and loss of quality of life. Many studies of SSRIs show severe brain abnormalities, such as shrinkage (atrophy) with brain cell death in humans and the growth of new abnormal brain cells in animal and laboratory studies. They frequently produce an apathy syndrome — a generalized loss of motivation or interest in many or all aspects of life. The SSRIs frequently cause irreversible dysfunction and loss of interest in sexuality, relationship and love. Withdrawal from all antidepressants can cause a wide variety of distressing and dangerous emotional reactions from depression to mania and from suicide to violence. After withdrawal from antidepressants, individuals often experience persistent and distressing mental and neurological impairments. Some people find antidepressant withdrawal to be so distressing that they cannot fully stop taking the drugs.

Benzodiazepine (benzos) anti-anxiety drugs and sleep aids: Xanax, Klonopin, Ativan, Valium, Librium, Tranxene and Serax; Dalmane, Doral, Halcion, ProSom and Restoril used as sleep aids

Benzos deteriorate memory and other mental capacities. Human studies demonstrate that they frequently lead to atrophy and dementia after longer-term exposure. After withdrawal, individuals exposed to these drugs also experience multiple persisting problems including memory and cognitive dysfunction, emotional instability, anxiety, insomnia, and muscular and neurological discomforts. Mostly because of severely worsened anxiety and insomnia, many cannot stop taking them and become permanently dependent. This frequently happens after only six weeks of exposure. Any benzo can be prescribed as a sleep aid, but Dalmane, Doral, Halcion, ProSom and Restoril are marketed for that purpose.

Non-benzo sleep aids: Ambien, Intermezzo, Lunesta and Sonata

These drugs pose similar problems to the benzos, including memory and other mental problems, dependence and painful withdrawal. They can cause many abnormal mental states and behaviors, including dangerous sleepwalking. Insufficient data is available concerning brain shrinkage and dementia, but these are likely outcomes considering their similarity to benzos. Recent studies show that these drugs increase death rate, taking away years of life, even when used intermittently for sleep.

Stimulants for ADHD: Adderall, Dexedrine and Vyvanse are amphetamines, and Ritalin, Focalin, and Concerta are methylphenidate

All of these drugs pose similar if not identical long-term dangers to children and adults. In humans, many brain scan studies show that they cause brain tissue shrinkage (atrophy). Animal studies show persisting biochemical changes in the brain. These drugs can lead directly to addiction or increase the risk of abusing cocaine and other stimulants later on in adulthood. They disrupt growth hormone cycles and can cause permanent loss of height in children. Recent studies confirm that children who take these drugs often become lifelong users of multiple psychiatric drugs, resulting in shortened lifespan, increased psychiatric hospitalization and criminal incarceration, increased drug addiction, increased suicide and a general decline in quality of life. Withdrawal from stimulants can cause “crashing” with worsened behavior, depression and suicide. Strattera is a newer drug used to treat ADHD. Unlike the other stimulants, it is not an addictive amphetamine, but it too can be dangerously overstimulating. Strattera is more similar to antidepressants in its longer-term risks.

Mood stabilizers: Lithium, Lamictal, Equetro and Depakote

Lithium is the oldest and hence most thoroughly studied. It causes permanent memory and mental dysfunction, including depression, and an overall decline in neurological function and quality of life. It can result in severe neurological dilapidation with dementia, a disastrous adverse drug effect called “syndrome of irreversible lithium-effectuated neurotoxicity” or SILENT. Long-term lithium exposure also causes severe skin disorders, kidney failure and hypothyroidism. Withdrawal from lithium can cause manic-like episodes and psychosis. There is evidence that Depakote can cause abnormal cell growth in the brain. Lamictal has many hazards including life-threatening diseases involving the skin and other organs. Equetro cases life-threatening skin disorders and suppresses white cell production with the risk of death from infections. Withdrawal from Depakote, Lamictal and Equetro can cause seizures and emotional distress.

Summarizing the tragic truth

It is time to face the enormous tragedy of exposing children and adults to any psychiatric drug for months and years. My new video introduces and highlights these risks and my book Psychiatric Drug Withdrawal describes them in detail and documents them with scientific research.

All classes of psychiatric drugs can cause brain damage and lasting mental dysfunction when used for months or years. Although research data is lacking for a few individual drugs in each class, until proven otherwise it is prudent and safest to assume that the risks of brain damage and permanent mental dysfunction apply to every single psychiatric drug. Furthermore, all classes of psychiatric drugs cause serious and dangerous withdrawal reactions, and again it is prudent and safest to assume that any psychiatric drug can cause withdrawal problems.

Widespread misinformation

Difficulty in stopping psychiatric drugs can lead misinformed or unscrupulous health professionals to tell patients that they need to take their drugs for the rest of their lives when they really need to taper and withdraw from them in a careful manner. As described in Psychiatric Drug Withdrawal, tapering outside of a hospital often requires psychological and social help, including therapy and emotional support and monitoring by friends or family.

Meanwhile, there is no substantial or convincing evidence that any psychiatric drug is useful longer-term. Psychiatric drug treatment for months or years lacks scientific basis. Therefore, the risk-benefit ratio is enormously lopsided toward the risk.

Science-based conclusions

Whenever possible, psychiatric drugs should be tapered and withdrawn either as an inpatient or as an outpatient with careful clinical supervision and a support network as described in Psychiatric Drug Withdrawal. Keep in mind that it is not only dangerous to take psychiatric drugs — it can be dangerous to withdraw from them. The safest solution is to avoid starting psychiatric drugs! It is time for a return to psychological, social and educational approaches to emotional suffering and impairment.

Psychiatrist Peter R. Breggin‘s scientific and educational work has provided the foundation for modern criticism of psychiatric drugs and electroconvulsive therapy. He leads the way in promoting more caring, empathic and effective therapies. His newest book is Guilt, Shame and Anxiety: Understanding and Overcoming Negative Emotions. His website is Breggin.com.

Peter R. Breggin, MD is a psychiatrist in private practice in Ithaca, New York. Dr. Breggin criticizes contemporary psychiatric reliance on diagnoses and drugs, and promotes empathic therapeutic relationships. He has been called “the Conscience of Psychiatry.” See his website at www.Breggin.com

More than 70,000 children prescribed anti-depressants in last 12 months

More than 70,000 under-18s, including nearly 2,000 children of primary school age, were prescribed anti-depressants in England last year, it has been reported. Experts have called for caution in giving the drugs to youngsters, warning that potential long-term effects on developing brains are not fully known. Mental health campaigners say access to other treatments, such as ‘talking therapies’, should be made more widely and easily available as a first resort.

GPs have said the prescription figures are evidence of youngsters seeking treatment, which is encouraging, but have backed calls for greater access to other therapies. NHS data obtained by The Times through freedom of information requests showed 7.3 million people were given at least one antidepressant prescription in England in 2017.

The drugs were used by one in six adults, the statistics suggested, with the total number marking an increase of nearly 500,000 since 2015.

The number of anti-depressant prescriptions has more than doubled in the last decade. A psychiatrist at Oxford University, Andrea Cipriani, said that doctors needed to be careful of prescribing anti-depressants to the developing brain. ‘We don’t know the long-term consequences,’ he said.

 

Read more: https://metro.co.uk/2018/07/21/70000-children-prescribed-anti-depressants-last-12-months-7742975/?ito=cbshare

Drugs alone won’t fix our epidemic of depression

To fight a rising tide of depression and suicide, psychiatrists need to do more than just fill patients up with pills
The New York Times recently published an important investigative report shining a long-overdue light on the painful, sometimes disabling experience of withdrawing from antidepressants – drugs that millions of Americans have been taking, sometimes for decades

The recent deaths of Kate Spade and Anthony Bourdain threw into stark relief the human toll that depression can take. But the problem is complex, with multiple factors. We are seeing a striking increase in the number of Americans diagnosed with depression, and an accompanying increase in suicides. This is coupled with the promiscuous and sharply increasing prescription of antidepressants to 34.4 million Americans in 2013-2014, up from 13.4 million just 15 years earlier. And this pervasive prescribing continues despite the lack of proof of the drugs’ long-term effectiveness; their mixed results even with short-term treatment; the frequent side-effects – weight gain, gastrointestinal problems and sexual dysfunction – that are themselves depressing. Meanwhile, we are paying the prohibitive financial costs of depression – an estimated annual average of $210.5bn in treatment and lost productivity.

These numbers raise critical questions: why are so many Americans becoming depressed? Why do rates of suicide, depression’s dire and irreversible consequence, continue to increase – by 25% since 1999 according to a recent Centers for Disease Control and Prevention report? Why are we treating vast numbers of these depressed and suicidal people with drugs that are of limited effectiveness? How can we do better?

Depression is characterized by low energy and despondency, negative self-esteem, pervasive pessimism, difficulties with eating, sleeping and sexual functioning, and helplessness and hopelessness. It is caused by biological, psychological, social and economic and spiritual challenges which are increasing in number and severity and often compound one another. These include decreases in social support and the loneliness that follows; high levels of stress about the economy, and the future; the hyper-competitiveness and hypercritical self-assessments of youth; sedentary lifestyles and poor diet; and our addiction to our digital devices.

The prevailing psychopharmacological treatment is based on the theory that depression is a neurotransmitter disorder. Pharmaceutical manufacturers and physicians are fond of making an analogy between depression and type-1 diabetes. The bodies of type 1 diabetics do not produce enough insulin, so diabetics receive insulin by injection. Depressed people, the analogy goes, are incapable of producing adequate amounts of neurotransmitters and must be prescribed drugs to increase them.

This is incomplete and misleading. Some depressed people may have lower levels of serotonin or norepinephrine. But no one knows how many, and doctors rarely measure these levels before prescribing drugs. A variety of emotional, social, nutritional and environmental factors affect a person’s fluctuating neurotransmitter levels, which in turn affect how a person functions. In other words, low levels are likely to be the symptoms, not the cause, of depression. Unfortunately, the prevalent view of depression as a “Prozac deficiency disease” prevents many Americans from seeking out a more comprehensive, safe and effective approach, grounded in self-care and group support.

Meditation is fundamental to this approach. Slow, deep breathing relaxes our body, quiets our mind, and lowers the stress which often precipitates depression. It quiets activity in the amygdala, a portion of the emotional brain responsible for fear and anger, and enhances activity in the hippocampus, which mediates stress and memory and is damaged by depression. Meditation thereby promotes functioning and increases tissue mass in the frontal part of the cerebral cortex, where depression has inhibited judgment, self-awareness and compassion. Meditation also makes it easier for us to connect with others who may provide comfort, intimacy and support. It gives us perspective – helping us see that what seemed insurmountable is manageable. It promotes compassion, and facilitates finding mood- and life-enhancing meaning and purpose.

Physical activity complements meditation. As a depressed person moves, she overcomes her inertia, releases tension and reclaims and enjoys a body that seemed alien, even hostile. Jogging, tai chi, yoga and dance all lower stress and stress hormones, may help rebuild the hippocampus and enhance activity in the frontal cortex. Exercise by itself can be at least as effective as drugs in relieving depression.

These self-care tools enhance the production of the neurotransmitters that drugs are aimed at – serotonin, dopamine and norepinephrine – without damaging side-effects. And the active engagement that self-care requires may itself be the most effective antidote to depression’s hallmark symptoms of hopelessness and helplessness.

Rise in people seeking help over prescription pills bought online

Clinic set up for teenagers sees high number of adults seeking treatment after illicitly buying drugs such as Xanax to treat anxiety

A pioneering clinic set up to help teenagers addicted to Xanax and other prescription drugs is being sought out by adults who use pills purchased illicitly on the internet.

At the beginning of the year Dr Owen Bowden-Jones opened the Addiction to Online Medicine (Atom) service in London, a free, easy-to-access NHS clinic run by Central North West London NHS Foundation Trust that offers one-to-one meetings and group mindfulness sessions.

The clinic, thought to be the first of its kind in the UK, was established in response to the growing problem of teenagers addicted to prescription drugs, particularly Xanax, bought illegally on the web.

What has surprised Bowden-Jones is that a third of current referrals are over 20. “When we established the clinic we were at the peak in terms of interest in Xanax and we were seeing a lot of young people using it,” he says. “But one of the cohorts we have seen are people in their 20s and 30s – people who are prescribed a medicine and then they seek it online, either because the dose they have is not enough or the medicine is stopped by their GP .”

He adds: “Teenagers tend to use [prescription drugs] for the intoxicating effect, to get giddy and drunk, but older people tend to use it to treat symptoms, particularly anxiety. We have had a number of patients with traumatic experiences and for them these medicines are being used to anaesthetise themselves.”

The adult group tend to use benzodiazepines to treat anxiety and tend to be women, he says. They have a job, have a partner, friends and a social network, “but have a secret that they have been buying drugs online and not telling people. They are often quite ashamed about it, but they found they cannot cope without prescription medicines.”

Benzodiazepines are currently prescribed on the NHS but are only supposed to be used in the short term. Research shows around four in every 10 people who take them every day for more than six weeks become addicted.

In the UK, alprazolam is not available on the NHS and can only be obtained on a private prescription. Tranquillisers are controlled under Class C of the Misuse of Drugs Act and possession without a prescription could lead to a prison sentence of up to 2 years and an unlimited fine.

full article (Guardian)

How do we find and treat the ‘hidden cohort’ of patients dependent on opioid painkillers? 

ORAT – Opioid Risk Assessment Tool (ORAT)
‘People who are addicted to painkillers are a really complex group,’ says Jon Royle, chief executive of the Bridge Project. ‘You’ve got people who are prescribed painkillers and who are also using illicit drugs and have complex addiction issues. And you’ve got other people who were prescribed them to manage pain legitimately, so where the pain relief is required and where it has become an actual addiction problem is no longer clear cut.’ Among the patient group are those with complex emotional, psychological problems, who are taking anything to make themselves better, he explains. ‘So there are a lot of issues to work with when you get into this cohort.’

At the Bridge Project, based in Bradford, staff had experienced success in running a benzodiazepine withdrawal service for the past seven years, targeting patients in primary health care and GP practices.‘Doing that kind of work in primary care, we were also coming across a great deal of patients addicted to prescribed painkillers as well,’ says Royle. As with the benzos, ‘these patients are never going to roll up at an addiction treatment service on the high street – but that doesn’t mean that there’s not tens of thousands of them out there, people who’d say “I’ve never been near an illegal drug in my life”.’

So they decided to develop a model along similar lines to the benzodiazepine scheme, going into GP practices with the highest levels of prescribing and using the Opioid Risk Assessment Tool (ORAT) – which sits alongside the patient record system, Emis – to screen patients. They then worked with GPs to review the patients’ prescribing and liaised with specialist doctors and addiction practitioners to offer treatment, detoxification and support such as cognitive behavioural therapy (CBT). The response has been ‘really good, with far better outcomes than with opiate users’, says Royle – success he attributes to planting the service within primary care.

ORAT – Dependency detector

Prescription drug addiction: government launches investigation

Public Health England will review prescription of medicines including opioid painkillers

The government has ordered an investigation into the growing problem of addiction to prescription drugs such as painkillers and medicines to treat anxiety and insomnia.

Steve Brine, the public health minister, has acted after it emerged that one in 11 (8.9%) patients treated by the NHS in England last year was given a drug that can induce dependency.

Fears about excessive prescription has also been boosted more than 100% rise in the number of antidepressants prescribed in England over the last decade and the fact antidepressants prescribed in England over the last decade and the fact that prescription of addictive medicines has increased by 3% over the last five years.

Full story – https://www.theguardian.com/society/2018/jan/24/prescription-drug-addiction-government-launches-investigation