Anti-depressants likely do more harm than good, study suggests

Commonly prescribed anti-depressants appear to be doing patients more harm than good, say researchers who have published a paper examining the impact of the medications on the entire body. See Also: Health & Medicine Pharmacology Birth Defects Mental Health Research Mind & Brain Depression Disorders and Syndromes Psychiatry Reference COX-2 inhibitor Psychoactive drug Seasonal affective disorder Anti-obesity drug "We need to be much more cautious about the widespread use of these drugs," says Paul Andrews, an evolutionary biologist at McMaster University and lead author of the article, published recently in the online journal Frontiers in Psychology. "It's important because millions of people are prescribed anti-depressants each year, and the conventional wisdom about these drugs is that they're safe and effective." Andrews and his colleagues examined previous patient studies into the effects of anti-depressants and determined that the benefits of most anti-depressants, even taken at their best, compare poorly to the risks, which include premature death in elderly patients. Anti-depressants are designed to relieve the symptoms of depression by increasing the levels of serotonin in the brain, where it regulates mood. The vast majority of serotonin that the body produces, though, is used for other purposes, including digestion, forming blood clots at wound sites, reproduction and development. What the researchers found is that anti-depressants have negative health effects on all processes normally regulated by serotonin. The findings include these elevated risks: developmental problems in infants problems with sexual stimulation and function and sperm development in adults digestive problems such as diarrhea, constipation, indigestion and bloating abnormal bleeding and stroke in the elderly The authors reviewed three recent studies showing that elderly anti-depressant users are more likely to die than non-users, even after taking other important variables into account. The higher death rates indicate that the overall effect of these drugs on the body is more harmful than beneficial. "Serotonin is an ancient chemical. It's intimately regulating many different processes, and when you interfere with these things you can expect, from an evolutionary perspective, that it's going to cause some harm," Andrews says. Millions of people are prescribed anti-depressants every year, and while the conclusions may seem surprising, Andrews says much of the evidence has long been apparent and available. "The thing that's been missing in the debates about anti-depressants is an overall assessment of all these negative effects relative to their potential beneficial effects," he says. "Most of this evidence has been out there for years and nobody has been looking at this basic issue." In previous research, Andrews and his colleagues had questioned the effectiveness of anti-depressants even for their prescribed function, finding that patients were more likely to suffer relapse after going off their medications as their brains worked to re-establish equilibrium. With even the intended function of anti-depressants in question, Andrews says it is important to look critically at their continuing use. "It could change the way we think about such major pharmaceutical drugs," he says. "You've got a minimal benefit, a laundry list of negative effects -- some small, some rare and some not so rare. The issue is: does the list of negative effects outweigh the minimal benefit?"

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Too Much Sitting Can Kill You, Study Suggests

For better health, try standing up more, a new study suggests. Those who spend 11 or more hours a day sitting are 40 percent more likely to die over the next three years regardless of how physically active they are otherwise, researchers say. Analyzing self-reported data from more than 222,000 people aged 45 and older, Australian researchers found that mortality risks spike after 11 hours of total daily sitting but are still 15 percent higher for those sitting between 8 and 11 hours compared to those sitting fewer than 4 hours per day. "The evidence on the detrimental health effects of prolonged sitting has been building over the last few years," said study author Hidde van der Ploeg, a senior research fellow at the University of Sydney. "The study stands out because of its large number of participants and the fact that it was one of the first that was able to look at total sitting time. Most of the evidence to date had been on the health risks of prolonged television viewing." The study is published in the March 26 issue of the Archives of Internal Medicine. Average adults spend 90 percent of their leisure time sitting down, van der Ploeg said, and fewer than half meet World Health Organization recommendations for 150 minutes of at least moderate-intensity physical activity each week. The data was collected as part of Australia's 45 and Up Study, a large, ongoing study of healthy aging. Strikingly, the elevated risks for dying from all causes remained even after taking into account participants' physical activity, weight and health status. Sixty-two percent of participants said they were overweight or obese (a similar proportion to Americans), while nearly 87 percent said they were in good to excellent health, and one-quarter said they spent at least 8 hours each day sitting. Inactive participants who sat the most had double the risk of dying within three years compared to active people who sat least, van der Ploeg said, and among physically inactive adults, those who sat the most had nearly one-third higher odds of dying than those who sat least. Because many people must sit for long hours at their jobs, they should make sure a greater portion of their leisure time is spent standing, walking or engaging in other movement, said Dr. Suzanne Steinbaum, director of Women and Heart Disease at Lenox Hill Hospital in New York City and a spokesperson for the American Heart Association. "Yes, you have to work, but when you go home it's so important you don't go back to sitting in front of the computer or television," Steinbaum said. "After the 8-hour mark, the risks go up exponentially. It's really about what you're doing in your leisure time and making the decision to move." Several workplaces in Australia are testing sit-stand work stations, van der Ploeg said -- a generally well-received initiative that may be a future option for other offices. "Try ways to break up your sitting and add in more standing or walking where possible," she suggested. While the study uncovered an association between total sitting hours and death risk, it did not prove a cause-and-effect relationship. The study was limited by the relatively short follow-up period of less than three years, experts said, which may have obscured undiagnosed health problems among participants that could have led to earlier death. Dr. David Friedman, chief of heart failure services at North Shore Plainview Hospital in Plainview, N.Y., said those who sit longer "tend to be sicker, have obesity issues and cardiovascular problems. Perhaps they're less ambulatory in the first place." Van der Ploeg acknowledged these limitations and said more studies will need to replicate the findings and focus more on sitting's influence on developing conditions such as diabetes, cancer and heart disease. "Studies that measure sitting time with activity monitors instead of questionnaires will also help build the evidence base," she said. "All these studies will further inform us of the exact relationship between sitting and health conditions, which ultimately will result in public health recommendations like we already have for physical activity."

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