December 08, 2009Oh, Paxil, You Personality Changer!A new study came out this month in the Archives of General Psychiatry, asserting that Paxil reduces symptoms of neuroticism and improves extraversion in patients with major depression. In effect, it changes peoples' personalities. This is taken by the researchers to be a good thing because: "High neuroticism is a personality risk factor that reflects much of the genetic vulnerability to major depressive disorder (MDD), and low extraversion may increase risk as well. Both have been linked to the serotonin system." Um, OK. I'm not even going to get into how crazy it sounds to essentially promote a pill--known to damage sperm, lessen sex drives, induce suicidality, cause physical dependence, linked to some birth defects, known to blunt emotions--in order to alter someone's personality. Isn't that therapy's job? The whole study gives me the creeps. A much more straightforward account of the study can be found at PsychCentral.com. Posted by Philip Dawdy at December 8, 2009 12:03 AM
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Personality change?
Yup, that's pretty much on the money!
When these researchers are studying neuroticism and extraversion they are picking up on traits known to be "mildly hypomanic". Sure - more exuberance, more outgoing, more talkative and sociable - who wouldn't want this? The only problem arises when the hypomania begins to become a bit too much. Early on in the Prozac Survivors Support Group I talked to a man whose wife had taken Prozac because she was afraid to drive on major freeways. Well, the Prozac cured her of this but then she went on to other things - like leaving her house in the evening to hang out at bars, etc. The upshot was when she drove off one morning and headed to Florida about 1,000 miles away. She went beach partying, etc. and left behind her husband and child. Very exurberant woman. Here is a case from SSRI Stories where it could be speculated that this woman either suffered from trauma or from her antidepressants. Notice that she was a very exurberant type of personality to begin with and, also, that her "mugging" could have caused a mild brain concussion. People with head injuries need to be very cautious taking an antidepressant. The "tulips" point to a bizarre SSRI reaction in this woman, though. http://www.ssristories.com/show.php?item=1262 First paragraph from the Columbus Dispatch Online reads: "A Grove City middle-school teacher who crashed her car into a home early yesterday morning is suspected in a bizarre string of about 15 arson fires in the past two weeks, police said." Paragraph 34 reads: "Kenworthy said Cooper told her that she was taking anti-depressants prescribed by a family doctor, but that her condition only worsened with the medication." http://www.dr-bob.org/babble/20000411/msgs/29975.html Trauma the cause...or Antidepressant Here's an article from the Columbus Dispatch Online which suggests that this woman's tragic and possibly felonious situation was caused by a recent trauma, worsened by antidepressants. But I wonder if the atypical response to the antidepressants couldn't have been what really drove her over the line? I've certainly heard of people inexpicably shoplifting after taking SSRI's, especially at too high a dose. Of course we can't tell for sure what happened here, but what is your educated guess? A Grove City middle-school teacher who crashed her car into a home early yesterday morning is suspected in a bizarre string of about 15 arson fires in the past two weeks, police said. "Property was found in the Jeep that was identified as stolen out of vehicles in Grove City,'' Capt. Dennis Deskins said. Kenworthy said Cooper's behavior changed radically over the past two weeks. She said Cooper told her that she had been attacked two weeks ago, but that she didn't report it to police. Kenworthy said Cooper told her that she was taking anti-depressants prescribed by a family doctor, but that her condition only worsened with the medication. "This is far from normal behavior, especially for a schoolteacher,'' Deskins said.
The extraversion can lead from hypomania to mania. Here are ten cases of woman school teachers on antidepressants who molested their young male students. Someone told me that the "O'Reilly Factor" said there was one case of this kind being reported to them every week. Of course, the newspapers don't mention the antidepressants because they don't think to but, in these ten cases, they did. Yes, antidepressants can not only lead to pyromania and kleptomania as illustrated in my last comment on the woman school teacher in Ohio but they can also lead to "nymphomania". And, yes, the famous Debra LaFave case is one of these ten cases. http://www.ssristories.com/show.php?item=285 http://www.ssristories.com/show.php?item=286 http://www.ssristories.com/show.php?item=265 http://www.ssristories.com/show.php?item=2237 http://www.ssristories.com/show.php?item=2239 http://www.ssristories.com/show.php?item=2389 http://www.ssristories.com/show.php?item=2698 http://www.ssristories.com/show.php?item=3143 http://www.ssristories.com/show.php?item=3298 http://www.ssristories.com/show.php?item=3652 Posted by: Rosie at December 8, 2009 07:14 AM The irony of all this, at least in the case of the woman afraid to drive on major freeways is that cognitive/behavioral therapies have been shown to help with overcoming such things. No drugs required. From these stories, speaking as a neurotic introvert myself, sounds like those traits are preferable to going off on carefree extraverted bender!! Posted by: Miranda at December 8, 2009 09:06 AMRosie, Yes. Mind altering! At SSRI-sex men and women claim they have no sexual fantasies anymore. Archives of General Psychiatry??!! How in God's name does this stuff get through peer review? Oh I know, it's probably ghostwritten by GSK, the manufacturer. To add insult to injury it get's media hype. If anyone has any doubt about how corrupt clinical research has become this study ought to set them right. The authors appear to have lost all common sense and ethical grounding. But when EPS (earnings per share) and financial kickbacks are at stake, who cares? Posted by: Sara at December 8, 2009 10:19 AMI reposted it: http://justana-justana.blogspot.com/2009/12/ssris-to-treat-deviant-sexual-behavior.html Posted by: Ana at December 8, 2009 10:26 AMSome people go absolutely bonkers on SSRIs. Doctors like to call it hypomania because it makes plausable that the patient could have exhibited the same behavior without the SSRI. Passing off a blatantly iatrogenic event as a "natural" mood episode represents exactly the kind of accountability we've come to expect from psychiattry. Posted by: mark at December 8, 2009 10:28 AM
Still, I think the character defects I displayed while I was on Lexapro were always there. I just wasn't able to hide them as well when I was on medication. I think I probably have "neuroticism" and introversion. These things are not all bad. Being cautious can keep you safe and being shy is not the end of the world. I am so much happier being me -- smart and kind of inhibited -- off the drugs, than I was as the irresponsible, lazy, muddled, apathetic person I was when I was on the medication. I thank God every day I'm free from antidepressants. My life has improved almost constantly since I stopped taking pills. I always had what I needed to handle life's problems, but I allowed myself to be persuaded that a drug could erase my unhappiness. I won't make that mistake again! Ana, Thanks for putting some of SSRI Stories on your blog. Hope things are going well for you in that beautiful country of Brazil. Rosie Posted by: Rosie at December 8, 2009 01:52 PMisn't it fair to say, it gives you the creeps because it's a medication? "most anticonvulsants have a similar side effect profile - shall we conclude that you think it's better to just suffer seizures than take these 'nasty' medications?" Good point! If the benefits of taking an anticonvulsant were no more seizures, it would probably be worth the risk. If the benefit is: the side effects from taking an SSRI may be lessened, not worth it at all. Rosie, Risks: suicide, homicide, violent behavior, hallucination, disturbed sense of reality... and other minor ailments. Clonazepam was a anticonvulsant back in the 80ies. "I'm not even going to get into how crazy it sounds to essentially promote a pill...in order to alter someone's personality." no-one was promoting that. Not in this paper anyway. This was about antidepressants for the treatment of depressed people, not for personality change. "Isn't that therapy's job?" Great question - which this study already answered, because some patients got Cognitive Therapy instead of paroxetine, and their personality change was smaller than the paroxetine group's. But only slightly smaller! Therapy was nearly as bad (or is it good?) as the SSRI. Can we expect a post titled "Oh, Therapy, You Personality Changer?" "I would note that most anticonvulsants have a similar side effect profile." That's a bit harsh, on SSRIs. SSRI side effects are mild, if they occur at all, and sometimes even fun. Anticonvulsants can be really unpleasant. Posted by: Neuroskeptic at December 10, 2009 08:36 AM"SSRI side effects are mild, if they occur at all, and sometimes even fun." I bet 90% of Furious Seasons regular readers would disagree, including myself. Neuroskeptic, can you cite a link to a study run by people not connected with drug companies over at least 5 years that would prove your point that SSSRI side effects are mild? And the study would have to be a good cross section of people. Thanks! Posted by: AA at December 10, 2009 02:17 PMYep - here's a Cochrane Review showing that for depression in primary care, only one out of every 20 to 90 people will decide the side effects are bad enough to want to drop out of the clinical trial (Number Needed to Harm 20-90 for SSRIs). http://www.ncbi.nlm.nih.gov/pubmed/19588448 "For withdrawal due to adverse effects for patients on SSRIs, the relative risk for harm was 2.05, 95% CI 1.11 to 3.75. For withdrawal due to treatment failure for patients on SSRIs, reported In other words there were some side effects, a few people found them serious enough to stop taking the drug, but this was counterbalanced by the people who stopped taking the placebos because they didn't work. Posted by: Neuroskeptic at December 11, 2009 01:11 AMNeuroskeptic, thank you for the link. "In other words there were some side effects, a few people found them serious enough to stop taking the drug, but this was counterbalanced by the people who stopped taking the placebos because they didn't work." ROLF Seriously I cannot stop laughing! ROLF I love it! This is the only funny thing going on at Furious Seasons: the eternal "this drugs have helped millions of people" I hear it today from the psychiatrist I have to go to take the prescriptions to buy the drug. Wow...apparently shyness/introversion is one of those life threatening personality traits that just needs to be nipped in the bud before causing any longterm problems...damn, guess I am crazier than I thought. So apparently, I just should have stuck with the option that put me on the whole diagnosis and med-go-round: taking Prozac, which did in fact trigger a manic episode and the onset of bipolar when I was 22. That, along with everything else I just read in the comment thread, really just confirms that the implications of sticking everyone and their dog on SSRIs rather than guiding them toward therapy (if they're looking for help and see the personality traits as something to be overcome),or giving suggestions on how to better function in various situations, isn't a risk worth taking. The laziness of tossing medication at a potential problem rather than assessing a course of effective treatment strikes me as incredibly dangerous, especially for doctors concerned with liability and malpractice suits. I'm probably the last person on here who has a right to get high and mighty about medication - I willingly stay on the pills, and, to be honest, Big Pharma money (I won't name which drug company for the sake of my father's job security) put a roof over my head and paid my college tuition. But I'm both horrified and disgusted at how the pursuit of more money and more credibility compromises ordinary people's stability and lives. Posted by: lindeseig at December 12, 2009 11:47 AMLaziness! Good characterization, lindeseig! I have always felt that drugs, in and of themselves, aren't good or bad. I mean, they're just chemical compounds. So i don't think you need to qualify your opinions at all. I don't even really have a problem with the way drug companies promote their product, because they are for-profit companies and that is what for-profit companies do; they try to make a profit. They have to, to continue to develop newer drugs. It's the manner in which they're prescribed that needs to be called into question. It is the doctors who are ultimately responsible to their patients. That's why i feel this whole situation is so dangerous, because there is no good guy and bad guy. The main problem, i think, is these doctors, who cannot reasonably be characterized as "bad guys" because they are just well-meaning, caring, overworked humans (many of whom have egos the size of New Jersey) making giant, human mistakes in reasoning. Posted by: Sarah at December 14, 2009 09:12 AM"ROLF Seriously I cannot stop laughing! ROLF I'm glad you find evidence so hilarious! You should try reading my blog, you'd find it a real hoot. "Unfortunately, a six to 8 week study proves nothing since many adverse affects don't show up until many years down the road. That is why I asked if you had a link to a study that was at least 5 years duration." I don't know of any, but I don't know of any 5 year studies of many treatments. There's no hard evidence that riding a bicycle for 5 years doesn't cause baldness - cyclists beware. Posted by: Neuroskeptic at December 18, 2009 02:15 AMPost a comment
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