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Mental Illness and the ‘Right to Try’

Following the recent high-profile suicides of Kate Spade and Anthony Bourdain, Reuters published an article arguing that the “rise in U.S. suicides” indicates a “need for new depression drugs.” Despite appearing to be a shameless plug paid for by Big Pharma, the article acknowledges the difficulty in developing new antidepressant medication, including evidence that current drugs don’t actually work for approximately half of the people taking them.  Considering the strong evidence for a placebo effect, it is possible that the percentage of patients actually helped by these medications is even smaller.

While the evidence seems to indicate that these drugs are only minimally-helpful for people suffering from depression, the evidence for adverse side effects is much stronger. In other words, the drugs probably won’t help you, but they may make you feel even worse than you did before taking the medication. Several studies have shown that the use of antidepressants and anti-anxiety medication increase the risk of suicide, violence, and homicide for patients of all ages (not just children and teenagers, as previously thought). Professor Peter Gotzsche argues that antidepressants are only as beneficial as their placebo effect for most people, while causing many more to experience an increase in suicidal thoughts or actions.  As reported by The Telegraph:

Prof Gotzsche said death rates of those taking such drugs were frequently under-reported, highlighting a meta-analysis by the United States Food and Drug Administration (FDA) in which he had estimated there to have been 15 times more suicides among people taking antidepressants than reported, partly because the FDA only included events up to 24 hours after patients stopped taking the drug.

The truth about antidepressants isn’t readily available for consumers (or even their physicians). As Dr. Mark Hyman explains:

Drug companies are not forced to publish all the results of their studies. They only publish those they want to. The team of researchers that reported their findings in The New England Journal of Medicine took a critical look at all the studies done on antidepressants, both published and unpublished. They dug up some serious dirt …

The unpublished studies were not easy to find. The researchers had to search the FDA databases, call researchers, and hunt down hidden data under the Freedom of Information Act. What they found was stunning.

After looking at 74 studies involving 12 drugs and over 12,000 people, they discovered that 37 of 38 trials with positive results were published, while only 14 of 36 negative studies were published. Those that showed negative results were, in the words of the researchers, “published in a way that conveyed a positive outcome.”

That means the results were twisted to imply the drugs worked when they didn’t.

Another important piece of information is the fact that no one really knows what causes depression or how psychiatric medications work. The theory of depression that has taken hold is known as the Monoamine Hypothesis. It suggests that depression is the result of a deficiency of serotonin (among other monoamine neurotransmitters), but it is unknown if the theory accurately describes the primary cause of depression. While new research suggests that the cause of depression may actually be found in the immune system and its role in inflammation, pharmaceutical companies continue to push their products on uninformed consumers based on the outdated Monoamine Hypothesis.

One possible cause of inflammation is the imbalance between Omega-6 and Omega-3 fatty acids that is prevalent in the western diet (which I have written about previously as it pertains to the obesity epidemic). While a healthy ratio of Omega-6 to Omega-3 polyunsaturated fatty acids (PUFAs) is considered between 1:1 and 4:1, the standard western diet has shifted the ratio to somewhere between 15:1 to 20:1 (or even higher). The dietary changes largely responsible for this shift are the increased consumption of corn and soy products, which is itself fueled largely by government subsidization of these crops pushing down their price. And because they are artificially cheap, they are everywhere and in everything: the High Fructose Corn Syrup that has replaced sucrose, the corn and soybean oil in every processed food, and even the ethanol in gasoline.

Evidence is accumulating that supplementation with Omega-3 fatty acids, especially in the form of fish oil, is effective at treating depression and anxiety and also reducing inflammation. As I previously explained, the balance between Omega-6 and Omega-3 fatty acids directly affects the endocannabinoid system which is responsible for maintaining homeostasis throughout the body (including regulation of the immune system and inflammation).  Consuming excess Omega-6 fatty acids and too little Omega-3 fatty acids could be causing our endocannabinoid systems to produce the inflammation which is in turn causing the mental and physical illnesses associated with inflammation, showing that depression, anxiety, diabetes, cardiovascular disease, cancer, and Alzheimer’s may all have a similar root cause.

It shouldn’t be surprising that other studies have suggested that treatments for psychiatric disorders directed at the endocannabinoid system may be effective, and that cannabinoids are also remarkable for their anti-inflammatory properties. And of course, cannabis is also capable of providing immediate (though temporary) relief from symptoms of depression and anxiety in addition to the longer-term anti-inflammatory benefits that may also provide relief.

As I suggested in my previous article on the relationship between the endocannabinoid system, our diet, and obesity, government is not only largely-responsible for causing the problem; it also is standing in the way of reasonable treatment options. The same holds true here: if the western “subsi-diet” is at all responsible for the prevalence of depression and anxiety in our society, then government is also preventing us from accessing treatment options which have fewer negative side effects than what is currently being pushed by pharmaceutical companies. For example, weight gain is a common side-effect of prescription psychiatric medications. As demonstrated in the previously-cited research, cannabis use is associated with lower rates of obesity and its associated diseases.

While Reuters was busy pushing for the development of new pharmaceuticals to treat depression (including a ketamine nasal spray), one group in favor of cannabis prohibition suggested that Anthony Bourdain’s suicide might be the result of cannabis use: a completely irresponsible and disingenuous accusation, especially considering the strong association between prescription antidepressants and the increased risk of suicide. If Reuters was right about anything, it is that patients need more (and better) options. And while there are many who believe prescription psychiatric medications have improved their lives, there are many more still looking for treatments that will work for them (and without causing a host of horrible side effects). The ‘Right to Try’ bill recently signed by President Trump gives the terminally-ill the option to try experimental medications, but it offers nothing to those suffering from chronic diseases (including mental illness).

Maybe extending the ‘right to try’ to those with mental illness means some people will choose to try and treat their depression and anxiety with cannabis, or psilocybin, or LSD, ayahuasca, MDMA, or ketamine.  Maybe they’ll be urged to modify their diet to contain a healthier ratio of Omega-6 to Omega-3 fatty acids, or maybe they’ll take up exercise for its promotion of the brain-derived neurotrophic factor (BDNF) which also reduces inflammation and improves brain health. Or maybe they’ll opt for a standard prescription antidepressant, being fully-aware of the possible side-effects and its small chance of actually working. What is important is that people know and understand their options, and that they have those options in the first place. The ‘right to try’ should not be limited only to the terminally ill; it is critical for the Christian promotion of human flourishing, which is better realized before people are on their deathbed.

LCI posts articles representing a broad range of views from authors who identify as both Christian and libertarian. Of course, not everyone will agree with every article, and not every article represents an official position from LCI. Please direct any inquiries regarding the specifics of the article to the author. 

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