Associate Professor in Psychiatry (AdelaideU). Maudsley Deprescribing Guidelines: https://xitter.cf/t.co/MdD00qaw2z (US) https://xitter.cf/t.co/9eUVpPjCRX (UK)
London
Joined April 2013
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I've written a blog in response to @awaisaftab's misleading blog about Kalfas: "No, the Kalfas Meta-Analysis Doesn’t Prove Antidepressant Withdrawal Is Modest: Nonsense Disguised as Nuance" bit.ly/4ofhd7S
I think people are not aware of how much mis-information is propagated about this class of medications.
I remember being taught to say this to patients: that the increase in suicidality is caused by an increase in energy before an improvement in mood.
What studies show is simply an increase in suicidality when people are given these medications compared to placebo.
How many people have been talked into taking these medications because of the repetition of these talking points by prescribers?
Who Are the Real Purveyors of Medical Misinformation?
One of the most troubling things about psychiatry is how speculative explanations for drug harms become established facts through sheer repetition.
Take the claim that SSRIs can increase suicidality because they restore a depressed person’s energy before improving their mood, supposedly giving them the motivation to act on existing suicidal thoughts.
This is routinely presented as though it’s an established scientific explanation.
It isn’t. It’s a longstanding hypothesis for which convincing empirical evidence is lacking.
A 2009 review in Psychiatric Services examined this very theory and found no consistent evidence supporting it.
Yet rather than acknowledging that these drugs can themselves produce adverse psychological reactions, including agitation and akathisia, we’re offered a reassuring story about patients getting better.
It’s a striking example of how a superficially plausible sounding hypothesis can become received wisdom when it conveniently distracts from uncomfortable truths about drug harm.
Just because something is repeated as fact by someone in a white coat doesn’t make it any more true than any other forms of misinformation we hear online.
And when we see it we should call it out.
Mark Horowitz @markhoro.bsky.social retweeted
This would be funny if ketamine didn't have serious adverse effects. Ketamine has rapid effects because it makes you drunk/high and that temporarily overrides your underlying feelings (along with a strong placebo effect). There's nothing complicated about it.
Oxford research published last month found that ketamine reduces activity in a brain region involved in processing negative experiences.
The Department of Psychiatry’s findings offer new clues about its rapid antidepressant effects.
Find out more ⬇️
ox.ac.uk/news/2026-09-23-stu…
ALT A colourful, abstract illustration of the human brain, featuring intricate networks of interconnected lines and dots in pink, red, yellow, green and blue against a dark teal background. Below, white text on a dark blue background reads: ‘Study sheds new light on how ketamine may act rapidly in the human brain’. Underneath is the University of Oxford website address and name.
Such vital work!
Day 2 at the Science Festival!
The SafeMeds Hellas team continued engaging with the public, exploring how to read medication leaflets and report suspected adverse drug reactions through the Yellow Card system.
Empowering safer medication use through knowledge!
#SafeMedsHellas #ScienceFestival #MedicationSafety #Pharmacovigilance
Martin Ploderl explains with crystal clarity that studies find that the effect of antidepressants in children and adolescents do not differ from placebo in effect on depression. Given their clear harms this means that guidelines should no longer recommend these drugs for treating depression in children.
Guidelines however continue to do so on outdated studies. @NICEComms and others need to update guidance to prevent avoidable harm
Link to Martin’s blog below.
It is good to be reminded for the 100s of thousands of people trying to survive long-term psychiatric drug withdrawal injuries that there is hope for recovery, even if it takes years. What will it take for this extraordinary harm to be properly factored into the prescribing of these drugs in the first place?
It is important that @NICEComms reviews its guidelines based on this finding.
A single clinical trial of 40 children might have wrongly swayed medical evidence in favour of using Prozac to treat depression in children and adolescents, a group of researchers say.
go.nature.com/3U4nY27
It's always useful to hear anecdotes but it is important that we rely on good evidence when exposing children to medications that cause a wide variety of harms. The recent Cochrane review found that sertraline has "small and unimportant" effects on depression in children. It is not approved by the TGA for depression in children.
Personally I find this development validating. Having worked in adolescent MH @headspace_aus for 20 yrs I have never felt fluoxetine was very effective. More recent meds esp escitalopram & sertraline much more so (for a subset) & more effective for anxiety than depression per se
This is certainly the most consequential paper published in child and adolescent psychiatry for the last few years. It shows that the meta-analyses that current child psychiatry guidelines rely on to recommend fluoxetine for depression were skewed by an unbelievable trial (n=40) in Iran which found an effect 15 times larger than the average.
When this trial is removed all meta-analyses find the same as a recent Cochrane analysis which found 'small and unimportant differences.'
The flawed meta-analyses by Zhou and @cipriani in the @TheLancet and Lancet Psychiatry need to be corrected.
And guideline committees need to update their guidance in the context of the harms of these drugs including withdrawal effects, sexual effects and agitation/akathisia and suicidality in a minority of youths exposed to them.
Link below
Apologies to the good people at @Cipriani restaurant - no need to correct your no doubt excellent bolognaise. I meant Professor Cipriani @And_Cipriani
@NaudetFlorian
And the paper here: onlinelibrary.wiley.com/doi/…
“He said I shouldn’t have been taking Klonopin for so long, almost like I’d been writing my own prescriptions for the past nineteen years.”
A powerful account of benzodiazepine withdrawal—and the harm compounded when doctors fail to recognise it. This is just another story which shows why safe tapering and believing patients matters.
Link below
Some psychiatrists continue to insist that studies like Henssler prove that withdrawal is not a major concern, ignoring all the biases of the study. Dr Shapiro @BShapiroMD and I try to set the record straight here but I fear we are talking to people with closed ears.
Link below
Mark Horowitz @markhoro.bsky.social retweeted
How is this going to affect their emerging personalities, and what sort of adults will they become?
Mark Horowitz @markhoro.bsky.social retweeted
More worrying evidence of adverse pregnancy effects of SSRIs and reason to reign in prescribing, especially to young women
NEW STUDY:
-Children with prenatal exposure to antidepressants (mostly SSRIs) had an increased risk of Autism, ADHD, & behavioral-emotional-social difficulties.
These findings are consistent with antidepressant effects on fetal neurodevelopment.
Both maternal depression and antidepressant exposure were associated with increased risk, but the increase was greater with antidepressants than with untreated depression.
"Antidepressant exposure was associated with a 2.9% increase in absolute risk of special educational need among those exposed to depression."
"Antidepressant medication exposure without a record of depression was also associated with increased risk."
journals.plos.org/plosmedici…
Mark Horowitz @markhoro.bsky.social retweeted
This re-analyses shows an influential network meta-analysis of fluoxetine and placebo was influenced by an unreliable 'zombie trial'. If this is removed it shows minimal effects consistent with other meta-analyses. @NaudetFlorian onlinelibrary.wiley.com/doi/…