Are serotonin boosters neurotoxic?

According to Dr Joseph Glenmullen in Prozac Backlash studies have shown that some serotonin boosters exhibit signs of neurotoxicity. A study on a drug called Redux (abruptly recalled from the market in 1997 because of heart valve damage) examined the possibility of neurotoxicity.

Under the microscope, as they are injured, the axons look "swollen," "irregularly shaped," and "seemingly fragmented." In one study, monkeys treated with the drug for just four days showed evidence of "persistent" and "possibly permanent" damage more than a year later... If the damage is not too severe, the neurons sprout new branches in what literally amounts to a rewiring of the brain.

Prozac Backlash, p. 96.

Those experiments were done with a dose similar to what humans take for 6 months... a year... sometimes a decade or more. The "antipsychotics" (also known as major tranquilizers) fell out of favor once severe, permanent side effects such as tardive dyskinesia were revealed over a span of 20-30 years. Prozac and many SSRIs came into fashion in the 1990s, which means we are just now at the cusp where the long term effects will begin to be revealed. Conveniently, just after the patent expires, but that's a different story. The main problem is that the brain can sustain quite a bit of damage and still function. You can think of it as sort of a buffer or safety margin that has to be consumed until problems show up. However, aging has detrimental effects on the brain as well. This means that damage may be done by drugs earlier in life that won't reveal themselves until later, once the brain starts deteriorating from aging effects.

Studies of Ecstasy [MDMA] have shown that when damaged neurons sprout new branches, the rewiring of the brain is "highly abnormal," a chaotic jumble that does not follow the original pattern. Most alarming, researchers are concerned that the neurotoxicity could cause "increased risk for developing age-related cognitive impairment." Indeed, they are explicit that the "aberant reinnervation [abnormal rewiring of brain cells] such as that seen after MDMA injury may also occur during the course of neurodegenerative diseases [e.g., Parkinson's and Alzheimer's disease]. This is especially worrysome because patient with Alzheimer's type dementia "have significant 5-HT [serotonin] deficits in brain regions implicated in learning and memory" as well as deficits in other neurotransmitters.

Prozac Backlash, pp. 96-97

To be fair, Ecstacy is a serotonin releaser that will cause a sudden release of massive amounts of serotonin. However, most Ecstacy users don't pop pills every day, so it is an acute case vs the chronic case of SSRIs. Dr. Monika Wrona, writing in a June 1997 article published in the National Institude on Drug Abuse Research Monnograph Series, stated that serotonin is "very easily oxidized into a serotonergic neurotoxin." Dr. McCann at NIMH speculated that such damage to the brain caused by serotonin toxicity may be why the effect of the drugs wear off over time.

Regardless of whether it is brain damage from neurotoxicity or simply the brain adapting to the presence of a foreign drug, the before and after pictures are dramatic. Would you take a pill every day for months or years that did this?

Quick Links

Mish links to a Bloomberg article stating that half of Americans take at least one prescription pill a month. I agree with Mish's statement that: "Throughout grade and high school, I do not recall any kids with attention problems. How is it that attention-deficit disorder is now so widespread? Are kids today different? Why?"  Very good questions, Mish. 

I personally think kids are kids, and they should allowed to be kids. And if they have problems, it is likely something in their environment (*cough* parenting, or lack thereof) that is causing it.

Almost half of Americans took at least one prescription drug per month in 2008, an increase of 10 percent over the past decade, a U.S. study found.

One of every five children ages 11 or younger took at least one medication each month in 2008, led by asthma and allergy treatments, according to the survey released today by the U.S. Centers for Disease Control and Prevention. Among those ages 60 or older, 37 percent used five or more prescriptions per month.

The most common medications for adolescents were treatments for attention-deficit disorder, a condition in which people have trouble paying attention and engage in impulsive behavior.

For adults ages 20 to 59, antidepressants, including Eli Lilly & Co.’s Cymbalta and Pfizer Inc.’s Zoloft, were the most-used drugs. Cholesterol-lowering medications, including Pfizer Inc.’s Lipitor and AstraZeneca Plc’s Crestor, were the most common drugs taken by people ages 60 and over, with 45 percent of those in that age group on such therapies.

Also, this article from the NYT "Child’s Ordeal Shows Risks of Psychosis Drugs for Young" shows how some parents have gone full retard to deal with their kids.

“

Kyle at the time was very aggressive and easily agitated, so you try to find medication that can make him more easily controlled, because you can’t reason with an 18-month-old,” Dr. deGravelle said in a telephone interview. But Kyle was not autistic — according to several later evaluations, including one that Dr. deGravelle arranged with a neurologist. Kyle did not have the autistic child’s core deficit of social interaction, Dr. Gleason said. Instead, he craved more positive attention from his mother.

“He had trouble communicating,” Dr. Gleason said. “He didn’t have people to listen to him.”

After the neurologist review, the diagnosis changed to “oppositional defiant disorder” and the Risperdal continued.

Just 18 months old. Unreal.