Junk Science Benefits Big Pharma

Hundreds of thousands of pre and postmenopausal women are prescribed antidepressant drugs for depression, and research indicates that these women have a lower bone density and are thus at greater risk for osteoporosis than women who do not use these medications. You would think the connection would be easy to make between antidepressants and lower bone density, but the researchers discussed in the following article deduced that depression was the factor that increased the incidence of osteoporosis, not the antidepressants. This kind of pseudo-science must make the drug companies jump for joy. Instead of being forced to face the fact that their drugs are causing a problem, they instead can recommend the use of an additional medication to treat low bone density in their antidepressant customers.

Unfortunately, this type of pretzel logic often typifies the thinking of the pharmaceutical companies and the physicians who push their drugs. Instead of dealing with the underlying problems that are causing disorders, their philosophy is to just give patients one or more drugs to deal with the symptoms (and the side-effects that often accompany them). It is tragic to see the trust of so many people betrayed by this kind of nonsense. It is also an outrage that so many depressed people are given harmful medications that often do more harm than good, especially when there are natural options available to fight depression. These include a healthy diet, exercise (especially walking), natural sunlight, and supplements such as SamE and Lithium Orotate. Also, be sure to read tomorrows blog for the relationship between depression and constipation!


The Old Shell Game

Does depression contribute to bone loss?

Take nearly 90 women (all premenopausal, under the age of 46) who have major depressive disorder (MDD), and about 45 women of the same age who don't suffer from depression. Use a special x-ray technique to assess their bone density.

Results: Compared to subjects who aren't depressed, the depressed subjects have significantly greater thinning of the bone in the femoral neck (the section of the femur that's most vulnerable to fracture), and depressed subjects have a significantly higher incidence of low bone mass in the lower back and lumbar spine.

The conclusion is obvious, of course: Low bone mineral density is more prevalent in premenopausal women with MDD, so depression may be a risk factor for osteoporosis, right along with smoking and calcium deficiency.

Before we go on, can you spot what's wrong with this picture? It's easy - just follow the money.

Sleight of hand

Safe to say, a large majority of patients diagnosed with MDD end up taking antidepressants for extended periods.

In the study described above (funded by the National Institutes of Health and published last month in Archives of Internal Medicine), all of the MDD subjects were taking antidepressants. So does it seem more likely that their bone loss was prompted by depression, or prompted by antidepressant drugs?

In the Product Prescribing Information for Prozac, a list of "events" observed in clinical trials notes that osteoporosis was one of the side effects. It's considered a rare side effect, but still, there it is. The Prozac web site also notes that the drug impaired bone development in early animal studies.

And yet, most of the reports about this study would like us to believe that antidepressant drugs had no effect at all on subjects' bone health.

Ivanhoe Newswire: "Although the depressed women were on anti-depressant medication, the study indicated that was not a factor in increased bone loss."

Science Daily: "A previous study suggested that older adults taking antidepressants called selective serotonin reuptake inhibitors had more bone fractures than others. However, the current study showed that these medications were not linked to low bone mass in premenopausal women." How did the current study show no link? Science Daily doesn't open that can of worms.

Things start to get humorous with this from MedPage Today: "The investigators noted that the usefulness of antidepressants for bone mineral loss in major depression should be evaluated."

At first I thought I'd read that incorrectly, but then I came across this howler from HealthDay News: "It's not clear what role antidepressants might play, but by relieving the depression, the drugs may also help bone mineral density, the researchers said."

Riiiight. So what are we looking at here? Is the NIH kindly laying the groundwork for drug companies to sell osteoporosis drugs to depressed patients and antidepressant drugs to osteoporosis patients? That's a sweet win-win…provided you're not one of the patients.

Let's get real

What a difference five months make.

The MedPage Today report I mentioned above appeared on 11/26/07. And a MedPage Today report that appeared on 6/27/07, written by the same reporter, opened with this sentence: "Selective serotonin reuptake inhibitors (SSRIs) have been linked to decreased bone density in older women and men, two related studies found."

Granted, these two studies looked at older subjects, but does it seem logical that antidepressant drugs would benefit bone health in someone who's 45, then harm bone health in someone who's 55? It's preposterous!

The June MedPage Today article included this "Action Point": "Explain to interested patients that older depressed patients who benefit from taking SSRIs should be screened regularly for osteoporosis and for possible preventive drug therapy."

"Preventive drug therapy"? Hmmm. Here's an Action Point for you: Explain to any doctor that tries to sell you a preventive osteoporosis drug to go along with your antidepressant drug that you're a patient, not a dollar sign.

http://www.hsibaltimore.com/ealerts/ea200712/ea20071212a.html