June 29, 2009

Doctors On CNN, Fox News Criticize Long-Term Anti-Depressant Use

I was blown away on Saturday when, during cable news coverage of Michael Jackson's death, two doctors offering analysis were very critical of Jackson's reported long-term, chronic use of both painkillers and anti-depressants and noted that they could affect someone's heart health (while that's likely obvious to one and all with painkillers, it's probably not so obvious with anti-depressants). Sadly, I cannot find transcripts of either doctor on Fox News and CNN, but I can assure you they said it and it was a stunner to me, given how the mainstream media ignored the connection between anti-depressant use and sudden cardiac death in women, as reported by researchers in the Nurse's Health Study. It's also a stunner to me in light of how naive we've been as a culture when it comes to using anti-depressants very casually while assuming that there's no long-term impact from using the drugs.

Jackson was allegedly on a staggering cocktail of prescription drugs: thrice daily injections of Demerol; Dilaudid; Viccodine; and 120 mgs. a day of Zoloft and 40 mgs. a day of Paxil. He was supposedly taking the anti-depressants for OCD and social phobia issues. What Jackson was taking at the time of his death isn't entirely clear, since his toxicology report won't be available for many weeks and also since last night his personal physician, Conrad Murray, reportedly told Los Angeles police detectives that he hadn't injected Jackson with Demerol and, in the words of the doctor's lawyer, "There was no Demerol. No OxyContin."

He said nothing about anti-depressants, however.

So we shall see how all this prescription business plays out. Of course, Jackson was known to have used painkillers for many years to treat chronic pain problems and it's entirely possible that he'd become addicted to them. It's entirely possible that Michael was hooked on anti-depressants as well. Certainly, SSRIs can be very addictive (or create physical dependency, if you prefer) for some people.

That said, I want to make it clear that I am not blaming Zoloft and Paxil for Jackson's death. I am not saying that taking either drug will give any specific person a heart attack. But I am saying that, for now, that the two anti-depressants are inextricably entwined and linked to the death of MJ.

The research on long-term anti-depressant use is thin to begin with and there's not a lot of research on links between anti-depressant use and heart problems, but it is obvious to me that there is clearly something going on here and, as I wrote back in March, the nurse's study should be a big wake up call to doctors who've had patients on anti-depressants for many years and for patients themselves.

Posted by Philip Dawdy at June 29, 2009 12:03 AM
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It's strange that his doctor(s) didn't know SSRI's and demerol (pethidine/meperidine) are not a good mix, especially in such large amounts, the result being serotonin syndrome. But then, I guess, if the docs knew that, among other things, you would be out of business!

Keep up the good work Philip!

Posted by: Ashin Sopāka at June 29, 2009 04:35 AM

Plus long term use, a very low body weight makes the drugs more dangerous on the body.
A reporter on Tv this morning said Jackson was seriously underweight.
He said something like"It has also been reported that despite being 5ft 10in, Jackson’s weight had plummeted below nine stone (126 pounds) as he rarely ate."

Posted by: markps2 at June 29, 2009 06:33 AM

I doubt that the antidepressants alone will be specifically blamed for Michael Jackson's death.
It will probably be a combination of the antidepressants with the painkillers which are blamed.

In the 1929 stock market crash, the ability to buy stocks on margin was cited as the chief cause of the Crash and the subsequent Great Depression.
So Buying on Margin was immediately outlawed.

In the 2008 stock market crash the causes are still being analyized. Why would our "best and our brightest" suddenly lose their judgement and allow people, who were not qualified to buy houses, buy not just an average priced house but a $300,000 to$400,000 house. Why give these people no interest rates or very low interest rates with ballooning mortgages? Also, why would investors accept higher risks in the stock markets at higher price-earnings (PE) multiples with greater economic uncertainty;

The following article titled "The Jackson Factor" delves into these very reasons.

Here is the article [in part]:

Paragraphs 24 through 29 read "Even if readers could assume that the preceding section convincingly answers the question of "what is the source of funds?", they are left with the more vexing question of "why?", that is - why would investors accept higher risks in the stock markets at higher price-earnings (PE) multiples with greater economic uncertainty; combined with continuing bad news."

"The answer could well be something that market commentators rarely think about: namely the mood swings of the average investor. In other words, what is the role of specific drugs such as antidepressants in the current makeup of the market? Is it possible that the consumption of antidepressants has pushed investors to take greater (and growing) risks on the stock market?"

"Firstly, it must be acknowledged that I am on a well-trod rather than radical path here. Many years ago, a respected medical journal made the same point albeit about a different bubble. This was recounted by Michael Lewis, writing in Slate (article dated August 13, 2002) as follows:"
"When people talk about the mood in the financial markets they tend to assume that the market drives that mood. But of course it doesn't, not entirely. A few years ago a piece in the University of Michigan medical journal argued that the reason the Internet bubble reached such ridiculous heights was that huge numbers of investors were now taking drugs that lowered their inhibitions. With a third of the US investing population on Prozac or some other mood-enhancing drug, the paper concluded, it was no wonder that so many people believed the market would simply keep rising."

"Since he wrote that article, sales of antidepressants and related psychiatric-treatment drugs have increased dramatically in the US. Evidence suggests that the rapid increase in the sales of antidepressants could well have sown the seeds of the financial crisis in 2005-06 and later on. The following are excerpts from an excellent article in How Stuff Works titled 'Why are antidepressants the most prescribed drug in the US?':
"In 2007, the Centers for Disease Control and Prevention made an intriguing announcement. Antidepressants were the most frequently prescribed drug, overtaking the runner-up, high blood-pressure medications, by five million prescriptions. The study reported that doctors racked up 118 million prescriptions for antidepressants in 2005 (out of a total of 2.4 billion prescriptions). ... Antidepressants have the power to change your moods, and they accomplish this by affecting the amount of serotonin and norepinephrine in the brain. Serotonin and norepinephrine are neurotransmitters, which travel through neurons in the brain. Scientists don't know a great deal about how these neurotransmitters affect your mood. But they do know that when antidepressants alter how neurotransmitters travel, it stabilizes your emotions. ... So what's the reason behind the rising number of antidepressant prescriptions? One reason is that, despite their name, antidepressants are not prescribed solely for depression anymore. They are also used to treat chronic pain, anxiety, panic disorder, obsessive compulsive disorder and even eating disorders. ... You can't really address the reasons for antidepressant popularity without addressing the business of antidepressants."

http://www.atimes.com/atimes/Global_Economy/KF30Dj05.html

Jun 30, 2009

The Jackson factor

By Chan Akya

Posted by: Rosie at June 29, 2009 07:25 AM

Viccodine? Maybe Vicodin.

Posted by: Goods Pellman at June 29, 2009 09:50 AM

I assumed he dropped dead of a cardiac arrest from anorexia like Karen Carpentar did.

As far as 2 anti depressants killing someone? it took the life of someone in my life a couple of years ago.


The official toxiocology report came back showing death from 2 anti depressants "drug-drug interaction" and the cause of my friend of 43 years to die. Mother of 3 kids just after she turned 49. She never made it to 50.

Posted by: Stephany at June 29, 2009 10:22 AM

Let me just throw into this that it appears that Jackson may have been anorectic. Whether that was a side effect of heavy doses of narcotics, debilitating anxiety, deliberate starvation or some combination isn't clear. Jackson's evident obsession with plastic surgery and perpetual youth would be consistent finding with anorexia nervosa.

So, I would not rule out cardiac arrest associated with chronic starvation or dehydration/electrolyte imbalance. The guy has been beating his own body to a pulp for a couple of decades.

Incidentally, a now deceased friend and I had several conversations about Jackson when he was on trial back a few years ago. Both of us believed he would be dead within five years from a conscious, deliberate suicide or accidental death from a combination of drugs and starvation. Sadly, it appears that we may have been correct.

Posted by: Dr X at June 29, 2009 10:26 AM

you all may be onto something with the anorexia thing, as some reports now have it that mj was 112 lbs at his death on a 5'10" frame.

Posted by: Philip Dawdy at June 29, 2009 10:41 AM

The stock market crash, the death of Michael Jackson... is there anything bad antidepressants didn't cause? World War 2 for example - maybe someone sent them back in time and fed them to Hitler as a baby?

Seriously - we have no idea what killed the guy - if anything killed him and it wasn't just a random heart attack at 50 (not unheard of) - but if you're hoping for evidence that SSRIs gave someone a heart attack you might be waiting a long time.

Philip Dawdy responds: hm well i've not blamed anti-deps for the stock mkt or jackson's death, but they sure do appear to be intimately linked to the latter and there are people who will insist they are linked to the former, so go figure.

Posted by: Neuroskeptic at June 29, 2009 10:53 AM

Antidepressants can exacerbate symptoms of anorexia by causing "distorted body image" syndrome.

Bernard Madoff was sentenced to 150 years in prison today. It seems strange that a man his age who was on Wall Street for 49 years was actually honest for the first 31 years of his business dealings and then, suddenly, began a Ponzi scheme in 1991 - a year after Newsweek had Prozac on the cover [March 22, 1990] as a miracle drug and "better-then-well" drug. Among the hypomanias that Prozac/SSRIs can cause are kleptomania, etc.

Here is the article [in part]:

First sentence of paragraph 22 reads: "In his plea allocution, Madoff stated that he began his Ponzi scheme in 1991."

Second paragraph reads: "Madoff founded the Wall Street firm Bernard L. Madoff Investment Securities LLC in 1960, and was its chairman until his arrest on December 11, 2008."

http://en.wikipedia.org/wiki/Bernard_Madoff

Bernard Lawrence "Bernie" Madoff (pronounced / me d f/) (born April 29, 1938) is an American former financier and convicted felon. Madoff, who served as an non-executive chairman of the NASDAQ stock exchange, pled guilty to an 11-count criminal complaint, admitting to defrauding thousands of investors of billions of dollars and was convicted of operating a Ponzi scheme that has been called the largest investor fraud ever committed by a single person.[2] [3] Federal prosecutors estimated client losses, which included fabricated gains, of almost $65 billion.[4] On June 29, 2009, he was sentenced to 150 years in prison, the maximum allowed.[5][6]

Posted by: Rosie at June 29, 2009 11:02 AM

We can be darn sure that Michael Jackson's anorexia was part of the picture leading to his demise. I can't even begin to imagine what effects drugs are going to have when the body is getting zero nutrition and anorexia is well known to have cardiac effects. This guy had so many strikes against him I think it's a miracle he lived as long as he did.

I must say I am quite horrified at how these celebrities manage to get doctors to enable their prescription addictions. In fact I see it in people who aren't celebrities. There are scores of prescription junkies out there who make the rounds between doctors and find ones only too happy to write them more prescriptions and turn a blind eye to all the stuff they already have in their cabinets. It's pretty obscene and you can be pretty sure we are going to be seeing more and more of these celebrity deaths as time goes on.

Posted by: Sara at June 29, 2009 12:41 PM

Any serious scholar of the 2008 economic crash would want to consider all possibilites, including the fact that a nation [one out of six at one time or another have tried antidepressants]was medicated to the hilt on Prozac/SSRIs.

There was definitely some kind of mania driving the 2008 stock market crash. It should be looked into.

As for World War II, Hitler & most of the Germans were on amphetamines ---- Google "Hitler +amphetamines". Amphetamines came on the market in 1932 and Hitler was an avid taker. They made him paranoid [more paranoid]. He received a shot everyday from his doctor.

The human race is naturally inclined toward mania so why give our nation a drug which can either cause or exacerbate the symptoms of mania?

Posted by: Rosie at June 29, 2009 12:57 PM
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