Latest news with #Prozac
Telegraph
01-08-2025
- Health
- Telegraph
Are people's lives really more stressful than they were 30 years ago?
It may be, as recently reported in this paper, that many feel the current (alleged) mental health crisis to be 'overblown', but there must be something seriously amiss when, as the latest figures reveal, 8.6 million adults in England now take antidepressants. Almost more extraordinary still, this is twice as many as a decade ago and eight times more than back in the 1990s. Certainly much has changed over the past 30 years, not necessarily for the better, but people's lives can scarcely have become so much more stressful as to trigger an epidemic of gloom and despondency. This leaves two possible explanations for that eightfold rise in numbers. Either doctors have become much more diligent in seeking out and treating those suffering from depression, who were previously overlooked. Or more probably, this is yet a further instance of the phenomenon of medicalisation – in this case attaching a psychiatric label to the emotional state of unhappiness which is indeed common enough. The most commonly prescribed class of antidepressants, the SSRIs (such as Prozac) are, as many will know, psycho-stimulants boosting the levels of the neurotransmitter serotonin in the brain. While they are certainly effective in improving the mood of the truly depressed and the legions of the unhappy alike, they will also inevitably be exposed to the hazards of their potential adverse effects, highlighted by the current, acrimonious controversy over their prevalence and severity. Put (very) simply, serotonin serves multifarious functions besides its role in influencing mood. In the brain it is involved in memory, pain perception and sexual pleasure, as well as propagating the nerve impulses controlling the rate and contractility of the heart muscle and the motility of the gut. Prolonged stimulation of those serotonin receptors with SSRIs necessarily alters their sensitivity, predisposing, when the time comes to discontinue them, to a withdrawal syndrome referred to by the mnemonic FINISH – flu-like symptoms, insomnia, nausea, imbalance, sensory disturbance and hyper-arousal. Or as one woman described it more bluntly, 'physical and emotional turmoil, dizziness, exhaustion, electric shock sensations and suicidal thoughts'. Organisations such as the Royal College of Psychiatrists maintained this withdrawal syndrome to be 'usually mild, resolving within a couple of weeks'. This complacency was challenged successfully back in 2019 when it emerged that, on the contrary, more than half deemed their symptoms 'severe' persisting in some for three months or more. Not so, according to researchers at King's College London last month who maintained their interpretation of the relevant evidence suggest the symptoms 'cannot be judged as significant' – a claim that critics argue 'could cause considerable harm'. And so the dispute rumbles on though the current state of uncertainty only emphasises the folly of that upward spiral in prescribing these potent drugs so insouciantly to so many. The best remedy for nosebleeds The nuisance of a nosebleed is usually readily terminated by pinching the nose between finger and thumb for 15 minutes. Simpler still, for those in whom they are recurrent is a swimmer's nose clip that can be kept in place for as long as is necessary 'does not cause the finger aching associated with manual compression and is equally effective in children and adults,' suggests Phillip Turner, a casualty doctor. Better certainly than the traditional 'home remedy' of dangling a set of cold keys down the back of the neck – though a correspondent to The New Scientist some time ago suggested this might terminate the bleeding by inducing a reflex constriction of the blood vessels of the nasal lining. Improbable, one might think but subsequently confirmed by researchers at the University of Dresden. Investigating the effect of applying an ice pack to the back of the neck they found, sure enough, this resulted in a marked diminution in blood flow through the nasal blood vessels most susceptible to spontaneous bleeding.
Yahoo
31-07-2025
- Health
- Yahoo
How FDA panelists casting doubt on antidepressant use during pregnancy could lead to devastating outcomes for mothers
At a meeting held by the Food and Drug Administration on July 21, 2025, a panel convened by the agency cast doubt on the safety of antidepressant medications called selective serotonin reuptake inhibitors, or SSRIs, in pregnancy. Panel members discussed adding a so-called black box warning to the drugs – which the agency uses to indicate severe or life-threatening side effects – about the risk they pose to developing fetuses. Some of the panelists who attended had a history of expressing deep skepticism on antidepressants. SSRIs include drugs like Prozac and Zoloft and are the most commonly used medicines for treating clinical depression. They are considered the first-line medications for treating depression in pregnancy, with approximately 5% to 6% of North American women taking an SSRI during pregnancy. We are a psychologist certified in perinatal mental health and a reproductive psychiatrist and neuroscientist who studies female hormones and drug treatments for depression. We are concerned that many claims made at the meeting about the dangers of those drugs contradict decades of research evidence showing that antidepressant use during pregnancy is low risk when compared with the dangers of mental illness. As clinicians, we have front-row seats to the maternal mental health crisis in the U.S. Mental illness, including suicide and overdose, is the leading cause of maternal deaths. Like all drugs, SSRIs carry both risks and benefits. But research shows that the benefits to pregnant patients outweigh the risks of the SSRIs, as well as the risks of untreated depression. The panel did not address the safety of SSRIs following delivery, but numerous studies show that taking SSRI antidepressants while breastfeeding is low risk, usually producing low to undetectable drug levels in infants. The biology of maternal brain health Pregnancy and the months following childbirth are characterized by so many emotional, psychological and physical changes that the transition to motherhood has a specific name: matrescence. During matrescence, the brain changes rapidly as it prepares to efficiently take care of a baby. The capacity for change within the brain is known as 'plasticity.' Enhanced plasticity during pregnancy and the postpartum period is what allows the maternal brain to become better at attuning to and carrying out the tasks of motherhood. For example, research indicates that during this period, the brain is primed to respond to baby-related stimuli and improve a mother's ability to regulate her emotions. These brain shifts also act as a mental buffer against aging and stress in the long term. On the flip side, these rapid brain changes, fueled by hormonal shifts, can make people especially vulnerable to the risk of mental illness during and after pregnancy. For women who have a prior history of depression, the risk is even greater. Clinical depression interferes with brain plasticity, such that the brain becomes 'stuck' in patterns of negative thoughts, emotions and behaviors. This leads to impairment in brain functions that are essential to motherhood. New mothers with depression have decreased brain activity in regions responsible for motivation, regulation of emotion and problem-solving. They are often withdrawn or overprotective of their infants, and they struggle with the relentless effort needed for tasks that arise with child-rearing like soothing, feeding, stimulating, planning and anticipating the child's needs. Research shows that SSRIs work by promoting brain plasticity. This in turn allows individuals to perceive the world more positively, increases the experience of gratification as a mother and facilitates cognitive flexibility for problem-solving. Assessing the risks of SSRIs in pregnancy Prescription drugs like SSRIs are just one aspect of treating pregnant women struggling with mental illness. Evidence-based psychotherapy, such as cognitive behavioral therapy, can also induce adaptive brain changes. But women with severe symptoms often require medication before they can reap the benefits of psychotherapy, and finding properly trained, accessible and affordable psychotherapists can be challenging. So sometimes, SSRIs may be the most appropriate treatment option available. Multiple studies have examined the effects of SSRIs on the developing fetus. Some data does show a link between these drugs and preterm birth, as well as low birth weight. However, depression during pregnancy is also linked to these effects, making it difficult to disentangle what's due to the drug and what's due to the illness. SSRIs are linked to a condition called neonatal adaption syndrome, in which infants are born jittery, irritable and with abnormal muscle tone. About one-third of infants born to mothers taking SSRIs experience it. However, research shows that it usually resolves within two weeks and does not have long-term health implications. The FDA-convened panel heavily focused on potential risks of SSRI usage, with several individuals incorrectly asserting that these drugs cause autism in exposed youth, as well as birth defects. At least one panelist discussed clinical depression as a 'normal' part of the 'emotional' experience during pregnancy and following birth. This perpetuates a long history of of women being dismissed, ignored and not believed in medical care. It also discounts the rigorous assessment and criteria that medical professionals use to diagnose reproductive mental health disorders. A summary of the pivotal studies on SSRIs in pregnancy by the Massachusetts General Hospital Center for Women's Health discusses how research has shown SSRIs to not be associated with miscarriage, birth defects or developmental conditions in children, including autism spectrum disorder. The risks of untreated mental illness Untreated clinical depression in pregnancy has several known risks. As noted above, babies born to mothers with clinical depression have a higher risk of preterm birth and low birth weight. They are also more likely to require neonatal intensive care and are at greater risk of behavioral problems and impaired cognition in childhood. Women who are clinically depressed have an increased risk of developing preeclampsia – a condition involving high blood pressure that, if not identified and treated quickly, can be fatal to both mother and fetus. Just as concerning is the heightened risk of suicide in depression. Suicide accounts for about 8% of deaths in pregnancy and shortly after birth. Compared with these very serious risks, the risks of using SSRIs in pregnancy turn out to be minimal. While women used to be encouraged to stop taking SSRIs during pregnancy to avoid some of these risks, this is no longer recommended, as it exposes women to a high chance of depression relapse. The American College of Obstetricians and Gynecologists recommends that all perinatal mental health treatments, including SSRIs, continue to be available. Many women are already reluctant to take antidepressants during pregnancy, and given the choice, they tend to avoid it. From a psychological standpoint, exposing their fetus to the side effects of antidepressant medications is one of many common reasons for women in the U.S. to feel maternal guilt or shame. However, the available data suggests such guilt is not warranted. Taken together, the best thing one can do for pregnant women and their babies is not to avoid prescribing these drugs when needed, but to take every measure possible to promote health: optimal prenatal care, and the combination of medications with psychotherapy, as well as other evidence-based treatments such as bright light therapy, exercise and adequate nutrition. The panel failed to address the latest neuroscience behind depression, how antidepressants work in the brain and the biological rationale for why doctors use them in the first place. Patients deserve education on what's happening in their brain, and how a drug like an SSRI might work to help. Depression during pregnancy and in the months following birth is a serious barrier to brain health for mothers. SSRIs are one way of promoting healthy brain changes so that mothers can thrive both short- and long-term. Should the FDA, as a result of this recent panel, decide to place a black-box warning on antidepressants in pregnancy, researchers like us already know from history what will happen. In 2004, the FDA placed a warning on antidepressants describing potential suicidal ideation and behavior in young people. In the following years, antidepressant-prescribing decreased, while the consequences of mental illness increased. And it's easy to imagine a similar pattern in pregnant women. This article is republished from The Conversation, a nonprofit, independent news organization bringing you facts and trustworthy analysis to help you make sense of our complex world. It was written by: Nicole Amoyal Pensak, University of Colorado Anschutz Medical Campus and Andrew Novick, University of Colorado Anschutz Medical Campus Read more: Risk of death related to pregnancy and childbirth more than doubled between 1999 and 2019 in the US, new study finds US preterm birth and maternal mortality rates are alarmingly high, outpacing those in all other high-income countries Study shows an abortion ban may lead to a 21% increase in pregnancy-related deaths I receive royalties for the sales of my book RATTLED, How to Calm New Mom Anxiety with the Power of the Postpartum Brain. Dr Novick has a career development award from the National Institute of Child Health and Development (K23HD110435) to study the neurobiology of hormonal contraception. This funding was not used to support the preparation or publication of this article. The views expressed here are those of the author and do not represent those of the National Institutes of Health or the University of Colorado School of Medicine. Solve the daily Crossword
New York Times
30-07-2025
- Health
- New York Times
The F.D.A.'s Panel on Antidepressants During Pregnancy Was Alarmingly Biased
In 2011 I stopped taking Prozac because I wanted to conceive, and I wanted my baby to be as healthy as possible. I had experienced two bouts of major depressive disorder at that point, but my symptoms were well controlled by medication. Still, I tapered off the antidepressant, which is in a class of drugs called selective serotonin reuptake inhibitors, under a psychiatrist's care. I was med-free by January 2012. My doctor at the time never informed me of the risks of going off antidepressants for someone with my clinical history. Even back then, there was research showing that pregnant women with a history of clinical depression had a high rate of relapse if they went off their meds. Use of S.S.R.I.s by pregnant women has been widely studied; while there are certainly risks associated with the medications (they include a slight increase in absolute risk of postpartum hemorrhage and pre-eclampsia for the mother and a moderately increased risk of preterm birth and low birth weight), there is ample evidence that untreated depression in mothers can have its own set of risks, including low birth weight and preterm birth. I was pregnant by March, and by April my depression had relapsed. My extreme morning sickness didn't help matters, but I was a wreck. I wasn't sleeping, and I was so anxious that I bordered on delusional. I was convinced there would be a sarin gas attack on the subway, and every commute felt like a panic attack. My voice slowed and quieted, which is a typical cognitive sign of depression. I went back on Prozac by the end of my first trimester, and while my morning sickness was still oppressive, my mental health improved radically. I wasn't an outlier in terms of going off meds. Studies have shown that almost half of women who are on antidepressants stop taking them while pregnant, and according to a study of nearly 400,000 women published in January, these women 'did not appear to substitute with psychotherapy' — in fact, there was 'a slight decrease in psychotherapy claims relative to a trend line.' I tell you this as background for why I was eagerly awaiting the Food and Drug Administration's 'expert' panel last week on S.S.R.I.s and pregnancy. I was hoping for an in-depth, nuanced discussion of the benefits versus the risks of these well-studied drugs. I wanted someone to talk about how mental health care is inaccessible for so many pregnant women, and why those who would benefit from talk therapy alone may not be able to get it. I wanted to hear them discuss how ashamed many pregnant women feel if they are struggling with their mental health, because there is so much pressure to be joyful and glowing. But that's not what happened. Most of the panelists were clearly biased against antidepressant use, and some disclosed conflicts of interest in a research paper that went undisclosed during the presentation. Some went as far as arguing that depressed pregnant women weren't experiencing medical problems at all, even though the Centers for Disease Control and Prevention found that in 2020, mental health conditions were the leading cause of pregnancy-related deaths in the United States. Want all of The Times? Subscribe.
Time of India
25-07-2025
- Health
- Time of India
8 medications that should not be mixed with alcohol
We all have heard that alcohol should not be mixed with antibiotics. However, do you know that apart from antibiotics, there are many other medicines that do not mix with alcohol, even if you take them hours apart? Alcohol alters the effectiveness of medications while making their adverse reactions more severe. Here are eight types of medications that must never be consumed with alcohol. 1. Painkillers (Opioids and NSAIDs) You should never combine opioids with NSAIDs when taking pain medication that includes codeine, oxycodone, morphine, ibuprofen and naproxen. When opioids combine with alcohol, the breathing rate of patients decreases to dangerous levels which may result in death. Consuming NSAIDs with alcohol heightens the risk of stomach bleeding, along with ulcers. 2. Antidepressants and Anti-Anxiety Medicines SSRIs and benzodiazepines together with antidepressants and anti-anxiety medications including Zoloft, Prozac, Valium and Xanax require alcohol-free use. Their deadly combination results in severe sleepiness and dizziness, together with confusion. This further aggravates depressive episodes, and the risk of overdose increases manifold. 3. Antibiotics Metronidazole (Flagyl) and tinidazole along with isoniazid, react negatively when combined with alcohol. by Taboola by Taboola Sponsored Links Sponsored Links Promoted Links Promoted Links You May Like Indonesia: New Container Houses (Prices May Surprise You) Container House | Search Ads Search Now Undo The combination of these substances leads to nausea, vomiting, headaches, flushing as well as heart-related problems. Avoid drinking alcohol throughout your antibiotic treatment period, (make sure you do not have it at any time during the course), and even several days after finishing the medication. 4. Blood Thinners The effectiveness of warfarin blood thinners becomes less stable or their use becomes riskier, when patients consume alcohol. These medications become less safe when alcohol consumption occurs, because it elevates the danger of bleeding complications while forming blood clots. Before taking blood thinners, you should consult with your doctor regarding alcohol consumption. 5. Antipsychotic Medications The consumption of alcohol remains prohibited for patients who take antipsychotic drugs, used to treat schizophrenia alongside Quetiapine/Seroquel. The combination of alcohol with these medications leads to severe side effects including dizziness and drowsiness, as well as concentration issues and heart-related complications and seizure risks. 6. Diabetes Medications Taking insulin or diabetes pills with alcohol consumption will lead to harmful blood sugar reductions. The inability to detect blood sugar symptoms such as dizziness or confusion due to alcohol, makes it more likely for patients to experience severe complications. 7. Seizure Medications The combination of epilepsy and seizure medications including phenytoin, gabapentin and clonazepam should never occur with alcohol consumption. Using these substances together leads to excessive sleepiness and dizziness, and abnormal behavior and higher seizure risks. 8. ADHD Medications Adderall and Ritalin along with other stimulant medications used for ADHD, interact negatively when consumed with alcohol. The combination of these substances produces heightened side effects which include dizziness and drowsiness together with heart complications and decreased concentration abilities. Why Mixing Alcohol and Medication is Risky Medicines undergo altered absorption or breakdown processes in the body due to alcohol consumption, which leads to reduced effectiveness or increased toxicity. The consumption of alcohol enhances medication side effects including drowsiness and dizziness while simultaneously inflicting severe damage to liver function and stomach health and heart systems and nervous system tissue. Certain dangerous drug interactions can even be fatal. Sources PubMed The National Institute on Alcohol Abuse and Alcoholism (NIAAA) WebMD Healthdirect Australia
Los Angeles Times
23-07-2025
- Health
- Los Angeles Times
FDA panel on the use of antidepressants during pregnancy is alarming experts
The U.S. Food and Drug Administration is turning its attention to selective serotonin reuptake inhibitors, a class of antidepressant drugs long criticized by Health and Human Services Secretary Robert F. Kennedy Jr. On Monday morning, the FDA hosted a 10-person expert panel on the use during pregnancy of SSRIs, which include medications like fluoxetine (Prozac), sertraline (Zoloft) and citalopram (Celexa), among others. Nine of the panel's 10 members were researchers, doctors or psychologists who have previously questioned the safety of SSRIs publicly or spoken out against antidepressant use in general. Over the course of the discussion, several panel members cited studies that lacked appropriate controls, physicians not involved with the panel said. In other words, there was no way to be certain on the basis of the studies whether the observed health problems were caused by SSRIs, the underlying mood disorder or some other factor. Other participants described study findings inaccurately or incompletely, said outside experts. For example, few panelists considered the risks of SSRI use relative to the risks associated with untreated depression, which also contributes to poor outcomes for children and mothers. In the U.S., suicide is a leading cause of maternal death in the first year of a baby's life. An FDA spokesperson said the panel was part of the agency's 'broader efforts to apply rigorous, evidence-based standards to ingredient safety and modernize regulatory oversight' and did not respond to further queries about the agency's potential next steps. But healthcare professionals expressed concern that the panel could ultimately prevent women from getting the care they need. 'I was surprised and disappointed by the amount of misinformation that was presented,' said Dr. Katie Unverferth, a reproductive psychiatrist and medical director of UCLA's Maternal Mental Health Program. 'When we look at the body of data ... we find that there are no consistent associations [of] SSRIs with cardiac defects, pulmonary hypertension or neurodevelopmental issues in offspring,' she said, naming some of the harms panelists attributed to the drugs. 'This misinformation just creates intrusive thoughts. It's not helpful.' The panel included just one specialist in maternal mood disorders — Dr. Kay Roussos-Ross, an obstetrician-gynecologist and director of the Perinatal Mood Disorders Program at the University of Florida College of Medicine — who argued that SSRIs are for most patients a safe treatment option for serious mental health disorders in pregnancy. 'Mental health disorders are no different than medical disorders,' said Roussos-Ross. 'I want to stress that treating mental illness in pregnancy is not a luxury. It's a necessity,' she said. 'We're not asking [pregnant] women to not take their anti-hypertensives and risk death to them or their baby. We're not asking women to stop their diabetes medications. We should not be withholding SSRIs as a possible treatment for women who need it.' The FDA did not respond to questions about how experts were selected for the panel. Participant Dr. Josef Witt-Doerring runs a private clinic that helps patients wean off psychiatric medication. Another panelist, Dr. Roger McFillin, is a prolific podcaster and a skeptic of germ theory, the belief — widely held as a fundamental truth in medicine since the 19th century — that infectious diseases are caused by microorganisms. Panelist Dr. David Healy, a psychiatrist from Wales, made a number of confounding and misleading statements, insisting that 'mothers who are taking SSRIs in pregnancy have a 10-fold greater risk of having a baby with fetal alcohol syndrome' (that figure describes the subject population of a single 2011 study, not the general public). Healy also stated that 'any drug that causes birth defects will cause autism spectrum disorder also,' a claim that has no basis in any scientific research. Dr. David Urato, chief of maternal and fetal medicine at MetroWest Medical Center in Framingham, Mass., was the only panelist besides Roussos-Ross who cares directly for pregnant patients. He spoke forcefully on the potential harms the drugs pose to developing babies. 'Never before in human history have we chemically altered babies like this,' he said during the discussion. 'There is now more than enough evidence to support strong warnings from the FDA about how drugs disrupt fetal development and impact the moms.' Roussos-Ross argued that the increased risk of birth defects for babies exposed to SSRIs in pregnancy was statistically insignificant, and that children of mothers with untreated depression were more likely to have later behavioral problems than those of mothers who took medication for the disease. 'Having that [medication] not be available to women who need it would really be detrimental,' she said. At this, panel moderator Tracy Beth Høeg — a sports medicine doctor who is now a senior advisor for clinical sciences at the FDA — said, 'I'm going to do something unconventional. I'm sorry to play favorites, but Dr. Urato, I want you to weigh in now.' In response, Urato questioned the idea that depression can be alleviated with antidepressant medication at all. 'This idea about depression — [that it] can cause harm and therefore we treat [it] with these chemicals, and by getting the treatment we see improved outcomes — this is something we all would want. It's wishful thinking,' he said. 'But it's not actually what the data shows.' It was not clear to which data he was referring. In 2019, the most recent year for which data are available, one in every eight U.S. adults had a prescription for antidepressant medication. While the drugs don't work for all people with major depression, analyses of multiple studies have consistently found them to be significantly better than placebos at alleviating illness symptoms. The drugs have been a target of Kennedy's Make America Healthy Again movement, along with vaccines and food dyes. In his confirmation hearings and on podcast appearances, Kennedy has claimed — inaccurately — that the drugs are both linked to school shootings and harder to quit than heroin. There is no evidence for either claim. In February, President Trump placed Kennedy at the helm of the Make America Healthy Again Commission, a group tasked with, among other things, evaluating 'the prevalence of and threat posed by the prescription of selective serotonin reuptake inhibitors, antipsychotics, mood stabilizers, stimulants, and weight-loss drugs.' Healthcare professionals expressed frustration with the FDA's approach. 'There is already so much shame and stigma that surrounds these illnesses. There is also a lot of shame and stigma around taking medication during pregnancy or the postpartum period,' said Paige Bellenbaum, a perinatal mental health therapist and adjunct professor of social work at Hunter College. 'We are taking a giant step backwards in so many ways. This will reinstill the fear that was there to begin with [and] will ultimately result in the loss of life.' Alexandre Bonnin, an associate professor of pathology at USC, has studied the effects of prenatal SSRI exposure on the developing fetal brain for years. The most recent large studies in the field haven't found a statistically significant association between SSRIs and fetal harm, he said. 'Our finding, at least at the basic science level, suggests that the use of SSRIs in pregnancy can be beneficial if the mom is under major stress, anxiety or depression, because the maternal stress actually itself has many negative effects on fetal brain development,' he said.
