Hush-a-bye baby on the tree-top,
When the wind blows the cradle will rock;
When the bough breaks the cradle will fall,
Down will come baby, cradle, and all.
We face a problem as important or more important than Climate Change – the changing climate in healthcare – see Pharmageddon and Our Healthcare Climate. For a decade, RxISK has been pointing to a polypharmacy pandemic, the need to reduce medication burdens and beyond that to dangerous climate changes transforming the healthcare we had into health services – central to which is an inability to see that the treatments we give can cause harms.
We now face a growing Fertility Crisis. A few days ago, Emmanuel Macron, the President of France, told the French they have a crisis. The image above shows the falling sperm counts of French men.
This is a Fertility Crisis in its own right, but this Crisis also sharpens the focus on a broader Healthcare Crisis.
RxISK was set up to get to grips with drug induced injuries. When injured by medicines, we now face increasing problems, because pharmacovigilance, instead of getting to grips with our injuries, like Maleficent in the Sleeping Beauty, sets up impenetrable hedges of thorns between us and anyone who might rescue us – Malevigilance.
From the get-go, RxISK said drugs caused injuries. They can poison you. Few if any doctors, and not even lawyers suing pharmaceutical companies, want to embrace the obvious – that when we give or take drugs we are trying to bring good out of the use of a poison, an operation as delicate as attempting to defuse bombs.
Third Party Problems
Stating the obvious that drugs cause injuries increasingly provokes incendiary reactions, none more so than when the injuries happen to third parties – when an antidepressant triggers a homicide for instance. In the 1990s, the media could report murders and mention a link to Prozac, even adding that Prozac was controversial. But for over a decade now, all you get is a mention of the mental illness shooters have. The illness causes the problem and we need mentally ill folk on more, not less drugs. To be safe everyone should be on more drugs.
The sexual problems drugs cause also affect third parties. If either you or your partner are on drugs that sabotage lovemaking, you are both affected.
Sex has always been the lifeblood of the mainstream media. When the internet began, pornography followed by health rapidly became its biggest draw. It seemed a no-brainer a decade ago that the media would leap on the topic of antidepressants and sex. But both mainstream and underground media shunned any mention of the sexual difficulties drugs might cause.
On top of that we now have the Big Mama of third party problems – Falling Fertility. A drug that impairs your fertility affects not just you, and your partner, but the entire country in which you live. Its explosive implications can be seen across the world from the US-Mexican border, to drownings in the Mediterranean, and Japanese declarations of a population crisis – Pharmageddon and HealthCare Crisis.
No Baby No Hush
For nearly 20 years I have cited a 2004 rat study that shows Prozac dramatically drops male sperm counts and is toxic to the testes. To make the point, I routinely showed this slide commenting that we once thought excessive masturbation wiped out sperm but actually there ain’t nothing like an SSRI.
Juxtaposed with a standard company image of an SSRI putting things right to make the point.
A network of PSSD researchers brought the Prozac Rat Study back to my attention recently and between us we figured it might be time to ask the medicines’ regulators about it. Several people did. We asked the British and French regulators and struck lucky. (Its another story but Prozac should never have been licensed for Lilly to push it on children – it doesn’t have the positive trials for licensing – see Science, Kansas and Pancakes).
Back in 2007, pediatric Prozac was approaching a license review moment and the regulators asked Pilly to explain what was happening Rats on Prozac.
Lilly went minimal. The regulators asked if a hormonal alterations produced these findings. Lilly reported no endocrine effect. The regulators suggested it would be good to get industry wide views on the significance of these findings. Lilly agreed.
Follow-up correspondence and searches dragged in Danish and Swedish regulators, who were concerned and these concerns drew in a wider group of French and Scandinavian authorities who proposed The Fertility Label Changes.
In 2012, the SSRIs got some brand new words in their labels – see Link. It looks like most US and European labels adopted them – in the very small print hidden deep in the very lengthy sections drawn up for doctors.
As the document shows it looks like a simpler version was supposed to appear in Patient Information Leaflets or Medication Guides. These have not happened.
The proposed changes say sperm counts seem to return to normal after stopping – this is a watery version of the story. Sperm might recover to some extent after stopping SSRIs or SNRIs but not everyone can stop. Quantity may improve but we don’t know about quality.
We know nothing about what happens pubertal boys – or pre-pubertal boys or girls. Quite aside from sperm counts how is a teenage boy or girl going to respond to finding their genitals numb? What do they say to their parents? What happens if they consult the internet and find they may have PSSD or may be infertile forever?
The fertility and PSSD changes are similar. At RxISK we were pleased, as we put it, to help get PSSD into the label of antidepressants. But PSSD is in the small print for doctors rather than in the patient information leaflets that stand some chance of warning a person about what might happen them.
Why has the watered down fertility or PSSD information not found its way into patient information leaflets? Well in the United Kingdom we have it in print that NHS Digital, and the Mental Health Czar, Louis Appleby, along with the President of the Royal College of Psychiatrists, and the media do not want to deter you from taking your antidepressants.
Attempts to talk about hazards gets branded as pill-shaming. Back in 2012, it was just about possible to give a talk at the College of Psychiatry Scaremongers of the World Unite. This is no longer possible – thanks to Dave Nutt and others. People like Joanna Moncrieff run into serious problems attempting to raise serious problems – Psychotropic Drug Follies.
I was recently invited to participate in Dr Xand van Tulleken’s Cure or Con program on the BBC, tackling antidepressant dependence. Aoife emailed me.
We have a film of a lady who experienced really negative withdrawal symptoms after coming of anti-depressants and we feel you could provide knowledgeable advice and take-home information for viewers. We’d be keen for you to discuss how often this is happening, informed consent and what people should do if they’ve been affected. Our main priority is to reassure viewers – those who are currently taking anti-depressants or may be in the future to follow medical advice and not to make any changes to their medication. Aoife
Aoife, I don’t think your good intentions about not doing anything without medical input can work out. The dependence and withdrawal from antidepressants scene is a quagmire. Some doctors are bound to make things worse. I’ve given up telling people not to be guided by their own lights.
I heard nothing back from Xand. I’ve got history with the Van Tulleken brothers – Chris, Xand’s brother, also a doctor, came to cover the issue of antidepressants and children and chickened out of covering the story – The Greatest Failure in Medicine.
Chris and Xand sell themselves as medically qualified investigative journalists, taking on the tricky issues – the kind of people willing to defy censorship, and as doctors are ideally placed to do so on health issues. But like everyone else they seem to bow to the pressure to avoid deterring you from taking your antidepressants.
The chickens are coming home to roost as fewer and fewer humans get to roost.
What Ever Happened Informed Consent?
Falling male sperm counts are no laughing matter. They correlate with rates of testicular cancer, which are increasing. They correlate with male mortality and the gap in life expectancy between men and women in the West is rising.
The article that most comprehensively outlines the testicular ecosystem is by Niels Skakkebaek and colleagues. Its full of extraordinary and fascinating detail. You learn that in terms of getting the balance between testes and sperm right the Black-Tufted Marmoset is much more evolved than Humans who seem “uniquely poor at spermatogenesis”.
You can learn that even though uniquely poor, men still produce 1500 sperm per heartbeat – but they don’t mind them as well as the Black Tufted one. Drugs and endocrine disrupting environmental chemicals aren’t helping.
While nothing beats an SSRI at wiping out sperm counts, antidepressants are not the only source of the problem. Antihypertensive drugs cause problems, cytotoxic drugs used to treat cancer cause problems, testosterone and androgens surprisingly cause problems, because consumed testosterone turns off testosterone production in the testes.
In terms of male libido, all psychoactive drugs – benzodiazepines, antidepressants, anticonvulsants, antipsychotics and opioids – cause problems.
For men, there may be an upside to having PSSD in that there is a chance sperm counts will show some recovery while the person is off treatment and this can make it possible to aspirate sperm and father a child. Fertility problems may be worse for men who remain on, or can’t stop their SSRI, as sperm counts do not recover while on treatment.
When drugs come into the fertility frame, the talk once was about women and their failure to recover their fertility as a result of contraceptives. Men now look more likely to be at fault and for women there are drugs other than contraceptives to think about. The way things are going there may be no need to have adverts like these:
Drugs like the antidepressants and benzodiazepines can affect implantation, increase rates of miscarriage, trigger disinhibited abortions, but above all have a dampening effect on libido. In many countries, antidepressants are the second most commonly taken drugs by young women, after contraceptives and the most commonly taken drugs throughout a pregnancy – in part because of the difficulties stopping them.
The SSRIs women are more likely to take than men may also be sabotaging male sperm. Googling Prozac or SSRIs in lakes, rivers, drinking water and fish produces surprising results. Could drugs in the water really cause a problem? Yes. Serotonin is more primitive than testosterone or estrogen. Serotonin was there before we had sexes.
Thirty-two years ago, Sertraline launched in the UK. At the launch, the primitive role of Serotonin was pointed out. The message was that we have no real idea what we might see with widespread use of these drugs. Primitive Serotonin. We’ve found out a lot since but not anything company marketing departments want you to hear about.
Life But Not As We Know It
Make no mistake the Starship Enterprise is venturing where humanity has not gone before. The correspondence leading to label changes on SSRIs shows regulators busy covering their backs.
But happy if it doesn’t end up on the public’s radar.
The Japanese are talking desperately about copying French measures to make workplaces and financial structures more family friendly. In 2023, the Chinese population fell for the second year in a row and Fertility Rates are down to Japanese levels. Xi Jinping too is looking at incentivizing women.
The original IVF procedures were aimed at unblocking Fallopian Tubes. By 1991 in the UK a body had been set up to license clinics to deliver IVF. In 1992, the first thing it did was to approve IVF to compensate for male infertility linked to low sperm counts. By 2012, 5 million babies were being born by IVF. A few years later it was over 10 million. Even while IVF rates approach 10% in many countries from Japan to Europe, the assumption remains that women are not choosing to have children and we can change that by supporting them with more time out and financial incentives.
Chatting to women who have not had children or have friends who have not had children, people in my social circle, the story that comes back is fascinating – an inside out version of the Microgynon advert above. Men are feckless and you can’t find a decent one these days but they don’t mean it the way the Microgynon ad means it.
Younger women in contrast seem more aware of the fact that men are no longer dependable in the way the Microgynon advert assumed. The Fertility Rate of women in their 30s is higher than the Fertility Rate of women in their 20s or teens. It’s not the women’s fault – French women on average express a desire to have 2.3 children. This is more than replacement rate. If this were happening Emmanuel would be celebrating the Good News of Salvation.
A major survey in the BMJ in 2019 pointed to evidence that the Brits – and this likely applies to all the Western world – are no longer making love the way they used to – the way it was once assumed they always would. As Hamlet put it:
Young men will do it when they come to it, by G’ad they are to blame.
No longer it seems. Not wanting to have babies is one thing but not having sex is quite another.
The BMJ blamed depression. It’s hard to know what the author of the article might have really thought because as mentioned BMJ’s lawyers would not have let them blame the antidepressants 15% of the population are now taking – see When The Personal Becomes Political.
The depression being treated by SSRIs doesn’t cause problems like this. Modern ‘depression’ is a worried wellness. SSRIs don’t treat depression. They were branded as antidepressants at a time when benzodiazepine dependence made calling them anxiolytics, or serenics a problem.
(For those on SSRIs or SNRIs who view yourselves as seriously depressed and bridle at this thought – well you might bridle. If you were originally severely depressed, you were put on drugs never likely to help you – drugs that barely beat placebo. See Health’s Illusions.
If you know you have severe depression because of how bad things are when you reduce your drug, you have a severe disorder now – SSRI/SNRI dependence).
Since the BMJ article came out, there has been a Boston randomized controlled trial of men at infertility clinics trying to tease out if their ‘depression’ might be causing the problem. It doesn’t. Their antidepressants appear to be the biggest single factor in their problem – Yland et al.
There is more in Heaven and Earth than male sperm. The recent RSV vaccine posts bring out a serious point. Vaccines cause inflammatory responses which can be a problem in pregnancy, especially for any woman predisposed to pre-eclampsia. They likely all increase the risk of pre-term births. Pre-eclampsia and pre-term births have consequences for woman and children for the rest of their lives – Coming Clean on Neonatal Deaths.
Vaccine schedules are now recommending 6 vaccines during pregnancy – Tetanus, Diphtheria, Pertussis, Influenza, Covid and RSV. It looks like these interfere with each other so that the benefits you might get from one are lost once a woman gets multiple vaccines – No Room at the Inn. We have known for years from the work of Peter Aaby and colleagues that dead vaccines can in theory sabotage responses to other vaccines – but the evidence from RSV vaccines that this might now be happening to pregnant women hasn’t led women to rise up and reclaim Our Bodies, Our Selves.
We are now pouring chemicals into the wellsprings from which life bubbles. We are doing so without anyone checking that it is safe to do so. The regulators of medicines have no idea what is safe in pregnancy – by this I mean they have no boxes to tick when it comes to the third trimester. They are sitting down as we speak trying to work this out. The companies running vaccine trials have run them with protocols stating there will be no investigations of safety issues in this trial, and specifically limited the collection of adverse events.
There will be 2 linked posts next week – one offering a timeline on Antidepressants, Sex and Fertility and the other inviting older folk – over the age of 60 to contemplate voluntary altruistic euthanasia to help Emmanuel out of his difficulties.
The Cradle of Civilization
Cell by cell the baby made herself, the cells
Made cells. That is to say
The baby is largely made of milk. Lying in her father’s arms,
the little seed eyes
Moving, trying to see, smiling for us,
To see, she will make a household
To her need of these rooms –
Sara, little seed,
Little, violent, diligent seed. Come let us look at the world
Glittering: this seed will speak,
Max, words! There will be no other words in the world
But those our children speak. What will she make of a world
Do you suppose, Max, of which she is made?
Hush-a-bye baby on the tree-top,
When the wind blows the cradle will rock;
When the bough breaks the cradle will fall,
Down will come baby, cradle, and all.