Martha Rosenberg: Has the VA Got a PTSD Treatment for You!

A BUZZFLASH GUEST CONTRIBUTION
by Martha Rosenberg

Why are suicides among Iraq war soldiers twice that of other wars?

One reason could be that 80 percent of troops with post traumatic stress disorder (PTSD) are given drugs that didn't exist during other wars.

There are antidepressants such as Prozac, Zoloft, Paxil and Celexa (Selective Serotonin Reuptake Inhibitors/SSRIs) and Cymbalta and Effexor (Serotonin Norepinephrine Reuptake Inhibitors/SRNIs) that are so closely associated with suicide they carry suicide warnings.

660 people have killed themselves on SSRIs and SNRIs since 1988, according to published newspaper reports, including at least 17 Iraq war veterans. Many more have attempted suicide and committed felonies, self-harm, police standoffs, murders, murder/suicides and mass murders with high-powered weapons.

Yet what does the U.S. Department of Veterans Affairs suggest as a treatment for PTSD?

"We recommend SSRIs as first line medications for PTSD pharmacotherapy in men and women with military-related PTSD," says the VA's National Center for PTSD's Iraq War Clinician Guide, 2nd Edition. "Findings from subsequent large-scale trials with paroxetine [Paxil] have demonstrated that SSRI treatment is clearly effective both for men in general and for combat veterans suffering with PTSD."

In fact of veterans treated for PTSD, 89 percent were given antidepressants and 34 percent antipsychotics, according to an article in the June 2008 Journal of Clinical Psychiatry.

While scientific studies continue to confirm the danger of SSRI use in young and/or bipolar patients -- a January 2009 Journal of Affective Disorders article by VA authors recommends "close monitoring" for suicide for 12 weeks "following antidepressant starts" when risk greatly rises -- another voice says it's not what it looks like.

"Suicide attempt rates were lower among patients who were treated with antidepressants than among those who were not," says an article in the July 2007 American Journal of Psychiatry [Relationship Between Antidepressants and Suicide Attempts: An Analysis of the Veterans Health Administration Data Sets] by Robert Gibbons, director of the Center for Health Statistics at the University of Illinois at Chicago. "These findings suggest that SSRI treatment has a protective effect in all adult age groups. They do not support the hypothesis that SSRI treatment places patients at greater risk of suicide."

This is not the only time Gibbons has gone to bat for the controversial antidepressants.

In an article entitled "Early Evidence on the Effects of Regulators' Suicidality Warnings on SSRI Prescriptions and Suicide in Children and Adolescents," in the September 2007 American Journal of Psychiatry, he indicted "black box" suicide warnings that the FDA mandated in 2004 for a national rise in young peoples' suicides. Why? Because the warnings discouraged doctors from prescribing SSRIs!

Of course the "SSRI deficiency" argument is as insipid as blaming the obesity epidemic on the unavailability of fen phen. But many joined Gibbons in the round of big pharma "I-Told-You-Sos" including Charles Nemeroff of Emory University School of Medicine, who was later disgraced for undisclosed pharma conflict of interests.

Unfortunately Gibbons was wrong. The suicide stats he analyzed did not yet reflect the effect of the black box warnings and he ended up having to tell The New York Times the "early evidence" was actually not evidence at all but "suggestive." Oops.

Worse, Zoloft maker Pfizer contributed $30,000 to the article bellyflop, writes Alison Bass, author of Side Effects: A Best-selling Drug on Trial, in the Boston Globe. Not much Return on Investment there.

Of course it should come as no surprise -- except to journal editors -- that Gibbons is financially linked to Effexor maker Wyeth (now Pfizer) and that his second author John Mann is linked to Pfizer and GlaxoSmithKline.

A bigger surprise is that Gibbons is rolling in taxpayer funded grants from the National Institute of Mental Health, including some to study antidepressants and suicide.

What firewalls are in place to keep pharma "science" from becoming government science, promoting deadly pills?  

What protects U.S. taxpayers, public health monies -- and most importantly our veterans?

A BUZZFLASH GUEST CONTRIBUTION

Martha Rosenberg is a Chicago-based cartoonist and freelance writer.

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