By Rose Brown
University student Andrew Thomas was 16 when he went to a GP seeking something to help him cope with problems at school and at home. He left the doctor’s office with a prescription for the antidepressant citalopram.
“I was only in there for a few minutes,” he says.
“The doctor gave me a sheet with a few general questions on it like ‘how often do you feel sad?’ and I had to rate each one on a scale from one to five. We didn’t talk about personal problems or diet, no blood tests or anything.”
Tens of thousands of children in Australia are using brain-altering drugs that can double the risk of suicide and aggression, say concerned medical professionals.
Far from being sold illegally on the street, these pills are prescribed by doctors for patients as young as two and parents are being told it is safe and effective.
This is despite mounting evidence suggesting these drugs could be harmful and ineffective at best. In Australia, no antidepressant is registered to treat depression in people under 18, yet prescriptions are rising.
“Sometimes people think medication might be an easier, a quicker, solution but there’s no research to suggest that’s the case,” says Dr Melissa Weinberg, senior research fellow at the Young and Well Cooperative Research Centre.
More than 1000 children between the ages of two and six and 26,000 children under 16 were prescribed antidepressants in Australia in 2012-13, according to data from the Department of Human Services.
The most commonly prescribed antidepressants are selective serotonin reuptake inhibitors (SSRIs). Prozac was the first SSRI approved for use in the United States in 1987.
SSRIs are marketed as drugs that can positively influence a person’s mood or emotions by increasing serotonin levels in the brain.
Serotonin is a chemical that sends signals between nerve cells. After a signal is sent, serotonin is reabsorbed by the nerve cells. SSRIs are meant to work by inhibiting this reuptake to increase the amount of serotonin available to transmit further signals.
These changes to the brain were previously thought to happen slowly over a number of weeks. But in 2014 researchers lead by Dr Julia Sacher from the Max Planck Institute for Human Cognitive and Brain Sciences in Germany found that SSRIs can actually alter the whole brain in as little as three hours after just one dose.
It is hard to explain what effects antidepressants even have on depression because scientists don’t really know what depression is or how it is caused.
“There’s still a lot we don’t know about depression, about what it is and how it manifests,” says Dr Weinberg.
“Even though we think that we know a lot, we hear a lot more about depression these days than we used to, we are still very, very, very far from understanding what depression is.”
Currently, ‘depression’ is a label that can be attached to anyone who feels unhappy a lot, loses interest or enjoyment in activities, can’t sleep, is fatigued and can’t think clearly.
Unfortunately, this label doesn’t tell us anything about the cause of these symptoms.
“Some people have depression and it’s in response to a recent life event,” says Dr Weinberg.
“It’s a prolonged, stressful experience that they just haven’t been able to navigate, to overcome. So it’s constant, constant stress and pressure and that then leads to becoming depressed.
“In that sort of situation I wouldn’t necessarily think that medication is appropriate.”
Rebecca Lewis, campaign director at non-profit suicide prevention organisation R U OK, says in situations like this it helps to recognise “the importance of conversations between friends” and Dr Weinberg agrees.
“Feeling a sense of loneliness is very highly correlated with depression,” says Dr Weinberg.
“We often think that things like stress and anxiety lead to depression but research suggests that not having access to social support or feeling lonely is the most important predictor.”
“This can be a really important part of wellbeing and suicide prevention,” says Lewis.
When depression lacks a clear definition and when symptoms that are labelled as depression can be caused by all kinds of things, one might wonder how ‘depression’ came to be treated as a serotonin deficiency.
A study published in The New England Journal of Medicine in 2008 revealed that drug companies deliberately deceived the public into believing in the efficacy of antidepressants.
These companies were only releasing data that showed the benefits of antidepressants while hiding data that suggested they were ineffective.
Even so, the studies that were released showed antidepressants were almost no more effective than a placebo, while causing side effects in up to 86 per cent of people.
Some common negative effects of antidepressants include: weight gain, irritability, nausea, increased sweating, loss of motivation, dry mouth, teeth grinding, agitation or restlessness, loss of empathy, rash, drowsiness, insomnia, impulsivity, headaches, nervousness and hostility.
Other less common, though not rare, negative effects include: higher risk of drug and alcohol addiction, violent thoughts and impulses, strange or terrifying dreams, reckless behaviour, reduced inhibition, suicidal ideation, thought disturbance, full-blown psychosis, loss of judgement and mania.
In 2004, the United States Food and Drug Administration (FDA) looked at 372 antidepressant trials including nearly 100,000 patients. The study found suicidal tendencies were twice as common in people taking antidepressants compared to those on a placebo.
Later that year, drug companies were forced to include a ‘Black Box Warning’ on the insert with their drugs stating the risk of suicide if used in people under 18. It was then updated in 2006 to include people under 25.
Antidepressant prescriptions dropped just a bit after these warnings were introduced but that didn’t last long. Since then, prescriptions in the Western world have exploded.
Use of antidepressants in Australia for all age groups increased 95 per cent between 2000 and 2011, according to research by the University of Sydney.
Australia is now among the worst, ranked as the second highest prescriber of antidepressants in the world by the Organisation for Economic Co-operation and Development (OECD).
If you or someone you know is suffering from substance/drug abuse you can contact Lifeline on 13 11 14.