Last week Professor Healy spoke on RTE radio with Professor Veronica O’ Keane, consultant psychiatrist in Trinity College. The debate (podcast) centered on the ‘increased use of sedatives and antidepressants‘.
Professor O’ Keane stated that antidepressants are not addictive drugs, where-as Professor Healy said that they are indeed highly addictive and that it’s easier to come off benzodiazepines than antidepressants. Professor O’ Keane was ‘astonished’ at this ‘claim’ and gave a little snigger to show how absurd she thought this claim was.
Speaking on the long term use of antidepressants she said “Depression is not a condition that goes away; it’s a recurring condition and if people stop taking their antidepressants with this recurring condition, their chances of killing themselves are increased by two.” Professor Healy stated that it’s actually the drugs which increase the risk of suicide and violence and that “antidepressants come with ‘black box’ warnings in the US saying that they cause suicide.”
Professor O’ Keane then went on to say that “the black box warning that David is referring to is for under 24; there is no such warning for individuals over the age of 24 and in fact it reduces suicidal ideation in those over 65”. No mention of the black-box warning in this article where she states “Anti-depressants work in young people, in terms of alleviating suicidal ideation secondary to depression.” In the radio interview, she further went on to say “It’s very important that the public are aware, that the problem here is not antidepressants, the problem here is depression. Depression is the real killer.” Ah yes, it’s the person and not the drug.
Professor O’ Keane has been described as an ‘expert on mental health during pregnancy’. She stated here that “There is an idea that depressed women should struggle through pregnancy without help, and stay pure… But depression is a physical disorder and should be treated.” In a paper published in the British Medical Journal by O’ Keane et al, here, the study concluded that Untreated depression in pregnancy is associated with poorer maternal health practices and less favourable obstetric outcomes.
A letter regarding this paper was later published by the British Medical Journal, written by Adam C Urato, an attending Physician (Maternal-Fetal Medicine) at Tufts University, Boston. Dr Urato made some interesting points:
(1) I have several concerns regarding the recent “Pregnancy Plus” article entitled “Depression during pregnancy” by Veronica O’Keane and Michael Marsh. I am concerned with the content of the piece as well as the lack of transparency regarding the financial associations of Dr. O’Keane.
(2) In the introduction to the piece, the authors comment: “The case presented here highlights many of the key issues involved in the management of pregnant woman with depression, particularly the importance of active treatment.” Depression during pregnancy is a difficult issue and one that I deal with on a regular basis as a practicing perinatologist. Depression during pregnancy is very concerning, as is the use of antidepressants during pregnancy. Active treatment is usually with a selective serotonin reuptake inhibitor (SSRI) and there is much to be worried about with maternal and fetal exposure to these drugs. Antidepressants have not been shown to improve maternal or child health outcomes during pregnancy. And in various studies antidepressant use in pregnancy has been associated with increased rates of spontaneous abortion, congenital malformations, preterm birth, low birthweight, fetal death, seizures, neonatal withdrawal syndrome, persistent pulmonary hypertension of the newborn and a possible predisposition to psychopathology.
(3) The question many readers might have after reading a piece that emphasizes the importance of antidepressant medication use in pregnancy is whether Dr. O’Keane is being paid by the antidepressant makers.
Professor O’ Keane has in fact listed her ‘Conflict of Interest’ as being with Eli-Lilly, creators of Prozac and Duloxetine (Cymbalta); Here. In another Article here, she said Prozac belonged to a family of compounds which represents ” one of the few major breakthroughs in the treatment of psychiatric illness in the past 40 years.”
Interestingly, numerous articles have been published this week regarding the dangers of antidepressants in pregnancy, including this one in the Irish Independent. This article quotes the same Dr Adam Urato: “Doctors are putting thousands of pregnant women and their unborn children at serious risk of harm by prescribing them anti-depressants, senior doctors are warning. Senior doctors say that ‘study after study’ shows the most widely used class of anti-depressant, called selective seratonin reuptake inhibitors, or SSRIs, cause pregnancy complications including premature birth and pre-eclampsia, which can both be fatal. Emerging research also suggests SSRIs can double the rate of autism in children, and increase the risk of lung and bowel diseases. The situation amounts to ‘a large scale human experiment’, according to Dr Adam Urato, assistant professor of maternal-fetal medicine at Tufts University, School of Medicine, Boston.”
So, who’s right and who’s wrong? I know who I’d believe. Professor Healy has coincidentally been saying for years that antidepressants can cause terrible birth defects in children “…even as the evidence accumulates that these drugs cause birth defects, double the rate of miscarriages, and cause mental handicap in children born to mothers who have been taking them.”
Considering Professor O’ Keane works in Trinity, the same College that Shane attended, it wouldn’t take much out of her day to speak to Shane’s lecturers. It would be interesting to hear her views on my son, who was loved and respected by his lecturers and who was known by them as ‘An Chroí mór’ (the big heart). Yet after 17 days on Cipramil, he killed himself and another. Maybe she’s so sure of her own opinion, that she doesn’t need to listen to us mere parents!