The Widely Prescribed Drug that's No Better than a Placebo
Posted By Dr. Mercola | September 03 2011 | 26,440 views
Researchers have found that antipsychotic drugs which are widely prescribed to treat severe post-traumatic stress symptoms for veterans are no more effective than placebos. In addition, the drugs come with serious side effects.
The finding is such a serious blow to current treatment standards so directly that some experts say it could change treatment practices in the near future. Although the study focused on one medication, Risperdal, the results most likely extend to an entire class of drugs, including Seroquel, Geodon and Abilify.
According to the New York Times:
"The use of such drugs has grown sharply over the past decade, as thousands of returning soldiers and Marines have found that their post-traumatic stress symptoms do not respond to antidepressants, the only drugs backed by scientific evidence for the disorder. Doctors have turned to antipsychotics, which strongly affect mood, to augment treatment, based almost entirely on their experience with them and how they expect them to work."
Dr. Mercola's Comments:
A sizable number of U.S. combat troops are now taking either antidepressants or antipsychotic drugs to calm nerves strained by repeated and lengthy combat tours. But according to the results from the largest study of its kind in war veterans, even some of the most potent of these mind-altering drugs are no different from sugar pills in terms of the relief they provide.
According to the New York Times, this finding "challenges current treatment standards so directly" that the treatment practice for post-traumatic stress disorder (PTSD) might soon be altered.
After all, why take a drug fraught with dangerous side effects if it's been proven ineffective? I truly believe we need to start looking at other alternatives, because clearly, these veterans need help.
The question is what kind of treatment will actually work?
I think it's impossible to make any sort of blanket recommendation that would cover every case of PTSD. It's an extremely challenging situation, and different individuals may find relief using a variety of different methods. Here, I will only attempt to highlight a few suggestions that I believe can play an important role in the mental health of most people, but that's certainly not to say that these strategies will be successful for everyone—especially not when you're talking about combat-induced PTSD.
However, the evidence indicates that drugs are not the right answer for the majority of people suffering with various degrees of mental problems, including PTSD, and therefore I recommend making a concerted effort to seek to avoid them, if at all possible, and to carefully consider trying other alternatives first.
If you haven't read my recent comprehensive report on the dangers of using antidepressants, I would strongly encourage you to do so as it has a very detailed report that includes all my many concerns about this therapy.
Antipsychotic Drugs No More Effective than Placebo in PTSD Treatment
Of the enlisted who see heavy combat, 10-20 percent develop persistent symptoms of post-traumatic stress disorder (PTSD), and about 20 percent of those who seek treatment end up getting a prescription for an antipsychotic drug.
The reason why so many veterans are now prescribed antipsychotics is because PTSD symptoms were found to be unresponsive to antidepressants. Antipsychotics like Risperdal are more potent in terms of affecting and altering mood. However, according to a recent study published in the Journal of the American Medical Association (JAMA), the drug Risperdal is no more effective than a placebo, and is associated with a long list of potentially devastating side effects.
The study included 123 veterans with PTSD who received Risperdal, and another 124 who received a placebo. After six months of treatment, about five percent of the participants in both groups recovered, and between 10-20 percent in each group reported minor improvement.
According to the lead author, Dr. John H. Krystal, who is also the director of the clinical neurosciences division of the Department of Veterans Affairs' National Center for PTSD:
"We didn't find any suggestion that the drug treatment was having an overall benefit on their lives."
Although the study focused on just one drug, Risperdal, experts have stated that these results most likely extend to the entire class of similar drugs, which also include:
Seroquel
Geodon
Abilify
Risperdal
Risperdal is known as an "atypical antipsychotic," used to treat schizophrenia and biopolar disorder in adults, and irritability associated with autistic disorder in children. Side effects, some of which may be permanent, include:
Somnolence and fatigue Increased appetite and weight gain Upper respiratory tract infection
Restlessness Metabolic disorders Muscular tics, tremors, muscle stiffness
Vomiting, coughing, fever Indigestion Urinary incontinence
More serious side effects include:
Neuroleptic Malignant Syndrome, which can be fatal
Hormone disruption (including breasts producing milk and breast development in males)
High blood sugar and diabetes
Abilify
Abilify (aripiprazole) is a newer psychotropic medication, licensed for the treatment of bipolar disorder, schizophrenia, autism—and major depression when taken with antidepressants. I.e. it is used to augment the effects of the antidepressants—because, of course, antidepressants have also been found to be about as effective as a placebo, and sometimes less effective than a sugar pill...
Abilify is a perfect example of how polypharmacy is spreading and increasing, as ineffective drugs are simply "boosted" by yet another drug. The word 'polypharmacy' means "many drugs," and essentially refers to instances where an individual is taking too many drugs--either because more drugs are prescribed than clinically indicated, or when the sheer number of pills simply becomes a burden for the patient. Polypharmacy is a significant problem, because the more drugs you mix together, the greater the chances of serious side effects.
People (of all ages and walks of life) taking psychiatric drugs appear to be particularly prone to polypharmacy, which is disturbing since these drugs are quite potent and potentially dangerous when taken singularly. Abilify, for example, has 75 different side effects associated with it, including:
Low thyroid (hypothyroidism) or high thyroid (hyperthyroidism) Irritable bowel syndrome (IBS) Yeast infections Carpal tunnel syndrome
Gastroesophageal reflux disease (GERD) Gallstones and kidney stones Arthritis Impotence
Antidepressants Frequently Prescribed without Psychiatric Diagnosis
While surveys have discovered that only about half of those thought to need treatment for mental problems actually seek it out, other research shows that a large portion of the growth in antidepressant prescriptions is driven by an increase in antidepressant prescriptions by non-psychiatrist providers -- without any accompanying psychiatric diagnosis.
Over the course of the past two decades, the use of antidepressants in the U.S. has grown significantly, making them the third most commonly prescribed class of medications in the country. Between 2005, and 2008 nearly nine percent of Americans took at least one prescription in this drug class during any given month!
On August 4, Eurekalert reported:
"Between 1996 and 2007, the number of visits where individuals were prescribed antidepressants with no psychiatric diagnoses increased from 59.5 percent to 72.7 percent, and the share of providers who prescribed antidepressants without a concurrent psychiatric diagnosis increased from 30 percent of all non-psychiatrist physicians in 1996 to 55.4 percent in 2007."
As you can see, there are a number of concurrent problems festering in the field of mental health. Many who need help aren't getting it, while at the same time, a great many are being overtreated with potentially dangerous drugs... All in all, what this tells me is that we need to become more open-minded when it comes to the treatment of psychiatric problems. And we need to become more adept at addressing lifestyle issues that contribute to deteriorating mental health.
If Drugs Don't Work, What Does?
There's no cut and dry answer to that question.
"[S]tudies suggest that talk therapy, alone or in combination with antidepressants, can accelerate the relief of common symptoms, like nightmares and reclusive behavior. These psychotherapies tend to include relaxation skills; incrementally increased exposure to stress triggers; and challenging some inaccurate assumptions that fuel anxiety," the New York Times reports, adding:
"… Dr. Krystal said the benefits many doctors thought they were getting from the drugs "quite possibly came from simply engaging the patient in treatment, and not from the medication."
Additionally, according to other research, it takes about twice as long for your body to 'reset' itself physiologically once you return from combat deployment. This means that if you've been in a combat zone for 12 months, you can expect it to take about 24 months to recover once you get back home, so give yourself enough time to work through it.
As mentioned above, learning relaxation skills along with reprogramming of emotional triggers are likely to be some of the most important treatment strategies.
Energy Psychology, Eye Movement Desensitization and Reprocessing (EMDR), Neurolinguistic Programming (NLP) and other similar techniques can help accomplish both of those simultaneously. Although most forms of energy psychology are easy to learn and eventually perform on yourself, when it comes to the treatment of PTSD, I would highly recommend seeking out a trained professional that you feel comfortable with, rather than trying to do it on your own.
Important Lifestyle Factors to Consider to Help Strengthen Mental Stability
Even if you have a decent diet, nutritional deficiencies are pervasive and can easily contribute to depression, as can other "lifestyle deficiencies." Dietary factors have also been linked to other more serious psychiatric disorders.
Here are a few of the most important lifestyle factors that you'll want to address, whether you're trying to address depression, PTSD, or any other mental health problem:
Animal based Omega-3 fat: This is one of the most common nutritional deficiencies that can have a major impact on your mental health. Many people don't realize that their brain is 60 percent DHA, which is an animal-based omega-3 fat. Dr. Stoll is a Harvard psychiatrist and was one of the early leaders in compiling the evidence supporting the use of animal based omega-3 fats for the treatment of depression. He wrote an excellent book that details his experience in this area called The Omega-3 Connection.
Another vitamin deficiency that can contribute to depression is vitamin B12, which affects about one in four people.
Vitamin D is also important. One study found that people with the lowest levels of vitamin D were 11 times more prone to be depressed than those who had normal levels. Additionally, a study published in the September 9, 2010 issue of the Archives of General Psychiatry found that maintaining proper levels of vitamin D in utero and during early infancy can even help prevent schizophrenia later in life.
The best way to get vitamin D is through regular year-round exposure to sunshine. Remember, SAD (Seasonal Affective Disorder) is a type of depression that we know is related to sunshine deficiency, so it would make sense that the perfect way to get your vitamin D is through sun exposure, or a safe tanning bed if you can't have regular access to the sun. Your next option, if these two superior options are not available, is to use a vitamin D supplement—just make sure to check your levels regularly to make sure you’re maintaining optimal levels.
Another important deficiency is exercise. There’s a veritable mountain of well-done scientific research pointing to the fact that exercise is one of the most potent treatments we have for depression. Unlike drugs, it is FAR more consistently effective than placebo when done properly.
Sound sleep is another critical issue. You can have the best diet and exercise program possible but if you aren't sleeping well your mental health can suffer. Sleep and depression are so intimately linked that a sleep disorder is actually part of the definition of the symptom complex that gives the label depression.
If You or Someone You Love Has Just Returned From Military Duty …
Please make sure to take steps to help heal the emotional wounds. Left untended, emotional trauma like the experience of battle can lead to serious health problems down the road -- anything from depression to heart attacks and cancer is possible. Be sure to pay VERY careful attention to the above physical cofactors as they will make any emotional technique work that much more effectively.
Learning to address your stress is imperative both for mental and physical health, particularly if you're suffering with symptoms of PTSD. Exercise is very helpful for this aspect. Other common stress reduction tools with a high success rate include prayer, meditation and yoga, for example.
By applying techniques such as Energy Psychology in conjunction with other stress reduction tools, you can teach your body how to try and maintain an alert yet relaxed state, which will help strengthen your inherent coping mechanisms when faced with stressful situations that trigger your anxiety symptoms.
Last, but certainly not least, please remember that your mind and mood is significantly affected by your diet, so don't dismiss that part. While it may not be a miracle cure in and of itself, it can be extremely difficult to achieve mental health without the proper foundation of a sound diet and exercise plan. For an inspiring testament of how one man (who had suffered with a debilitating anxiety disorder for 11 years) managed to resolve his anxiety through dietary changes alone when everything else had failed, please read this previous article.
My heart goes out to you if you, or someone you love, have experienced a situation or tragedy in life that resulted in PTSD. I hope you will find encouragement, strength, hope, true heaing and complete recovery from your symptoms.
