Psychopharmaceuticals and ethics

When we were discussing the effects of medicating young children with ADHD, I was reminded of my uncle.  He was put on medication to treat depression when we was around 3 years old.  40 years later, he was diagnosed with Parkinson’s Disease.  He has always been convinced that this was due to taking anti-depressants from a young age.  In “Synaptic Sickness”, LeDoux mentions that reserpine and chlorpromazine could lead to the development of tardive dyskinesia, which includes symptoms of rigidity similar to Parkinson’s disease.  I am unsure of what type of anti-depressants he was on (though I know that tricyclic and Monoamine Oxidise Inhibitors were popular in the 1950s), most target either dopamine, serotonin, or norepinephrine.  A decreased amount of dopamine is associated with Parkinson’s Disease, so I believe there is some merit to the argument that he was affected by the use of pharmaceutical drugs.

The Synaptic Sickness chapter in the book and this idea really bring to light the ethics of using drugs, especially on young children as John talked about in class on Tuesday.  If my uncle was on drugs that inhibited reuptake or increased the amount of dopamine in his brain, would his brain adapt and begin to produce less dopamine? Is it possible that these two conditions are related? Our brains are greatly impacted by our experiences and substances we use.

Most of the articles I found for this subject included using antidepressants in patients suffering from Parkinson’s Disease.  Although none of them cited antidepressants as a cause, this article found that SSRIs worsened the symptoms in the motor function of Parkinson’s patients.  Due to ethical issues (since Parkinson’s doesn’t occur in other species, it is very difficult to do research on), they merely observed patients that had been treated with some form of antidepressants (tricyclic, SSRI, SARI, SNDRI, antagonists, NDRI, and SNRI) in the past five years.  They found five patients (out of 140) that experienced worse motor symptoms (shaking, rigidity, tremors, and slow movement) after using SSRIs.  They found no significant results for the other types of anti-depressants.  Note: the amount of time that patients were on antidepressants varied, which could change whether or not their brain was altered, especially since most of these medications requires a few weeks for effectiveness.  As LeDoux mentions in Synaptic Self, this could be due to changes in gene activation and protein synthesis.

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5 thoughts on “Psychopharmaceuticals and ethics

  1. Wow yea, this is exactly what we were talking about at the end of class in terms of how we don’t know what so many of the long term side effects of these drugs are. Also, that’s interesting about how Parkinson’s doesn’t occur in other species. I wonder why that’s true for certain diseases and what prevents it from occurring in these other animals.

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  2. Actually, we do have animal models of Parkinson’s disease. There is both toxin-induced and genetically linked models. I use rotenone (a pesticide) to study PD in Drosophila, it causes motor deficits and DA neuron degeneration. There are also genetic models of drosophila, though I’m not sure what the literature is like on genetic PD models and antidepressants.

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  3. I can definitely see the logic in the link between use of antidepressants at such a young age affecting later occurrences of things such as Parkinson’s disease. As we talked about in class the brain of a child is extremely sensitive and we need to take extra precautions when prescribing medications. Instead, psychotherapy should be more common for children of younger ages. I am still baffled by the idea of making diagnoses at age 3. I remember from my abnormal psychology class certain mental illnesses such as bipolar disorder does not seem to have a real form in childhood and thus is not diagnosed, which makes much more sense to me.

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  4. Yes, and I know that schizophrenia often doesn’t appear until young adulthood. I am guessing (and hoping) that most psychiatrists today wouldn’t diagnose antidepressants for a 3 year old. It is important to remember the time- late 1950s. This was when a lot of the antidepressants were becoming popular though they knew vary little about the side effects or even why the drugs worked in the first place!

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