Treating Panic Disorder - What the NHS Say.

Thanks once again to Ruth for pointing me to the following web page on the NHS website.

The NHS write about SSRi treatment for panic disorder:

"There are two main forms of treatment for panic disorder - psychological therapy and medication. Depending on your individual circumstances, you may require either one of these types of treatment or a combination of the two."

On one hand, I'd like to applaud them for going into psychological therapy, on the other hand, their advice on SSRi treatment does not clearly explain the consequences for the patient. In fact, it throws up more questions.

Here is what they say about treating panic disorder with SSRi's:

Section One - [My comments in yellow]

Selective serotonin reuptake inhibitors (SSRIs) are a form of antidepressant which work by increasing the level of a chemical in your brain called serotonin.

Out goes the chemical imbalance theory and in comes, 'let's just flood your brain with extra serotonin'. Maybe the NHS should add; Nobody knows how SSRi's work - not even the manufacturers of SSRi's.


They merely condense 'how SSRi's work' into one line. It's sugar-coated pharma talk.

Here's my take:

SSRi stands for, Selective Serotonin Reuptake Inhibitor. In layman's terms, SSRi's try to boost serotonin by selectively stopping the reuptake of it among brain cells.

The areas of the brain responsible for release and reuptake are similar, they work on the same molecule. SSRi's cannot understand which one it is supposed to work on. So it may block both. This can result in no coping molecules in the brain.

SSRI's block another coping molecule in the brain called dopamine. It has been suggested that dopamine is the chemical that releases the euphoria you feel when you are happy. If SSRi's suppress...or block this molecule, your brain becomes confused, it's akin to taking the handles off a working clock.

If you cannot seem to cope because you have marital problems, financial problems, are grieving, feel shy, feel panicky, then stop and think if SSRi treatment will 'fix' this or add to your woes.


To use an analogy, if you had problems enjoying sex, would you wish for your genitals to be removed?

If your brain is not functioning correctly... or is invaded by chemicals that don't belong in there then expect some sort of backlash. The agitation listed as a 'common' side effect is more than just 'agitation' - it's basically your brain trying to figure out why it has stopped working properly, why its molecules are being blocked and why it is being flooded [invaded] with extra serotonin.

With confusion comes frustration - which in turn could lead to anger, an anger so uncontrollable [because your brain cannot control it] that it could lead to homicidal behaviour [1], [2]

SSRIs are the most commonly prescribed form of antidepressant for the treatment of panic disorder. They are normally started at a low dose before gradually being increased as your body adjusts to the medicine. Common side effects of SSRIs include:

•nausea,
•low sex drive,
•blurred vision,
•diarrhoea or constipation,
•dizziness,
•dry mouth,
•loss of appetite,
•sweating,
•feeling agitated, and
•insomnia (not being able to sleep).

Talk about playing down adverse reactions! Okay, granted they list the above as 'common' side effects - maybe they should list the other side effects to redress the balance and to give the patient [and doctor] a better understanding of what lays ahead for them should they decide to journey down the road of SSRi treatment. Maybe the NHS should add:

There is an established direct link between suicide and violent behaviour and the use of SSRIs [3]

Drug companies selectively publish studies on antidepressants. They have published nearly all the studies that show benefit - but almost none of the studies that show these drugs are ineffective. [4]

For a full list of SSRi side effects and not the sugar coated NHS/Pharma one, visit http://www.antidepressantsfacts.com/LongTermSSRI.htm

When you first start taking SSRIs, your feelings of anxiety and panic may seem to get worse. However, in the majority of cases this is only temporary, and you will usually find that your symptoms start to return to normal levels within a few days of taking the medicine. Speak to your GP if you feel that your symptoms have worsened, and are not showing signs of returning to normal levels after a few days.

Speak to your GP? Why? Your GP has just prescribed you a drug that he/she DOES NOT know the mechanics of. He/she DOES NOT know how it works. Why then would any patient want to go back to a person who had given them something that they knew nothing about other than what the manufacturers of these drugs had told them? You, the patient, are taking these drugs on trust. It's basically a religion, you either believe or you don't - Doctor's believe, that's why they prescribe it, they do so on trust. You, the patient, put your trust in your doctor because... well, because that's what is expected of you, isn't it?

When you start taking a SSRI, you should see your GP after two, four, six, and 12 weeks in order to check your progress, and to see if you are responding to the medicine. Not everyone responds well to antidepressant medicines, so it is important that your progress is carefully monitored.

The guideline the NHS offer here is absurd. How can a doctor 'carefully' monitor someone he/she sees once every two weeks? What about the space in between? The definition of 'Careful' is: [5]

1. Attentive to potential danger, error, or harm.
2. Thorough and painstaking in action or execution.
3. Protective; solicitous.
4. Full of cares or anxiety.

Donald Schell, 60, had been taking Seroxat for just 48 hours when he shot and killed his wife, his daughter, his granddaughter and himself. The jury found SmithKline Beecham (now GlaxoSmithKline) liable for deaths caused by a patient taking an antidepressant. A federal jury in Cheyenne, Wyo., ordered SmithKline Beecham (now GlaxoSmithKline) to pay $6.4 million to relatives of Donald Schell. [2]

Was Schell told,"When you start taking a SSRI, you should see your GP after two, four, six, and 12 weeks in order to check your progress, and to see if you are responding to the medicine?"


If your GP feels it is necessary, you may require regular blood tests or blood pressure checks when taking antidepressant medication. If after 12 weeks of taking the medication you do not show any signs of improvement, your GP may try prescribing an alternative SSRI for you to see if that has any effect.

When recommending a blood test for you to take you may wish to ask your doctor to see if it can ascertain whether or not you are 2D6 deficient. Genetic testing is available to identify people who are likely to have difficulty with about 25% of all drugs, including Prozac, Seroxat, codeine, ibuprofen, Viagra, Claritin, and propranolol. These folks have variations in the gene responsible for an enzyme needed to metabolize these drugs, known as 2D6. Without 2D6 to break them down, the drugs can build up to toxic levels in the body, causing adverse effects including death. [6]

This test is expensive and would cost the NHS millions of pounds should it become mandatory. If you have the 2D6 deficiency you will not be able to break down certain drugs which will result in toxic poisoning.

Your doctor or the NHS would not have told you this. The one thing that HAS been scientifically proven is kept from you.

How long will I have to take an SSRI for?

The length of time that you have to take an SSRI will vary, depending on how well you respond to the treatment.

No study has ever been done regarding long term use of SSRi's. In essence, YOU ARE part of the study. You are the lab rat. These drugs were granted a licence without a 'long term study' - most drugs are.

Even if you feel that your panic disorder has been successfully treated, it is likely that you will need to keep taking the medication for at least six to 12 months. If this is the case, and you stop taking your SSRI medication before this time, the risk of your symptoms recurring once you stop taking the medication may be increased. Some people may have to take SSRIs for longer than six to 12 months.

Straight from the pharmaceutical handbook of 'Talking Nonsense' and a game of Russian Roulette for those with the 2D6 deficiency. What the above para is basically saying is, it's impossible to judge if your 'illness' has gone away so keep taking the medication regardless of the consequences. Remember, not even the manufacturers of SSRi's know how they work, they assume, which is in essence making an ass out of you and me. [7]

What the NHS fail to tell you when they state, "Some people may have to take SSRi's for longer than six to 12 months," is the reason.

Ask current and former patients if they've ever had physical withdrawal symptoms after stopping use of an SSRi. A good place to start is Paxil Progress [8]. Don't expect the manufacturers, doctors or medicine regulators to tell you about the addiction problems with SSRi's. You are on your own. You are left to deal with the addiction. The only help you will get will be from current and former patients, unless of course you are in a strong financial position to book into a detox clinic.

When you and your GP decide that it is appropriate for you to stop taking your SSRI medication, you will gradually be weaned off it, by slowly reducing your dosage. However, you should never stop taking your medication unless your GP specifically advises you to.

Sugar coated and merely playing down risk. Here's another example of 'sugar-coating'.

If‘discontinuation reactions’ occur in patients stopping [Seroxat], the majority will experience symptoms that are mild to moderate in intensity, and are usually limited to two weeks.
Mary Anne Rhyne
GlaxoSmithKline spokesperson
2005

Never mention the word 'Addiction' - it will devastate sales!

If you want to know how difficult it is to taper, view the Seroxat withdrawal complaints pdf file. [9]

Even when taken for a suitable length of time, approximately half of all people whose symptoms have been treated while taking SSRIs find that their panic attacks return once they stop taking the medication.

Which catagorically means - There is NO cure. How can the NHS make a statement like this? Isn't the return of the 'illness' after stopping medication, simply the patient craving his/her serotonin fix? It's reasonable to suggest that isn't it? Why are the NHS claiming it's the 'illness' returning? How is this measured?

A study by Irving Kirsch et al showed that antidepressant use in people with mild to moderate depression is useless. [10]

For some people this means having to take SSRIs on a long-term basis. For others, a course of cognitive behavioural therapy can help to reduce the risk of your symptoms recurring.

There we have it in a nutshell, "For some people this means having to take SSRi's on a long-term basis."

What started as 'treatment' now ends up in addiction. The NHS are claiming that 'some people' may have to take SSRi's on a long term basis - despite the fact that no study has ever been undertaken regarding long term use of SSRi's.

To recap:

The areas of the brain responsible for release and reuptake are similar, they work on the same molecule. SSRi's cannot understand which one it is supposed to work on. So it may block both. This can result in no coping molecules in the brain.

Nobody knows how SSRi's work, not even the manufacturers. It's based on theory.

If you are 2D6 deficient, chances are you will get toxic poisoning from certain SSRi's. This is a fact.

No study has ever been undertaken regarding long term use of SSRi's.

In its study, the U.S. Centers for Disease Control and Prevention looked at 2.4 billion drugs prescribed in visits to doctors and hospitals in 2005. Of those, 118 million were for antidepressants.

High blood pressure drugs were the next most-common with 113 million prescriptions.

The use of antidepressants and other psychotropic drugs -- those that affect brain chemistry -- has skyrocketed over the last decade. [11]

Your brain is your hardware, SSRi's are software that have not been fully tested, they have been put out on the market pretty much like a beta version of new software one can download off the Internet. Any glitches are reported back to the programmer/s, the glitches are then rectified until the product is ready to launch.

Can you imagine if I created software for aviation radar systems and my selling point was, "Hi, I've created some software for your radar systems. I don't have a clue how it works but my theory suggests that it does. I'm not totally sure if there are any bugs in the software that may make your radar systems to shut down, but hey, that's only a minor point."

I'd be laughed out the office and the men in white coats would be sent for.

SSRi's are basically promoted on the same principle.

Fid

Read the new book, The Evidence, However, Is Clear...The Seroxat Scandal

By Bob Fiddaman

ISBN: 978-1-84991-120-7
CHIPMUNKA PUBLISHING

AVAILABLE FOR DOWNLOAD HERE


PAPERBACK COMING SOON





1. School Shootings Linked to Psychotropic Drugs. http://www.antidepressantsfacts.com/2000-05-16-School-Shootings-Psychotropic-Drugs.htm

2. Paxil Maker Held Liable in Murder/Suicide. http://www.baumhedlundlaw.com/media/ssri/Paxil_murder.htm

3 - Glenmullen, J. (2000) Prozac Backlash: overcoming the dangers of Prozac, Zoloft, Seroxat, and other antidepressants with safe, effective alternatives. Simon & Schuster.

4 - Turner EH et al. 2007. Selective publication of antidepressant trials and its influence on apparent efficacy. New England Journal of Medicine. 358: 252-260.

5 - Definition of 'Careful'. http://www.thefreedictionary.com/carefully

6 - Testing for enzyme deficiency. http://findarticles.com/p/articles/mi_m0ISW/is_245/ai_111496944/

7 - “When you assume, you make an ass out of u and me.” ~ Oscar Wilde on Assumption.

8 - Paxil Progress. http://www.paxilprogress.org/forums/

9 - Withdrawal Complaints [Seroxat]. http://www.fileden.com/files/2008/5/6/1899375/WITHDRAW.pdf

10 - Initial Severity and Antidepressant Benefits. http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0050045

11 - Antidepressants most prescribed drugs in U.S. http://www.cnn.com/2007/HEALTH/07/09/antidepressants/index.html




ORDER THE PAPERBACK
'THE EVIDENCE, HOWEVER, IS CLEAR...THE SEROXAT SCANDAL' By Bob Fiddaman
SIGNED COPIES HERE OR UNSIGNED FROM CHIPMUNKA PUBLISHING