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Dopamine agonists such as Mirapex (pramipexole) can cause compulsive eating and weight gain
Wednesday, November 02, 2005 6:12 am Email this article
Dopamine agonists, that is drugs that stimulate dopamine receptors, such as Mirapex (pramipexole), can cause compulsive eating and weight gain according to a new paper from researchers at Colum 7 patients taking Mirapex developed compulsive eating
The report describes 7 patients taking Mirapex (pramipexole) who developed compulsive eating and weight gain.
Included men and women
They included both men (3) and women (4).
Mirapex (pramipexole) used for Parkinson’s Disease
The most common use for dopamine agonists such as Mirapex (pramipexole) is for Parkinson’s Disease.
All of these cases involved patients given the drug for Parkinson’s Disease.
AVERAGE WEIGHT GAIN 29 LBS
Average weight gain 29 lbs, or 15% of body weight
The average weight gain was 29 pounds, or approximately 15 percent of body weight.
Average BMI increase of 4 units
The average increase in body mass index (BMI) was an increase of 4 units, for example, increasing from 25 to 29.
WEIGHT GAIN & BMI INCREASE OF EACH PATIENT
Weight gains of 13-53 lbs
The seven patients gained from 13 to 53 pounds.
Subject #1 gained 29 lbs
The first patient gained 29 pounds, increasing from 125 pounds to 154 pounds.
Subject #2 gained 40 lbs
The second patient gained 40 pounds, increasing from 251 pounds to 290 pounds.
Subject #3 gained 35 lbs
The third patient gained 35 pounds, increasing from 275 pounds to 310 pounds.
Subject #4 gained 15 lbs
The fourth patient gained 15 pounds, increasing from 161 pounds to 176 pounds.
Subject #5 gained 15 lbs
The fifth patient gained 15 pounds, increasing from 183 pounds to 198 pounds.
Subject #6 gained 13 lbs
The sixth patient gained 13 pounds, increasing from 172 pounds to 185 pounds.
Subject #7 gained 53 lbs
The seventh patient gained 53 pounds, increasing from 180 pounds to 233 pounds.
BMI increased from 2-7 units
Their BMI increased from 2.2 to 7.5 units.
All reported dramatic increase in food intake, and new cravings
“All subjects reported that they had increased their food intake dramatically,” the authors write, “[an experienced] new-onset food cravings for carbohydrates, sweets, and/or salty foods.”
4 of 7 binge eating
“Four reported new-onset binge eating; the others reported compulsively eating both larger portions of food at mealtimes and more frequent snacks throughout the day.”
6 of 7 binge eating in the middle of the night
Six of the seven subjects reported a tendency to compulsively snack or binge in the middle of the night.
Woman reports loss of inner sense of control
One woman “reported the subjective feeling that she had lost her inner sense of control.”
Depression reported by one person
One subject reported severe depression while on the drug.
Anxiety reported by two people
Two other subjects reported anxiety while taking the drug.
Most people reduced dose or stopped taking the drug due to weight gain
Six of the seven subjects were so concerned about the compulsive eating and weight gain that they either reduced their dose or stopped taking the drug altogether.
MORE DETAILS ABOUT 2 SUBJECTS
Here are more details that were given about two of the subjects.
SUBJECT #1: WOMAN GAINS 29 LBS IN 7 MONTHS
Subject #1: 54-year-old woman gained 29 lbs in seven months
The first person was a 54-year-old woman.
Subject #1: Starting weight 125 lbs, BMI 22
Before starting on Mirapex (pramipexole) she weighed 125 pounds, and had a body mass index (BMI) of 22.2 (lean).
Subject #1: Developed craving for cookies, crackers, and pasta
After starting on 1.5 mg of Mirapex (pramipexole), she developed a new craving for cookies, crackers, and pasta.
Subject #1: Compulsive eating, middle-of-the-night binges
She began eating compulsively, and began binging in the middle of the night.
Subject #1: 29 lbs weight gain in seven months
After taking Mirapex (pramipexole) for seven months, she had gained 29 pounds—nearly 23 percent of her body weight. Yikes!
Subject #1: BMI increased from 22 to 27
Her BMI had increased from 22.2 to 27.2.
The drug was stopped, and her cravings, compulsive eating and weight gain stopped. They do not say whether or not she has lost weight.
SUBJECT #2: MAN GAINS 40 LBS
Subject #2: 64-year-old man gained 40 lbs
The second subject was a 64-year-old man.
At the age of 61, he was started on Mirapex (pramipexole) for treatment of his Parkinson’s Disease.
Subject #2: Starting weight 251 lbs, BMI 35
His started at 251 pounds, and a BMI of 35.
Subject #2: Developed toxic side effects at 4.5 mg per day
After gradually increasing his dose to 4.5 mg per day, he developed toxic side effects including
- compulsive gambling
- visual hallucinations, and
- excessive daytime sleepiness
Subject #2: Despite warnings, he increased dose to 9 mg per day
Despite repeated warnings from this doctor, he continued to increase his dose to as high as 9 mg per day.
Subject #2: Developed cravings for chocolate and sweets
While taking high doses Mirapex (pramipexole), he developed new cravings for chocolate and sweets.
Subject #2: Developed compulsive eating and night binging
He also developed compulsive eating and uncontrollable middle-of-the-night binging.
Subject #2: Weight increased from 251 to 290 lbs, BMI from 35 to 40
His weight increased from 251 pounds to 290 pounds, a weight gain of nearly 40 pounds or roughly 16 percent of his body weight.
His BMI increased from 35 to 40.5.
Subject #2: A fitted mouth plate did not help slow his eating
“He was fitted with a mouth plate in an attempt to decrease his caloric intake (by slowing down his eating), without apparent benefit,” the paper notes.
Subject #2: Cravings and compulsive eating improved when dose losed to 3 mg per day
After lowering his dose to 3 mg per day, “his food cravings and compulsive eating improved, as did his hypersexuality, hallucinations, and excessive daytime sleepiness.”
Subject #2: Symptoms disappeared when the drug was stopped
“When he discontinued [the drug] these symptoms resolved completely,” according to the paper.
Subject #2: Lost 13 lbs three months after the drug was stopped
Three months after stopping the drug, he had lost 13 pounds of the 40 pounds he had gained, and his BMI had decreased from 40.5 to 39.
Comment: I disagree with their conclusion. I believe serotonin deficiency is cause.
The authors of this paper concluded that the drug Mirapex (pramipexole) “may have unmasked an ‘overeating diathesis’—[that is, a predisposition to overeating]—by simultaneously increasing food cravings and decreasing the ability to control the response to these cravings.”
Based on my personal experience with nutritional supplements and amino acids over the past 23 years, I think the reason for the compulsive eating and food cravings is much simpler than that.
I believe that it is due to a serotonin deficiency.
In my personal experience, when you increase dopamine, noradrenaline or adrenaline, you in turn decrease serotonin.
In my personal experience, they live on opposite ends of a see-saw or teeter-todder; dopamine, noradrenaline and adrenaline on one end, and serotonin on the other end.
By the way, dopamine, noradrenaline and adrenaline are closely related: dopamine is converted to noradrenaline in the body, which is then converted to adrenaline.
When I have taken drugs such as ephedrine and caffeine—which increases release of dopamine, noradrenaline and adrenaline—I find that if I don’t balance it with the amino acid L-tryptophan or 5-HTP at night, after several days I become quick to anger, have trouble sleeping and develop cravings for carbohydrates.
This is a sign of serotonin deficiency.
In my personal experience, the opposite is also true.
When you increase serotonin, you lower dopamine, noradrenaline and adrenaline.
When I have taken too much tryptophan or 5-HTP, I experience a decrease in sexual desire and sexual performance, and can also develop anxiety.
This is a sign of dopamine deficiency.
These are all side effects of serotonin reuptake inhibitors (SSRIs) such as Prozac and Zoloft.
A FEW MORE COMMENTS LATER
I have a few more comments about this that I will add later, hopefully later this evening.
Nirenberg M, Waters C. Compulsive eating and weight gain related to dopamine agonist use. Mov Disord. 2005 Oct 31.
Division of Movement Disorders
Department of Neurology
Columbia University Medical Center
New York, New York, USA
Melissa J. Nirenberg
Weill Cornell Medical College
Department of Neurology and Neuroscience
428 East 72nd Street, Suite 400
New York, NY 10021
Articles on the same subject can be found here:
On Nov 05, 2005 at 7:28 am Randy Smith, MD wrote:
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This is the opposite of what I would have predicted. Usually dopamine blockade stimulates appetite ? this is commonly seen with antipsychotic drug treatment where dopamine blocking is the primary drug mechanism. An alternative explanation such as serotonin depletion sounds more reasonable.
On Nov 11, 2005 at 3:00 pm Larry Hobbs wrote:
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On Jul 04, 2008 at 8:22 pm Itsme wrote:
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I just wanted to add my experience.
I gained about 50 pounds over the course of two years while taking dopamine agonists, dopamine reuptake inhibitors, and dopaminergics. I was self-medicating trying to treat my treatment-resistant depression. I had already tried many of the standard antidepressants with no luck, so I decided to tackle dopamine. I ordered a variety of prescription meds from India over the two year period.
During this time I was on the Atkins Diet. I have been on it for almost 10 years, and my weight had been above where I would have liked it, but fairly steady. When I started taking the dopamine agonists, I had uncontrollable hunger, something that I had never had before or since to this degree. To gain 50 pounds in two years while adhering strictly to the Atkins Diet takes an unbelievable amount of eating.
After about two years of the dopamine agonists (with no particular luck on the depression front) I had gained 50 pounds, and I suddenly realized that it was the dopamine agonists that were causing the problem. It's funny because it really was like a light-bulb coming on. It was like the idea hit me that it was the Dopamine agonists, and I knew that was why.
I stopped them almost two years ago and since then I have lost all of the extra 50 pounds and some more besides. Yeah!!!
I don't remember everything that I tried but it included:
L-Tyrosine (25 g per day),
These results may not be typical or expected, but I have no doubt at all that it is what caused my weight gain.
On Jul 04, 2008 at 9:07 pm Larry Hobbs wrote:
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Thank you very much for sharing your story.
I posted it here so that more people will see it:
Were you taking 25 grams (25,000 mg) of L-tyrosine per day?
That's a huge amount.
One gram (1000 mg) is roughly the amount that would fit into the last digit of a man's little finger.
A paper several years ago found that low levels of tryptophan in the blood caused people taking SSRI's such as Effexor to experience "agitated depression".
It seemed that if the body did not have enough serotonin, which is made from tryptophan, it caused "treatment resistant depression".
It took me 12 years to realize this, and I don't think Western cultures appreciate this the way that Asian cultures do, but I believe that balance is extremely important.
Driving up dopamine too high is just as bad as having it too low.
The same with serotonin.
You might try L-tryptophan or 5-HTP and see if it helps.
A nutritionally-oriented doctor who is familiar with the use of amino acids, which may be difficult to find, would be extremely helpful simply because they have treated thousands of patients and know what tends to work and what does not.
5-HTP is one step closer to serotonin than L-tryptophan, but 5-10 years ago I read an article by a naturopathic doctor, I think, who said that he preferred using L-tryptophan to 5-HTP, although I don't remember exactly why.
It may have been that he simply felt that it worked better, although a number of studies have tested 5-HTP and found it to be effective for mild depression.
L-tryptophan >> 5-HTP >> serotonin
May I ask your gender, age and weight?
If you'd rather not answer, that's OK.
On Oct 01, 2008 at 7:12 am Itsme wrote:
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I am a 50+ year old male. At the time I was taking the dopamine-related medications I started out at around 250 and ended up at a high weight of 305. That was about 2 1/2 years ago that I ended up at that weight, and since then I have gotten my weight back down.
I was indeed taking 25 grams of l-tyrosine per day. I would buy the 1 kg containers from bulknutrition. I used a scale to measure 25 g the first time, then found a measuring scoop that would hold that amount. Because l-tyrosine is very light and fluffy, it takes quite a bit to weigh 25 g. I think that it ended up being around 1/3 of a cup. I would dissolve it in a large glass of water and drink it down at one go. Of course I didn't start at that level, I started with much less and worked my way up. The 25 g was based on a figure that I had read somewhere about a maximum dosage of between 150 and 200 mg/kg per day.
Without getting too involved in the story, I decided about 5 or 6 years ago that I was a smart guy and that with enough research I should be able to find a solution to my treatment-resistant depression. My doctor had tried quite a few meds, but with no luck with any of them.
I actually first started with serotonin-related things. I tried 5-HTP and l-tryptophan first. Then I tried prozac, zoloft, effexor, celexa, lexapro, and maybe a couple of others, but to no avail.
I then tried the SNRIs, Ixel (french), cymbalta and effexor, but no luck with them either.
I tried some stuff for ADHD that is scheduled (not ritalin), so I won't mention the specific medications, although I did have a prescription for one of them.
When I mentioned the dopamine-related meds in my earlier post, I neglected to mention wellbutrin.
I also tried tianeptine (Stablon), which if you are not familiar with, you should look into. It works the opposite way from an SSRI like prozac -- It actually accelerates the reuptake of serotonin.
I tried most of these alone and a few in well-recognized combinations.
After the serotogenics, then the SSRIs, then the SNRIs failed, I really expected that the dopamine-related meds would work for my depression, but they didn't.
Because I'm on the Atkins diet, none of the other meds made me gain weight, even if they have a reputation for doing so. On the other hand, when I was experimenting with dopamine I was an eating machine.
I focused longer on the dopamine-related meds than I did the other classes of meds because I was certain that they would be the solution to my problem, but they weren't. As I mentioned in my earlier post, I went along for about two years not associating my weight gain with the dopamine-related meds. Then one day I had the realization about what was going on and I tapered whichever med I was on, and that was that. No more eating machine.
Sometime after that, I bit the bullet and started taking an MAOI, and I had reasonably good results with it. My depression has remitted by probably 80 or 90%. I wish now that I had tried an MAOI years ago. The dietary restrictions scared me then. And let me tell you that if you are going to take them you must observe the restrictions. I got a little too complacent and ate some cheese that I shouldn't have and had a hypertensive crisis. But I could make a several page story just out of that.
Larry, thanks for your comments and suggestions.
On Oct 01, 2008 at 7:36 am Larry Hobbs wrote:
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I just recently became aware of Joan Mathews-Larson, PhD who wrote the book called "Depression-Free, Naturally: 7 Weeks to Eliminating Anxiety, Despair, Fatigue, and Anger from Your Life".
On Amazon here:
The book is the same as "7 Weeks to Emotional Healing: Proven Natural Formulas for Eliminating Depression, Anxiety, Fatigue, and Anger from Your Life" which is the hardcover version.
On Amazon here:
She also wrote "Seven Weeks to Sobriety: The Proven Program to Fight Alcoholism through Nutrition".
On Amazon here:
It is incredibly fascinating.
She treats depression, anxiety, alcoholism and drug addiction as a biochemical problem with great success and using no drugs.
She does lots of lab testing to figure out biochemical deficiencies that a person has and then gives them vitamins, minerals and amino acids.
I agree with her approach 100%.
She says that most people who come to see her are anxious and depressed, and most are on one or two SSRI's.
She gets them off all drugs. Amazing.
She says it works very well and very fast.
She says the body heals itself when you give it what it needs.
She talks about how some people who have come to see her have felt depressed and suicidal their entire life, and a few have said, "I've bought a gun. If you can't help me, I'm going to end it."
She said this is scary, but no one has every committed suicide.
I also bought a couple speeches she gave recently at a conference for $5 each -- well worth it. I would have gladly paid many times this much.
You can find them here:
If you do a Google search for "Joan Mathews-Larson mp3", you can also find a couple interviews that she has done that are posted on-line that you can download for free.
For example, one interview can be downloaded from here:
Also search for her name on iTunes.
There is one podcast where she is interviewed, although the other interviews and speeches she gave are much more informative.
Her website is:
On Oct 01, 2008 at 7:44 am Larry Hobbs wrote:
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Joan Mathews-Larson, PhD also did an interview with Dr. Julian Whitaker on his radio program about treating alcoholism -- I forget if she talked about treating depression -- and the programs are available for download for a couple months, or you can contact Dr. Whitaker's office to purchase past shows.
Look for Hour 3 on Tuesday - July 17, 2007.
On Oct 01, 2008 at 7:49 am Larry Hobbs wrote:
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In her speeches, Joan Mathews-Larson, PhD quotes Linus Pauling, who won 2 Nobel Prizes, and Dr. Jonathan Wright, who I have a great deal of respect for, who have said that drugs will never be as effective as natural substances that the body has evolved on for millions of years.
I agree 100%.
On Oct 06, 2008 at 9:51 pm Itsme wrote:
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Thanks for taking the time to post those links. I went to amazon and looked at the book "Depression-Free, Naturally: 7 Weeks to Eliminating Anxiety, Despair, Fatigue, and Anger from Your Life" that you mentioned. I am planning on purchasing the book.
As you can tell by my post, I believe in taking responsibility for my own health, and finding solutions wherever possible.
I didn't mention this in my earlier post, but prior to trying to find medication for my depression, I did try to work with nutrional supplements.
At a health-food store near where I live, there is a lab technician who comes once a month and you can have him do any lab test that you would like. It is much cheaper than having it done at a doctor's office.
I've had some uncommon and expensive tests done. I had an amino-acid profile done. The first customer that he ever had who had done one. I had a fatty acid profile done. Both of those test showed everything in the normal range. My omega-3s tested at the high end of the range because I take a lot of fish oil (liquid, not the capsules). I started taking this for depression, but even though it didn't help with that, I continue to take it because it provides so many health benefits.
I've had lots of other tests, such as for mercury, and heavy metals, copper, magnesium, and several other minerals, lots of thyroid test, sex hormone tests, other hormone tests, food allergies, and other allergies.
In the past, this lab tech has been unable to do hair mineral analysis, but he has just added that capability, and I intend to avail myself of that.
Even though everything has tested out normally, I have tried all the vitamin, mineral, and amino acid supplements normally suggested for depression, but with no success. I have also tried some of the herbal and other remedies, but with no luck either. The most success that I had was with SAMe. It worked for me for a few weeks the first time I took it, but it stopped working, and has never worked again when I have tried taking it again after that.
In all, I have probably tried about 50 or more supplements. I know that supplements generally work in a subtle fashion, so I give them a fairly long while to work, and I look for small improvements.
I used to think that I would have one of these tests, and that I would find a smoking gun. Something like very low magnesium, for instance. Then my fantasy was that I could treat the underlying low levels and my depression would eventually go away. However, as time as gone on, and I've had more tests with no smoking gun, I have come to believe that I will not find one.
Clearly there is an uderlying biochemical problem, but a blood test may not indicate it. Perhaps the problem lies in my having some difficulty transporting some chemical across the blood brain barrier. No blood test will show that, unless I had a blood sample directly from my brain. They do that in research studies, but not as routine medical practice.
I still take quite a few supplements because I believe that they will have a positive impact on my health.
I want to get the book that you mentioned to see if perhaps it can suggest some supplements that I have not tried, or some tests that I have not had done, or even some eating patterns that might be useful.
On Oct 07, 2008 at 9:05 am Larry Hobbs wrote:
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If possible, you might consider going to see Dr. Larson in Minneapolis.
Here is the phone number for her Health Recovery Clinic.
Having done this for 30 years and treated thousands of patients, so she knows exactly what to test for, exactly how to treat it, exactly how long it will take, exactly what works and what does not.
She tests for things like high levels of kryptopyrroles, also called pyrroles, and if levels are elevated, she has a specific formula for treating it.
She calls the condition Pyroluria and she says it is very common in people who come to her clinic.
In one of her speeches, she said that just about everybody who comes to her clinic has anxiety and depression.
She also talks about how eliminating food allergies can have a dramatic impact.
On Oct 07, 2008 at 9:39 am Larry Hobbs wrote:
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A note about tyrosine dose.
You noted earlier that you were taking 25 grams of tyrosine -- 25,000 mg per day.
Tyrosine converts to dopa which converts to dopamine which converts to noradrenaline which converts to adrenaline.
Taking tyrosine increase the amount of noradrenaline, but only by a maximum of 13 percent.
This is because the enzyme that converts tyrosine into noradrenaline is 70-80 percent saturated.
Therefore, taking more than a small amount -- although I don't know what that amount is -- does not add anything.
Tryptophan, which converts into serotonin, is similar, however, this enzyme is only about 50 percent saturated.
Studies have found that 3 grams of L-tryptophan -- 3000 mg -- doubles serotonin levels, but increasing the dose above this had no further effect.
By the way, based on my experience with taking tryptophan over the last 26 years, 3 grams of tryptophan -- 3000 mg -- is way too much.
Based on this -- and this is just a wild guess -- I imagine that taking anything more than maybe 1000 mg or 1500 mg of tyrosine has no further effect.
It is as if a garden hose were connected to a bathtub, the same amount of water comes out of the hose regardless of whether the tub contains 10 gallon of water or 100 gallons of water.
Putting more water in the tub would not increase the speed at which the water is coming out of the hose.
The same seems to be true of tyrosine (and tryptophan, for that matter.)
The point being that taking maybe 1000 mg of tyrosine probably does as much good as taking 25,000 mg.
On Nov 09, 2010 at 3:03 am Paul wrote:
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If lowering serotonin could cause weight gain, then why is it that SSRIs - which increase serotonin through blockade of the serotonin transporter - cause weight gain, especially with long-term use?
It is well-known that SSRIs and tricyclic antidepressants contribute to weight gain and increased appetite when used for a long period of time.
Cocaine and amphetamines decrease appetite and weight, but they also increase dopamine by blocking its reuptake.
On Nov 09, 2010 at 9:17 am Larry Hobbs wrote:
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It turns out that SSRI's can deplete serotonin.
This is probably simply because they prevent reuptake, keeping serotonin around longer which give MAO enzymes more time to break it down.
SSRI's also reduce the number of serotonin receptors.
I used to believe in antidepressants like SSRI's, thinking they were a good thing, but now I don't. I now believe that antidepressants cause problems long-term.
See the interview that Dr. Mercola did with Robert Whitaker, the author of "Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America" about how:
- antidepressants are NOT very effective in the short-term, and
- when given long-term, they convert a short-term illness into a chronic problem,
- increase the risk of converting someone from unipolar depression to manic-depression,
- may cause cognitive problems,
- are not "normalizing agents", but instead are "abnormalizing agents",
- REDUCE serotonin levels and
- DECREASE serotonin receptors.
The transcript of the interview as shown above is posted on Dr. Mercola's website here:
The interview is on YouTube in 7 parts starting here:
Joan Mathews Larson, PhD, author of "Depression-Free Naturally", who has treated people with anxiety and depression for 30 years and uses no drugs, has also talked about the same thing.
On Nov 09, 2010 at 9:18 am Larry Hobbs wrote:
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Here are the 39 most important points from Dr. Mercola's interview with Robert Whitake.
1. Robert Whitaker notes that for "mild to moderate depression, basically the drug-treated group doesn?t do any better in any sort of clinically significant way in terms of relieving the target symptom of depression than the placebo group [ in the short-term ]."
2. Before antidepressants were used, people with depression, even with major depression, usually got better.
3. In 1974, Dean Skyler, head of the depression section at the National Institutes of Mental Health wrote, ?Most depressive episodes will run their course and terminate with virtually complete recovery without specific intervention.?
4. Someone else wrote, ?Depression is on a whole, one of the psychiatric conditions with the best prognosis for eventual recovery with or without treatment. Most depressions are self-limited.?
5. Since most people recover from depression on their own, the initial rationale for using drugs was to see if they could help people recover faster.
6. However, what doctors started noticing was that when depressed patients were given antidepressants, they were relapsing more frequently.
7. So the question became are these drugs turning a short-term illness into a chronic illness?
8. Only about 15% of patients given antidepressants stay well for a long period of time. 85% have relapses and the depression becomes a chronic illness ( because of the drugs ).
Near the end of the interview, Robert Whitaker says that, "By the way, the NIMH [ National Institute of Mental Health ] looked at this in the late 1990?s what is the untreated course of major depression today and they found that those old epidemiological studies that showed that 85% were well at the end of the year, still held true."
In other words, 85% of people who are NOT given antidepressants are well at the end of a year.
However, among people who are GIVEN antidepressants, only 15% stay well in the long run.
So are long-term use of antidepressants helping people?
Based on these numbers, it appears that long-term use of antidepressants are making things much worse for people.
9. Robert Whitaker says "? by the 1990s, this change in the long-term course of depression was so pronounced that finally it would be actually addressed by researchers and there was a guy named Giovanni Fava from Italy who said, 'Hey, listen, the course is changing with antidepressants. We?re changing it from an episodic illness to a chronic illness and we really need to address this.'
"Not only that, the depression is sort of sinking into people in sort of a deeper way than before [ in people who are given these drugs ]."
10. As [ Giovanni Fava from Italy ] said, it?s almost as if the drug sensitize people to depression long-term.
11. Even the American Psychiatric Association essential admits this in their 1999(?) textbook noting that we used to think people would get well and that the long-term course of major depression was pretty favorable. But now, we?re seeing that?s it a chronic pernicious disease but they?re talking about medicated depression not unmedicated depression.
12. Robert Whitaker says, "A very famous psychopharmacologist named Ross Baldessarini at Harvard Medical School -- He?s one of the fathers of psychopharmacology -- who says, 'We really need to investigate this. This is what our research is showing.'
He says, "It?s not pleasant to consider but we have to look at this. Are these drugs depressogenic? [ That is, are these drugs CAUSING depression? ]"
13. Robert Whitaker says, "... a psychiatrist at Columbia University named Donald Kline [ said ], ?Listen, stop talking about this. Nobody is interested in this question. The FDA is not interested. The NIMH [ National Institute of Mental Health ] is not interested. Nobody is interested. We?re just not going to investigate this and really you don?t see the research done that would investigate it.?
"And that?s the moment you can really see psychiatry sort of betraying its patients because here you have mainstream people writing about it seems like over the long-term where we?re turning depression into a chronic course that maybe these drugs in fact are depressogenic over the long-term."
[ It seems obvious that Dr. Kline from Columbia University said this because he was being paid by the drug companies. Do you think it is any different for any other drug -- blood pressure drugs, cholesterol drugs, diabetes drugs, psychiatric drugs? I imagine that a lot of people assume that you can believe whatever a University researcher says because they are academics and only interested in scientific truth. But the exact opposite is true in this example. This University researcher wants everyone to ignore the problem and pretend it does not exist. He even says that the FDA and the National Institute of Mental Health are not interested in the problem either. So if you are interested in knowing if antidepressants CAUSE long-term depression, would you believe Dr. Kline, a University researcher who is saying that nobody is interested in this? I wouldn't. Assuming that it is true that the FDA and the National Institute of Mental Health wish to ignore the problem as Dr. Kline states, would you believe what the FDA or the National Institute of Mental Health has to say about it? Unfortunately, I would not. Beware of how money affects what people say. Beware of how drug company money affects what the Hypertension Society says, and what the National Cholesterol Education Program guidelines says, and what the Diabetes Society says, and what the American Psychiatric Association says. I realize it is easy to think, "Well, surely if this was a problem the FDA and the National Institute of Mental Health would warn doctors and the public about this," however, this does not appear to be the case. ]
14. A study on depression in the late-1990's from Duke University compared
- drugs-only versus
- exercise-only versus
They expected the drugs-plus-exercise group to do the best, but this was NOT the case.
They found that the exercise-only group did the best after 10 months, and found that drugs HINDERED the long-term stay-well rate in the drugs-plus-exercise group.
15. Britian has recently changed its recommendations, saying that antidepressants should NOT be used as first-line therapy. That they are just not that effective and have all these side effects.
Doctors in Britian are now writing prescriptions for exercise for depression. The number of doctors writing prescriptions for exercise was 4% in 2007, and now is 25%.
16. Antidepressants INCREASE the risk of converting depression to manic depression, that is, from unipolar depression to bipolar depression.
Robert Whitaker says, "And you definitely see this that the drugs are meant to rouse, right? That the risk of having a manic episode or a quasipsychotic episode when you go on an antidepressant is real and so one of the things we?ve seen with the use of the SSRI is of course is this incredible extraordinary boom in bipolar diagnoses and that is definitely tied to the widespread use of antidepressants."
17. Robert Whitaker says, "Now, in kids, something like 25% to 50% of all kids placed on an antidepressant, who stays on that antidepressant for five years will convert to bipolar illness."
18. Robert Whitaker says, "With adults, it seems like about 25% of long-term of users that begin with a diagnosis of unipolar depression will convert to bipolar."
"Now, by bipolar used to be a fairly rare disorder but now it?s becoming much more common."
19. He goes on to say, "Well, when you convert from depression to bipolar, now you?re in a category where you?re often treated with a cocktail of medications including an antipsychotic medication and long-term bipolar outcomes are really problematic in this country.
"Only about 35% of bipolar patients now are employed."
20. The research suggests that antidepressants may cause cognitive decline.
"... as one researcher at Massachusetts General Hospital said when we look for it, we find that it?s quite common."
21. The idea that antidepressants fix a chemical imbalance "is scientific nonsense". It has NEVER been proven. It was NOT about science. It was about marketing.
In fact, he later talks about how these drugs CAUSE chemical imbalances.
They REDUCE serotonin levels -- that is, cause a serotonin deficiency -- and REDUCE the number of serotonin receptors.
Note: Joan Mathews Larson, PhD, who has been treating addiction, depression and anxiety with natural treatments for 30 years with much higher success rates that I have seen anywhere else, talks about the same thing -- that these drugs deplete the body of serotonin and reduce serotonin receptors.
22. In 1983 -- four years before Prozac was released in 1987 -- the National Institutes of Mental Health "concluded basically there is no evidence that there is anything wrong in the serotonergic system of depressed patients" Robert Whitaker notes.
23. Robert Whitaker says, "And the other thing that you have to understand then is if you don?t start off with the serotonergic problem when you?re depressed, like you don?t have low serotonin, but now you put yourself on a drug and this drugs blocks then normal reuptake of serotonin, your brain actually will undergo changes to try to compensate for that blockade and what happens, the brain changes in two ways, the pre-synaptic neurons actually put out less serotonin and your post-synaptic neurons actually pair away the density of the their serotonergic receptors.
"So, you start out with a normal serotonergic system.
"You go on and anti-depressant and you actually physiologically end up with a low serotonergic state. This is very well understood.
"So, in essence, I know this sounds ironic but drugs cause the very thing that was hypothesized to cause depression and that is for this low physiological state."
24. "... in 1996, Steven Hyman who is then head of the NIMH [ National Institute of Mental Health ], today he is Provost of Harvard University -- He?s a neuroscientist -- He published this paper called Initiation and Adaptation: A Paradigm for Understanding Psychotropic Drugs.
"And here is what he said that drugs like antidepressants work.
He says they work by, ?Perturbing neurotransmitters systems not balancing them? and in response to that perturbation, he said, ?The brain undergoes these compensatory adaptations? that I?ve just explained and then he says, at the end of this adaptation, the brain is operating in a manner that is, ?Both qualitatively and quantitatively different than normal.?
So these are not normalizing agents from a scientific point of view, really they are abnormalizing agents...
25. Robert Whitaker says,
"So, this is really key.
"Are these normalizing agents? No.
"Are they abnormalizing agents? Yes."
26. Dr. Mercola says, "Yeah, the ultimate irony is that the drugs are causing the very things that they were designed to cure."
27. Antipsychotic drugs cause problems also by blocking dopamine receptors. This causes the body to pour out more dopamine which increases the vulnerability to psychosis.
28. Robert Whitaker says, "... there is a historical story as to why our country is deluded, our society is deluded and believes in this chemical imbalance story."
He notes that in the 1970's, psychiatry felt like it was under siege because there were also non-MD's -- social workers, counselors, psychologists who were all competing for the same patients.
Anti-anxiety drugs were also seen as addictive and harmful.
So, starting in 1980, they put out the DSM3 -- [ Diagnostic and Statistical Manual of Mental Disorders ] -- "which put psychiatry and psychiatric disorders into a medical model" and they touted using drugs for these conditions because social workers, counselors, psychologists [ non-MD's ] could not prescribe drugs, so this would eliminate their competition.
29. Robert Whitaker states, "? in 1980, the American Psychiatric Association, as its annual meeting, started allowing pharmaceutical companies to sponsor symposiums.
"They [ pharmaceutical companies ] had always been allowed to put up exhibits on the exhibit floor but now they were actually allowed to sponsor scientific 'presentations.'
"At that point, they began hiring academic physicians, people at major medical schools, to serve as the speakers at those events.
"And this is where the wall breaks down between academic psychiatry and the pharmaceutical companies because now the top doctors in the country, the top psychiatrists are going to start becoming paid to tell a story that pharmaceutical companies basically want told.
"And pretty soon they?re serving as advisors, they?re serving as consultants, they?re getting research grants as speakers.
"There is a lot money flowing to ?the thought leaders? in psychiatry or the key opinion leaders.
"And in essence, they become the salesman for these product lines and they?re very effective salesmen and they have basically created this false story."
"And unfortunately they get paid; they can make a lot of money.
"I mean, some of the amounts have come out of Senator Grassley?s investigation. We?re talking of millions of dollars going to the top key opinion leaders within psychiatry.
"So that?s how come we got this delusion. We had these storytelling forces within society come together that wanted to tell a story of drugs that were safe, effective, wonder drugs that fix chemical imbalances.
"And, unfortunately, that story was out of sync with the research. It?s just not a scientific story.
30. In 1985, the US spent $0.6 billion ($600 million).
Today, the US spends $40 billion, nearly a 70-fold increase.
31. In 1987 when Prozac was introduced, there were 1.25 million people on government disability due to mental illness.
Today, twenty years later, there are 4 million people on government disability due to mental illness.
32. Robert Whitaker says, "So here we have this new embrace of a medication that is said to be a wonder drug and what do we see, we see disability rates do to depression and disability rates do to bipolar illness are skyrocketing."
33. Robert Whitaker goes on to say, "I mean there is some evidence that really pretty consistent evidence that the longer you?re on antidepressant medications frankly, the harder it is to get off.
"In other words, your vulnerability to relapse when you come off it increases."
34. Robert Whitaker says, "Television ads now, we have this new ad for Abilify which is an antipsychotic, it says, two-thirds of people with an antidepressant are still depressed. Now, add a drug. Well, you want to say ?well apparently the drug is not working too well if two-thirds are still depressed.?
35. Robert Whitaker says, "Anyway, it?s quite clear that when that happens, you can have some very severe withdrawal symptoms and it?s not just symptoms of depression returning, you might have all sorts of odd symptoms and then what happens is withdrawal can be so difficult that people just say, ?Heck, I?ll just stay on my drug.?
"So that?s a real problem in a way that the drugs can act like a trap and I do believe the longer you?re on them, this isn?t well studied but the longer you?re on, the harder it is to come off.
"Really, there is some sense; the harder it is for your brain to sort of renormalize and receptor density is to return to normal and all.
36. Dr. Mercola notes, "But anyway, you just do not, and I want to emphasize it a lot, do not stop these medications cold turkey, you are just asking for trouble.
"You can, most of the time, wean off of them slowly. It might be a few weeks. It might be a few a few months but you just got to go off them slowly."
"It can really be helpful to have someone supporting you and watching you and sort of helping you understand -- I?m talking about if you?re weaning yourself from medications - - and helping you understand some of the symptoms you maybe be feeling may be related to drug withdrawal and give you some sense of how long you may be experiencing those withdrawal symptoms, because you can have withdrawal symptoms even when you gradually withdraw."
37. Dr. Mercola says, "So I mean the message that needs to be shared is one that you really compiled and put together and really reinforce is that you just got to avoid these medications."
38. Dr. Mercola asks if there is any indication for these drugs.
Dr. Mercola compares this to statins noting that, "For the most part, I believe almost all Statins, the drug used to lower cholesterol are absolutely dangerous and should be avoided by almost everyone but there is a small subset of people about one in a thousand who have a genetic disease. It?s called familial hypercholesterolemia and their cholesterols usually run about 350 or so and they seem to benefit from it."
39. Robert Whitaker notes that in people with severe depression as rated on the Hamilton Scale, that antidepressants work better than placebo in 6-week studies.
He states, "So, this again is what the National Institute of Clinical Excellence in Britain concluded is that that shows there is some rationale for using antidepressants in that subset of depressed patients. Even sort of as a first line therapy."
... "You want to remember that, so I think the rationale use would be in this subset [ of severely depressed patients ] would be okay, use it to help people get out of the severe symptoms on a short-term basis and as that happens, help them encourage to make changes whether it be diet, exercise, get in to community groups, join clubs, whatever it might be and then help them wean off, try to help them wean off after six weeks, eight weeks."
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