This book addresses the over-prescribing of antidepressants in people with mostly mild and subthreshold depression. It outlines the steep increase in antidepressant prescription and critically examines the current scientific evidence on the efficacy and safety of antidepressants in depression. The book is not only concerned with the conflicting views as to whether antidepressants are useful or ineffective in various forms of depression, but also aims at detailing how flaws in the conduct and reporting of antidepressant trials have led to an overestimation of benefits and underestimation of harms. The transformation of the diagnostic concept of depression from a rare but serious disorder to an over-inclusive, highly prevalent but predominantly mild and self-limiting disorder is central to the books argument. It maintains that biological reductionism in psychiatry and pharmaceutical marketing reframed depression as a brain disorder, corroborating the overemphasis on drug treatment in both research and practice. Finally, the author goes on to explore how pharmaceutical companies have distorted the scientific literature on the efficacy and safety of antidepressants and how patient advocacy groups, leading academics, and medical organisations with pervasive financial ties to the industry helped to promote systematically biased benefit-harm evaluations, affecting public attitudes towards antidepressants as well as medical education, training, and practice. Michael P. Hengartner is a senior researcher and lecturer at the Zurich University of Applied Sciences, Switzerland. He has published over 130 peer-reviewed journal articles and four book chapters. He was an expert evaluator for the European Research Council and the World Health Organization and currently is a member of the Swiss School of Public Health, the German Society for Social Psychiatry, and the European Public Health Association.

This book addresses the over-prescribing of antidepressants in people with mostly mild and subthreshold depression. It outlines the steep increase in antidepressant prescription and critically examines the current scientific evidence on the efficacy and safety of antidepressants in depression. The book is not only concerned with the conflicting views as to whether antidepressants are useful or ineffective in various forms of depression, but also aims at detailing how flaws in the conduct and reporting of antidepressant trials have led to an overestimation of benefits and underestimation of harms. The transformation of the diagnostic concept of depression from a rare but serious disorder to an over-inclusive, highly prevalent but predominantly mild and self-limiting disorder is central to the books argument. It maintains that biological reductionism in psychiatry and pharmaceutical marketing reframed depression as a brain disorder, corroborating the overemphasis on drug treatment in both research and practice. Finally, the author goes on to explore how pharmaceutical companies have distorted the scientific literature on the efficacy and safety of antidepressants and how patient advocacy groups, leading academics, and medical organisations with pervasive financial ties to the industry helped to promote systematically biased benefit-harm evaluations, affecting public attitudes towards antidepressants as well as medical education, training, and practice.

"The Evidence-Based Guide to Antipsychotic Medications" is a table-rich, comprehensive overview of current knowledge regarding the use of antipsychotic medications to treat a broad range of psychiatric conditions, from anxiety disorders to schizophrenia.

USE OF ANTIDEPRESSANT IN ELDERLY: FROM CURRENT EVIDENCE TO CLINICAL PRACTICEINTRODUCTION: in choosing an antidepressant in an older depressed patients it is recommended that selection be based on the best side effect profile, lowest risk of drug-drug interactions and pharmacokinetics profile in elderly. The aim of this study was to evaluate antidepressant prescription adequacy in institutionalized elderly based on the current evidence.OBJECTIVES: describe antidepressant prescriptions in a sociosanitary center and evaluate its adequacy according to the latest guidelines for antidepressant prescription in elderly.METHODS: retrospective, descriptive and transversal study about the use of antidepressants in elderly that involved 114 institutionalized patients 65 years of age and older. Evaluation of the adequacy of antidepressants prescription was evaluated in based of: indication and dosage in elderly. We obtained data of: age, sex, diagnosis, antidepressant and dosage from the electronic prescription and a computer-based medication prescription system for dispensing drugs in the sociosanitary center.RESULTS: We included 114 institutionalized patients (60% women, average age 87 [65-99]. 48,2% (n=55) were receiving any antidepressant: 32,7% (n=18) trazodone, 27,2% (n=15) escitalopram, 18,1% (n=10) mirtazapine, 11% (n=6) paroxetine, 5,4% (n=3) venlafaxine, 3,6% (n=2) sertraline and 1,8% (n=1) fluoxetine. We detected 7,3% (n=4) trazodone and escitalopram prescriptions using a higher than advised doses in elderly patients.CONCLUSION: there are more women institutionalized in geriatric centers. Almost 50% percent of institutionalized patients were taking any antidepressant. Trazodone and escitalopram were the drugs most prescribed. Trazodone prescriptions using a higher than referred doses were detected in less than 10% in our sample.

Fluoxetine, best known by the trade name Prozac®, unlike other psychotropic drugs whose effects were serendipitously stumbled upon, was the first developed for a precise mechanism of action, that is, the ability to selectively inhibit serotonin reuptake, based upon the theory that increasing the availability of serotonin would treat major depression. Once approved by the FDA in 1987, fluoxetine quickly became the most prescribed psychotropic drug worldwide and its success in improving mood disorders has triggered the development of a large number of congener molecules, commonly known as SSRIs after their purported mechanism of action. However, a quarter of a century after its development, the idea that fluoxetine asserts its positive behavioral effect through inhibition of serotonergic reuptake is not firmly established. This book reviews several preclinical and clinical reports suggesting that the pharmacological effects of fluoxetine may be mediated by means other than the regulation of serotonin, including the regulation of gene expression, modifying epigenetic mechanisms as well as modifying microRNAs. One of the most prominent mechanisms for the therapeutic relevance of fluoxetine relates to influencing neuroplasticity by enhancing neurotropic factors, including BDNF signaling and altering adult neurogenesis. The ability of fluoxetine to rapidly increase neurosteroid levels accounts for the fast anxiolytic effects of this drug. Fluoxetine action at sigma-1 receptor or modulating glutamatergic neurotransmission as well as the combination of fluoxetine with other psychotropic drugs is discussed in relation to its therapeutic effects. While fluoxetine was primarily prescribed as an antidepressant, this drug currently represents a treatment of choice for a broad spectrum of psychiatric disorders, including post-traumatic stress disorder and a range of anxiety disorders. This drug even possesses analgesic actions and is a valuable therapy for stroke. This book also highlights emerging evidence on the gender-specific effects of fluoxetine, its potential adverse features, including its addiction liability in combination with psychostimulants, and the impact of perinatal fluoxetine exposure.

THE INTERNATIONAL BESTSELLER: A radically new way of thinking about depression and anxiety 'A book that could actually make us happy' SIMON AMSTELL 'This amazing book will change your life' ELTON JOHN 'One of the most important texts of recent years' BRITISH JOURNAL OF GENERAL PRACTICE 'Brilliant, stimulating, radical' MATT HAIG 'The more people read this book, the better off the world will be' NAOMI KLEIN 'Wonderful' HILLARY CLINTON 'Eye-opening' GUARDIAN 'Brilliant for anyone wanting a better understanding of mental health' ZOE BALL 'A game-changer' DAVINA MCCALL 'Extraordinary' DR MAX PEMBERTON Depression and anxiety are now at epidemic levels. Why? Across the world, scientists have uncovered evidence for nine different causes. Some are in our biology, but most are in the way we are living today. Lost Connections offers a radical new way of thinking about this crisis. It shows that once we understand the real causes, we can begin to turn to pioneering new solutions – ones that offer real hope.

The New York Times bestselling examination of the revolutionary antidepressant, with a new introduction and afterword reflecting on Prozac’s legacy and the latest medical research “Peter Kramer is an analyst of exceptional sensitivity and insight. To read his prose on virtually any subject is to be provoked, enthralled, illuminated.” —Joyce Carol Oates When antidepressants like Prozac first became available, Peter D. Kramer prescribed them, only to hear patients say that on medication, they felt different—less ill at ease, more like the person they had always imagined themselves to be. Referencing disciplines from cellular biology to animal ethology, Dr. Kramer worked to explain these reports. The result was Listening to Prozac, a revolutionary book that offered new perspectives on antidepressants, mood disorders, and our understanding of the self—and that became an instant national and international bestseller. In this thirtieth anniversary edition, Dr. Kramer looks back at the influence of his groundbreaking book, traces progress in the relevant sciences, follows trends in the use and public understanding of antidepressants, and assesses potential breakthroughs in the treatment of depression. The new introduction and afterword reinforce and reinvigorate a book that the New York Times called “originally insightful” and “intelligent and informative,” a window on a medicine that is “telling us new things about the chemistry of human character.”