The history of antidepressants

Wikipedia:  A 2012 international review article states that the idea that antidepressants might contribute to suicide in depressed patients was first raised in 1958. For 30 years antidepressants were primarily used in severely depressed and often hospitalized patients. The issue of suicidality on selective serotonin reuptake inhibitors (SSRIs) became one of public concern with reports in 1990 that Prozac could lead to suicidality in patients. Fourteen years later, warning labels were put on antidepressants suggesting particular difficulties “during the early phase of treatment, during treatment discontinuation, and when the dose of treatment is being changed, and that treatment related risks may be present in patients being treated for syndromes other than depression, such as anxiety or smoking cessation.”

People under the age of 24 who suffer from depression are warned that the use of antidepressants could increase the risk of suicidal thoughts and behaviour. Federal health officials unveiled proposed changes to the labels on antidepressant drugs in December 2006 to warn people of this danger.  The FDA warns against the use of Paxil for children and teens depression in favor of Prozac.

SSRI prescriptions for children and adolescents decreased after U.S. and European regulatory agencies issued warnings about a possible suicide risk with antidepressant use in pediatric patients, and these decreases were associated with increases in suicide rates in children and adolescents in both the United States with a 14% increase, and 50% increase in the Netherlands.

A 2009 study showed increased risk of suicide after initiation, titration, and discontinuation of medication. A study of 159,810 users of either amytriptyline, fluoxetine, paroxetine or dothiepin found that the risk of suicidal behavior is increased in the first month after starting antidepressants, especially during the first 1 to 9 days.


One antidepressant, Prozac, recently generated a Newsweek cover story, leaped to the top of the drug charts, and then ran into a storm of controversy. Sales figures for August, September, and October 1990 show that more than 400,000 new prescriptions for Prozac are being written each month in the United States. Total sales in 1991 are expected to reach one billion dollars…

Antidepressants are very much in vogue, but they have been around for a long time. Elavil (amitriptyline) and Parnate (tranylcypromine), for example, have been in use for three decades. In 1984, thirty-four million prescriptions were written for antidepressants, placing them a distant second behind the minor tranquilizers; but the Prozac craze is narrowing the lead. More than two-thirds of antidepressant prescriptions are for women.

The great majority of antidepressant prescriptions are written by nonpsychiatric physicians. Psychiatrists, however, set the tone for the widespread use of these agents. Right now psychiatrists are advocating their use for a variety of disorders, from depression and anxiety to eating problems, premenstrual tension, phobias, and obsessions and compulsions. They have become a jack-of-all-trades drug. This in itself should warn us not to trust the claims being made…,8599,1895672,00.html

5/6/2009, Why Antidepressants Don’t Live Up to the Hype

But in the past few years, researchers have challenged the effectiveness of Prozac and other SSRIs in several studies. For instance, a review published in the Journal of Affective Disorders in February attributed 68% of the benefit from antidepressants to the placebo effect. Likewise, a paper published in PLoS Medicine a year earlier suggested that widely used SSRIs, including Prozac, Effexor and Paxil, offer no clinically significant benefit over placebos for patients with moderate or severe depression.

Now a major new study suggests that both critics and proponents might be right about SSRIs: the drugs can work, but they appear to work best for only a subset of depressed patients — those with a limited range of psychological problems. People whose depression is compounded with, say, substance abuse or a personality disorder may not get much help from SSRIs — which is unfortunate for the 45% to 60% of patients in the U.S. who have been diagnosed with a common mental disorder like depression and also meet the criteria for at least one other disorder, like substance abuse.

Data from the Center for Disease Control and Prevention from 2011 shows that antidepressants prescriptions increased by nearly 400 percent between the early 90’s and 2005-2008 in the United States. Antidepressants are the third most commonly prescribed medication in the US, used by roughly one in ten people over the age of 12…

In the wake of the FDA warning, SSRI’s were demonized, and SNRI’s, serotonin- norepinephrine re-uptake inhibitors, were advocated in their place. Now, a study published in the journal Pediatrics shows that SNRI’s are no more effective at preventing suicide than SSRI’s…

According to the CDC, less than one third of those on antidepressants have seen a mental health professional in the last year…

2/26/2008, The creation of the Prozac myth

In the 20 years since its launch, 40m people worldwide have taken the so-called wonder drug – but research revealed this week shows that Prozac, and similar antidepressants, are no more effective than a sugar pill. So how was the myth created? Psychoanalyst Darian Leader traces the irrepressible rise of the multibillion dollar depression industry, while others explore the clinical and cultural impact of Prozac, its perceived personal benefits – and sometimes terrible costs…

The new research, published in the Public Library of Science Journal, found that a placebo was just as effective as the drugs – excepting in some cases of severe depression, where it was not the drugs that did well, but the placebos that did worse…

The new negative results might seem to promise a change of direction. But they may just be the other side of the industry coin. What remains unchallenged is the diagnosis of depression itself. GPs diagnose it every minute of the day, celebrities reveal they suffer from it and soap opera characters wrestle with it. Yet 40 years ago depression was hardly anywhere. A tiny percentage of the population were deemed to suffer from it. So what happened?

These developments actually followed a surprising course. The story of depression cannot be dissociated from the story of its supposed remedies. And these, like nearly all psychotropic drugs, were not the result of targeted research, but of chance association. The first drugs had in fact been used as antihistamines, yet they seemed to have effects on mood, energy and anxiety…

Where depression had been rated at 50 per million in the early 60s, by the 90s this had jumped to 100,000. These remarkable changes coincided with the crisis in the market for minor tranquilisers such as Librium and Valium, prescribed for anxiety. As these widely used drugs were found to be highly addictive, it looked as if a substantial market was about to collapse…

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