Psychiatric drugs save lives and promote healing

Note: The following is the text of an Op-Ed written by Dr. Michael Kalm for the Salt Lake Tribute on June 27, 2017 in response to a letter to the editor regarding the recent murders at the Mother Emanuel Church in Charleston, SC.

The Salt Lake Tribune published a letter to the editor titled, "Drugs, not guns, to blame for mass shootings."

It is tragically ironic that the writer of the letter was as misinformed about the realities of psychiatric medications, as the killer of the innocents at "Mother Emanuel" Church in Charleston was misinformed about "black men raping white women" and black people "taking over the country."

Perhaps the writer of the letter should be forgiven in that even the FDA has sometimes fallen victim to false scares. In 2004, the FDA issued a "black box" warning about suicidal ideation among adolescents taking antidepressant medications. This resulted in a decrease in the number of antidepressant prescriptions written.

This was a tragic error by the FDA. A study published in the prestigious "Archives of General Psychiatry" examined suicide rates in adolescents, aged 10-19, comparing 588 ZIP code regions across the United States. During the 10-year period of the study, whenever the prescriptions of antidepressant medication went up, the actual suicide rate went down. ZIP code by ZIP code. The FDA, cognizant of that study and mindful of the data that there were no documented completed suicides by adolescents taking antidepressant medications as prescribed, modified the "black box" warning in 2007 to remind the public that depression itself carried a high risk of suicide. Still, data shows that antidepressant prescriptions have remained lower than 2004 levels in the adolescent population.

Not only is there an inverse relationship between antidepressant usage and suicide, psychiatric medications have been shown to have a neuroprotective effect in brains, both animal and human. In bipolar disorder, it is very common for cognitive dysfunction to accompany the disease. But, as reported in a 2013 study, in the "The good news is that some of the medications, such as lithium, quetiapine (Seroquel), and valproate (Depakote, Depakene), have very positive effects on some of the things that may be deranged in bipolar disorder, such as abnormalities of brain-derived neurotrophic factor (BDNF) and the protein Bcl-2. Lithium enhances BDNF and Bcl-2. These are neuroprotective factors that may lead to neuronal health. Lithium may also reduce oxidative stress."

These neuroprotective effects have been noted since 2002, and further studies have replicated the findings. In 2009, a large review study published in "Dialogues in Clinical Neuroscience," showed the data supporting neuroprotective effects of medications, not only in bipolar disorder, but in depression and psychotic disorders.

It is a massive understatement to say that it is truly unfortunate that just as scurrilous websites can promote the kinds of lies that delude a young man like Dylann Roof to provoke him to mass murder, there are equally scurrilous websites that can frighten people who suffer from the genuine brain disease of mental illness away from the very treatments that can save their lives and promote healing.