For nearly a century, the American pharmaceutical industry has been at the leading edge of creating new lifesaving medications for patients all around the world.

But occasionally, the endless pursuit of profit takes indirect precedence over the health of the very same customers the industry is meant to serve.

Think of the opioid crisis and how nearly half a million Americans died from an overdose in less than 20 years. Or take the case of CEO and young prodigal founder Elizabeth Holmes and her miraculous blood testing devices at Theranos. She was later convicted of wire fraud and conspiracy on a massive scale.

There’s a similar line when looking at the history of the wonder drug of the modern age—SRRI antidepressants. Even more strikingly, the current path of SSRIs seems to follow the journey of another miracle drug from just a few decades before; Valium.

Treating Anxiety in America

Anxiety is nearly as big of a modern problem as depression: an estimated 260 million individuals suffer from anxiety disorders worldwide.1 Valium (diazepam) was first released in the U.S. in 1963 as an improved version of older benzodiazepine formulations to treat anxiety.

Over two times more potent than its predecessors, this wonder pill quickly shot to the top of national drug sales lists, earning the rank of top-selling pharmaceutical in the United States from 1969 to 1982.2

It was so wildly successful that other pharmaceutical companies quickly scrambled to invent competing versions, noting the huge opportunity for profits in a market that saw 2.3 billion Valium tablets sold in 1978.2

Throughout the 1970s, mass public and professional opinion were almost completely in favor of Valium despite breakthrough reports showing potential for abuse of the drug.2 But these early reports were mostly ignored.

In 1976, the chief of clinical pharmacology at Massachusetts General Hospital was quoted as saying, “I have never seen a case of benzodiazepine dependence.”3 He even went on to describe addiction to Valium as “. . . an astonishingly unusual event.”

At the height of Valium’s popularity in the mid-1970s, roughly 14% of Americans filled prescriptions for this — allegedly — non-addictive pill.2

Of course, there was some opposition to Valium and other benzodiazepines. A New York Times piece in 1974 questioned the prevailing wisdom that Valium represented a safe and effective treatment for anxiety.4 And yet, most primary care physicians and psychiatrists continued to prescribe Valium in droves.

The Valium tide began to shift in the early 1980s as research started generating data that became increasingly difficult for health professionals to ignore. Multiple analyses agreed: not only was benzodiazepine dependence real, but it was also occurring even at prescribed levels.5,6

A Similar Story for SSRIs and SNRIs

The institutional dismissal of benzodiazepine withdrawal is strikingly similar to the modern-day treatments of SSRI and SNRI discontinuation effects. Professional and popular opinion regarding antidepressants has also followed a similar line.

When first introduced, Prozac—an SSRI—was hailed as a wonder drug and a medication that represented a real answer to depression. SSRIs and SNRIs were marketed and viewed by the public as safe and trusted “quick-fix” solutions for all types of depression that came with few to zero side effects.

This stance has changed little over the last few decades, at least on the part of pharmaceutical companies and mainstream medicine.

But from a science and clinical application perspective, this stance is becoming increasingly at odds with the body of available research evidence. A growing number of validated, peer-reviewed analyses have confirmed: not only is antidepressant withdrawal a legitimate phenomenon, but it is far worse than withdrawal associated with benzodiazepine discontinuation, with longer-lasting and more severe manifestations.7

With such large amounts of evidence piling up, it is only a matter of time before the pharmaceutical industry recognizes that antidepressant withdrawal is a completely valid diagnosis and needs to be addressed to help the millions of Americans who have or wish to discontinue antidepressants.

Do You Take Antidepressants?

I have spent decades successfully treating patients for depression with an approach called Integrative Psychiatry—a practice that takes into account an individual’s personal lifestyle and needs to treat afflictions like depression.

If you or a family member is looking to stop taking antidepressant medication, my easy-to-read ebook guide explains everything about antidepressant cessation, including what to expect, effective ways to approach it, and how to deal with any problems on the journey.

If you are a physician and interested in learning about an effective method to help patients effectively wean off of antidepressants, please check out our course on Managing Medication Side Effects, or read my latest book, Functional Medicine for Antidepressant Withdrawal.

Ready to improve patient outcomes?

Learn more about the 2023 Psychiatry Redefined Fellowship below!

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References

  1. World Health Organization. World Mental Health Day 2017. WHO.int. https://www.who.int/mental_health/world-mental-health-day/2017/en/. Published October 10, 2017. Accessed February 24, 2020.
  2. Sample I. Leo Sternbach. The Guardian. https://www.theguardian.com/society/2005/oct/03/health.guardianobituaries. Published October 2, 2005. Accessed March 23, 2021.
  3. Aviv R. The challenge of going off psychiatric drugs. The New Yorker. https://www.newyorker.com/magazine/2019/04/08/the-challenge-of-going-off-psychiatric-drugs. Published April 8, 2019. Accessed July 3, 2020.
  4. Altman L. Valium, most prescribed drug, is center of a medical dispute. The New York Times. NYtimes.com. https://www.nytimes.com/1974/05/19/archives/valium-mostprescribed-drug-is-center-of-a-medical-dispute-wide-use.html. Published May 19, 1974. Accessed July 1, 2020.
  5. Petursson H, Lader MH. Benzodiazepine dependence. Br J Addict. 1981;76(2):133-145.
  6. Lader MH, Petursson H. Benzodiazepine derivatives–side effects and dangers. Biol Psychiatry. 1981;16(12):1195-1201.
  7. Cosci F, Chouinard G. Acute and persistent withdrawal syndromes following discontinuation of psychotropic medications. Psychother Psychosom. 2020;89(5):283-306.