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Evidence-biased Antidepressant Prescription

Evidence-biased Antidepressant Prescription
Author: Michael P. Hengartner
Publisher:
Total Pages: 0
Release: 2022
Genre:
ISBN: 9783030825881

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This book addresses the over-prescribing of antidepressants in people with mostly mild and subthreshold depression. It outlines the steep increase in antidepressant prescription and critically examines the current scientific evidence on the efficacy and safety of antidepressants in depression. The book is not only concerned with the conflicting views as to whether antidepressants are useful or ineffective in various forms of depression, but also aims at detailing how flaws in the conduct and reporting of antidepressant trials have led to an overestimation of benefits and underestimation of harms. The transformation of the diagnostic concept of depression from a rare but serious disorder to an over-inclusive, highly prevalent but predominantly mild and self-limiting disorder is central to the books argument. It maintains that biological reductionism in psychiatry and pharmaceutical marketing reframed depression as a brain disorder, corroborating the overemphasis on drug treatment in both research and practice. Finally, the author goes on to explore how pharmaceutical companies have distorted the scientific literature on the efficacy and safety of antidepressants and how patient advocacy groups, leading academics, and medical organisations with pervasive financial ties to the industry helped to promote systematically biased benefit-harm evaluations, affecting public attitudes towards antidepressants as well as medical education, training, and practice. Michael P. Hengartner is a senior researcher and lecturer at the Zurich University of Applied Sciences, Switzerland. He has published over 130 peer-reviewed journal articles and four book chapters. He was an expert evaluator for the European Research Council and the World Health Organization and currently is a member of the Swiss School of Public Health, the German Society for Social Psychiatry, and the European Public Health Association.


Evidence-biased Antidepressant Prescription

Evidence-biased Antidepressant Prescription
Author: Michael P. Hengartner
Publisher: Springer Nature
Total Pages: 355
Release: 2021-12-09
Genre: Psychology
ISBN: 3030825876

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This book addresses the over-prescribing of antidepressants in people with mostly mild and subthreshold depression. It outlines the steep increase in antidepressant prescription and critically examines the current scientific evidence on the efficacy and safety of antidepressants in depression. The book is not only concerned with the conflicting views as to whether antidepressants are useful or ineffective in various forms of depression, but also aims at detailing how flaws in the conduct and reporting of antidepressant trials have led to an overestimation of benefits and underestimation of harms. The transformation of the diagnostic concept of depression from a rare but serious disorder to an over-inclusive, highly prevalent but predominantly mild and self-limiting disorder is central to the books argument. It maintains that biological reductionism in psychiatry and pharmaceutical marketing reframed depression as a brain disorder, corroborating the overemphasis on drug treatment in both research and practice. Finally, the author goes on to explore how pharmaceutical companies have distorted the scientific literature on the efficacy and safety of antidepressants and how patient advocacy groups, leading academics, and medical organisations with pervasive financial ties to the industry helped to promote systematically biased benefit-harm evaluations, affecting public attitudes towards antidepressants as well as medical education, training, and practice.


Lost Connections

Lost Connections
Author: Johann Hari
Publisher: Bloomsbury Publishing
Total Pages: 417
Release: 2020-11-12
Genre: Psychology
ISBN: 1526634082

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THE INTERNATIONAL BESTSELLER: A radically new way of thinking about depression and anxiety 'A book that could actually make us happy' SIMON AMSTELL 'This amazing book will change your life' ELTON JOHN 'One of the most important texts of recent years' BRITISH JOURNAL OF GENERAL PRACTICE 'Brilliant, stimulating, radical' MATT HAIG 'The more people read this book, the better off the world will be' NAOMI KLEIN 'Wonderful' HILLARY CLINTON 'Eye-opening' GUARDIAN 'Brilliant for anyone wanting a better understanding of mental health' ZOE BALL 'A game-changer' DAVINA MCCALL 'Extraordinary' DR MAX PEMBERTON Depression and anxiety are now at epidemic levels. Why? Across the world, scientists have uncovered evidence for nine different causes. Some are in our biology, but most are in the way we are living today. Lost Connections offers a radical new way of thinking about this crisis. It shows that once we understand the real causes, we can begin to turn to pioneering new solutions – ones that offer real hope.


Fluoxetine

Fluoxetine
Author: Graziano Pinna
Publisher:
Total Pages: 412
Release: 2015-04-01
Genre:
ISBN: 9781634820769

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Fluoxetine, best known by the trade name Prozac®, unlike other psychotropic drugs whose effects were serendipitously stumbled upon, was the first developed for a precise mechanism of action, that is, the ability to selectively inhibit serotonin reuptake, based upon the theory that increasing the availability of serotonin would treat major depression. Once approved by the FDA in 1987, fluoxetine quickly became the most prescribed psychotropic drug worldwide and its success in improving mood disorders has triggered the development of a large number of congener molecules, commonly known as SSRIs after their purported mechanism of action. However, a quarter of a century after its development, the idea that fluoxetine asserts its positive behavioral effect through inhibition of serotonergic reuptake is not firmly established. This book reviews several preclinical and clinical reports suggesting that the pharmacological effects of fluoxetine may be mediated by means other than the regulation of serotonin, including the regulation of gene expression, modifying epigenetic mechanisms as well as modifying microRNAs. One of the most prominent mechanisms for the therapeutic relevance of fluoxetine relates to influencing neuroplasticity by enhancing neurotropic factors, including BDNF signaling and altering adult neurogenesis. The ability of fluoxetine to rapidly increase neurosteroid levels accounts for the fast anxiolytic effects of this drug. Fluoxetine action at sigma-1 receptor or modulating glutamatergic neurotransmission as well as the combination of fluoxetine with other psychotropic drugs is discussed in relation to its therapeutic effects. While fluoxetine was primarily prescribed as an antidepressant, this drug currently represents a treatment of choice for a broad spectrum of psychiatric disorders, including post-traumatic stress disorder and a range of anxiety disorders. This drug even possesses analgesic actions and is a valuable therapy for stroke. This book also highlights emerging evidence on the gender-specific effects of fluoxetine, its potential adverse features, including its addiction liability in combination with psychostimulants, and the impact of perinatal fluoxetine exposure.


Unhinged

Unhinged
Author: Daniel Carlat
Publisher: Simon and Schuster
Total Pages: 272
Release: 2010-05-18
Genre: Psychology
ISBN: 9781416596356

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IN THIS STIRRING AND BEAUTIFULLY WRITTEN WAKE-UP CALL, psychiatrist Daniel Carlat exposes deeply disturbing problems plaguing his profession, revealing the ways it has abandoned its essential purpose: to understand the mind, so that psychiatrists can heal mental illness and not just treat symptoms. As he did in his hard-hitting and widely read New York Times Magazine article "Dr. Drug Rep," and as he continues to do in his popular watchdog newsletter, The Carlat Psychiatry Report, he writes with bracing honesty about how psychiatry has so largely forsaken the practice of talk therapy for the seductive—and more lucrative—practice of simply prescribing drugs, with a host of deeply troubling consequences. Psychiatrists have settled for treating symptoms rather than causes, embracing the apparent medical rigor of DSM diagnoses and prescription in place of learning the more challenging craft of therapeutic counseling, gaining only limited understanding of their patients’ lives. Talk therapy takes time, whereas the fifteen-minute "med check" allows for more patients and more insurance company reimbursement. Yet DSM diagnoses, he shows, are premised on a good deal less science than we would think. Writing from an insider’s perspective, with refreshing forthrightness about his own daily struggles as a practitioner, Dr. Carlat shares a wealth of stories from his own practice and those of others that demonstrate the glaring shortcomings of the standard fifteen-minute patient visit. He also reveals the dangers of rampant diagnoses of bipolar disorder, ADHD, and other "popular" psychiatric disorders, and exposes the risks of the cocktails of medications so many patients are put on. Especially disturbing are the terrible consequences of overprescription of drugs to children of ever younger ages. Taking us on a tour of the world of pharmaceutical marketing, he also reveals the inner workings of collusion between psychiatrists and drug companies. Concluding with a road map for exactly how the profession should be reformed, Unhinged is vital reading for all those in treatment or considering it, as well as a stirring call to action for the large community of psychiatrists themselves. As physicians and drug companies continue to work together in disquieting and harmful ways, and as diagnoses—and misdiagnoses—of mental disorders skyrocket, it’s essential that Dr. Carlat’s bold call for reform is heeded.


Discontinuing Antidepressant Medications

Discontinuing Antidepressant Medications
Author: Giovanni Fava
Publisher: Oxford University Press
Total Pages: 193
Release: 2021-10-28
Genre: Medical
ISBN: 0192896644

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"When I started my residency training program in psychiatry in Italy, more than four decades ago, depression was the psychiatric disorder that particularly attracted my attention. In 1980 I decided to move to United States to further pursue my interest, first in Albuquerque, New Mexico, and then in Buffalo, New York, where I was offered to establish a depression unit. I was convinced that depression was essentially an episodic disorder, that there were powerful remedies against it (antidepressant drugs) and chronicity was essentially a consequence of inadequate diagnosis and treatment. Today, if I think of my views then, I am surprised of my naivete and clinical blindness. We have become aware that depression is essentially a chronic disorder with multiple acute episodes along its course (1). But my view was then shared by almost any expert in the field"--


The Evidence-Based Guide to Antidepressant Medications

The Evidence-Based Guide to Antidepressant Medications
Author: Anthony J. Rothschild
Publisher: American Psychiatric Pub
Total Pages: 426
Release: 2012-09-24
Genre: Medical
ISBN: 1585629804

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The second book in the Evidence-Based Guides series, The Evidence-Based Guide to Antidepressant Medications, provides a clear reference to the current knowledge and evidence base for the use of antidepressants among a variety of patients across a wide range of disorders. Chapters within this guide are authored by experts in their respective areas of practice, and synthesize a large amount of medical literature into a comprehensive, yet understandable, concise, reader-friendly guide. Each chapter covers both the FDA-approved and off-label use of antidepressant medications and the evidence base for their use. Each chapter also features useful tables pertaining to specific topics, such as summaries of uses and efficacy, and important clinical pearls of wisdom in the Key Clinical Concepts. Topics covered in chapters within this text include: Use of selective serotonin reuptake inhibitors, MAOIs, and tricyclic antidepressants in major depressive disorder, bipolar depression, psychotic depression, and treatment-resistant depression. Acute management of anxiety disorders, obsessive-compulsive disorder, and specific phobias through antidepressant use. Use of antidepressant medication in medically ill patients, such as those with cardiovascular, pulmonary, gastrointestinal, renal, and endocrine diseases, as well as cancer, chronic pain, HIV, burns and hospital-based trauma. Developmental considerations necessary to keep in mind when prescribing antidepressants to children and adolescents, along with an outline of controlled studies and their special attention to safety. Medication management in geriatric patients, including antidepressant use among depressed elderly patients with dementia, stroke, or Parkinson's disease. Risks and benefits of prescribing antidepressants during pregnancy and lactation. Together, the authors have synthesized a large amount of medical literature into a comprehensive, yet understandable, concise, reader-friendly guide. The Evidence-Based Guide to Antidepressant Medications is a must-have reference for psychiatrists and other practicing clinicians, residents in training, psychiatric nurses, social workers and researchers.


A Guide To Treatments that Work

A Guide To Treatments that Work
Author: Peter Nathan
Publisher: Oxford University Press
Total Pages: 705
Release: 2002-01-18
Genre: Psychology
ISBN: 0199760985

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A fully revised and updated edition of this unique and authoritative reference The award-winning A Guide to Treatments that Work , published in 1998, was the first book to assemble the numerous advances in both clinical psychology and psychiatry into one accessible volume. It immediately established itself as an indispensable reference for all mental health practitioners. Now in a fully updated edition,A Guide to Treatments that Work, Second Edition brings together, once again, a distinguished group of psychiatrists and clinical psychologists to take stock of which treatments and interventions actually work, which don't, and what still remains beyond the scope of our current knowledge. The new edition has been extensively revised to take account of recent drug developments and advances in psychotherapeutic interventions. Incorporating a wealth of new information, these eminent researchers and clinicians thoroughly review all available outcome data and clinical trials and provide detailed specification of methods and procedures to ensure effective treatment for each major DSM-IV disorder. As an interdisciplinary work that integrates information from both clinical psychology and psychiatry, this new edition will continue to serve as an essential volume for practitioners of every kind: psychiatrists, psychologists, clinical social workers, counselors, and mental health consultants.


The Neurobiological Basis of Suicide

The Neurobiological Basis of Suicide
Author: Yogesh Dwivedi
Publisher: CRC Press
Total Pages: 485
Release: 2012-06-25
Genre: Medical
ISBN: 143983881X

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With recent studies using genetic, epigenetic, and other molecular and neurochemical approaches, a new era has begun in understanding pathophysiology of suicide. Emerging evidence suggests that neurobiological factors are not only critical in providing potential risk factors but also provide a promising approach to develop more effective treatment and prevention strategies. The Neurobiological Basis of Suicide discusses the most recent findings in suicide neurobiology. Psychological, psychosocial, and cultural factors are important in determining the risk factors for suicide; however, they offer weak prediction and can be of little clinical use. Interestingly, cognitive characteristics are different among depressed suicidal and depressed nonsuicidal subjects, and could be involved in the development of suicidal behavior. The characterization of the neurobiological basis of suicide is in delineating the risk factors associated with suicide. The Neurobiological Basis of Suicide focuses on how and why these neurobiological factors are crucial in the pathogenic mechanisms of suicidal behavior and how these findings can be transformed into potential therapeutic applications.