Update on controversies about mental health medications

Update on controversies about mental health medications

The New York Times published an article, “Drugs, Greed and a Dead Boy,” on 11-4-15.  It is written by Nicholas Kristof, who has won two Pulitzer Prizes for his reporting.  The article discusses a recent book, “Overmedicated and Undertreated,” by Steven Francesco, who is described as a longtime pharmacy industry executive.  Mr. Francesco’s book is a memoir of raising his troubled son, Andrew.

Obviously, they had a bad outcome, with Andrew dying from a complication from Seroquel. Mr. Francesco advocates that, even as an industry insider, there are serious problems with how the pharmacy industry is marketing mental health medications to kids, especially off-label prescribing – and 80% of mental health medications prescribed to children is prescribed off label.

Courtesy of the ever-prolific Ken Pope and his posting service, the Journal of Psychiatry published an online article, “The Sequential Integration of Pharmacotherapy and Psychotherapy in the Treatment of Major Depressive Disorder: A Meta-Analysis of the Sequential Model and a Critical Review of the Literature.”  If you do not have a subscription, as is probably the case, you can purchase the article for $35.  The most interesting finding described in the Abstract, which is free to view, is probably the most important finding: “Patients randomly assigned to CBT who had antidepressants tapered and discontinued were significantly less likely to experience relapse/recurrence compared with those assigned to either clinical management or continuation of antidepressant medication”

And, again courtesy of Ken Pope, the Journal of Clinical Psychiatry published “Antidepressant Use and Lifetime History of Mental Disorders in a Community Sample: Results From the Baltimore Epidemiologic Catchment Area Study.”  Among the results: “Among antidepressant users, 69% never met criteria for major depressive disorder (MDD); and 38% never met criteria for MDD.”

The authors conclude: “Many individuals who are prescribed and use antidepressant medications may not have met criteria for mental disorders. Our data indicate that antidepressants are commonly used in the absence of clear evidence-based indications.”

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