December 08, 2009

Oh, 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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Comments

Personality change?

Yup, that's pretty much on the money!


Fid

Posted by: Bob Fiddaman at December 8, 2009 02:59 AM

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
Posted by Rick on April 14, 2000, at 10:12:13

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?
Rick
------
Police suspect teacher in rash of arson cases (Columbus Dispatch 4-14-00)
Saturday, April 15, 2000

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.
Elizabeth Cooper, 27, of 2323 Sonora Dr., was in critical condition last night at Ohio State University Medical Center with a head injury from the accident.
One of her bosses said that Cooper always has been "bubbly and energetic,'' but that her personality changed and aberrant behavior began after she was assaulted about two weeks ago.
Police gave this account of what happened yesterday:
Shortly after 1 a.m., a Jeep Wrangler was spotted speeding east on Holton Road, just outside Grove City.
At the time, a deputy with the Franklin County Sheriff's Office, a Grove City police officer and a Jackson Township paramedic were responding to a string of fires late Wednesday and early yesterday morning.
"The officers were actually following the pattern of the fires'' to guess where the arsonist would strike next, said deputy Terry Wassmuth, who investigated the crash.
That's when they saw Cooper's vehicle run a stop sign and pass them.
"By the time they could get turned around, she had already wrecked,'' Wassmuth said.
The car failed to make a left turn and careened more than 300 feet through a front lawn, leveled a 9-foot pine tree and slammed into the front of Dan and Jerri Turner's ranch house at 1375 Holton Rd.
Mr. Turner awoke to what he thought was an explosion.
"I come out of the bed in about one-tenth of a second just screaming, 'Danny!','' he said.
Danny, his 16-year-old son, whose room the vehicle had hit, yelled back that he was OK.
A 27-inch television set against the wall was thrown across the room and landed at the foot of his bed.
"His room's absolutely destroyed,'' Mrs. Turner said. "You can just see how close enough it was to a disaster.''
Mr. Turner estimates the crash caused $70,000 worth of damage to his home.
Cooper was flown by helicopter to OSU Medical Center. Cooper's family, who gathered last night at the hospital, declined to comment.
Because of her injuries, Grove City police have been unable to interview Cooper, who they say could face charges of arson, theft and receiving stolen property.
Grove City police said the possible charges stem from what they discovered when they investigated the crash.

"Property was found in the Jeep that was identified as stolen out of vehicles in Grove City,'' Capt. Dennis Deskins said.
Those items include a cellular phone and a purse with credit cards that police say were taken from cars on Saturday and Sunday. In both cases, papers inside the car were set on fire.
In addition, at least 15 arsons in two weeks -- one house and the rest vehicles -- have been linked to one another. Grove City police said they think that Cooper set those fires.
Cooper has worked as a foreign-language teacher at Finland Middle School since August 1995, said Jeff Warner, spokesman for South-Western City Schools.
Warner said that school officials learned about Cooper's accident through the sheriff's office, but that he knows nothing of any investigation linking her to arsons or thefts.
"She is a very good teacher, and her performance has been very good,'' he said. "We're saddened by the incident and hope she will recover.''
Brian Cantrell, who lives across the street from Cooper, said, "We chatted when we saw each other outside. I just hope she's OK. She's a really nice person. She left me a Christmas gift outside my door from the bath-and-body shop where she worked.''
Management officials at Bath & Body Works, 2185 Stringtown Rd., said Cooper worked part time at the store.
For the past two years, Cooper also worked weekends as a server at Max & Erma's, 411 Metro Place N. in Dublin, said Nora Kenworthy, an assistant manager at the restaurant.
"She's a great employee. She's very bubbly. Very outgoing. She was very good at her tables,'' she said.
Ali Starling, office manager at the restaurant, said, "She'd walk up to you and put a smile on your face.''

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.
Immediately after, her performance slumped, and "she wasn't herself,'' Kenworthy said.

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.
When she went to work last weekend, she broke down several times and couldn't make it through her shift, her boss said.
Cooper also told Kenworthy that she shoplifted more than $100 of merchandise from Meijer, 1661 Hilliard-Rome Rd., on April 2. She was caught and received a summons on the theft charge, according to court documents. She has no other criminal record.
Cooper confided to her boss, "I don't understand what's wrong with me. I've never done anything like this.''
Experts say trauma can affect people in strange ways.
"Certain traumatic behaviors can indeed and do cause individuals to engage in bizarre behavior at times,'' said Nick Marzella, a psychologist who works with law-enforcement agencies.
In another bizarre twist in the case, residents at the fires told Jackson Township fire officials that tulips had been stolen from their yards. Found near Cooper's Jeep at the crash site was a bouquet of red tulips still attached to their bulbs.

"This is far from normal behavior, especially for a schoolteacher,'' Deskins said.


Posted by: Rosie at December 8, 2009 06:41 AM

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 AM

Rosie,
Thanks for the data.
I did a post about SSRI-stories and I already expressed my gratitude for your work.

Yes. Mind altering! At SSRI-sex men and women claim they have no sexual fantasies anymore.
What happened?
This is appalling!
And there is a book where one can read that the use of antidepressants SSRIs could be used as treatment for rapers.
I will search at my blog and put the link here.

Posted by: Ana at December 8, 2009 09:59 AM

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 AM

I 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 AM

Some 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


When I had my bad experience with an antidepressant, I became more uninhibited. This might have seemed like a major personality shift from the outside, but I think it was just that the drug made me apathetic so I didn't care so much about the consequences of my actions. It also impaired my critical thinking skills (I became noticeably better at math when I stopped taking the drug) so I wasn't able to really evaluate my options or make good decisions.

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!

Posted by: A at December 8, 2009 12:20 PM

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 PM

isn't it fair to say, it gives you the creeps because it's a medication?
I would note that 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?
looking at the tables of contents of psychiatric journals does not constitute journalism - even if you read the abstracts, too.

Posted by: captain caveman at December 8, 2009 04:12 PM

"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.


Posted by: Damaged at December 9, 2009 06:29 AM

Rosie,
An actress committed suicide here and she was taking antidepressant.
Unfortunately the media don't make any kind of statement but I have already read some people that committed suicide and was taking antidepressant.
They don't name the drug.
Thank you but it is part of my job reporting what is going on at SSRIs-stories.

Risks: suicide, homicide, violent behavior, hallucination, disturbed sense of reality... and other minor ailments.
Good!
lol

Clonazepam was a anticonvulsant back in the 80ies.
What now?
The pharma-whores are so funny!
Their arguments are being easily questioned if someone has tow informations.

Posted by: Ana at December 10, 2009 01:56 AM

"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.

Posted by: Damaged at December 10, 2009 11:20 AM

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 PM

Yep - 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
as a reduction in effect and hence a positive result, suggesting more treatment failure in the placebo group is reported as a relative risk less than one, the relative risk was 0.51, 95% CI 0.34
to 0.78. Forwithdrawal due to any reason for patients on SSRIs, the relative
risk was 1.02, 95% CI 0.72 to 1.44."

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 AM

Neuroskeptic, thank you for the link.


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.

Posted by: AA at December 11, 2009 11:56 AM

"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
ROFL
LOL
LOL
LOL
.............LOL..............

Seriously I cannot stop laughing!
LOL

ROLF
ROFL
kkkkkkk
Shuashuashuahsuahuasuhauhsuhaushhuah
(this is how young people "laughs" in social networks in Portuguese)
shuaahsuhauhuhahsuhauhushuhauhushauhaa

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.
It's just like visiting a drug-dealer. He said that clonazepam "helps a lot of people"....
Well, the young girl that is taking it for one month will surely trust him.
I don't want to see her in the next 5 years.
She is having side effects without knowing. She told me all she is experiencing and I can tell what is side effect and what is her problem.
She should be in therapy! Not in the psychiatric office.
I started having panic attack after starting the clonazepam that was prescribed for me because I could not sleep.
Fortunately the psychiatrist, he has already died, didn't diagnosed me depressed or anything else.
He said I needed therapy, psychoanalysis.
He had a psychiatric clinic and was very fond of drugs.
But I'am sure that if he was alive he would be appalled by what is happening and would be raising his voice.
He is a very famous psychiatrist in Brazil "Ulysses Vianna" is his name.
Unfortunately some psychiatrists are using his name after his death.
Google him.

Posted by: Ana at December 11, 2009 01:11 PM

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 AM

Laziness! 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
ROFL
LOL
LOL
LOL
.............LOL..............

Seriously I cannot stop laughing!
LOL

ROLF
ROFL
kkkkkkk"

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 AM
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