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Are anti-depressants safe? Spain joins biggest-ever global study
11/10/2019
A GLOBAL study on anti-depressant use in which Spain took part has shown that these highly-prescribed drugs are, in fact, safe, even long-term.
Published in the journal JAMA Psychiatry, the investigation is 'without doubt the most conclusive' into the long-term safety of various types of anti-depressants, including tricyclic and SSRI medication, according to Dr Eduard Vieta, scientific director of Spain's Mental Health Research Centre (CIBERSAM).
“It shows that, properly used, they provide much greater benefit than risk,” Dr Vieta reveals.
A total of 4,471 case studies and 252 full-text articles with data from 1,012 individual effect-size estimates were used in 45 meta-analyses – or reviews of existing research reports – albeit some of the newer drugs available, such as the Danish-created Vortioxetine, retailed as Brintellix, did not have enough information to hand at present.
But the other most popular types, such as Prozac, Seroxat and Sertraline are said to be 'very safe' with 'no convincing evidence' of major health risks.
According to the JAMA Psychiatry report, typical adverse effects include an increased suicide risk in patients aged 18 and under, pre-term births or autism spectrum disorders in children whose mothers or fathers had taken SSRIs before or during conception or pregnancy, sexual dysfunction, bone fractures caused by acquired osteoporosis, and upper gastrointestinal bleeding.
In most cases, a probability rating of 5% - considered the minimum for evidence to be 'significant' in medical and psychological, among other scientific, studies – was not reached, and many of the serious adverse effects were found to have been caused by the conditions the medications were prescribed for rather than the drugs themselves.
For example, sexual dysfunction may be a result of depression itself and merely aggravated by the effects of anti-depressants, and suicide risk may already be present, but the 'clarity of mind' created by taking these medications may enable those with suicidal thoughts to 'plan' their attempts properly.
No evidence was found for anti-depressants actually preventing suicide, however.
Children with autism spectrum disorders born to parents on anti-depressants were found to be low enough in number that the risk can be considered insignificant, although in some cases, the patient taking anti-depressant medication may already have an underlying, possibly undiagnosed, autism spectrum disorder which is simply inherited by their offspring.
As many as one in 10 users of anti-depressants report gastrointestinal disorders such as nausea, diarrhoea, acid, and cramps, as well as excessive yawning and tiredness, insomnia when doses are increased, restlessness and muscular contractions, but in the vast majority of cases these wear off after a few weeks and the digestion issues can often be prevented by not taking the drugs on an empty stomach.
One of the worst-tolerated 'normal' side-effects of the newly-released Vortioxetine reported is generalised itching, either upon initial prescription or upon dosage increase, but again, this usually ceases after the first one to three weeks.
The vast majority of 'normal' or 'expected' anti-depressant side-effects can be successfully treated while they last if the patient finds them intolerable.
Dr Evangelos Evangelou, epidemiologist at Greece's Ioannina University and at Imperial College London – the main author of the research, which involved scientists from all over Europe, the USA, Canada and Asia – said: “Although we have shown that anti-depressants are safe, we need to bear in mind that adverse effects need to be clinically controlled and monitored during treatment.”
Earlier, but recent, research has shown that up to one in four people worldwide suffer from the type of psychiatric conditions for which anti-depressants would normally be prescribed – anxiety, panic attacks, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), major (circumstantial, temporary and very severe) depression, dysthymic (chronic, but milder and usually hereditary) depression, bipolar (formerly 'manic') depression, and bulimia and other eating disorders – and that its prevalence is similar in almost every country, albeit higher than average in third-world women.
At present, it is thought that between 8% and 10% of US residents take at least one type of anti-depressant, although the actual clinical need for them could be higher given that, in the United States, income typically dictates access to healthcare.
Overall, anti-depressants are the third-most prescribed type of medications on earth.
Related Topics
A GLOBAL study on anti-depressant use in which Spain took part has shown that these highly-prescribed drugs are, in fact, safe, even long-term.
Published in the journal JAMA Psychiatry, the investigation is 'without doubt the most conclusive' into the long-term safety of various types of anti-depressants, including tricyclic and SSRI medication, according to Dr Eduard Vieta, scientific director of Spain's Mental Health Research Centre (CIBERSAM).
“It shows that, properly used, they provide much greater benefit than risk,” Dr Vieta reveals.
A total of 4,471 case studies and 252 full-text articles with data from 1,012 individual effect-size estimates were used in 45 meta-analyses – or reviews of existing research reports – albeit some of the newer drugs available, such as the Danish-created Vortioxetine, retailed as Brintellix, did not have enough information to hand at present.
But the other most popular types, such as Prozac, Seroxat and Sertraline are said to be 'very safe' with 'no convincing evidence' of major health risks.
According to the JAMA Psychiatry report, typical adverse effects include an increased suicide risk in patients aged 18 and under, pre-term births or autism spectrum disorders in children whose mothers or fathers had taken SSRIs before or during conception or pregnancy, sexual dysfunction, bone fractures caused by acquired osteoporosis, and upper gastrointestinal bleeding.
In most cases, a probability rating of 5% - considered the minimum for evidence to be 'significant' in medical and psychological, among other scientific, studies – was not reached, and many of the serious adverse effects were found to have been caused by the conditions the medications were prescribed for rather than the drugs themselves.
For example, sexual dysfunction may be a result of depression itself and merely aggravated by the effects of anti-depressants, and suicide risk may already be present, but the 'clarity of mind' created by taking these medications may enable those with suicidal thoughts to 'plan' their attempts properly.
No evidence was found for anti-depressants actually preventing suicide, however.
Children with autism spectrum disorders born to parents on anti-depressants were found to be low enough in number that the risk can be considered insignificant, although in some cases, the patient taking anti-depressant medication may already have an underlying, possibly undiagnosed, autism spectrum disorder which is simply inherited by their offspring.
As many as one in 10 users of anti-depressants report gastrointestinal disorders such as nausea, diarrhoea, acid, and cramps, as well as excessive yawning and tiredness, insomnia when doses are increased, restlessness and muscular contractions, but in the vast majority of cases these wear off after a few weeks and the digestion issues can often be prevented by not taking the drugs on an empty stomach.
One of the worst-tolerated 'normal' side-effects of the newly-released Vortioxetine reported is generalised itching, either upon initial prescription or upon dosage increase, but again, this usually ceases after the first one to three weeks.
The vast majority of 'normal' or 'expected' anti-depressant side-effects can be successfully treated while they last if the patient finds them intolerable.
Dr Evangelos Evangelou, epidemiologist at Greece's Ioannina University and at Imperial College London – the main author of the research, which involved scientists from all over Europe, the USA, Canada and Asia – said: “Although we have shown that anti-depressants are safe, we need to bear in mind that adverse effects need to be clinically controlled and monitored during treatment.”
Earlier, but recent, research has shown that up to one in four people worldwide suffer from the type of psychiatric conditions for which anti-depressants would normally be prescribed – anxiety, panic attacks, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), major (circumstantial, temporary and very severe) depression, dysthymic (chronic, but milder and usually hereditary) depression, bipolar (formerly 'manic') depression, and bulimia and other eating disorders – and that its prevalence is similar in almost every country, albeit higher than average in third-world women.
At present, it is thought that between 8% and 10% of US residents take at least one type of anti-depressant, although the actual clinical need for them could be higher given that, in the United States, income typically dictates access to healthcare.
Overall, anti-depressants are the third-most prescribed type of medications on earth.
Related Topics
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