Just when you’re about to give up on your government and join the Tea Party or the Occupiers, it comes along and does something to renew your faith in the institution.
In this case, it’s a study sponsored by the National Institutes of Health and published in the Proceedings of the National Academy of Sciences, right here for free. It’s about what happened when researchers gave Paxil to rats right around the time they got pregnant. What happened to their babies, or pups, as momma rats call them
Turns out the Paxil wasn’t so good for the pups. I recommend you slog through the article, but here’s the 411.
manipulation of 5-HT during early developmentin both in vitro and in vivo models disturbs characteristic chemoarchitectural and electrophysiological brain features, including changes in raphe and callosal connections, sensory processing, and myelin sheath formation. Also, drug-exposed rat pups exhibit neophobia and disrupted juvenile play behavior.
Quick translation: Giving relatively high doses of Paxil to rat mommas early in their pregnancy makes their pups’ brains develop differently. And the pups have stranger anxiety and refrain from play more than the pups of untreated mothers. Male pups sshow these effects more than female.
The researchers argue that these results might be relevant to the increase in autism in human pups, or babies as their mommas call them. Autstic kids also tend to have stranger anxiety and trouble playing with their peers. This is a long, long leap, but it’s also really suggestive, for at least three reasons:
1. It might actually be true that among the factors fueling the autism epidemic is the depression epidemic, or should I say the antidepressant epidemic. The fact that this is even possible should be enough to bring us up short, because what it really means is that this is not something that we know the answer to. Or, to put it another way, in figuring out whether or not to approve these drugs, or to warn women about risks if they are sexually active and uncontracepted, the FDA did not look at acute effects of the SSRIs on these structures and processes. Now, you can’t expect them to look at everything, but really these findings are pretty basic, if you’re interested in what happens in early pregnancies of animals taking antidepressants. Remember, the thalidomide tragedy happened because no one, except one lonely FDA bureaucrat, thought to ask the question about in utero exposure to the drugs. So this one just goes on the long list of variables in the enormous uncontrolled experiment known as the pharmacological era. History will not judge us kindly.
2. Consider what would happen if, say, marijuana or MDMA (Ecstasy) were to turn out to cause these kinds of effects in rats. The National Institute on Drug Abuse, the Drug Czar, the Partnership for a Drug-Free America would already be carpet bombing you with more news about how dangerous these drugs are. Part of the justification for this differential treatment is that antidepressants have clinical value and illicit drugs do not. But at least pot and ecstasy do what they’re supposed to do most of the time, which is more than you can say for Paxil.
3. Psychiatric News ran a story–in the same issue that they ran a piece reporting that psychedelic drugs can change your personality for the better, like that’s news, and another resurrecting the supposedly dead neurotransmitter imbalance theory of depression –on the PNAS report. In it, a psychiatrist worried out loud that the study might “be used as a rationale for pregnant women to not use SSRIs.” As if that would be the worst thing in the world, and just another, you know, hysterical reaction to flames fanned by antipsychiatrists.
This is what psychiatrists always say when their credibility is called into question: that if people stop believing them, they will go off their meds and thus, presumably, off their rockers. But I wonder just how much proof there is about this. I mean, probably one-third of my patients are on psychotropic drugs (other than alcohol or pot, I mean). And most of them have either read my depression book or the articles I’ve written or heard me on the radio or otherwise know I’m a critic of psychiatry and of antideprssants in particular. I talk with them frequently about the topic. It’s a classic setup for someone to try to please me by going off their drugs. And do you know it has never happened? Not once has someone said, “You know, I read that thing of yours, and I’m kicking the habit.” So if it’s not happening to me, I wonder to whom it is happening. I suspect this reaction is more about psychiatrists’ wish to have a good reason to shut up their critics than it is about what actually happens in the real world.
