Do Antidepressants and Other Psychiatric Drugs Kill a Half Million People a Year?

P. D. Mangan
Dec 6, 2016 · 4 min read
Image for post
Image for post

Executive Summary

  • Antidepressant use is very high
  • An anti-psychotic drug, Abilify, is the number one best-selling drug (by revenue) in the US
  • People who take psychiatric drugs have much higher death rates
  • Psychiatric drugs appear to be so ineffective that the higher death rates couldn’t possibly be justified

Antidepressant use is very high

Doctors hand out antidepressants and other psychiatric drugs like candy these days. Is that a worthwhile thing to be doing? Do antidepressants and other psychiatric drugs kill a half million people a year? Let’s look at the evidence.

Of Americans over the age of 12, 11% take antidepressants. Following graph is from the CDC, showing antidepressant use by age and sex. Women are much more likely, ~3 times so, to take them as men, in middle age, and ~2.5 times more overall. White people are 3 to 4 times more likely to take them than others. These data are nearly 10 years old, so it’s probably worse now. (Or better, if you like this trend.)

Image for post
Image for post

Is it worse? Latest data indicates that ~23% of women in their 40s and 50s take antidepressants, the highest figure for any age group or sex. Given the higher rates of white people taking these drugs, the rate for middle-aged white women would be considerably higher.

These figures may or may not include the anti-psychotic drug Abilify, which is the top-selling drug in the U.S. They may include it in the data because it’s also marketed for major depression. Abilify costs $800 for a monthly supply of 30 tablets.

Are psychiatric drugs safe?

Peter C. Gøtzsche, a Danish professor of psychiatry, argues in an article in the BMJ that psychiatric drugs are both incredibly unsafe and incredibly ineffective.

He says that randomized trials are biased because they include patients already taking other drugs, and he estimates 15 times more suicides among people taking antidepressants than have been reported to the FDA.

A cohort study found 3.6% greater all-cause mortality in people taking antidepressants; the control group is the same people before they started taking them.

Gøtzsche used only people over 65 years old in his estimates, since falls are an important cause of death in people taking psychiatric drugs, and falls would presumably not kill many people in those under that age. Using Danish prescription data, and scaling up to the U.S. and the European Union, he estimates 539,000 annual deaths from these drugs.

As he says, the benefits are minimal.

There’s a rebuttal to this (at the link), but given the bias toward prescribing these drugs, this side of the story needs more airing in my opinion. The author of the rebuttal “has done paid lectures or been on advisory boards for all major companies producing drugs used in affective and related disorders.”

Another article at the BMJ estimates the increased mortality from benzodiazepines, the class of tranquilizers that includes Valium and Lorezapam. (These are included in the previous estimates.)

For those taking more than 90 mg a day of benzodiazepines, death rates were nearly 7-fold higher than for those taking none. Death rates showed a dose-response effect too — the more they took, the higher the death rate.

Are antidepressants effective?

Given the high estimated death rate, antidepressants would have to be incredibly effective to justify their use. Dr. Gøtzsche believes they are not, and could and should be all but stopped. He advises using them acutely only, and tapering off as soon as possible.

I’m not qualified to argue against him, but my bias is to believe him. It seems doubtful to me that one quarter of all middle-aged American women need an antidepressant, much less Abilify.

To me, it looks like a case of Big Pharma medicalizing a social problem for profit.

Major depression is a serious illness and requires treatment. But, as the title of the debate remarks, does long-term use of psychiatric drugs do more harm than good? The answer to that question matters a great deal for the health of both individuals and society.

PS: My most recent book is Dumping Iron.

Mission.org

A network of business & tech podcasts designed to…

Sign up for Mission Daily

By Mission.org

Mission Daily Newsletter Take a look

By signing up, you will create a Medium account if you don’t already have one. Review our Privacy Policy for more information about our privacy practices.

Check your inbox
Medium sent you an email at to complete your subscription.

P. D. Mangan

Written by

Health, fitness, and anti-aging through lifting weights, paleo diet, and intermittent fasting. I’ve written 6 books on health and fitness.

Mission.org

A network of business & tech podcasts designed to accelerate learning. Selected as “Best of 2018” by Apple. Mission.org

P. D. Mangan

Written by

Health, fitness, and anti-aging through lifting weights, paleo diet, and intermittent fasting. I’ve written 6 books on health and fitness.

Mission.org

A network of business & tech podcasts designed to accelerate learning. Selected as “Best of 2018” by Apple. Mission.org

Medium is an open platform where 170 million readers come to find insightful and dynamic thinking. Here, expert and undiscovered voices alike dive into the heart of any topic and bring new ideas to the surface. Learn more

Follow the writers, publications, and topics that matter to you, and you’ll see them on your homepage and in your inbox. Explore

If you have a story to tell, knowledge to share, or a perspective to offer — welcome home. It’s easy and free to post your thinking on any topic. Write on Medium

Get the Medium app

A button that says 'Download on the App Store', and if clicked it will lead you to the iOS App store
A button that says 'Get it on, Google Play', and if clicked it will lead you to the Google Play store