Is it any wonder teenagers think it is okay to take Xanax?

On 29 March, The Times newspaper reported that teenagers are buying Xanax on the internet, thinking it is safe to consume.  After all it is offered on prescription in the US and is consumed by celebrities.  Xanax is a benzodiazepine, a class of drug that has been widely prescribed to patients since the 1960s, although Xanax itself is not approved for prescribing on the NHS.  Benzodiazepines are highly addictive and can cause a great deal of pain and distress even when taken as prescribed.   Withdrawal from the drug can be severe and can last for months or years.

Meanwhile, the general public is regularly being persuaded that taking pills to feel emotionally better is in fact a very good thing.  On 22 March, The Times printed a different article on antidepressants, reporting results of the Cipriani et al meta-analysis published in The Lancet medical journal.

The article began

“More than a million extra people should be offered antidepressants after the largest study of its kind concluded that they worked, experts have said.  Patients and GPs must not be squeamish about treating mental health problems with drugs, according to scientists who found that every one of 21 common antidepressants was better than a placebo.”

It continued

“About two million people in Britain are thought to suffer from depression, yet studies suggest that only a sixth get the help they need. About 65 million antidepressant prescriptions are written in England each year, a figure that has doubled in a decade. This has led to concern about use of the drugs, which cost the NHS £267 million in 2016. Andrea Cipriani, who led the latest study, said: “Undertreated depression is a huge problem and we need to be aware of that. We tend to focus on overtreatment but we need to focus on this.”

It would seem therefore that only 333,330 patients are receiving the treatment they need for depression.  Yet, official statistics show that over seven million patients are being prescribed antidepressants in England alone and almost one million in Scotland.  If Wales is included, the total figure must be around nine million.   So why are all these patients taking antidepressants if only 333,330 patients are receiving treatment?   Perhaps the two million refers to people who are suffering from moderate to severe depression as this was the focus of the Lancet paper.  Are most patients on antidepressants for mild depression perhaps or for other mental health conditions or pain?  It just seems odd that antidepressants are so widely prescribed, yet it is thought that GPs and patients are “squeamish” about treating mental health issues with drugs.

The article continued

“John Geddes, senior author of the paper, published in The Lancet, said that widespread criticism of antidepressants “puts people off accessing effective treatment” and they should be reassured. “There’s something about taking a drug for a mental health problem that people think, ‘That’s not what I want to do’, so it’s important to be clear about the efficacy,” Professor Geddes said. “We do tend to be a bit squeamish about it . . . If it was cancer and only one in six were getting access to effective treatment we’d think there was something squiffy going on.” He estimated that at least a million more people should have drugs or psychotherapy.”

So again I am wondering why at least nine million patients are taking antidepressants not to mention antipsychotics and other drugs prescribed for mental health problems.

At no point in this article was there any mention of the fact that the meta-analysis only looked at the effectiveness of antidepressants over 8-12 weeks, yet most patients will take prescribed antidepressants for much longer than this.

The article continues

… Carmine Pariante, from the Royal College of Psychiatrists, said: “This meta-analysis finally puts to bed the controversy on antidepressants.”

Of course, The Lancet paper has done nothing to put to bed the controversy and has in fact sparked a bigger controversy about the entire subject.

What sort of impression is being given to our young people .. surely they are being encouraged to think that taking a pill is perfectly normal and even desirable, after all it is being promoted by leading academics and clinicians at a prestigious University and is being reported widely in the mainstream and social media.  I don’t know if teenagers are listening to this, perhaps not, but surely they cannot be immune to the messages.

The tragic death of Annette McKenzie’s daughter, Britney, has led Annette to raise a petition to the Scottish Parliament calling for a review of informed consent for 16-18 year olds when being prescribed medication for mental health problems.  Perhaps Britney too had no idea the strength of the drugs she had been prescribed and the potential for harm.  She was only 16 years old and had little experience of consuming prescription drugs, let alone powerful ones.

Many patients in the prescribed harmed community feel that they were never warned of the dangers associated with the drugs they were prescribed and took them in good faith assuming that all would be well.   Most rue the day they took their doctor’s advice and accepted a prescription.

Perhaps there is a lesson here to be learned.   Teenagers consuming illegal Xanax, the widespread promotion of antidepressant drugs to the public, the failure to warn patients of adverse effects and the prescribing of powerful medication to teenagers without parental knowledge.  I do hope action is going to be taken on all fronts on this subject.

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