Everyone who reads RxISK posts will know that SSRI and related drugs (some antibiotics, painkillers, antihistamines and most antidepressants) can cause sexual dysfunction. This has been known since 1961.
And that they can cause suicide. This has been known since 1959.
And that they can cause birth defects. The first publication by an Australian obstetrician, William McBride, on this dates from the mid-1960s, very soon after his reports about the tranquilliser thalidomide.
The defining moment for SSRIs and birth defects was in 2009 when GlaxoSmithKline’s paroxetine was found guilty by a Philadelphia jury of causing Liam Kilker’s birth defects – a verdict that cost GSK over $1 billion but you’d never know it. GSK’s news management swung into operation and almost no-one heard about this outcome with medical readers of the BMJ and other major journals to this day treated with articles about the importance of treating depression in pregnancy with antidepressants.
If someone has a bit of time, it would be interesting to chase the CDC site trumpeting World Birth Defect Day and see what they have to say about the role of drugs in general and antidepressants in particular in causing birth defects.
Both macrolide, fluoroquinolone and certain tetracycline antibiotics have been linked to birth defects but will CDC mention this?
One of the best know pieces of information in the Western world may be that thalidomide causes birth defects. This drug brought us two shocks. One was the shocking nature of the defects – armless, legless babies. The other was the shock that a drug could cause birth defects – the idea that environmental factors could cause birth defects was not then in our DNA.
The extent to which the problems thalidomide causes became known outside the “West” has been less clear. In South America Chemie-Gruenenthal, the marketers of thalidomide, made it widely available until relatively recently – endorsed by WHO, with the company boss being made some kind of Knight of the Catholic Church. There were likely far more children born with thalidomide caused birth defects in Brazil than ever there were in any European country.
What is less well known in the West or anywhere else is that thalidomide caused sexual dysfunction and agitation up to and including suicidality.
Almost identical to an SSRI in its profile of effects. This is not surprising in that like most antidepressants thalidomide began life as an antihistamine and was loaded from the start therefore with boundary issues – birth defects, agitation and sexual dysfunction.
Ditto isotretinoin and finasteride. Chances are most, perhaps all, drugs causing birth defects also cause sexual changes and akathisia – such as mirtazepine, ondansetron and others.
Thalidomide got on the US market in the early 1990s, 30 years after the birth defect crisis. Its US step-parent, Celgene, quickly brought a derivative Lenalidomide (Revlimid) on the market as a treatment for multiple myeloma (while pushing the off-label envelope to get it used for cancers in general).
The frisson of a link to thalidomide – thalidomide-chic – and an eye-watering price made Celgene a stock-market darling.
Lenalidomide also causes birth defects, sexual dysfunction and agitation up to and including suicidality (SSRI-like) as does a more recent derivative Otezla which is marketed for skin conditions.
For decades after the thalidomide crisis broke in 1961, women steered clear of drugs during pregnancy.
GSK and other pharmaceutical companies took their time but by the 1990s they were well on their way to getting pregnant women back consuming drugs (and vaccines). Not just consuming but being among the greatest consumers of all – women of child-bearing years have been the core SSRI market.
It is a given today for pregnant women to avoid alcohol and also eating soft cheeses, or cold meats, and avoiding hot showers and all sort of other things like tea or coffee – all of which pregnant women now do – but on no account they are told should they stop taking their pills. Think of the horrific damage you will do to your unborn child if you are remotely depressed or anxious – do the right thing and take your pills.
If a drug causes gross birth defects like a missing limb or a heart problem or spina bifida, it is almost for certain that it will cause behavioural problems also.
The children of mothers taking antidepressants – the only group of drugs for which we have large enough datasets to offer a reasonably confident view – appear to have greater rates of autistic spectrum disorders (learning disabilities), hyperactivity or other conduct disorders (likely to be labelled as ADHD), anxiety disorders and “depression” appearing in their children in their teenage years.
They may also be more likely to be asexual.
And to have fetal alcohol syndrome. Antidepressants cause alcohol cravings strong enough to overcome all the signs now in restaurants telling women to avoid alcohol if they are pregnant.
There are no signs about avoiding antidepressants or related drugs even though despite women in general drinking far less alcohol when pregnant we have dramatically escalating rates of “neurodiversity” and “gender fluidity”.
It seems almost for certain that most birth defects stem from environmental causes. But industry’s (not just pharma’s) message to doctors and politicians is a Dalek like – DNA, DNA, DNA. Tell women birth defects stem from their DNA.
How do we get the right message into our DNA. What is it about industry’s ability to play on our guilt that lets them get us to do things we know are risky at the very time we are trying desperately to avoid taking risks?
Answering this would be a useful contribution to WBD Day.
(Does the non-Anglo world – and this includes America – know about Daleks and Dr WHO and the phrase Exterminate, Exterminate, Exterminate?).