Timoclea,
We have opposing views on this issue and it would be futile to debate.
I would only ask you to post the proof that ANY 'mental illness' is genetic. If you can't, then it would seem more appropriate/accurate to say that certain 'mental illnesses' are ASSUMED to be genetic; rather than to make a declarative statement- Another problem with scientist and researchers, they present their assumptions as if they were the truth. Run a biased 'study' and present their 'results' as fact.
There's a good article below that gives insight into the British attitude, which is contrary to what you suggested, and compares and contrasts the US and Britian. The latter much more conservative. You think the US has more people with genetic defects? Or more profit-driven greedy people offering the latest and greatest quick fix?
As my friend said the other day, "Maybe the fascist establishment wants children to be quiet and docile. The government might want to pathologize people with certain temperaments."
That may seem far-fetched to you since you are learned in the school of psychiatry, but many see this outrageous drugging of our children as a form of eugenics. Have you stopped to contemplate what our culture will look like in 20-40 years? Matrixville. Will the children in future generations be able to produce their own brain chemicals, or be dependent on a pill, because their parents and their parents took SSRIs and the ability to produce brain chemicals was 'bred' out of them. What might that be like? You do know that continued use will inhibit the body's ability to produce? It creates dependence.
When I address this issue, I am not attacking your choice to take psych drugs. I will not sit back and listen to anyone suggest that 'mental illnesses' are genetic and a pill will fix them, when there is NO scientific data to PROVE either.
http://society.guardian.co.uk/mentalhea ... 22,00.htmlDrugs for depressed children banned
The exception is Prozac, which is licensed for use in depressed children in the US. But the MHRA will warn that, at best, it helps only one child in 10.
Excellent database of related articles:
http://www.benzo.org.uk/ads.htmhttp://www.dallasnews.com/sharedcontent ... 04dnnatseatbelt.4be39.html
A 49 percent rise in the use of attention deficit/hyperactivity disorder drugs by children younger than 5 in the last three years contributed to a 23 percent increase in usage for all children.
"Behavioral medicines have eclipsed the other categories this year," said Dr. Robert Epstein, Medco's chief medical officer. Antibiotics still top the list of the most commonly used children's drugs, but parents are paying more for
behavioral drugs, such as stimulants or antidepressants, according to the analysis of drug use among 300,000 children.
The most startling change was a 369 percent increase in spending on attention deficit drugs for children younger than 5.
But the use of other behavioral drugs also jumped in the last three years. Antidepressant use rose 21 percent, and drugs for autism and behavior disorders jumped 71 percent, compared to a 4.3 percent rise in antibiotics.
http://www.denverpost.com/Stories/0,141 ... 61,00.htmlhttp://www.ahrp.orgUnder the guise of "screening for depression," a High School-based clinic in Denver operates much like a drug dispensing outpost for SSRI drug
manufacturers at taxpayer expense. The Denver Post reports that students who come in for a physical check up are "screened" for depression by use of a suggestive questionnaire. The students invariably leave the clinic with an
antidepressant drug prescription:
"One benefit is that the program offers students one-stop shopping. They can be diagnosed and treated and, in some cases, even prescribed antidepressants without leaving school."
http://www.philly.com/mld/philly/living ... 799.htm?1cThe use of antidepressants among children grew three- to tenfold between 1987 and 1996, data from various studies indicate, and a newer survey found a further 50 percent rise in prescriptions between 1998 and 2002. The explosion in antidepressant use occurred even though the vast majority of clinical trials
have failed to prove that the medicines help depressed children.
The spike in prescriptions over the last five years has been especially sharp among children younger than 6, even though there is virtually no clinical trial data on these youngest patients.
http://www.canada.com/edmonton/edmonton ... 9bd2-7faf-4bff-9214-b935936948ed
Children who took a placebo showed strong improvement and those who took the real drugs didn't do significantly better. Two small studies found no advantage for the antidepressants over the placebo.
None of the drugs has been approved in Canada for anyone under 18, but doctors are prescribing them "off-label" -- which they are allowed to do -- to children as young as three for depression, anxiety, social phobia, attention problems and obsessive-compulsive disorder.
http://www.motherjones.com/news/feature ... rders.htmlDisorders Made to Order
Word of the hidden epidemic began spreading in the spring of 2001. Local newscasts around the country reported that as many as 10 million Americans suffered from an unrecognized disease. Viewers were urged to watch for the symptoms: restlessness, fatigue, irritability, muscle tension, nausea, diarrhea, and sweating, among others. Many of the segments featured sound bites from Sonja Burkett, a patient who'd finally received treatment after two years trapped at home by the illness, and from Dr. Jack Gorman, an esteemed psychiatrist at Columbia University. Their testimonials were intercut with peaceful images of a woman playing with a bird, and another woman taking pills.
The timing of the media frenzy was no accident. On April 16, 2001, the U.S. Food and Drug Administration (FDA) had approved the antidepressant Paxil, made by British pharmaceutical giant GlaxoSmithKline, for the treatment of generalized anxiety disorder. But GAD was a little-known ailment; according to a 1989 study, as few as 1.2 percent of the population merited the diagnosis in any given year. If GlaxoSmithKline hoped to capitalize on Paxil's new indication, it would have to raise GAD's profile.
New York Times, May 25, 2004
COMMENTARY
Two Countries, Two Views on Antidepressants
By SALLY SATEL, M.D.
Excerpts:
Where you stand depends on where you sit."
This saying usually applies to political issues, but it is also relevant to medicine. Consider the current controversy over the prescription of
antidepressants to children, and the different reactions of British and American regulators and physicians.
After examining a series of 13 clinical trials including more than 2,300 children and adolescents, drug regulators in Britain strongly urged doctors not to use certain antidepressants, among them Paxil, Luvox and Zoloft, for childhood depression because the risk of self-harm and suicidal thoughts was
judged to be too great.
In the United States, however, officials at the Food and Drug Administration, relying on the same clinical data, have yet to make up their minds on the safety issue, and doctors here continue to prescribe antidepressants to
children in volume.
In Britain, 40,000 patients under 19 years old are taking antidepressants, mostly those in the class known as selective serotonin reuptake inhibitors, or S.S.R.I.'s, according to the Medicines and Healthcare Products Regulatory
Agency. This compares with estimates of one million children and adolescents taking
such medication in this country.
Adjusted for population, that means that American doctors are five times as likely as British doctors to prescribe antidepressants to children. Most British physicians consider psychotherapy, not drugs, to be first-line
treatment for childhood and adolescent depression.
Why the different approaches? Much of the answer lies in contrasting medical cultures. "The British think we overdiagnose and overtreat children," said Dr. David G. Fassler, a child psychiatrist at the University of Vermont College
of Medicine.
Prof. Frank Furedi, a sociologist at the University of Kent in England, agreed. "We are more cautious about medicalizing the problems of children," he said.
The same phenomenon can be seen in the treatment of attention deficit hyperactivity disorder. Despite clear benefits, physicians in Britain were slow to use Ritalin and other stimulants, in part because hyperactivity itself was
considered very rare until well into the 1980's.
Meanwhile, American physicians were diagnosing hyperactivity in children in the late 1960's, and regarded stimulants as standard frontline treatment.
Americans' greater faith in medication in these situations may reflect an enthusiasm about technological progress.
"We in Britain are more skeptical of advances in general," said Dr. David Healy, a psychiatrist at the University of Wales College of Medicine and a critic of antidepressant use in children. "For example, it took us longer to adopt imaging technology like CAT scans and M.R.I.'s as routine."
Unquestionably, antidepressants have saved countless lives, but they also reinforce the existence of the very disease they are meant to treat. As Dr. Healy argued in his new book, "Let Them Eat Prozac," when drugs are developed for a
specific condition, rather than for a general state like stress, pharmaceutical companies end up marketing mental illnesses, not just pills.
"It is no coincidence," he said, "that an explosive increase in diagnoses of depressive illness followed the development of S.S.R.I.'s."
In the United States, the tendency to sell diagnoses gets an extra boost from direct-to-consumer advertising, which is banned in Britain.
In addition, patients in Britain have less choice among medications than they do in the United States. As Dr. Steven A. Schroeder, a former president of the Robert Wood Johnson Foundation, who once studied medicine in London,
said, "Patients have less power in Britain than they do here."
Britain's National Health Service determines the medications that the government will purchase and that physicians will prescribe. Americans have more autonomy in choosing doctors and in negotiating treatments because they pay, either directly or through insurance.
The British, Dr. Schroeder said, seem to have a more modest sense of entitlement. "There, the population is less demanding of treatment for
behavioral and other problems," he said, "and are less likely to seek help for such things
as" attention deficit disorder, chronic fatigue and impotence.
At the same time, in the United States, managed care, with its strong emphasis on cost-saving, creates its own demands. Pills are cheaper than
psychotherapy, and so they are more popular.
"Initially, managed-care companies promoted psychopharmacology for depressed adults," Dr. Fassler said. "Now there's more pressure to treat children and adolescents with medication. And more and more of the prescribing is being
done by pediatricians as opposed to child and adolescent psychiatrists."
All these factors help explain why British health regulators have a lower tolerance for risk, especially when benefits may be minimal.
Practically no one disputes that antidepressants are only minimally effective in children. Some children appear to be helped enormously - hence the many doctors who swear by these medications - but the studies indicate that on average, the advantage over placebo treatment is small. (The British exempted Prozac from their warnings, because the regulators concluded that there was more evidence for its effectiveness and safety in children).
The important issue, then, is whether antidepressants truly worsen the potential for suicide. The F.D.A. says it does not yet know the answer because in the clinical trials, minor episodes of self-harm and more serious episodes
were lumped together under the umbrella term "possibly suicide-related event."
No distinction, for example, was made between young patients who took large overdoses of the drugs or who tried to hang themselves, and those who made superficial scratches on their arms. There were no actual suicides in the studies.
The F.D.A. has asked researchers at Columbia to reclassify the cases of self-harm to clarify their nature. In the meantime, the agency has issued strong warnings to doctors to closely monitor patients they are treating with these
medications. This summer, the agency will weigh the potential risks of the drugs against the clinical benefits and presumably reach some conclusion.
In comparison, the British, through their different prism, see little need to pursue the question. Lacking a strong cultural investment in antidepressants, they have already decided that any risk of self-harm is too high.
Sally Satel is a psychiatrist and a resident scholar at the American Enterprise Institute.
