“Are there any substantial studies that focus on the of long-term side effects of SSRI antidepressants?”
This was the question posed recently in the New York Times “Ask Well” column. Everybody should be asking their doctor, their friends and their legislators why this is the response: “The short answer is no. But your question gets to the heart of an important problem that we have in this country: that all medications are approved by the FDA on the basis of relatively short-term studies, even though many are used long-term for medical and psychiatric disorders that are chronic, if not lifelong.”
That answer applies to a vast majority of medicines (over-the-counter and prescription). The system for reporting adverse effects are mostly voluntary and there are no systemic long-term studies of any drug lasting 10 or more years (according to the NYT column).
In the case of SSRIs, because they have been used in such quantity (by 40 million Americans) and for so long (for more than 30 years) the medical community has essentially conducted a test on the US public, which, fortunately, has not shown a pattern of long-term adverse effects. Conducting long-term trials on the general public is unethical; I believe that most people taking drugs don’t know that their medicine (in most cases) has not been tested for long-term side effects of SSRI. And those in drug trials — potentially millions of us — have a right to know that we are subjects in an experiment.
Side Effects of SSRIs That Are Significant For Some Patients
Side effects of SSRI are significant for some patients. And if one trolls the Internet, it’s not hard to find self-reported, anecdotal complaints of SSRI-related toxicity. But there haven’t been any studies to support the assumption that the SSRIs are causing those problems.
My family was given a similarly vague answer when we asked about the Ritalin a doctor was prescribing for our (then) 12-year old. We were concerned about the neurological interactions of stimulants. We were told that there were no long-term studies, but that children have been taking the drug for so long, the doctors would have seen a problem. That wasn’t an answer we were willing to live with. Too many drugs have been approved for use by the FDA, allowed to be prescribed to the general public and years later, terrible adverse effects were found. Fortunately, ADHD is not usually life-threatening, and we could make the decision that we would forego medicines and work with behavioral therapy, nutrition, and non-drug options.
Many chronic illnesses offer fewer choices for their sufferers — in reality most have to take their prescriptions to stay alive or to function because the risk of avoiding medicine is too high. A good example is depression, — something like 12% of those with untreated depression attempt suicide.
People with depression, epilepsy, HIV/AIDS, and so many other long-term medical challenges deserve to know the risks they are taking every time they swallow a pill or get an injection. The disease may not offer a choice of care, but the doctors should be able to offer information about possible adverse repercussions a medicine might bring. The public should not be used for long-term drug trials: this violates all ethical standards.
