Monday, January 20, 2014

Avoiding Sadness The Canadian Way: Take A Pill

Pill Pushers

An article, by Sharon Kirkey, in the National Post says that Canadians are among the world's greatest users of antidepressants in the world, a trend that is both worrisome and costly, since such pharmacological substances do not have much effect for mild-to-moderate depression. In many cases, medical doctors are prescribing antidepressants for sadness.

Kirkey writes:
Canadians now rank among the highest users of antidepressants in the world: in 2011, the last year for which comparative figures are available, Canada reported the third highest level of consumption of antidepressants among 23 member nations surveyed by the Organization for Economic Co-operation and Development.
The OECD figures, contained in its recently released “Health at a Glance” report, shows Canadians consumed 86 daily doses of antidepressants for every 1,000 people per day in 2011, more than the United Kingdom (71 doses per day), Spain (64) and Norway (58). Canada was behind only Iceland (106 doses per 1,000 people per day) and Australia (89 doses) among the countries surveyed. (The data are expressed as “defined daily doses,” which means the average daily maintenance dose for the condition for which the drug was prescribed.)
In Canada 42.6 million prescriptions for antidepressants were filled by retail drugstores in 2012, up from 32.2 million in 2008, according to figures provided to Postmedia News by prescription-drug tracking firm IMS Brogan. Citalopram (sold under the brand name Celexa), venlafaxine, (Effexor) and the generic drug, trazodone, make up the three top-selling antidepressants in Canada.Paris and others stress that antidepressants are essential in cases of severe, debilitating and life-threatening depression.
But the pills, including Prozac and its cousins that were held out to be miraculous when they hit the market in the late 1980s, are being swallowed by millions of Canadians every day, even while studies suggest that, in cases of mild depression, where “you’re still working, you’re still functioning,” Paris says, the drugs often don’t work, or they produce a temporary placebo effect, which doesn’t last.
“And then you get onto this thing, where you try another one, and you try a third one, and then you add some other type of drug entirely,” Paris says. “It’s a whole treadmill of pharmacology people get caught up in,” he said. Once people start taking the drugs, they’re often terrified to stop. “The fear of relapse has driven doctors to keep people on them for years,” Paris says.
There is a difference between sadness and depression. The former is often a transient human emotion that is based on a situation; the latter far more severe that affects the ability to function effectively in society. There are criteria set out in clinician handbooks, which rate the depression as mild, moderate or severe; the most noted handbook is the DSM-V.

Many of the antidepressants are subscribed by family doctors, but in most cases the physicians lack the training, the experience and the time to make a valid medical assessment. Part of the problem is that physicians want to help their patients feel better, which raises the issue of patient expectations today. Are we as humans expecting too much from the pharmaceutical industry in helping us cope with life? Is sadness not part of the human condition, and our attempts to eliminate or control sadness is taking us in the wrong direction, toward the elimination of uncomfortable emotions?

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You can read the rest of the article at [NatPost].

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