Tag Archives: psychiatrists

SSRIs anti-depressants

Here we begin our look at antidepressants with a guide to the most popular type of drug prescribed for this condition – SSRIs.

SSRIs What are they?

The most widely prescribed antidepressants in the UK are selective serotonin re-uptake inhibitors – commonly known as SSRIs. More than ten million prescriptions were filled for SSRIs in the UK in 2000.

SSRIs include Prozac, Seroxat, and Lustral. They were developed in the late 1980s and have been prescribed since the beginning of the 1990s.

Who are they suitable for?

SSRIs are mainly prescribed for depression but they can also help in other conditions such as some forms of anxiety disorder, such as obsessive compulsive disorder and some eating disorders like bulimia.

SSRIs only work on the brain chemical serotonin. They act by blocking the reabsorption of serotonin in the brain.

Dr Tony Cleare, an expert in the treatment of depression at the Institute of Psychiatry in London, says, ‘Serotonin is released by the brain and after it has been used by the cells, it is ‘recycled’. SSRIs stop the recycling process so there is more of the chemical in the brain.’

This process boosts your serotonin levels, helping to beat depression.

Dr Cleare says one reason SSRIs are so heavily prescribed is because many doctors believe they have fewer side effects compared to older antidepressant drugs and the side effects they do have are easier to live with. But this is currently an area of controversy among the medical profession.

Doctors also favour them as they do not have as many negative interactions with other drugs as the older antidepressants.

What are the side effects?

There is a huge debate currently raging over whether SSRIs can actually make depression even worse, triggering suicidal feelings.

Dr David Healy, a psycho-pharmacologist at the University of Wales College of Medicine, has highlighted the concerns about the side effects of SSRIs and the extent to which people can be addicted to them.

He has also highlighted concerns that Seroxat, an SSRI, may cause suicidal feelings, a claim denied by the manufacturers.

Depression

Depression

Dr Tony Cleare, an expert in the treatment of depression at the Institute of Psychiatry in London, says when people are depressed, they have little motivation to do anything, which also takes away the motivation to kill themselves.


Once they start taking antidepressants, they regain their motivation but may not yet have beaten the depression, leading them to commit suicide.

Experts are also divided over whether SSRIs are habit forming. The Royal College of Psychiatrists say there is no evidence that antidepressants cause dependency, but reports on SSRIs now contradict this view.

A study in the Journal of Risk and Safety in Medicine in 1998 raised a number of concerns over dependency associated with SSRIs. Dr Healy from the University of Wales College of Medicine has also found evidence in trials that non-depressed people develop withdrawal symptoms when they stop taking the drug.

A group of more than 60 people in the UK who say they have become hooked on the SSRI Prozac are now trying to decide if they can take legal action against the manufacturers. They say the pharmaceutical company failed to warn doctors that it could create dependency.

Although patient information and guidelines for taking SSRIs warn that patients may become more depressed and feel like attempting suicide at the beginning of their treatment, the mental health charity Mind feels these warnings are not adequate.

The Medicines Control Agency – the government body that makes sure all medicines on the UK market reach certain safety standards – recently said it would consider examining the issue of withdrawal symptoms ‘in the near future’.

Other side effects of SSRIs include nausea, vomiting, anorexia with weight loss, constipation nervousness, anxiety and loss of libido. Talk to your doctor if you are worried about the side effects of your treatment.

Tackling obesity in the UK

Organisations representing nearly every doctor in the UK have united in a single campaign to tackle rising levels of obesity.

The campaign will start by reviewing the case for fat taxes, promoting exercise, restricting food advertising and other measures.

They criticised sponsorship of the Olympics by fast food firms as sending “the wrong message”.

The Department of Health said it was taking action to combat obesity.

A spokesman for the campaign, Prof Terence Stephenson, said the government’s current strategy of “partnering” food firms in order to tackle obesity “might be seen as counter-intuitive”.

Almost a quarter of adults in the UK are thought to be obese and some predictions suggest half of children will be obese or overweight by 2020, with Prof Stephenson saying they were “storing up problems for the future”.

“This is a huge problem for the UK. It’s much bigger than HIV was, much bigger than swine flu.”

The Royal Medical Colleges and Faculties represent some 200,000 doctors across all specialities, from GPs to paediatricians and surgeons to psychiatrists.

They have described their campaign as an “unprecedented” union – as part of the Academy of Medical Royal Colleges (AoMRC) – on an issue of public health.

AoMRC spokesman Prof Stephenson said: “Every doctor I’ve ever spoken to feels obesity is a huge problem for the UK population.”

He said a united voice had “more of a chance” of tacking obesity.

The first phase of the campaign will try to find out what works. It will review evidence for diets, exercise, taxation, minimum pricing, changing advertising and food labelling, which medical procedures work and how children are educated.

Recommendations could target food companies who sponsor major sporting events – such as the Olympics – and fast food outlets which operate close to schools.

Prof Stephenson said allowing companies such as Coca-Cola and McDonalds to sponsor the London 2012 Olympics “sends the wrong message.”

“They clearly wouldn’t be spending the money if they didn’t benefit from being associated with successful athletes,” he said.

A McDonald’s spokesperson said the Olympics was “the biggest catering operation in the world,” adding: “Sponsorship is essential to the successful staging of the Olympics.”

Prof Stephenson told the BBC a campaign to persuade people to eat healthy food might work in the same way as the current anti-smoking drive.

Obesity

Obesity

There have been heavy restrictions on advertising smoking in the UK, on TV and at sports events, and a consultation is being launched on whether cigarettes should be sold in plain packaging.

“It’s much more likely, as in smoking, that the solution will lie in changing the environments, changing the way people are exposed to marketing, advertising and pressures to buy these kinds of foods,” he said.

“Another aspect of that is the taxation of cigarettes to deter people from buying them – that seems something we should look at in relation to food,” he said.


However, Prof Stephenson said he did not think society could simply exercise its way out of the problem of obesity.

“My own personal experience is you have to exercise a huge amount to lose weight, I would have to run on a treadmill at maximum speed for an hour to counter-effect the calories from one or two Mars bars.

“Most people in modern life just don’t have the time in our lives to spend several hours a day exercising.”

These are not the final recommendations of the doctors groups. The plan is to spend the next three months gathering the evidence.

The Department of Health said it welcomed the colleges’ “emphasis on obesity as this is one of our key public health priorities,” and highlighted the change4life campaign to encourage healthier living, and the “responsibility pledge” by some food and drink companies to improve public health.

A spokesman added: “We are committed to identifying the best possible evidence of what works in tackling obesity which everyone across the country has a role to play in and we look forward to seeing the evidence of the Royal Colleges inquiry.”

Prof Stephenson said there was nothing wrong with the government working with food manufacturers to improve public health “but to rely on the industry seems counterintuitive”.

Prof Sir Neil Douglas, chair of the Academy of Royal Medical Colleges, said: “This won’t be just another report that sits on the shelf and gathers dust. It will form the bedrock of our ongoing campaigning activity.

“We are absolutely determined to push for whatever changes need to happen to make real progress in tackling obesity – which is why we’re casting the net wide to get input from a range of organisations and individuals.”