Misinformation about Antidepressants on the Internet
There is a lot of misinformation about antidepressants on the internet.
Richard J. Metzner, M.D.
Clinical Professor
Semel Institute for Neuroscience and Human Behavior at UCLA
Founder, DepressionConsultant.com
Some of it comes from well-meaning patients who assume their own unfortunate treatment experiences can be generalized to everyone. Others have different reasons, perhaps also well-intended. Life Extension®, a company that sells vitamins and nutritional supplements, seems to believe that its products are better than antidepressants for relieving depression.
A brief blog entitled “Why Antidepressants Don’t Work” by a diet doctor named Michael A. Smith, M.D., appeared on Life Extension’s website March 1, 2012. The piece, received favorably by many who were directed to it on sites like Twitter, contained misleading factual errors starting with the inaccurate title. Antidepressants do work when used correctly. I'm confronting this misinformation for the sake of depressed people who need to know the truth, not to denigrate Life Extension or to convey any opposition to the use of vitamins and supplements when useful. On the contrary, my first research at Johns Hopkins Medical School involved studying the critical role of vitamin B6 in serotonin metabolism, and I've seen many times with patients how nutritional deficiencies can contribute to medical and psychiatric problems.
INCORRECT INFORMATION ABOUT ANTIDEPRESSANT EFFECTIVENESS:
The blog wrongly stated that: “Less than 50% of patients prescribed antidepressants actually get better.” and cited a news report in Nature as its source. What the Nature report actually said was that: "roughly one-third of people with depression ... do not respond to current therapies," referencing a nationwide U.S. study showing that the majority (67%) of depressed patients achieved remission after receiving one or more antidepressant therapies.
INCORRECT INFORMATION ABOUT ANTIDEPRESSANT FUNCTION:
The piece went on to say that “antidepressants for the most part work by preventing the removal of one neurotransmitter from the brain — serotonin, the ‘feel-good’ neurotransmitter.” Actually, only five of the more than two dozen antidepressants in current use are SSRI’s (selective serotonin reuptake inhibitors). Others modify norepinephrine and dopamine neurotransmission with or without affecting serotonin. Personalized antidepressant treatment pays attention to those differences and helps improve treatment results by matching patients to the right medications.
INCORRECT INFORMATION ABOUT ANTIDEPRESSANT MECHANISMS:
Finally, the website asserted that “the most popular class of antidepressants does not increase serotonin production. The drugs only prevent its removal from the synaptic cleft...simply preventing its removal doesn’t address the deficiency.” The facts? Studies measuring serotonin metabolism in the brain show very clearly that SSRIs do increase serotonin levels initially, after which they are kept in balance by natural feedback mechanisms.
The blog ends by listing some vitamins and supplements which it declares to be the best way to treat depression. A more balanced article might have said that regular exercise and good nutrition are important components of a depression treatment program, but that without antidepressants or other types of professional treatment there will be little hope for the millions of people who suffer from depression each year and the 15% who die from suicide.
Ernest Hemingway once said: “Every man should have a built-in automatic crap detector operating inside him.” Perhaps Life Extension knows of supplements which could stimulate compelling gastrointestinal disturbances in people before they release misinformation into cyberspace.
LIFE EXTENSION'S RESPONSE ON TWITTER THREE HOURS AFTER WE POSTED THE ABOVE ARTICLE:
Copyright 2012, Scaled Psychiatric Systems, Inc. All rights reserved.