Metrick: Is treatment worse than depression?

It seems the pharmaceutical industry may have to add another side effect to the long list of warnings that accompanies the stable of antidepressant drugs it has been hawking for the past dozen years or so.

The ads touting these drugs as the latest wonder cures for depression or anxiety appear repeatedly each day on television. The commercials always end with a standard disclaimer advising of the possible side effects of their use: nausea, dry mouth, sleeplessness, decreased libido, constipation, diarrhea, loss of appetite, etc.

Now the companies might just be warning that the use of an antidepressant may also increase the risk of suicide.

The U.S. Food and Drug Administration on Monday asked drug makers to include detailed warnings alerting doctors and consumers to watch for suicidal tendencies, agitation and hostility in patients using the drugs.

The new warnings cover Prozac, Paxil, Zoloft, Effexor, Celexa, Lexapro and Luvox – known as seratonin reuptake inhibitors (SSRIs) – as well as Wellbutrin, Serzone and Remeron, which are a different class of drugs.

The FDA’s move comes on the heels of an emotionally charged public hearing in February in which dozens of distraught family members testified that they blamed the drugs for the suicides or suicide attempts of their loved ones.

Unfortunately, it’s uncertain what effect the FDA ruling will have on drug makers, who have not said whether they will comply with the agency’s request. Vera Hassner Sharav, president of the New York-based patient advocacy group, the Alliance for Human Research, told me that she sees the ruling as "equivocating and ambiguous."

"It gives a warning but says, ‘We don’t have the evidence.’ Now, if you don’t have the evidence that the drugs are to blame, what’s the point of putting the warnings on them?" she said. "The FDA has had this data in their files for years – either they didn’t warn the public in order to shield the industry, or they’re incompetent."

Dozens of lawsuits have been filed against drug makers by families of patients who committed or attempted suicide while taking antidepressants. For its part, the FDA says it is reviewing 25 clinical trials of the drugs on children and will release its findings this summer.

The British government last year banned the use of all such drugs except Prozac for the treatment of depression in children. But the problem is not confined to adolescent patients.

Independent studies have suggested a link between antidepressants and suicide since 1990, when Harvard researcher Dr. Martin Teicher reported that an internal Eli Lily study of adults showed "a greater incidence of suicide attempts in people in the study receiving Prozac than in people receiving placebo ..."

The big drug companies have labeled those kinds of studies as "proprietary" and have refused to release the findings of such reports. But they’ve been very forthcoming in releasing research results that show no links between antidepressants and an increased risk of suicide.

Remember, these antidepressant medications have become a giant cash cow for the pharmaceutical industry, with as many as 30 million Americans estimated to be taking one or another of them. Heck, you can even visit any number of online pharmacies for a free medical consultation with a doctor and have your prescription shipped to you right away.

Of course, as one of the service representatives for prescriptiondrugs.com told me Wednesday over the telephone, you do have to answer the doctor’s questions "truthfully."

Depression is a very serious and debilitating disease. And antidepressants can play a vital role in helping people overcome it. But the rush to overprescribe these drugs for a vast array of ailments is quite disturbing, especially when the full range of risks that accompany them seem to still remain pretty much uncertain.

It’s part of a syndrome that can be thought of as the "Drugging of America," a growing trend reminiscent of the "Brave New World" described by Aldous Huxley in his novel of the same name. The residents of Huxley’s future world were freed from the anxieties, cares and conscience of their present-day counterparts through the use of the drug "Soma," which brought the phrase, "Don’t worry, be happy" to a whole new level.

Better living through chemistry, indeed.