Philip over at Furious Seasons thinks that antidepressants shouldn’t be made available over-the-counter in the U.S. (e.g., without a prescription). His entry was based upon this article over at Time magazine that interviews Josephine Johnston, an associate for law and bioethics at the nonpartisan research institute, the Hastings Center.
The real question you have to ask yourself when asking, “When should a drug become commonly available without a prescription?” is weighing the risks of harm versus the benefits of access. It’s a simple equation that can be readily backed by data from empirical, published studies.
With virtually all antidepressants, the risks of harm are still fairly significant. We don’t know quite why they work the way they do, they can take up to 8 to 12 weeks for a person to feel their positive effects, and there seems to be an increased risk of suicidal thinking associated with some of them.
In addition, we’ve seen over the past year how some antidepressants appears to be no more effective than a sugar pill, suggesting much of the positive effects of antidepressants isn’t in their active ingredient, but instead in their role in the treatment process.
So while one can make the argument that popular drugs should become over the counter (why isn’t Viagra available without a prescription then?), it’s a silly and specious argument to make. Why not make stimulants used to treat ADHD widely available? Hey, why stop there, let’s make cocaine available too! You can’t base such decisions on a drug’s “popularity.”
Instead, we need to make decisions about what becomes available over the counter on the data — date showing efficacy and data showing safety. And while all FDA-approved medications are already proven safe and effective, that doesn’t mean they should be made more widely available to anyone without a prescription.
So we agree, while it’s just a hypothetical question, it’s one where the answer is pretty clear — at this time, antidepressants should not be made available over the counter (OTC), without a prescription.
Read the blog entry at Furious Seasons: Prozac Over the Counter? Oh, Hell No!
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ADHD Report» Blog Archive » OTC (Over the Counter) Antidepressants (5/27/2008)
8 Comments to
“OTC (Over the Counter) Antidepressants”
I agree that anti-depressants should not be made available over the counter. My reasoning is that much of the general public still does not know the difference between being sad and being clinically depressed. If anti-depressants were available OTC, I shudder to think how many people would start popping pills regardless of whether or not they were diagnosed with depression by a mental health professional. The only ones who would benefit from these medications going OTC are the drug companies, and they already have enough money.
Wendy Aron, author of Hide & Seek: How I Laughed at Depression, Conquered My Fears and Found Happiness
http://www.wendyaron.com
This should be a no-brainer! (Er, so to speak.) SSRIs, like all psychoactive drugs, are strong medicine, and they do have significant side effects. They are the kind of drug that should not be used without counseling and supervision.
Also, my opinion is that it’s very important for people with mood and anxiety disorders to get a proper, professional diagnosis. Here is just one scenario: a person who is feeling very depressed takes OTC fluoxetine/Prozac — and suddenly becomes over-the-top manic because she was actually experiencing the first episode of her bipolar disorder, and the SSRI completely destabilized her. She is not under a pdoc’s (or even her general practitioner’s) supervision, so her condition is not diagnosed until significant harm is caused by her worsened illness.
Plus, as the Josephine Johnston mentioned in her interview, “to provide them over the counter, you’re decoupling them from [an important part of the treatment].” A pill alone without even education about one’s condition, let alone counseling, is not good treatment, in my opinion.
Talk about irony. Psychologists have been denied prescription-writing privileges (correctly so, imo), but we’re reading about possible merits of providing antidepressants OTC for folks to pop on their own. Undiagnosed, unmonitored, uneducated, unknowing of the effects on other medical conditions, unaware of withdrawal dangers, and unmindful of the risk of adding another ingredient to the cocktail of meds so many of us take?
Does anyone else find it peculiar that the person interviewed is weighing the rights of consumers from the legal/bioethical viewpoint, and parroting a variety of others’ opinions, but there’s no input from the medical side?
Prilosec and Prozac side by side? What WERE these people smoking.
Talk about irony. Psychologists have been denied prescription-writing privileges (correctly so, imo), but we’re reading about possible merits of providing antidepressants OTC for folks to pop on their own.
Undiagnosed, unmonitored, uneducated in action and safety, unknowing of the effects on other medical conditions, unconcerned about side effects and withdrawal warnings, and unaware of the risk of adding another ingredient to the cocktail of meds so many of us take.
In re subject and context, does anyone else find it peculiar that the person interviewed is addressing consumers’ *rights* to have drugs from the legal/bioethical viewpoint, not risks, benefits and abuse issues beyond parroting a variety of others’ opinions peppered with “it’s my understanding”?
Prilosec and Prozac side by side. Not a pretty thought.
I don’t think they should be made available over the counter, but I think that the information should be made more available so that people in general aren’t so in fear of asking for the psychological help or counseling that they need instead of fearing social repercussions for it.
yes I think antideppression meds should be over the counter espesially these days. Their are alot of depressed woman an man in the world and being that things are so slow in the world it would stop maybe alot of crime and anger in te work force and on the road (road rage)
Since it took almost two years for various doctors to figure out what worked for me, I find the OTC idea incomprehensible. An important part of the process was going back frequently to be monitored for the effectiveness of the drugs. Without monitoring, I would never have arrived at the proper combination (and without abject poverty, I would probably still be on them, even though I don’t need to be any more).
As for your Rhetorical question, “why not make cocaine legal OTC?” Why not? Seriously? Why not make Cocaine legal over the counter. Obviously the social costs would be far less if cocaine was legal, and cocaine might actually be the best anti-depressant out there.
Hell, I have tried everything legal to treat my depression and nothing treats it better, more quickly with the least side effects than cocaine. No I am not a junky, nor have I taken it for more than a couple of consecutive days and even then I have not taken it in years, but if it were possible to purchase cocaine where it quality, purity and potentcy has been insured by a certified lab, and I would not have to deal with a criminal element to get a drug that could actually help me, then why not?
Yes obviously, a few people develop problems with drugs like cocaine, but a few people also develop problems with alcohol or cigarettes, or even coffee. Once upon a time cocaine was legal, and served in Coca-Cola, and the turn of the century certainly seems like a productive, prosperous and rather crime free period in American history.
So seriously, why not sell cocaine over the counter? It does not seem any worse than the various snake oils that the big pharma companies are pushing now, and the social consequences of contraband have proven themselves far worse than the social cost of unprohibited drug use.
Botttom Line:
ANTIDEPRESSANTS [OPIATES AND BENZO'S] ARE DANGEROUS MEDS NO BETTER THAN A PLACEBO AND DO MORE HARM THAN GOOD. THEY CHANGE THE BRAINS CHEMISTRY….BLUNT FEELINGS OF LOVE AND ATTACHMENT….ALTER THE PERSONALITY…..MAKE ONE NOT CARE…..MAKE YOU SELFISH AND SELFCENTERED ALONG WITH A HOST OF OTHER NOT SO CHARMING SIDE EFFECTS. [OVER 50 SIDE EFFECTS] THEY TAKE AWAY THE GOOD ALONG WITH THE BAD FEELING! NOT GOOD OR NEEDED. THEY ARE GIVEN OUT BY REG DOCS FOR NORMAL SADNESS AND MOST DOCS DO NOT MONITOR THEM. BIG PHARMA IS CULPABLE…..FOLLOW THE MONEY!
NO TO O.T.C. DRUGS…..LETS GET OFF OUR PYCHOLOGICAL NEED FOR THEM AND RELY ON COMMON SENSE AND GOOD NUTRITION.
OOPS! sorry for the caps - I hit the button by accident while typing.
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