The Prozac story brings interlinked problems to light, among them a wholesale creation of depression on so extraordinary and unwarranted a scale as to raise grave questions whether pharmaceutical and other health care companies are more wedded to making profits from health than contributing to it. This marketing [of psychopharmaceuticals], combined with a fall-off in the number of breakthrough compounds, suggests pharmaceutical companies are now better at marketing drugs than at making them.

This mass creation of depression affects even those who are not depressed. It is now widely assumed that our serotonin levels fall when we feel low, and this lowering is thought to have consequences for everything from diet to criminality. But there is no evidence for any of this, nor has there ever been. The huge gap between what is scientifically demonstrable and what people believe, points to a cultural fact that lies well beyond the "medicalization" so worrying to sociologists and bio-ethicists. It reaches to the level of the myths we make to live by...

[D]epression was all but unrecognized before the antidepressants; only about 50 to 100 people per million were thought to suffer from it. Current estimates put that figure at 100,000 to 200,000 affected people per million. This is a thousand-fold increase, despite treatments supposed to cure this terrible affliction...

Source:
Let Them Eat Prozac: The unhealthy relationship between the pharmaceutical industry and depression.
David Healy M.D.
Toronto: James Lorimer & Company (2003:13;20)

In his 1993 book, Listening to Prozac, [Peter] Kramer coined the rather chilling term cosmetic psychopharmacology to describe how Prozac and other medications can be used to make people feel "better than well" - "to give social confidence to the habitually timid, to make the sensitive brash, to lend the introvert the social skills of a salesman"... Cosmetic psychopharmacology, like cosmetic surgery and cosmetics in general, is based on the popular delusion that it is actually possible to be somebody else... [T]he entire modern biological approach to mental illness -- the so-called Medical Model -- fosters this same delusory hope, equating sickness of the soul with a neurological glitch, and promising patients an easy chemical normalization without their ever having to confront the existential crisis that is at the center of their pain...

Source:
Healing the Soul in the Age of the Brain: Why medication isn't enough.
Elio Frattarolli, M.D.
NY: Penguin (2001:10-11)

Michael Lesser is a nutritional psychiatrist, founder of the Orthomolecular Society and Nutritional Medicine, a communications company that sponsors major world conferences on Nutrition and Vitamin Therapy. This page examines his nutritional and orthomolecular approach to depression and other existential crises. It presents a viable, well-documented alternative that involves recognition of brain chemistry types and the use of type-specific diet and supplement regimens, whenever possible, in preference to psychopharmacological intervention.

"Prescription drugs have their place and purpose," writes Lesser, "[b]ut they are harsh, sometimes toxic, ...often addictive, and must be used with great care, despite the current tendency to almost casually recommend and use these chemicals." Drugs do not treat the root problem of conditions including grief, minor neuroses, schizophrenia, psychosis and antisocial behavior; rather, they treat symptoms.

The Brain Chemistry Plan: The personalized nutritional prescription for balancing mood, relieving stress, and conquering depression.
Michael Lesser M.D., with Colleen Kapklein
Paperback: 368pp.
Publisher: Perigee (7 January 2003)
ISBN: 0399528490

[N]utritional treatments ... can provide all the benefits of prescription drugs with none of the risks... [W]e all eat, and we all make choices about what we eat. My preference is always for the natural, safe, and effective nutritional approach, rather than the riskier use of prescription drugs, [s]o I recommend a diet tailored to an individual's brain chemistry [and] I always recommend some supplements of vitamins and minerals... I also often use amino acids, enzymes, fatty acids, and herbs, depending on the specific case...
(pp.5-6)

Lesser prescribes "Prozac, lithium and other drugs on the few occasions when they fill the bill", but he views such interventions as "only temporary interventions at best".

The body needs proper nourishment to function physically, mentally, and emotionally. Without proper nutrition, we can't handle the many stresses we all face. The dynamic balance of chemicals within our brains goes haywire, [resulting in] what we label anxiety, depression and obsession, among many other things in a variety of intensities...(p.9)

About Brain Chemistry...

We recognize about 100 neurotransmitters in the human brain. What do we know about them? Lesser tells us that

[v]irtually all neurons in the central nervous system, including the brain, are activated by excitatory neurotransmitters (glutamate being the most common) and deactivated by inhibitory neurotransmitters, including gama-aminobutyric acid (GABA) and glycine. The bulk of the highly organized information flow throughout the brain is regulated by nerve fibers containing the excitatory neurotransmitter glutamate ("glutamergic fibers") throughout the cerebral cortex. Other neurotransmitter pathways serve to modulate the glutamate reactions.

While there's only one way for the message to get through - via a neurotransmitter [in the synapse or gap] between neurons - there are [many] ways for the message not to get through:

• There is not enough of the neurotransmitter to do the job - signals within the neuron are unable to release it into the synapse.
• Oversensitive neurons release too much of the neurotransmitter, swamping and depleting the system.
• Reuptake of the neurotransmitter is poor, so there isn't enough to respond to the next signal.
• Too much of the neurotransmitter is broken down and the message can't be completed; nothing is left for the next signal.
• Another molecule blocks the receptor, and the neurotransmitter cannot connect.
• Inadequate or insufficient receptors, present on the receiving neuron, prevent reception of the neurotransmitter.

The disproportionate opportunities for failure, rather than success, make it that much more crucial that our brains get a constant supply of the correct neurotransmitters, and the raw materials for making them, in order to keep working smoothly. By and large, neurotransmitters become inactive once they've delivered a message... Though they exist throughout the body, they cannot move into the brain from outside it ... Instead, they are made ... in the brain, where and when they are needed... Your body will make only what it needs, from available materials...

Neurotransmitters are made from amino acids (the building blocks of all proteins), which we get from the food we eat. Poor diet, then, can leave us without the ability to make the chemical messengers necessary for healthy brain function...(pp.18-20)

The Brain Chemistry Types...

Lesser has identified six primary psychological types in his practice - each type evinces certain strengths when health is optimal, and suffers from specific psychiatric vulnerabilities when imbalances occur. His dietary and supplement recommendations are predicated on these differences.

Although he cautions that it has not been scientifically validated and should be construed to provide only a general guideline, Lesser presents a test instrument to help you identify your brain chemistry type. For purposes of personal use, the test is presented below.

Circle the number of each question that is generally true of you.

It is strongly recommended that you take the test
BEFORE you look at how the results are scored.

	Michael Lesser's Brain Chemistry Type Inventory Copyright © Michael Lesser 2003 Everyone knows they can count on me. I can't say "no". When I am sad or angry, most times other people don't know it. I don't need much in the way of material things. I am good in a crisis. I am not one to complain. I am very considerate, always thinking of other's needs, often before my own. I am pretty even-keeled - I don't get all worked up over things (good or bad). When I do get upset, I tend to feel depressed. I avoid conflict at all costs. I am safety-conscious. I like my life organized around a regular routine. I know what is right and what is wrong; I live by my principles. My friends say that I'm a worry wart. I think over every option carefully before making a decision. I am very careful with my money. I am a collector. I am very neat. I am definitely not a quitter. I put a premium on intelligence. I like to be spontaneous. I am a risk taker. I can be very persuasive. Feeling good and having a good time are high on my list of priorities. I have a hot temper. I always do the right thing. I am more a doer than a thinker or talker. When I get upset, I usually get angry. When I'm on a mission, I don't let anything get in my way. I am decisive. I am an optimist. I can talk a blue streak. I am very active; I've got a lot of energy. I am fun to be around. I like to be the center of attention. If I get sad or angry, everyone around me is sure to know about it. I am intuitive. When my mood changes, it can do so pretty dramatically. I like to have a leadership role in things. I am intense and passionate. I am shy. I am good at what I do. I have high moral standards. I keep to myself. Material things mean nothing to me. My feelings are easily hurt. I feel a lot of people just don't understand me. I can't stand anger. Spirituality is important to me. I am more a thinker than a doer. I am an outgoing person. I like to live life to the fullest. Sex is one of life's greatest pleasures. I can be fickle. I am "in touch with" my emotions. I enjoy flirting. When I get upset, I tend to feel anxious. Other people tend to be drawn to me. I am a "people person"; one of those "people who need people". I would do anything for love.

FDA Public Health Advisory
March 22, 2004

Subject: WORSENING DEPRESSION AND SUICIDALITY IN PATIENTS BEING TREATED WITH ANTIDEPRESSANT MEDICATIONS

Today the Food and Drug Administration (FDA) asked manufacturers of the following antidepressant drugs to include in their labeling a Warning statement that recommends close observation of adult and pediatric patients treated with these agents for worsening depression or the emergence of suicidality. The drugs that are the focus of this new Warning are:
Prozac (fluoxetine);
Zoloft (sertraline);
Paxil (paroxetine);
Luvox (fluvoxamine);
Celexa (citalopram);
Lexapro (escitalopram);
Wellbutrin (bupropion);
Effexor (venlafaxine);
Serzone (nefazodone); and
Remeron (mirtazapine).
[Read more]

ADVISORY
Health Canada advises Canadians of stronger warnings for SSRIs and other newer anti-depressants
2004-31
3 June 2004

OTTAWA - Health Canada is advising Canadians that all newer anti-depressant prescription drugs, known as Selective Serotonin Re-uptake Inhibitors (SSRIs) or Serotonin Noradrenalin Re-uptake Inhibitors (SNRIs), now carry stronger warnings. These new warnings indicate that patients of all ages taking these drugs may experience behavioural and/or emotional changes that may put them at increased risk of self-harm or harm to others.

The new warning for each of these drugs, which are listed below, appears in the information package received by patients and in the prescribing information available to health professionals.

Patients, their families and caregivers should note that a small number of patients taking drugs of this type may feel worse instead of better, particularly within the first few weeks of treatment or when doses are adjusted. For example, they may experience unusual feelings of agitation, hostility or anxiety, or have impulsive or disturbing thoughts that could involve self-harm or harm to others.

Should this happen to you, consult your doctor immediately. Do not discontinue your medication on your own. It is very important that patients do NOT stop taking their medication without first consulting with their doctor due to the labelled risk of discontinuation symptoms with all of these drugs, except bupropion. Treatment with these types of medications is safest and most effective when the patient communicates well with the treating physician about how he or she is feeling.

It is important to note that Health Canada has not authorized these drugs for use in patients under 18 years of age. The prescribing of drugs is a physician's responsibility. Although these drugs are not authorized for use in children, doctors rely on their knowledge of patients and the drugs to determine whether to prescribe them at their discretion in a practice called off-label use. Off-label use of these drugs in children is acknowledged to be an important tool for doctors.

Doctors are advised to carefully monitor patients of all ages for emotional or behavioural changes that may indicate potential for harm, including suicidal thoughts and the onset or worsening of agitation-type adverse events.

This advisory stems from advice given by an independant expert panel and is the result of Health Canada's extensive review of the latest worldwide safety data available for these drugs. It follows the advisory Health Canada issued on February 3 advising Canadians of the need for patients under the age of 18 who are being treated with newer anti-depressants to consult a physician. Following the meeting with the expert panel, Health Canada conducted an analysis of all adverse reactions experienced by patients taking SSRIs. Although Health Canada did not find a direct link between taking SSRIs and incidents of death, the Department felt it important to let health professionals and consumers know of the possible risks associated with the drugs.

This advisory applies to the following anti-depressants:

• Bupropion
(Wellbutrin® and Zyban®)
Note that both of these drugs share the same active ingredient. Zyban, a smoking cessation drug, now carries an appropriately modified version of the above warning.
• Citalopram (Celexa®)
• Fluoxetine (Prozac®)
• Fluvoxamine (Luvox®)
• Mirtazapine (Remeron®)
• Paroxetine (Paxil®)
• Sertraline (Zoloft®)
• Venlaflaxine (Effexor®)

Source:
Health Canada - Warnings/Advisories