Our Times: Fluoxetine Forever

Muckraking is an exercise in futility. The exposés get published, the authors may or may not get rewarded for their research and risk-taking, the evil-doers might have to slow down. But in due course the evil-doers resume rolling merrily along and the expose achieved nothing. 

Consider the Prozac example. Two years after Eli Lilly began marketing the first “Selective Serotonin Reuptake Inhibitor” antidepressant, St. Martin’s Press — a major publishing house — brought out “Toxic Psychiatry” by Peter Breggin, MD.  The book exposed pro-corporate bias in the FDA drug-approval process and listed the known adverse effects of SSRIs. (There was no data on the long-term risks, obviously.)

Breggin was not a lone voice crying in the wilderness. In 1997 Harvard University Press brought out “The Anti-Depressant Era” by David Healy, which exposed how Lilly had covertly been marketing “Clinical Depression” as a widespread medical disorder. (We’d been making this point in the AVA, meaning the alone to the alone). Maybe Breggin and Healy, with their barrage of negative facts and serious warnings, cost Lilly a few sales. But as of 2018, when last the CDC released its data (and before the pandemic pushed rates up) nearly 18% of all adult women in the US were on antidepressants — and just over 8% of men.

“Why Your Antidepressants Seem to Stop Working — and What to Do” was the hed on a recent Wall St. Journal piece. Reporter Andrea Petersen led with the same active voice:  ”You’ve been on the same antidepressant for years. Then suddenly, the medication seems to stop working,” 

For old time’s sake I read on: “Symptoms such as persistent sadness and a loss of interest in favorite activities resurge. Identifying the right solution can be difficult and largely trial-and-error: Some patients may need a higher dose of the same medication, while others may need to try a new drug or a new combination of drugs, doctors say.”

Nothing had changed, although Ms Petersen seemed to think she was onto a newly emerging pattern:  ”There are no statistics on how frequently antidepressants seem to suddenly fail in people who had been doing well on them,” she wrote. “But psychiatrists say they see it fairly regularly. 

 “‘It is a real phenomenon,’ says Charles B. Nemeroff, chair of the department of psychiatry and behavioral sciences at the University of Texas at Austin’s Dell Webb Medical School and president of the Anxiety and Depression Association of America.”

A real phenomenon that’s as old as the marketing of Prozac. Eli Lilly funded the studies establishing the safety and efficacy of Prozac — and didn’t have to share data from studies in which Prozac failed. That’s how the drug-approval process works. 

Petersen tells us,  ”Scientists aren’t certain exactly why psychiatric drugs appear to lose effectiveness for some patients.” (Meaning, after all these years they can’t quite measure the impact of that bombs they dropped in people’s brains.) “ There’s some evidence that long-term antidepressant treatment may reduce the number of serotonin receptors in the brain, says Dr. Nemeroff.”  

If Charles Nemeroff acknowledges “some evidence” and that SSRI “may reduce” serotonin levels,  there’s probably overwhelming evidence that Prozac et al significantly reduce your serotonin levels. 

Petersen of the WSJ didn’t ask Dr. Nemeroff the obvious follow-up questions: the extent of the damage, whether it was reversible, and which areas of the brain are involved. Maybe she did ask and just didn’t share the answers.  If the cause of suspected brain damage had been marijuana use, you could count on keener coverage. 

 The National Institute on Drug Abuse has spent hundreds of millions of taxpayer dollars trying to find marijuana-induced brain damage, and they have impressed their dire warnings on physicians and the public. Stacey Gruber, PhD, became a top neoprobe star in 2015 when she published “Marijuana Use Predicts Cognitive Performance on Tasks of Executive Function” and impressed Sanjay Gupta with ominous colorized brain activity. 

But pot partisans can take heart: in the Most Downplayed Story of 2015, Dr. Barbara J. Weiland and colleagues at the University of Colorado and the University of Louisville reported that marijuana use does not cause lasting changes in the brain. 

Andrea Petersen’s WSJ story could have run 25 years ago, word for word. “It can take weeks for a change in dosage or medication to bring relief. New side effects, such as increased anxiety or insomnia, can emerge. And each relapse of depression makes additional relapses more likely. People who have had one episode of depression have a 50% chance of having another, while those who have two episodes have an 80% chance of having another.”

In other words,  you’re probably going to be using this stuff for the rest of your life, don’t complain when it fails, if you’re lucky you’ll have long periods of remission. 

There was one new wrinkle to the Prozac story: the pandemic has been great for business. “Getting the medications right is especially important now as mental health problems have surged during the pandemic. About 23% of American adults reported symptoms of a depressive disorder and 28% reported symptoms of an anxiety disorder, according to a survey by the Centers for Disease Control and Prevention conducted in December and January. The percentages are a big increase compared with the 6.5% of American adults who said they had symptoms of depression and the 8.1% who had symptoms of anxiety disorders in 2019, according to the CDC.

“More people are taking antidepressant medications. The number of prescriptions for the most common antidepressants increased to 224 million in 2021 from 216 million in 2019, according to data from health-research firm IQVIA.”

The fact that marijuana can be a very effective anti-depressant — and our corporate masters now know it for sure — is why the retail cannabis outlets were allowed to stay in business throughout the pandemic. Cannabis is SOMA and this certainly is a brave new world we’re living in. 

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PS re Steve DeAngelo

Our initial inquiry into who gave us this legalization may have left the impression that Steve DeAngelo, the erstwhile Harborside Health Center honcho, is the sole —or supreme— villain. He isn't. And let the record show that for three decades DeAngelo took big personal risks and helped build the political movement that preceded the industry. Starting in the '70s he made many trips to Mexico to bring marijuana to the people of Washington, DC, and environs. He donated the product for all the smoke-ins organized by NORML and the Yippies. He funded Jack Herer's efforts to reintroduce US Americans to the multiple uses of hemp, and then the "Hemp Tours" that carried the message —and countless rolls of souvenir twine— to campuses and concert venues across the country. In 1998 he allied with Washington AIDS patients promoting a ballot initiative similar to California's Proposition 215. (A Soros-funded crew led by Bill Zimmerman swooped in with a much weaker measure.) He tried to start a business importing magnificent hempen clothing from Eastern Europe, but was foiled by Prohibition. 

DeAngelo moved to the East Bay in 2005, rented warehouse space and had a successful an indoor grow in Oakland. He soon co-founded and became the dominant partner at Harborside, a dispensary that looked more like an Apple store than a cannabis club. He helped fund the first analytic chemistry lab willing to handle the federally forbidden herb, and he heeded Dr. Tod Mikuriya's call to test for CBD content as well as THC. Harborside regularly bought 5,000 copies of O'Shaughnessy's at $1/per, for which I remain the Grateful Fred. 

DeAngelo's outsized ego made him both a comic and a tragic figure. As Harborside became a success, he hired a personal assistant named Gigi. When other successful ganjapreneurs began hiring personal assistants, DeAngelo hired a second assistant named Dani. "Dani is Gigi's Gigi," the head buyer explained. For a while Steve carried around and stroked a lapdog, a little chihuahua.

In 2010 DeAngelo and a partner named Troy Dayton organized a company called CannBe to find and woo investors into what they foresaw would be a multi-billion-dollar industry. Some observers thought DeAngelo's aim was to become very, very rich but he maintained —and still does— that his goal was and is to promote "wellness" by giving the masses access to "the plant."  He speaks in a voice that is soothing and messianic, and he effects a trademark look —hair braided in two long pigtails topped by a little porkpie hat. He aspires to be a cult leader but senses that he doesn't quite have the personal charisma, so he makes "the plant" the object of worship and positions himself as the high priest.

DeAngelo was not alone in urging people to be "single-issue voters," but he was the most overt and consistent advocate of this approach to politics, which glorified rightwingers like Rep. Dana Rohrabacher.  If anyone tried to point out that Rohrabacher was pro-war and anti-labor, pot partisans would say, "But he's good on our issue" and that would be the end of of the conversation.