1 A Fully Depressed Population
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I got so sick of looking at spreadsheets and data and analyzing it every which way possible, he said, but they knew there must be a mistake somewhere.This was, I think, the moment when Irving turned into the Sherlock Holmes of antidepressants.That’s why the drug companies conduct their scientific studies in secret, and afterward, they only publish the results that make their drugs look good, or that make their rivals’ drugs look worse.But Thomas Moore said there is a way beyond this.He explained to Irving that there was actually a way he could get access to all the data the drug companies don’t want us to see.Several months later, the data was released to them, and Irving began to go over it with the scientific equivalent of Sherlock Holmes’s magnifying glass.It’s an improvement of 1.8 points.Irving furrowed his brow.That’s a third less than getting better sleep.It was absolutely startling.Yet the data showed something else.The side effects of the drugs, by contrast, were very real.These are real drugs, with a real effect.They are highly unlikely to solve the problem for most people.Now he had the unvarnished science, and he was starting to realize he couldn’t continue as he had before.When Irving published these figures in a scientific journal, he expected a big fightback from the scientists who had produced all this data.One group of researchers wrote that it had been a dirty little secret10 in the field for a long time that the effects of these drugs on depression itself were in reality tiny.Irving thought, before he published, that he had a scoop, a previously unknown shocker.In fact, he had only discovered what many people in the field had privately known all along.She had been taking antidepressants for years.I’m absolutely not, he said to her.It’s that it has a different cause than the one you have been told about.She wasn’t convinced.She didn’t speak to him again for years.A short while later, Irving was handed another leaked study.This one struck me especially hard when I read about it, because it was talking directly about a situation I had been in.None showed a success.Paroxetine [another name for the [drug]](http://www.lineage.citymax.com/blog/2021/12/Choosing-Wedding-Clothes-can-be-a-quandary) is effective for major depression in adolescents.The internal discussion within the company from this time was also later leaked.In the end, in court,11 they were forced to pay $2.5 million in New York State for the lie after New York attorney general Eliot Spitzer sued them.But I had been prescribed the drug as a teenager by then, and I had continued to take it for more than a decade.Later, one of the world’s leading medical journals, the Lancet, conducted a detailed study of the fourteen major antidepressants that are given to teenagers.The journal concluded they shouldn’t be prescribed to teenagers any more.12Reading this was a turning point for me.But this was only the first of his revelations.The most shocking was still to come.It was definitely a clinical depression, one that I was going to have to have help to overcome, she said.What’s the evidence, he began to wonder, that depression is caused primarily by an imbalance2 of serotonin, or any other chemical, in the brain?Where did it come from?The serotonin story began,3 Irving learned, quite by accident in a tuberculosis ward in New York City in the clammy summer of 1952, when some patients began to dance uncontrollably down a hospital corridior.They could hardly miss it.So what, people started to ask, could these new drugs have in common?Nobody really knew where to look, and so for a decade the question hung in the air, tantalizing researchers.And then in 1965, a British doctor called Alec Coppen came up with a theory.What if, he asked, all these drugs were increasing levels of serotonin in the brain?If that were true, it would suggest that depression might be caused by low levels of serotonin.Gary Greenberg, who has written the history of this period, explains.One of them said it was at best a reductionist6 simplification, and said it couldn’t be shown to be true on the basis of data currently available.But a few years later, in the 1970s, it was finally possible to start testing these theories.It was discovered that you can give people a chemical brew that lowers their serotonin levels.After taking this brew, people should become depressed.They gave people a drug to lower their serotonin levels and watched to see what would happen.I went to see one of the first scientists to study these new antidepressants in Britain, Professor David Healy, in his clinic in Bangor, a town in the north of Wales.He has written the most detailed history of antidepressants we have.There was never any basis for it, ever.It was just marketing copy.There wasn’t ever a point in time when 50 percent of the field actually believed it. In the biggest study of serotonin’s effects on humans, it found no direct relationship9 with depression.Professor Andrew Skull of Princeton has said attributing depression to low serotonin is deeply misleading and unscientific.10It had been useful in only one sense.When the drug companies wanted to sell antidepressants to people like me and Tipper Gore, it was a great metaphor.It was still taken for [granted](https://gitee.com/uk_b6a6/sync/wikis/Nursery Management Systems) that these problems are caused by a chemical imbalance in the brain, and antidepressants work by correcting that chemical imbalance.If one chemical turns out12 not to be the psychological killer, they must start searching for another one.But Irving began to ask an awkward question.If depression and anxiety are caused by a chemical imbalance, and antidepressants work by fixing that imbalance, then you have to account for something odd that he kept finding.Antidepressant drugs that increase serotonin in the brain have the same modest effect, in clinical trials, as drugs that reduce serotonin in the brain.And they have the same effect as drugs that increase another chemical, norepinephrine.And they have the same effect as drugs that increase another chemical, dopamine.What do the people taking these different drugs actually have in common?After twenty years researching this at the highest level, Irving has come to believe that the notion depression is caused by a chemical imbalance is just an accident of history, produced by scientists initially misreading what they were seeing, and then drug companies selling that misperception to the world to cash in.And so, Irving says, the primary explanation for depression offered in our culture starts to fall apart.The idea you feel terrible because of a chemical imbalance was built on a series of mistakes and errors.It has come as close to being proved wrong, he told me, as you ever get in science.It’s lying broken on the floor, like a neurochemical Humpty Dumpty with a very sad smile.Could this really be true?I’m not trained in the kind of science he is a specialist in.I wondered if I was misunderstanding him, or if he was a scientific outlier.So I read all that I could, and I got as many other scientists to explain it to me as possible.The whole idea of mental distress being caused simply by a chemical imbalance is a myth, she has come to believe, sold to us by the drug companies.Lucy Johnstone14 was more blunt still.The serotonin theory is a lie.Surely there are procedures in place to stop something like this from happening?How could these drugs have gotten through the procedures in place, if they were really as limited as this deeper research suggested?I discussed this with one of the leading scientists in this field, Professor John Ioannidis, who the Atlantic Monthly has said may be one of the most influential scientists alive.16 He says it is not surprising that the drug companies could simply override the evidence and get the drugs to market anyway, because in fact it happens all the time.He talked me through how these antidepressants got from the development stage to my mouth.The companies are often running their own trials on their own products, he said.That means they set up the clinical trial, and they get to decide who gets to see any results.So they are judging their own products.Typically, it’s the company people17 who write up the [published [scientific]](https://vc.ru/u/945445-ali/331725-implantable-lens-operations) reports.This evidence then goes to the regulators, whose job is to decide whether to allow the drug onto the market.But Professor Ioannidis was telling me that in this match, the referee is paid by the drug company team, and that team almost always wins.The rules they have written are designed to make it extraordinarily easy to get a drug approved.If there are two, and there is some effect, that’s enough.I think that this is a field that is seriously sick, Professor Ioannidis told me.The field is just sick and bought and corrupted, and I can’t describe it otherwise. I asked him how it made him feel to have learned all of this.It’s depressing, he said.That’s ironic, I replied.Okay, so say it’s a placebo effect.Whatever the reason, people still feel better.Why break the spell?Of course, Irving says, there’s weight gain. I massively ballooned, and saw the weight fall off almost as soon as I stopped.Though it’s painful to talk about, this rang true for me, too.In the years I was taking Paxil, I found my genitals were a lot less sensitive, and it took a really long time to ejaculate.In young people, [these chemical [antidepressants]](https://www.pearltrees.com/newboilers3/item413391211) increase the risk18 of suicide.There’s a new Swedish study showing that it increases the risk of violent criminal behavior, Irving continued.In older people it increases the risk of death from all causes, increases the risk of stroke.In everybody, it increases the risk of type 2 diabetes.In pregnant women, it increases the risk of miscarriage [and] of having children born with autism or physical deformities.John’s Wort, Irving says, and we’d have all the positive placebo effects and none of these drawbacks.John’s Wort isn’t patented by the drug companies, so nobody would be making much profit off it.By this time, Irving was starting, he told me softly, to feel guilty for having pushed those pills for all those years.In 1802, John Haygarth revealed the true story of the wands to the public.Some people are really recovering from their pain for a time, he explained, but it’s not because of the power in the wands.It’s because of the power in their minds.It was a placebo effect, and it likely wouldn’t last, because it wasn’t solving the underlying problem.The intelligence excited great commotions, accompanied by threats and abuse, he wrote.Since Irving published his early results, and as he has built on them over the years, the reaction has been similar.Nobody denies that my own drug company admitted privately that the drug I was given, Paxil, was not going to work for people like me, and they had to make a payout in court for their deception.I wanted to study carefully what they say.Peter Kramer was watching as patient after patient walked into his therapy office in Rhode Island, transformed before his eyes after they were given the new antidepressant drugs.I read it soon after I started taking the drugs.I was sure the process Peter described so compellingly was happening to me.I wrote about it, and I made his case to the public in articles and interviews.His first argument is that Irving is not giving antidepressants enough time.But that isn’t enough.It takes longer for these drugs to have a real effect.This seemed to me to be an important objection.Irving thought so, too.So he looked to see if there were any drug trials that had lasted longer, to find their results.Peter then pointed to another mistake he believed Irving had made.Again, Irving thought this was a potentially important point, and one he was keen to understand, so he went back over the studies he had drawn his data from.He discovered that, with a single exception, he had looked only at studies of people classed as having very severe depression.25This then led Peter to turn to his most powerful argument.It’s the heart of his case against Irving and for antidepressants.In 2012, Peter went to watch some clinical trials being conducted, in a medical center that looked like a beautiful glass cube, and gazed out over expensive houses.When the company there wants to conduct trials into antidepressants, they have two headaches.Given all that, it’s pretty difficult for them to find anyone who will take part, so they often turn to quite desperate people, and they have to offer other things to tempt them.As he watched this, he was struck by something.When he saw people being asked to rate how well the drugs had worked, he thought they were often clearly just giving the interviewer whatever answer they wanted.The trials themselves are fraudulent.26It’s a devastating point, and Peter has proved it quite powerfully.But it puzzled Irving when he heard it, and it puzzled me.The leading scientific defender of antidepressants, Peter Kramer, is making the case for them by saying that the scientific evidence for them is junk.It’s a case against them.He soon changed the subject.He said that in cases like that, the collection of experts isn’t as expert or as numerous as what we’re talking about here.I think I want to cut off this conversation.Even Peter Kramer had one note of caution to offer about these drugs.He stressed to me that the evidence he has seen only makes the case for prescribing antidepressants for six to twenty weeks.Although I do think we’ve been reasonably lucky.There is no scientific consensus.