Antidepressants: Physical and Psychological Effects

Here is the list of Selective Serotonin Re-uptake Inhibitors (SSRIs) that appears in the book Medication Madness that I mentioned in my previous post.

Antipressants 

Celexa (citalopram)
Lexapro (escitalopram)
Luvox (fluvoxamirie)
Prozac and Serafem (fluoxetine)
Paxil (paroxetine)
Zoloft (sertraline) 

Other Newer Antidepressants 

Cymbalta (duloxetine)
Effexor (venlafaxine)
Remeron (mirtazapine)
Symbyax (Zyprexa and Prozac combined)
Wellbutrin and Zyban (bupropion) 

The older antidepressants belong to a class of compounds known as Tricyclic Antidepressants (TCAs) described by Wikipedia as:

... a class of medications that are used primarily as antidepressants. TCAs were discovered in the early 1950s and were marketed later in the decade.[1] They are named after their chemical structure, which contains three rings of atoms. Tetracyclic antidepressants (TeCAs), which contain four rings of atoms, are a closely related group of antidepressant compounds. Although TCAs are sometimes prescribed for depressive disorders, they have been largely replaced in clinical use in most parts of the world by newer antidepressants such as selective serotonin reuptake inhibitors (SSRIs), serotonin–norepinephrine reuptake inhibitors (SNRIs) and norepinephrine reuptake inhibitors (NRIs).

Older Antidepressants 

Anafranil (clomipramine)
Asendin (loxapine)
Elavil (amitriptyline)
Parnate (tranylcypromine)
Tofranil (imipramine)
Vivactil (protriptyline)
Surmontil (trimipramine)

I was reading this article from the Mail Online dated 16th March 2019 in which the antidepressant sertraline is under discussion. The article begins:

Liam Batten was, according to his devoted family, a gentle giant with a wicked sense of humour and a prodigious talent for technology. Despite the agoraphobia and anxiety that had plagued him since 2012 and left him afraid to leave his home, the 24-year-old managed to live a relatively full life after making friends around the world through the popular YouTube video game channels he ran. He loved music and occasionally, on good days, rode his bicycle. For many months, Liam had been taking sertraline, a common antidepressant and part of a group of drugs known as SSRIs, or selective serotonin re-uptake inhibitors. It is among the most commonly prescribed medicines in the world and has been used for nearly 30 years to treat anxiety and depression. In July 2018, Liam had put on weight and his dose of sertraline was doubled by his GP – although it was still within the maximum recommended level.  But nine days later, Liam was found dead in his bed after suffering a cardiac arrest in his sleep. There were no warning signs; Liam had no previously diagnosed heart condition or symptoms.

The following response from a "health professional" is typical and justifies the use of antidepressants on the grounds that the benefits outweigh the dangers.

With millions of people taking SSRIs, you will see incredibly rare, one-in-a-million side effects. But no drug is risk-free.

The article goes on to state that:

Sertraline has been available since 1990 and works by raising the levels of serotonin, a brain chemical linked to mood. Nearly 13 million prescriptions for the drug were dispensed in England alone in 2017 – ten times more than in 2007.

The figure of 13 million prescriptions, just for that particular brand of antidepressant, is disturbing. Wikipedia says that the drug is now generic and thus cheap. Previously, it was sold under the brand name Zoloft. As for "one-in-a-million side effects", the drugs labelling warns of:

... palpitations as a commonly reported side effect in up to one in ten people. It also says one in 100 may experience a ‘fast heartbeat’, and one in 1,000 could have a ‘heart attack, slow heartbeat, heart problem or poor circulation’. 

The self-confessed odds of side effects involving the heart are clearly more than one-in-a-million. Returning to the news article, the takeaway is that antidepressants can have very serious physiological effects, even on seemingly young and physically healthy adults. The adverse psychological effects are well documented in the book Medication Madness.

The dangerous psychological effects of antidepressants came to mind in the case of the recent horrific murder in Brisbane of a mother and her three children by the children's father who committed suicide. Here is a link to an article in the Brisbane Times. The article states that:

Police investigating the murder-suicide in Camp Hill have converged on Rowan Baxter's home, a day after he killed his estranged wife, Hannah, and their three children. Detectives hope his house at Carindale, in Brisbane's east, will give Ms Baxter's family some answers over an act that "beggars belief", according to senior police. 

Indeed the murders are so horrific that they are reminiscent of the types of incidents described in Medication Madness. So far there has been no mention made as to whether the children's father was on medication or not. The fact that the taking of antidepressants is so commonplace may mean that the medication is never even mentioned as a possible contributing factor in the violence. If he was taking medication for depression, then typically it will be the depression that is blamed for the violence and not the medication that may have exacerbated it. If alcohol or illegal drugs were involved as well then the waters are muddied even further.

So far there has not been any mention of medication being taken by the perpetrator. He was involved in counselling and a friend of his is reported as saying:

"Obviously the guy was suffering extreme depression and we really want to try and help men and prevent these things from happening in the future. We have got to identify the triggers that occur."

Well, if the perpetrator was taking antidepressants, then it could well be that a failure to take his medication or a change in the dosage may have been the trigger. Here is a link to a study that suggested antidepressants were linked to murders and murderous thoughts.