CCHR Applauds Call for Human Rights-based Approach to Mental Health

Posted on February 3, 2025 by cchrstl

A new article in Health and Human Rights Journal calls for an approach to mental health in which every aspect of it and its determinants is endowed with respect for, and the realization of, human rights.

by CCHR National Affairs Office 

A new perspective article calls for a more comprehensive, human rights-based approach to mental health that addresses the wider social, economic, and environmental factors that cause emotional distress. The article was published in Health and Human Rights Journal, a joint publication of Harvard University’s FXB Center for Health & Human Rights and Drexel University’s Dornsife School of Public Health.

The authors contrast a human rights-based approach with today’s biomedical approach, which assumes increased psychiatric screening, diagnosis and treatment of mental health symptoms will lead to mental well-being for individuals and nations. 

The article’s authors note that there has been criticism of the psychiatric influence, or “psychiatrization,” of the Sustainable Development Goals issued by the United Nations, which identified improved mental health as a priority for global development. Psychiatrization refers to the increasing influence of psychiatry through its institutions and practices affecting an increasing number of people and areas of life.

“Concerns about psychiatrization stem from the fact that the focus is predominantly on scaling up the diagnosis and treatment of mental disorders, without paying attention to how a biomedical approach is limited in addressing the environmental, social, economic, and political determinants of mental health,” wrote lead author Lisa Cosgrove, PhD, a professor in the Counseling Psychology Department at the University of Massachusetts and co-founder of the Centre for Mental Health, Human Rights, and Social Justice.

Cosgrove and colleagues call for a human rights-based approach to mental health which “ensures that every aspect of health care and its determinants is imbued with respect for, and the realization of, human rights.”

The article references Dainius P?ras, a child psychiatrist and former UN Special Rapporteur on the right to health, who argued that mental well-being should not be defined as the absence of a mental health condition, but instead is the result of a social, political, economic and physical environment that enables people to live a life of dignity, with full enjoyment of their rights in the pursuit of their full potential.

“The Citizens Commission on Human Rights applauds the call for a human rights-based approach to mental health,” said Anne Goedeke, president of the CCHR National Affairs Office. “CCHR is dedicated to ensuring human rights and dignity in the field of mental health.”

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End the Fraud and Abuse of Involuntary Psychiatric Detentions

Posted on January 27, 2025 by cchrstl

Research indicates psychiatric confinements against a person’s will have been increasing at three times the rate of the increase in population.  Investigations and U.S. Justice Department complaints have alleged that patients have been held and their insurance billed unnecessarily.

by CCHR National Affairs Office

The Citizens Commission on Human Rights (CCHR) has resolved, as a major focus of its national efforts in 2025, to raise awareness of the abusive and costly practice of detaining people against their will in psychiatric facilities, with the goal of ending the practice.  CCHR is a mental health industry watchdog.

State laws on psychiatric detentions vary in the U.S., but nearly all states allow involuntary inpatient civil commitments, evaluation and treatment of individuals deemed a danger to themselves or others.  However, this determination is completely subjective, which opens the potential for fraud and abuse. 

CCHR chapters around the world have for years complained to the proper authorities on behalf of individuals reporting to the organization that they were wrongly committed to a psychiatric facility, forced to take psychiatric drugs, held for long periods of time, traumatized by circumstances in the facilities, and released in worse condition than when they were first detained.

Exposés of the practice have also appeared in the press.  A recent investigation by reporters at the New York Times focused on Acadia Healthcare, one of the largest chains of for-profit behavioral health facilities in the U.S., and concluded, “Acadia has lured patients into its facilities and held them against their will, even when detaining them was not medically necessary.”

Acadia allegedly maximized insurance billing by using various excuses to continue holding patients, sometimes until their insurance coverage ran out.  Acadia reportedly charges as much as $2,200 a day for some patients.  With the bulk of Acadia’s revenue coming from government insurance plans, including Medicaid and Medicare, taxpayers are footing the bill for most of these detentions.

In September, Acadia agreed to pay $19.85 million to settle allegations that the company knowingly submitted false claims for payment to Medicare, Medicaid and TRICARE for medically unnecessary services for patients it improperly admitted to its facilities and patients held for excessive lengths of stay, according to the U.S. Department of Justice.

Similarly, in 2020 another of the largest U.S. chains of for-profit psychiatric facilities, Universal Health Services, agreed to pay $117 million to settle Justice Department allegations that included billing for medically unnecessary inpatient admissions and keeping patients longer than medically necessary.

Evidence shows that involuntary commitment has become far more prevalent in recent years.  A 2020 study at the UCLA School of Public Affairs found that in the 22 states which provided civil commitment data for the five-year period ending in 2016, the states’ average yearly involuntary detention rate increased at three times the rate of their average population growth.  It has been estimated that four of every ten admissions to psychiatric facilities are involuntary, a figure that reportedly rose by 27% over the last decade.

The increased risk of suicide in the period following discharge from psychiatric confinement is well recognized, with the risk even greater for those who are admitted to psychiatric facilities against their will.

The World Health Organization (WHO) has called on countries to end coercive mental health practices.  “People subjected to coercive practices report feelings of dehumanization, disempowerment and being disrespected.  Many experience it as a form of trauma or re-traumatization leading to a worsening of their condition and increased experiences of distress,” WHO advised.

The Citizens Commission on Human Rights is dedicated to ending this abusive practice.  “The power of a psychiatrist or other mental health practitioner to deprive individuals of their liberty based on purely subjective evaluations, which will always have the potential for abuse and which research has shown to be harmful to patients, must stop,” said Anne Goedeke, president of the CCHR National Affairs Office.  “This will be a major focus for us in 2025, as we work to restore human rights to the field of mental health.”

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Missouri Psychiatrist and Co-Conspirator Finally Brought to Justice

Posted on January 6, 2025 by cchrstl

In 2004 the Citizens Commission on Human Rights of St. Louis (CCHR STL) filed a formal complaint against St. Louis, Missouri psychiatrist Franco Sicuro, for fraud and abuse related to a patient’s alleged misdiagnosis and mistreatment lasting over a very painful fifteen months.

Sicuro headlined the news in 2020 when he was indicted by the U.S. Attorney’s Office, Eastern District of Missouri, for $15 million in health care fraud.

Eventually Sicuro pleaded guilty in 2022 to a felony conspiracy charge and admitted that Medicare, Medicaid and other insurers lost more than $3.8 million based on fraudulent reimbursement claims submitted by clinical laboratories that he owned. Sicuro has since satisfied the restitution owed, and agreed to forfeit $3.1 million in assets.

Finally in 2024 the U.S. Attorney’s Office, Eastern District of Missouri, reported that Sicuro’s co-defendant, Carlos Himpler, was sentenced to 20 months in prison and fined $100,000 for submitting more than $3.8 million in fraudulent claims to Medicare, Medicaid and private health care benefit programs.

This kind of criminal fraud is rampant in the psychiatric industry. Experience has shown that there are many criminal mental health practitioners. If you become aware of such, file a fraud report here: https://www.cchr.org/take-action/report-psychiatric-abuse.html.

CCHR St. Louis was among the first to spot and make known this psychiatrist’s criminal behavior and thanks to its persistent education with health and regulatory agencies on the abuses of psychiatry justice was able to prevail.

What is needed is legislation that provides not only more effective oversight but also stronger accountability measures: criminal and civil penalties, removal from CMS programs (Centers for Medicare & Medicaid Services) and their funding, and hospital closure where systemic abuse is found. Only such a comprehensive solution can begin to thwart the level of abuse, fraud and malpractice that is so widespread today in the for-profit mental health industry.

Contact your local, state and federal representatives and express your opinions about this. Find contact information for your Missouri legislators here: https://www.senate.mo.gov/LegisLookup/ZipLookup

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New Study Finds Antipsychotic Drugs Worsen Behavior in Nursing Home Residents

Posted on December 23, 2024 by cchrstl

New research provides additional evidence that off-label prescribing of antipsychotic drugs for elderly patients with dementia is not effective in reducing behavioral symptoms and exposes them to risks of serious side effects.

by CCHR National Affairs Office

Antipsychotic drugs significantly worsened behavior in two out of three nursing home residents using the drugs, a new study indicates.  The researchers say their findings support the importance of focusing on approaches other than the use of antipsychotics for the behavioral symptoms of elderly patients.  The Citizens Commission on Human Rights (CCHR) urges caregivers and family members to report any instance of harm or abuse from the use of antipsychotics to CCHR, as well as the Centers for Medicare and Medicaid Services (CMS). 

The new study explored the association between antipsychotics and worsening behavior in patients in long-term care facilities.  Antipsychotics are commonly prescribed for agitation or other behavioral disturbances in older people with dementia. 

Researchers at the University of Waterloo in Ontario, Canada, analyzed data from nearly 500,000 Canadian nursing home residents from 2000 to 2022 and found that nearly 68% of the residents who used antipsychotics had worse behavioral problems during follow-up checks. 

“Our findings support the importance of focusing on non-pharmacological approaches to care, especially in the setting of those experiencing BPSD [behavioral and psychological symptoms of dementia],” the researchers concluded.

The study further found that 26% of nursing home residents in Canada were prescribed antipsychotics for off-label uses not approved by the FDA. 

“Sometimes people may say they don’t have enough staff to deal with these issues, but the reality is that these medications can make disability and cognitive impairment worse,” said John Hirdes, Ph.D., a professor in the School of Public Health Sciences at Waterloo University who was part of the research team. 

The researchers recommended getting to the source of dementia patients’ behavioral issues and providing non-drug support first.  That support may be in the form of better pain management, activities to reduce anxiety, gentle exercise, or music and art therapy, which have been shown to improve behavioral symptoms without the need for antipsychotic drugs. 

“Although the positive effects of non-pharmacological treatment are widely discussed in the [medical] literature, these approaches are infrequently and inconsistently implemented,” the researchers wrote.  The study was published in the Journal of the American Medical Directors Association.

In 2005, the U.S. Food and Drug Administration (FDA) issued its most serious “black box” warning for atypical (second-generation) antipsychotics, including Abilify, Zyprexa, Seroquel and Risperdal, after finding the drugs nearly double the rate of death in elderly dementia patients.  In 2008, the FDA extended the warning to all antipsychotics by including typical (first-generation) antipsychotic drugs, such as Haldol, Thorazine and Prolixin, and added a warning for stroke and other cerebrovascular adverse events in elderly patients with dementia.

Atypical antipsychotic drugs, initially promoted as safer than older generation antipsychotics, not only failed to prove safe when used for behavioral treatment in older adults with dementia, but also failed to show evidence of effectiveness, a 2013 study found. 

Antipsychotics carry the risks of serious side effects, including tremors, anxiety, confusion, restlessness, rigidity, tardive dyskinesia (uncontrollable muscle movements), cognitive decline, stroke, cardiovascular events, and an increased risk of death in elderly dementia patients that prompted the FDA warning.

The CMS National Partnership to Improve Dementia Care in Nursing Homes worked successfully to reduce the percentage of long-term nursing home residents in the U.S. who are prescribed antipsychotic drugs from 23.9% in 2011 to 14.8% at the end of 2023, but the rate hit a low of 14% in 2019 and has risen since then.  Some 2.2 million Americans aged 65 and older are currently prescribed antipsychotic drugs.

Resident rights in the federal regulations for long-term care facilities prohibit the use of medications for discipline or the convenience of others.  CCHR urges caregivers and family members to report any wrongful prescribing of antipsychotics to nursing home patients by contacting CCHR, as well as CMS.

WARNING:  Anyone wishing to discontinue or change the dose of an antipsychotic or other psychiatric drug is cautioned to do so only under the supervision of a physician because of potentially dangerous withdrawal symptoms.

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CCHR Calls for Repeal of Laws Allowing Forced Psychiatric Detention Amid Evidence of Abusive and Racist Use

Posted on December 16, 2024 by cchrstl

New study finds requests made under Massachusetts law to transport people against their will for psychiatric evaluation were made by health professionals who had not seen the individuals who were the subject of their requests, and those individuals were disproportionately Black people.

by CCHR National Affairs Office

The vast majority of requests to law enforcement and emergency medical services in Boston to transport individuals against their will to a hospital or psychiatric facility for psychiatric evaluation, often leading to involuntary commitment, were made by health professionals who had not seen the individuals who were the subject of their requests, a new study has found.  The individuals forcibly transported and evaluated were disproportionately Black people.  The Citizens Commission on Human Rights (CCHR) is calling for the repeal of laws allowing such gross violations of human rights. 

A team of researchers led by Kevin M. Simon, MD, MPH, Chief Behavioral Health Officer of the Boston Public Health Commission and an instructor in psychiatry at Harvard Medical School, analyzed the 488 written applications made by health and mental health professionals for involuntary mental health transport and evaluation in Boston over a one-year period in 2021-2022. Massachusetts law allows the involuntary procedure if medical or mental health professionals believe a person is a danger to him/herself or others. 

The researchers found that in three out of every four (76%) requests, the professionals had not seen the individuals they were asking to be forcibly transported for psychiatric evaluation, acting instead on information received from other sources.  They further found that the individuals subject to the involuntary procedures were disproportionately Black people.

“The analysis revealed racial disparities: 41% of involuntary hospitalization applications were for individuals identified as Black or African American, but this racial group represents only 23% of Boston’s population,” the researchers wrote.  The study is available online in advance of publication in Psychiatric Services.

Statewide, tens of thousands of people are involuntarily transported for psychiatric evaluations each year in Massachusetts.  Similar involuntary procedures are found in state laws across the U.S. 

CCHR and investigative reporters have uncovered the fraud and abuse at many psychiatric facilities from the misuse of state mental health laws to wrongly detain, evaluate and treat individuals against their will, while billing their insurance for it.

Because of such reported harm, the World Health Organization (WHO) issued guidance in 2021, advising countries to end coercive mental health practices, which it said are used “despite the lack of evidence that they offer any benefits, and the significant evidence that they lead to physical and psychological harm and even death.” 

The WHO guidance extends its call for prohibiting coercion even to those in mental health crisis, stating, ”People subjected to coercive practices report feelings of dehumanization, disempowerment and being disrespected.  Many experience it as a form of trauma or re-traumatization leading to a worsening of their condition and increased experiences of distress.”

The Citizens Commission on Human Rights agrees.

“We must end the abusive business as usual of psychiatrists and other mental health practitioners depriving individuals of their liberty with the stroke of a pen, causing people to be taken by force to a psychiatric facility, forced to undergo unwanted psychiatric evaluation and treatment, then claiming that this coercive, traumatizing experience is for the good of the individual,” said Anne Goedeke, president of the CCHR National Affairs Office.  “Human rights must be restored to the field of mental health.”

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As International Human Rights Day Approaches, CCHR Urges Adoption of the Mental Health Declaration of Human Rights

Posted on December 9, 2024 by cchrstl

International human rights standards call for human rights-based approaches in the field of mental health.  Citizens Commission on Human Rights is working to make those rights a reality through the promotion of the Mental Health Declaration of Human Rights.

by CCHR National Affairs Office

The Citizens Commission on Human Rights (CCHR) National Affairs Office announces it will be carrying out a promotional campaign, launching on International Human Rights Day, to raise awareness of the Mental Health Declaration of Human Rights.  This Declaration, like the United Nations Universal Declaration of Human Rights (UDHR) that inspired it, lays out fundamental human rights, but as specific to the field of mental health. International Human Rights Day marks the signing of the UDHR on December 10, 1948.

All human rights organizations set forth codes by which they align their purposes and activities. The Mental Health Declaration of Human Rights articulates the guiding principles and goals for the field of mental health to which CCHR adheres.

The mental health rights in the Declaration include the right to be treated with dignity, the right to fully informed consent to mental health treatment based on the full disclosure of risks, as well as the right to refuse consent, and the right to know what alternative treatments are available.  The Mental Health Declaration of Human Rights sets forth these and other fundamental mental health human rights to which CCHR believes everyone is entitled.

International human rights standards call for changes in mental health approaches to ensure human rights are respected.  In 2017, Dr. Dainius P?ras, the United Nations Special Rapporteur on the right to health, called for “a sea change” in mental health care around the world to replace “outdated practices that violate human rights.” 

More recently, the World Health Organization (WHO) issued guidance in 2021 for promoting a rights-based approach to mental health.  WHO observed that “an entrenched overreliance on the biomedical model in which the predominant focus of care is on diagnosis, medication and symptom reduction…hinder[s] progress towards the full realization of a human rights-based approach.”  It called for mental health systems and services to align with international human rights standards, including the U.N. Convention on the Rights of Persons with Disabilities, which aims to protect the human rights and fundamental freedoms of all persons with disabilities.

CCHR is making the Mental Health Declaration of Human Rights more widely known.  Because adequate protections for human rights in the field of mental health are vital, CCHR urges that these rights be recognized by the widespread adoption of this Declaration.

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CCHR Calls on FDA to Require Updated Antidepressant Warnings After Research Finds Withdrawal Symptoms Are Common

Posted on November 25, 2024 by cchrstl

Withdrawal symptoms are experienced by nearly half of the people trying to quit antidepressants, even if tapered over several weeks, research finds.  CCHR says prescribing information and medication guides do not adequately convey this widespread risk and calls on FDA to require updates.

by CCHR National Affairs Office

Close to half of the people who quit antidepressants experience withdrawal symptoms regardless of whether they stop suddenly or taper their dosage over several weeks, a new study finds.  In light of recent research, Citizens Commission on Human Rights (CCHR) calls on the U.S. Food and Drug Administration (FDA) to require antidepressant manufacturers to carry more adequate warnings in their prescribing information and medication guides on the risk of withdrawal symptoms when patients stop using the drugs.

The new research, published in Molecular Psychiatry, investigated the incidence of so-called antidepressant withdrawal syndrome by reviewing drug trials of antidepressants that included data on withdrawal symptoms.  What researchers found is that nearly half of study participants experienced withdrawal symptoms when stopping antidepressants after having used the drugs for 8 to 12 weeks in the trials.

“The pooled incidence of AWS [antidepressant withdrawal syndrome] from all available studies was 42.9% [and] from 11 RCTs [randomized controlled trials] was 44.4%,” the researchers concluded.  They found no significant difference in the incidence between the types of antidepressants used.  

They also found that the longer antidepressants were used, the greater the incidence of withdrawal symptoms, with the incidence rising to over 51% for those who quit after taking antidepressants for longer than 24 weeks. 

These findings are consistent with prior research.  One study found that more than half (56%) of people who attempt to come off antidepressants experience withdrawal effects, with nearly half (46%) of them describing the symptoms as severe.  Another found that among people whose withdrawal effects were persistent, ranging in duration from 5 to 166 months, 81% experienced mental health disturbances like anxiety, depression, emerging suicidality and agitation.  Physical symptoms, primarily headache, fatigue, dizziness, brain zaps, visual changes, muscle aches, tremor, diarrhea, and nausea, were experienced by 75%.

CCHR has previously called for updated warnings in prescribing information and medication guides to more adequately warn prescribers and consumers of the increased risks of atrial fibrillation, stroke, cardiovascular disease, and long-lasting and permanent sexual dysfunction from the use of antidepressants. 

CCHR has also called on the FDA to issue an updated Drug Safety Communication on the risks to newborns from their mothers’ continued use of antidepressants during pregnancy.  Those risks include premature birth, lower birth weight, neonatal hospitalization and withdrawal symptoms.

“The FDA, which is responsible for ensuring pharmaceutical drugs are safe, must take immediate action due to the growing body of research indicating that adverse effects when using or attempting to stop using antidepressants are more widely experienced and potentially more severe than current prescribing information and medication guides indicate,” said Anne Goedeke, president of the CCHR National Affairs Office.  “FDA action is long overdue on this urgent public health issue.”

WARNING: Anyone wishing to discontinue or change the dose of an antidepressant or other psychiatric drug is cautioned to do so only under the supervision of a physician because of potentially dangerous withdrawal symptoms or other complications.

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CCHR Calls on FDA to Update Antidepressant Information for Increased Risks of Stroke and Heart Disease

Posted on November 18, 2024 by cchrstl

New research finds antidepressants increase the risk of stroke, atrial fibrillation, heart failure and other cardiovascular events. Citizens Commission on Human Rights calls on the U.S. Food and Drug Administration to update medication guides to reflect these risks.

by CCHR National Affairs Office

The increased risk of stroke and other cardiovascular diseases faced by depressed individuals is due to their use of antidepressants, not to the depression itself, a new study indicates.  Citizens Commission on Human Rights (CCHR) calls on the U.S. Food and Drug Administration (FDA) to update antidepressants prescribing information and medication guides to fully disclose these risks now established by research.

Prior research had looked for, but had not found an underlying biological mechanism to account for the increased risk of cardiovascular diseases in depressed people.  Until now, the contribution of antidepressants to the risks of stroke and heart diseases had not been adequately evaluated. 

Researchers in the new study used methodology that allowed them to separately assess the effect of major depression and antidepressants on seven cardiovascular conditions: arrhythmia, atrial fibrillation (AFib), coronary artery disease, high blood pressure, heart failure, stroke, and cardiovascular diseases as a group. 

They found that the use of antidepressants increased the risk of atrial fibrillation and stroke by 44% each; arrhythmias by 28%; coronary artery disease, high blood pressure, and heart failure by 16% each; and overall cardiovascular disease by 35%.  They concluded that the association of depression with these cardiovascular diseases is primarily accounted for by depressed patients’ use of antidepressants, not from depression itself.

“The use of antidepressants is linked to heightened risks of each CVD [cardiovascular disease],” the researchers reported, publishing their results in the British medical journal, BMJ Mental Health.

Heart diseases and stroke are major health concerns in the U.S.  “Cardiovascular disease and stroke are common and costly, and their prevalence is rising,” warned a recent article in Circulation, the journal of the American Heart Association.  

The FDA-approved prescribing information and medication guides for antidepressants, such as Zoloft, Prozac, Cymbalta and Pristiq, do not currently mention the potential risks of stroke and cardiovascular diseases associated with the use of the drugs.  Some 45 million Americans are currently taking antidepressants prescribed by their psychiatrists or other prescribers.

“It is incumbent on the FDA to require antidepressant manufacturers to update the information provided to patients to warn of the potential risks of stroke, atrial fibrillation, heart failure, and other life-threatening cardiovascular events from the use of these drugs,” said Anne Goedeke, president of the CCHR National Affairs Office.  “Consumers have the right to know the full extent of the potential dangers of antidepressants.”

WARNING: Anyone wishing to discontinue or change the dose of an antidepressant or other psychiatric drug is cautioned to do so only under the supervision of a physician because of potentially dangerous withdrawal symptoms or other complications.

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CCHR Calls on FDA to Revise Guidance on Use of Antidepressants by Pregnant Women

Posted on November 11, 2024 by cchrstl

Recent research adds to medical literature indicating potential risks to newborns from pregnant women using antidepressants. Citizens Commission on Human Rights calls on the U.S. Food and Drug Administration to review the research and issue updated guidance. 

by CCHR National Affairs Office 

Many pregnant women choose to stop using antidepressants during their pregnancy for reasons that include avoiding the risk of potential harms to their baby from the drugs.  The Citizens Commission on Human Rights (CCHR) calls on the U.S. Food and Drug Administration (FDA) to conduct an urgent review of recent research concerning those harms and issue updated guidance to health care professionals and the public in an FDA Drug Safety Communication.

Expectant mothers who continue taking antidepressants incur the risks of a number of potential harms to their newborns, according to recent research.  A 2022 comprehensive analysis of data from over 45,000 babies found that pregnant women who used antidepressants had greater risks of premature birth, lower birth weight, and neonatal hospitalization for their newborns than pregnant women who quit the drugs. 

The study also found that the risk of their newborns experiencing withdrawal symptoms was more than doubled in women who continued their antidepressants.  Those symptoms include excessive crying, irritability, jitteriness, feeding problems, respiratory distress, and hypoglycemia.

Pregnant women’s use of antidepressants can negatively affect brain development in their children and increase the risk of certain birth defects and miscarriage.  Fetal exposure to antidepressants, especially during the first trimester of pregnancy, is associated with an increased risk of fetal death, including stillbirth.

“In light of a growing body of recent research indicating greater risks of serious negative outcomes to babies from women taking SSRI and SNRI antidepressants during pregnancy, the FDA should conduct an urgent review of these studies’ results and issue an update to health care professionals and the public reflecting these risks,” said Anne Goedeke, president of the CCHR National Affairs Office. 

“Prescribers have an obligation to fully disclose to their pregnant patients the risks to their babies of taking antidepressants during pregnancy, as well as discuss evidence-based, non-drug alternatives,” she added.

In a new study, researchers found that pregnant women who had stopped using antidepressants and who did not have severe mental health conditions faced no greater risk of psychiatric hospitalizations, mental health outpatient visits, self-harm, suicide, death from any cause, or taking sick leave compared to women who continued to use the drugs during pregnancy.

The prescribing of antidepressants was called into question by a 2022 study which found that the theory of a chemical imbalance in the brain – a lack of the brain chemical serotonin – causing depression had no scientific basis.  If a lack of serotonin is not the cause of depression, then antidepressants prescribed to increase the availability of serotonin in the brain are fixing a problem that does not exist.  

WARNING: Anyone who wants to stop taking an antidepressant is cautioned to do so only under the supervision of a physician because of the risk of potentially dangerous withdrawal symptoms or other complications.

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Researchers Report Concern over Antidepressants Causing Long-Lasting Sexual Dysfunction; CCHR Calls on FDA to Act

Posted on October 28, 2024 by cchrstl

Decades after sexual dysfunction caused by antidepressants was first reported to persist after patients stopped taking the drugs, how many people experience continuing sexual problems is still not known.  Citizens Commission on Human Rights calls on the FDA to address the issue without further delay. 

by CCHR National Affairs Office

Researchers active in investigating the adverse effects of psychiatric drugs have expressed concern over the lack of scientific data on the prevalence of antidepressant-caused sexual problems that persist after patients stop taking the drugs.  The condition has caused marriages to break up, and people are known to have committed suicide as a result of it.  Because the antidepressants most at issue are selective serotonin reuptake inhibitors (SSRIs), the condition is called post-SSRI sexual dysfunction (PSSD).

Research indicates that while taking antidepressants, 25%-80% of patients encounter sexual difficulties they had not experienced before taking the drugs.  Patients report that the sexual dysfunction strained their relationships, deepened their depression, lowered their self-esteem, and brought on feelings of failure.

In a recent article in Epidemiology and Psychiatric Sciences, psychiatrist and psychopharmacologist David Healy, M.D., and Dee Mangin, M.D., both professors at McMaster University in Canada, report that “while sexual dysfunction is a well-known side effect of taking selective serotonin reuptake inhibitors (SSRIs), in an undetermined number of patients, sexual function does not return to pre-drug baseline after stopping SSRIs.”

PSSD can comprise a range of sexual symptoms experienced while taking antidepressants that continue after the drugs are no longer used, including a lack of sexual drive, lack of sexual sensation, and problems with sexual performance that were not experienced before starting on the drugs.  In addition to SSRIs, serotonin-norepinephrine reuptake inhibitors (SNRIs) and some older tricyclic antidepressants are also known to cause PSSD.

According to Healy and Mangin, the problem of PSSD has been known for decades, with the condition first reported to the drug regulatory agency in the UK in 1991 and first reported in the medical literature in 2006.  However, there are still no known treatments for the condition.

PSSD can have a devastating impact on patients’ lives.  The researchers write that “PSSD can lead to marriage break-up and job loss.”  Professor Healy reveals that he is “aware of at least 20 cases of people who have committed suicide as a result of the condition.”

“This has never been properly investigated and described, and there is an urgent need to understand the incidence, prevalence and natural history of PSSD, with a focus on informing prevention as well as investigating treatments,” the researchers wrote.

In 2018, Healy and Mangin were among 22 signers of a citizen petition delivered to the U.S. Food and Drug Administration (FDA), calling on the agency to strengthen the warning on antidepressants’ labeling to adequately convey the serious risk of persistent, even permanent sexual side effects after the use of antidepressants has stopped.  The petition also called for the FDA to require SSRI and SNRI manufacturers to send a “Dear Health Care Provider Letter” to inform psychiatrists, family doctors and other prescribers about the risk, placing an obligation on them to fully inform their patients of the risks.

After similar petitions were filed in 2018 with drug regulatory agencies in Europe and Canada, warnings were updated by the European Medicines Agency in 2019 and by Health Canada in 2021 to reflect the risk.  However, the FDA has yet to take final action.

Recently, a lawsuit was filed in the U.S. District Court for the District of Columbia by one of the petition signers, claiming the FDA has failed to take final action on the petition and seeking a court order requiring the FDA to act.

The lawsuit states that antidepressant labeling warns of sexual problems that may be experienced while taking antidepressants, but “current labeling in the United States does not adequately convey the risk of broad, severe, and potentially permanent post-treatment changes to sexual function.” 

“The devastating sexual side effects from antidepressants, harming the sex lives of an untold number of the 45 million Americans taking these psychiatric drugs – side effects that can persist and even become permanent – should have been addressed years ago by the FDA,” said Anne Goedeke, president of the National Affairs Office of the Citizens Commission on Human Rights.  “The FDA needs to act now, without further delay.”

A key rationale for prescribing antidepressants in the first place – to fix a chemical imbalance in the brain – was found to be without scientific merit.  A 2022 comprehensive review of research into whether a lack of the brain chemical serotonin causes depression concluded there was no convincing evidence to support the theory.  This calls into question the prescribing of SSRI and SNRI antidepressants that make more serotonin available in the brain, if no known chemical deficiency exists.

WARNING: Anyone wishing to discontinue or change the dose of an antidepressant or other psychiatric drug is cautioned to do so only under the supervision of a physician because of potentially dangerous withdrawal symptoms.

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