12 Dangers of Psychoactive Drugs

Dangers of psychoactive drugs - Dr. Axe

Even if the name is not familiar — psychotropic, psychiatric or psychoactive drugs, or psychopharmaceuticals — the many classes of drugs they include are commonly known:

  • antidepressants
  • anti-anxiety medications
  • ADHD medications
  • antipsychotics
  • mood stabilizers
  • anti-panic agents
  • anti-obsessive agents
  • hypnotics (sedatives)

In fact, one in six American adults reported taking a psychiatric drug in 2013. (1) And while 13 percent of the U.S. population takes an antidepressant, almost one in four women ages 50 to 64 take one. (2)

These are alarming statistics, in particular because there are many dangers of psychotropic drugs that are overlooked. And the question must be asked if the benefits of these mind-altering, behavior-changing medications outweigh the risks. To go further, I question the possibly unethical financial underpinnings of the pharmaceutical industry when it comes to the development and testing of these drugs, and then of course the clinicians who prescribe them.


12 Dangers of Psychotropic/Psychoactive Drugs

1. Side Effects and Withdrawal Symptoms

Most people are aware that psychotropic drugs come with a laundry list of potential serious side effects. However, even clinicians are beginning to wonder if the risks are worth it. For example, the Copenhagen Trial Unit in Denmark reviewed SSRIs for depression and their related side effects and concluded: 

SSRIs might have statistically significant effects on depressive symptoms, but all trials were at high risk of bias and the clinical significance seems questionable. SSRIs significantly increase the risk of both serious and non-serious adverse events. The potential small beneficial effects seem to be outweighed by harmful effects. (3)

Comparing these same issues, a 2002 review of the studies submitted to the FDA for the six most popular antidepressants at the time was concerned with the risks of side effects versus helpful effects, as approximately 80 percent of the medication response is duplicated in placebo control groups when these studies were compared. They stated, “If drug and placebo effects are additive, the pharmacological effects of antidepressants are clinically negligible. If they are not additive, alternative experimental designs are needed for the evaluation of antidepressants.” (4)

Many of the “typical” side effects don’t necessarily require physician care, but can greatly impact quality of life. One well-documented side effect is weight gain, which occurs in some people during the use of any class of psychoactive drugs. (5) SSRIs, just one class of antidepressants, has been linked with extrapyramidal side effects, which are muscle and movement disorders previously thought to only happen to people on antipsychotic medications for illnesses like schizophrenia. (6)

Below, I have listed the known side effects of the classes of prescription psychotropic drugs. These do not all necessarily apply to each specific class of drugs within each category, but many of them overlap.

Side effects of antidepressants include: (78, 9)

  • Nausea
  • Vomiting
  • Weight gain
  • Diarrhea
  • Sexual dysfunction (ED or inability to reach orgasm)
  • Sleepiness
  • Dry mouth
  • Blurred vision
  • Gastrointestinal problems
  • Constipation
  • Rash
  • Syndrome of inappropriate antidiuretic hormone (SIADH)
  • Hyponatremia (dangerously low sodium levels)
  • Galactorrhea and hyperprolactinemia (breastfeeding related issues)
  • Prolonged bleeding time and abnormal bleeding
  • Bruxism (abnormal grinding or clenching of teeth)
  • Hair loss
  • Dizziness
  • Suicidal thoughts and/or attempts
  • New or worsening depression or anxiety
  • Agitation/restlessness
  • Panic attacks
  • Insomnia
  • Aggressiveness
  • Loss of inhibition (impulse control)
  • Mania
  • Akathasia
  • Dyskinesia
  • Tardive dyskinesia
  • Parkinsonism

Side effects of anti-anxiety meds include: (7)

  • Drowsiness
  • Dizziness
  • Nausea
  • Blurred vision
  • Headache
  • Confusion
  • Tiredness
  • Nightmares
  • Unsteadiness
  • Problems with coordination
  • Difficulty thinking or remembering
  • Increased saliva
  • Muscle or joint pain
  • Frequent urination
  • Blurred vision
  • Changes in sex drive or ability
  • Fatigue
  • Cold hands
  • Dizziness or lightheadedness
  • Weakness

Side effects of stimulants include: (7, 10)

  • Difficulty falling asleep or staying asleep
  • Loss of appetite
  • Stomach pain
  • Headache
  • Sudden death in patients who have heart problems or heart defects
  • Stroke and heart attack in adults
  • Increased blood pressure and heart rate
  • New or worse behavior and thought problems
  • New or worse bipolar illness
  • New or worse aggressive behavior or hostility
  • New psychotic symptoms (such as hearing voices, believing things that are not true, are suspicious) or new manic symptoms in children and adolescents
  • Peripheral vasculopathy, including Raynaud’s phenomenon, in which fingers or toes may feel numb, cool, painful, and/or may change color from pale, to blue, to red
  • Motor tics or verbal tics (sudden, repetitive movements or sounds)
  • Personality changes, such as appearing “flat” or without emotion

Side effects of antipsychotics include: (7, 11)

  • Drowsiness
  • Dizziness
  • Restlessness
  • Weight gain (the risk is higher with some atypical antipsychotic medicines)
  • Dry mouth
  • Constipation
  • Nausea
  • Vomiting
  • Blurred vision
  • Low blood pressure
  • Uncontrollable movements, such as tics and tremors (the risk is higher with typical antipsychotic medicines)
  • Seizures
  • A low number of white blood cells, which fight infections
  • Rigidity
  • Persistent muscle spasms
  • Tremors
  • Restlessness
  • Tardive dyskinesia
  • Akathisia
  • Parkinsonism

Side effects of mood stabilizers include: (7)

  • Itching, rash
  • Excessive thirst
  • Frequent urination
  • Tremor (shakiness) of the hands
  • Nausea and vomiting
  • Slurred speech
  • Fast, slow, irregular, or pounding heartbeat
  • Blackouts
  • Changes in vision
  • Seizures
  • Hallucinations (seeing things or hearing voices that do not exist)
  • Loss of coordination
  • Swelling of the eyes, face, lips, tongue, throat, hands, feet, ankles, or lower legs

Side effects of anticonvulsants (used as mood stabilizers) include: (7)

  • Drowsiness
  • Dizziness
  • Headache
  • Diarrhea
  • Constipation
  • Changes in appetite
  • Weight changes
  • Back pain
  • Agitation
  • Mood swings
  • Abnormal thinking
  • Uncontrollable shaking of a part of the body
  • Loss of coordination
  • Uncontrollable movements of the eyes
  • Blurred or double vision
  • Ringing in the ears
  • Hair loss
  • Cause damage to the liver or pancreas, so people taking it should see their doctors regularly
  • Increase testosterone levels in teenage girls that may lead to polycystic ovarian syndrome (a disease that can affect fertility and make the menstrual cycle become irregular)

It is important to note that not every person on one of these medications will experience side effects. However, as you can see, these are extreme risks to take, particularly when it seems that up to 90 percent of the impact of at least some of these medications can be duplicated by placebo (or other treatment).

2. Increased Risk of Suicide

For several years after the dawn of SSRIs, the pharmaceutical companies who own them insisted that the reports of suicide in connection to those medications were false and linked only to the fact that these individuals were depressed before being on the medication, and that depression is what led to the taking of their own lives.

Finally, in a “Dear Healthcare Professional” letter released in May 2006 from GlaxoSmithKline, it was admitted that paroxetine, one SSRI, could potentially worsen the risk of suicide, particularly in young people. (12) This letter came after many lawsuits, hearings and battles about the increased risk of suicide on SSRIs.

Unfortunately, the evidence suggests that at least some drug manufacturers were aware of these risks as long ago as the 1980s. Eli Lilly, the manufacturer of fluoxetine brands, was found to have “lost” documents relating to the drug’s propensity to cause both suicidal thoughts and violent behavior in some patients. These documents were withheld in a relevant case in which the manufacturer was consulted about a workplace killer, Joseph Wesbecker, who began taking the medication shortly before becoming violent. (13)

A 1990 study at the Harvard Department of Psychiatry followed six patients who developed suicidal thoughts after starting a fluoxetine prescription, none of whom had experienced this phenomenon before beginning the medication. (14)

There was a report released in the New England Journal of Medicine in 1991 recounting the development of suicidal behavior in two women recently prescribed fluoxetine for depression, in which the patients’ suicidal ideation ceased shortly after being taken off the medication. (15)

That same year, six adolescent patients between 10–17 years of age developed suicidal thoughts after beginning a fluoxetine regimen for OCD. Four of the patients did report having these thoughts prior to being medicated. (16)

In 2000, a study published in Primary Care Psychiatry noticed a startling two suicides out of just 20 study participants in a trial comparing sertraline (an SSRI) to reboxetine (an SNRI). They stated the suicides took place shortly after both patients began to display akathisia (a movement disorder) and disinhibition. (17)

CNN was the first major news network to report on the connection between fluoxetine and suicide in 2005, releasing the “Prozac Documents.”

This was shortly after the FDA, in 2004, issued a “black box warning” to be added to all antidepressant prescriptions, stating that these medications can increase the risk of suicide in patients under 18 years of age. (18) Black box warnings are the strongest type the FDA requires on drug labels. As more research was published, the FDA then modified the warning, this time in 2007, to reflect the same warning for patients up to 24 years of age. (19)

The National Institute of Mental Health (NIMH, part of the US Department of Health and Human Services) addresses this issue on their website, discussing an FDA review on SSRIs that found children and adolescents were about twice as likely to attempt suicide than patients on placebo. (20) The NIMH also advises any patients on these medications to report suicidal thoughts to their doctor immediately. (7)

Another study reported that while children in this particular trial were only 1.5 times more likely to attempt suicide when on antidepressants than those who were not, they observed that those on antidepressants were 15 times more likely to complete a suicide attempt. (21)

It’s not just children at risk, however. Two major analyses on antidepressants and suicidal ideation have recommended these black box warnings to extended to all patients, as they found adults to be at increased risk, too — perhaps double the risk, just like children and adolescents. One of the reports even pointed out that the studied trials included healthy adults with no history of mental illness developing suicidal and violent thoughts during and while withdrawing from the medications! (22, 23)

There is some evidence that the risk is most elevated during the four weeks after beginning a new prescription for antidepressants or other psychotropic drugs — a time period that, according to the Department of Veterans Affairs, correlates with the overwhelmingly most frequent time of suicide for veterans being treated with psychoactive medications. (24)

In 2008, the FDA released a warning regarding anticonvulsants (used to treat epilepsy and, sometimes, anxiety) reporting they likely increase the risk of suicidal thoughts in patients. (25)

A review of sedative and hypnotic chemicals (including anti-anxiety drugs, alcohol and other depressive substances) and their connection to suicide risk found that, while they could not definitively say these substances increase the risk for suicide in subjects with anxiety, they do seem to cause depressive symptoms and disinhibition in perhaps five percent of patients. (26) The latter of those symptoms is one mentioned above as a potential precursor to suicidal ideation in patients on psychoactive drugs.

Antipsychotic medications, such as those used to treat schizophrenia, do not seem to increase suicide risk more than placebo. (27)

3. Heart Problems

Symptoms of heart trouble are common side effects of many psychotropic drugs, including all classes of antidepressants and some antipsychotic drugs. SSRIs seem to carry the least risk of these types of medications for cardiac problems, but are sometimes associated with heart malfunction. (28)

The three risk factors for sudden cardiac death (SCD) in subjects taking psychotropic drugs may be defined as physiological factors (e.g., low heart rate of a highly active person), physiopathological (co-occurring symptoms like liver failure or hypothyroidism) and “therapeutic,” in which cases the medications interact with other drugs. In patients diagnosed with heart disease taking these medications, the risk of sudden cardiac death is significantly elevated. (29)

 

Dangers of psychoactive drugs - Dr. Axe

 

4. Pregnancy and Birth Complications

A 2012 review in PLoS One reported that women were more likely to experience pregnancy and childbirth complications when prescribed psychotropic medications, particularly in early pregnancy. The complications listed include miscarriage, perinatal death (stillbirth and death within the first 7 days after delivery) and a higher likelihood of terminating pregnancy. Women with bipolar disorder (manic depression), schizophrenia and all other psychotic disorders were excluded due to the nature of their conditions, leaving only patients treated for depression and anxiety. (30)

Antidepressants are one major class of psychoactive drugs observed for their impact on pregnancy. While SSRIs (newer antidepressants) are associated with less pregnancy and birth risks than tricyclic antidepressants (TCAs), multiple sources report “major malformations” occur more often in women on antidepressants versus those who have never been exposed. The miscarriage rate nearly doubles from 7.8 percent in unexposed mothers versus 14.8 in exposed mothers. (31, 32)

In 2010, a massive review of the Swedish Birth Register including 14,821 women and a total of 15,017 infants found an association between antidepressant treatment and: (33)

  • Higher rates of induced and Caesarean section births
  • Increased preterm birth rate
  • Pre-existing diabetes
  • Chronic hypertension
  • Congenital heart defects in infants
  • Hypospadias
  • Higher congenital malformation rate (in TCAs only)

The researchers concluded that:

Women using antidepressants during pregnancy and their newborns have increased pathology. It is not clear how much of this is due to drug use or underlying pathology. Use of TCAs was found to carry a higher risk than other antidepressants and paroxetine seems to be associated with a specific teratogenic property [an agent that can cause problems in fetal development].

One reason for this, at least in regards to SSRIs, is the way the drugs may impact SERT function in embryonic and fetal development. SERT, the serotonin transporter, is an important part of emotional disturbance models. Animal models of research suggest that an unborn child’s SERT being disrupted by SSRIs while in the womb could contribute to psychiatric problems in the child’s adult life, due to epigenetic shifts the medications may cause. (34, 35)

In 2005, the major brand of paroxetine was required to list an FDA warning on packaging warning of birth defects. (36)

Babies may also be affected in other ways by SSRIs. For example, it is documented that newborns may experience withdrawal symptoms 48 hours after birth after being exposed to SSRIs in the womb. (37) Health Canada (a government organization) issued a warning to consumers in 2006 that SSRIs taken by pregnant mothers had been linked to the development of a serious lung disorder in newborns. (38) Infants who were exposed to SSRIs late in pregnancy are also at an increased risk of persistent pulmonary hypertension of the newborn (PPNH), which occurs when the normal circulatory transition from mother to child does not happen correctly, causing extremely low blood oxygen levels. (40)

Other dangers of psychoactive drugs are also connected to issues with pregnancy and birth, although the waters sometimes become muddied in research because some severe psychiatric conditions, like bipolar disorder and schizophrenia, are associated with risks of these complications, both when unmedicated and potentially exacerbated by medication. (41)

Regarding mood stabilizers, a 2010 review of studies in the New Zealand Journal of Psychiatry found that pregnancy exposure to any of the four most commonly used mood stabilizers was associated with higher birth defect rates and other pregnancy/neonatal issues. There was limited evidence to suggest one particular medication, valproic acid, may be associated with below-average developmental outcomes in these children. (42)

Mood stabilizers, primarily lithium, may be dangerous to use while breastfeeding, as passing the drug along to an infant can result in lithium toxicity. (43)

Infants exposed to SSRIs and benzodiazepines also appear to be about three times more likely to experience a form of neonatal abstinence syndrome (NAS), characterized by drug withdrawal symptoms after birth. Results were worst when paroxetine and clonazepam were prescribed together. (44) NAS also occurs often in infants born to mothers addicted to illicit psychoactive drugs.

When it comes to antipsychotics, the research is somewhat unclear. A 2005 study of 151 births found no statistically significant differences in birth defects for women taking atypical (2nd generation) antipsychotics versus a control group of unmedicated mothers, although the medications did seem to correlate with low birth weights. (45) However, an observational study completed in 2008 for 570 births found that all antipsychotic medications were associated with higher risk of major malformation, with no specific drug being more or less likely. The authors also noted that these medications were associated with nearly double the risk that the pregnant mom would develop gestational diabetes and have a 40 percent increased risk of having to get a Caesarean section. (46)

A review also published in 2008 confirmed the increased risk of birth and pregnancy complications. The author found that atypical antipsychotics seemed to carry a higher risk of gestational diabetes and, opposing the 2005 study above, noted higher than normal birth weights in babies exposed to these 2nd generation antipsychotics. (47)

Although most people are aware of the impact of illicit psychotropic drugs on infants, it should be said that exposure to tobacco, cocaine, marijuana and many other illicit psychotropics in the womb all seem to be connected with developmental problems for children later in life, although many early central nervous system symptoms do abate over the first year of life. (48)

5. Violent Behavior

In November 2002, FOXNews reporter Douglas Kennedy conducted a three-part series on the connection between antidepressants and ADHD medications and violent behavior. Over the following decade and a half, he has recounted to the public many stories of young people committing violent acts, most often school shootings. (49)

Subsequently, Congress began investigating these claims, as well as many research agencies. Many of the results were staggering.

  • 33 percent of child and adolescent subjects in one study on atomoxetine, a stimulant prescribed for ADHD, exhibited “extreme irritability, aggression, mania or hypomania.” (50)
  • The European Medicines Agency issued a press release in 2005 stating that suicide-related behavior and aggression/hostility were more common in children and adolescents on antidepressants compared to placebo. (51)
  • Dr. David Healy, an outspoken psychiatrist regarding the unacceptable collusion between pharmaceutical companies and the field of psychiatry, reviewed several cases of violence for which he had been called as an expert witness in court, as well as others, such as the Joseph Wesbecker case. He states categorically, “Both clinical trial and pharmacovigilance data point to possible links between these drugs and violent behaviours… The association of antidepressant treatment with aggression and violence reported here calls for more clinical trial and epidemiological data.” (52)
  • A review of 130 published studies on antidepressants found that healthy adults with no history of psychological illness had a doubled risk of both suicidal behavior and violence when taking and/or withdrawing from SSRIs. (53)

Meanwhile, limited evidence points to a potentially contrary conclusion. Specifically, Sweden has found that the rate at which released prisoners violently reoffend is lower while on psychotropic medication. (54)

6. Worsened Mental Illness

Yes, you read that correctly. It’s possible that psychotropic medications are actually worsening and contributing to the rise in mental illness diagnoses. Robert Whitaker explains how this may be happening in his paper Anatomy of an Epidemic: Psychiatric Drugs and the Astonishing Rise of Mental Illness in America. One basic premise of this work is that the disproved “chemical imbalance” theory has led to the development of medications that try to fix a problem that doesn’t exist, and thereby alter brain chemistry and worsen symptoms of various mental illnesses. (55)

Whitaker outlines the explanation given by renowned Harvard brain research scientist, Steven Hyman, MD, by explaining that antidepressants, anti-anxiety medications and antipsychotics disturb neurotransmitter function that was not actually broken in the first place. When the human brain adjusts to these changes, it changes the way the cells of the brain signal one another and the way genes are expressed. A person’s brain begins to function in a way that is “qualitatively as well as quantitatively different from the normal state.” In short, psychiatric drugs “induce [emphasis added] a pathology.”

Throughout the development of neuroleptics (antipsychotics), SSRIs and benzodiazepines, various studies were conducted and observations made pointing to the possibility that these medications may actually be effective only in the short-term, but then worsen issues over time. Whitaker uses many examples of drug study subjects who end up with drastically poorer results after taking antipsychotics than comparative subjects on placebo to demonstrate his conclusion.

Another critic of excessive prescribing of psychoactive drugs is Giovanni Fava, editor-in-chief of Psychotherapy and Psychosomatics, a scientific journal. Fava first expressed his concern about long-term use of antidepressants in 1994, claiming they may increasing “the biochemical vulnerability to depression, and worsen its long-term outcomes and symptomatic expression.” (56)

He again reviewed the available science in 2011, detailing several important discoveries about the way antidepressants may actually worsen depression over time, including: (57)

  • After six months, antidepressants no longer protect the patients from symptoms of depression compared to placebo.
  • When patients are switched from one antidepressant to another, patients are unlikely to remain in remission, unlikely to tolerate the new medication and very likely to relapse.
  • Antidepressants are associated with the development of manic symptoms, leading to bipolar disorder.

One review, published in 1975, looked at results from two, separate five-year follow-up studies of patients with long-standing mental illness admitted to mental hospitals and community-based mental health centers. The first study included the use of no psychotropic drugs, while the second included drug therapy as the central tenet of treatment. Somewhat surprised by what he found, the author stated: (58)

One unexpected finding of the comparison is the suggestion that these drugs might not be indispensable; in fact, they might actually prolong the social dependency of some discharged patients.

Whitaker’s theory that the “chemical imbalance” myth perpetuates this worsening of mental illness, two studies have examined the effect of telling patients their depression was caused by a simple chemical imbalance versus no explanation or a “biopsychosocial model,” meaning the currently accepted theory that biological, psychological and social factors all contribute to depression in complex and often indefinable ways.

Both studies found that the chemical imbalance explanation did not improve the blame that depressed patients often feel for their condition, but did worsen the patient’s perceived ability to work to correct their problem through psychotherapy, which they believed would be ineffective. Those patients overwhelmingly requested medication over therapy and expected their long-term prognosis to be worse than those given no explanation or the biopsychosocial model. (59, 60)

7. Car Accidents

It may sound odd, but individuals taking antidepressants, benzodiazepines and Z-drugs (benzodiazepine agonists used to treat insomnia) have a much higher chance of getting into motor vehicle accidents, according to multiple studies. (61, 62, 63) These results are particularly true for people over 65 and get worse with higher doses of these medications. (64)

8. Poor Immune Function

It’s possible that taking antidepressants as well as MDMA (ecstasy) and cocaine may alter and suppress your immune system. A 2003 trial named fluoxetine and others like it as some of the most likely culprits. (65)

This may be due to the way antidepressants impact serotonin and neurotransmitters. When you’re on an antidepressant, serotonin stays in nerve junctions for a longer period of time. This interferes with cell signaling that impacts immunity, as well as stunts the growth of infection-fighting T-cells. (66)

9. Drug Abuse and Addiction

In some people, legal psychotropic drugs are associated with higher rates of illicit drug use and dependence. For example, an Australian study in 2000 found that when TCAs were prescribed to heroin users, more users overdosed. The study authors also noted that many of the IV drug users were also currently taking prescribed antidepressants during the course of the study. (67)

Anti-anxiety meds are habit-forming, according to the National Institute of Mental Health, and should only be taken for short periods of time to avoid addiction. (7)

Many people also illegally use and distribute prescription medications for their recreational “benefits.” For example, methylphenidate is a stimulant often prescribed for narcolepsy. This drug is often abused because it creates cocaine-like effects when snorted. (68)

It is also common to hear of people in high-stress work or school environments taking amphetamine plus dextroamphetamine, a popular ADHD stimulant, even when not prescribed to keep up with demanding schedules. And it almost doesn’t even need to be said that using hardcore illicit drugs such as ecstasy, cocaine or methamphetamine is associated with extremely destructive addiction and abuse.

10. Sexual Dysfunction

Named as a side effect of many psychotropic drugs, sexual dysfunctions like impotence may be even more common than previously thought, particularly in regards to antidepressants. One study found that 59 percent of participants reported some form of sexual dysfunction during the study duration. (69)

A meta-analysis published in 2009 discovered that, based on the well-designed studies available, anywhere between 25.8 and 80.3 percent of people taking antidepressants may suffer sexual dysfunction. (70)

11. Elevated Risk of Breast Cancer

Conflicting reports suggest that it’s possible use of antidepressants over a long period of time may be associated with a higher risk of developing breast cancer. In 2000, a study claimed that people taking TCAs and one specific SSRI, paroxetine, had an elevated risk of breast cancer when taking the medication for more than two years. (71)

A 2003 review said they found no sufficient evidence that antidepressants as a whole contribute to breast cancer risk, but that long-term SSRI use may lead to more cases. (72) Then, a review published in 2005 refuted this and said their results led them to see no statistically significant difference in breast cancer risk when taking SSRIs. (73)

12. Diabetes

For over a decade, it has been suspected that psychoactive drugs used to treat serious mental illnesses such as schizophrenia and related psychoses may be connected to diabetes. Researchers reviewed available data in 2008 and found that there is not a correlation between serious mental illness itself and the development of diabetes, but that there is a potentially significant connection between the drug treatment used. (74)

At least one study has directly associated the antipsychotic olanzapine with more frequent occurrence of diabetes symptoms. (75)


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