Antidepressant Fashion Medicine Watch Mental Health

The Chemical Imbalance Myth and Antidepressant Harm

The Chemical Imbalance Myth and Antidepressant Harm

by Dr. Joseph Mercola

Within the U.S., an estimated 17.Three million American adults (7.1% of the grownup inhabitants), skilled no less than one main depressive episode in 2017.1 The very best charges are reported amongst these aged between 18 and 25.2 Nevertheless, not solely is there proof that melancholy is vastly overdiagnosed, however there’s additionally proof displaying it’s routinely mistreated.

With regard to overdiagnosis, one 2013 study3 discovered solely 38.Four% of members with clinician-identified melancholy truly met the DSM-Four standards for a serious depressive episode, and solely 14.Three% of seniors 65 and older met the standards.

As for remedy, the overwhelming majority are prescribed antidepressant medicine, regardless of the very fact there’s nearly no proof to recommend they supply significant assist, and loads of proof displaying the harms are larger than sufferers are being advised.

Based on a 2017 research,Four 1 in 6 People between the ages of 18 and 85 have been on psychiatric medicine, most of them antidepressants, and 84.Three% reported long-term use (three years or extra). Out of 242 million U.S. adults, 12% have been discovered to have crammed a number of prescriptions for an antidepressant, particularly, in 2013.

In accordance with data5 introduced by a watchdog group, lots of of hundreds of toddlers are additionally being medicated with highly effective psychiatric medicine, elevating critical moral questions, together with questions concerning the future psychological and bodily well being of those youngsters.

Current research are additionally shedding a lot wanted mild on the addictive nature of many antidepressants, and reveal that the advantages of those medicine have been overblown whereas their negative effects — together with suicidal ideation — and have been downplayed and ignored for many years, putting sufferers at pointless danger.

The Chemical Imbalance Fantasy

One researcher answerable for elevating consciousness about these necessary psychological well being points is professor Peter C. Gøtzsche, a Danish physician-researcher and outspoken critic of the drug business (as his e-book, “Lethal Medicines and Organized Crime: How Huge Pharma Has Corrupted Healthcare,”6 suggests).

Gøtzsche helped discovered the Cochrane Collaboration in 1993 and later launched the Nordic Cochrane Centre. In 2018, he was expelled by the Cochrane governing board following the publication of a scathing critique of a Cochrane evaluate of the HPV vaccine, through which he and his coauthors identified a number of methodological flaws and conflicts of curiosity.

Over the previous a number of years, Gøtzsche has revealed quite a few scientific papers on antidepressants and media articles and a ebook discussing the findings. In a June 28, 2019 article,7Gøtzsche addresses “the dangerous fantasy” about chemical imbalances — a debunked speculation that continues to drive using antidepressants to this present day. He writes, partially:eight

“Psychiatrists routinely inform their sufferers that they’re sick as a result of they’ve a chemical imbalance within the mind and they’ll obtain a drug that fixes this …

Final summer time, certainly one of my researchers and I collected details about melancholy from 39 common web sites in 10 nations, and we discovered that 29 (74%) web sites attributed melancholy to a chemical imbalance or claimed that antidepressants might repair or right that imbalance …

It has by no means been attainable to point out that widespread psychological issues begin with a chemical imbalance within the mind. The research which have claimed this are all unreliable.9

A distinction in dopamine ranges, for instance, between sufferers with schizophrenia and wholesome individuals can’t inform us something about what began the psychosis … [I]f a lion assaults us, we get terribly frightened and produce stress hormones, however this doesn’t show that it was the stress hormones that made us scared.

Individuals with psychoses have typically suffered traumatic experiences up to now, so we should always see these traumas as contributing causal elements and never scale back struggling to some biochemical imbalance that, if it exists in any respect, is extra more likely to be the results of the psychosis moderately than its trigger.10

The parable about chemical imbalance could be very dangerous. It makes individuals consider there’s something critically improper with them, and typically they’re even advised that it’s hereditary.

The results of that is that sufferers proceed to take dangerous medicine, yr after yr, maybe even for everything of their lives. They worry what would occur in the event that they stopped, notably when the psychiatrists have advised them that their state of affairs is like sufferers with diabetes needing insulin.”

Actual Explanation for Melancholy Is Sometimes Ignored

Based on Gøtzsche, there isn’t any recognized psychological well being problem that’s brought on by an imbalance of mind chemical compounds. In lots of instances, the true trigger is unknown, however “fairly often, it’s a response to unhealthy dwelling circumstances,” he writes.11

He additionally cites the ebook,12 “Nervousness — The Inside Story: How Organic Psychiatry Acquired It Mistaken,” written by Dr. Niall McLaren, by which the writer exhibits that nervousness is a significant factor in and set off of most psychiatric issues.

“A psychiatrist I respect extremely, who solely makes use of psychiatric medicine in uncommon instances … has stated that most individuals are depressed as a result of they stay miserable lives,” Gøtzsche writes.

“No drug may help them stay higher lives. It has by no means been proven in placebo-controlled trials that a psychiatric drug can enhance individuals’s lives — e.g., assist them return to work, enhance their social relationships or efficiency at college, or forestall crime and delinquency. The medicine worsen individuals’s lives, a minimum of in the long term.13“

Gøtzsche rightfully factors out that antipsychotic medicine create chemical imbalances; they don’t repair them. As a gaggle, they’re additionally considerably misnamed, as they don’t handle psychotic states. Moderately, they’re tranquilizers, rendering the affected person passive. Nevertheless, calming the affected person down doesn’t truly assist them heal the underlying trauma that, in lots of instances, is what triggered the psychosis within the first place.

As famous in a single 2012 meta-analysis14 of research taking a look at childhood trauma — together with sexual abuse, bodily abuse, emotional/psychological abuse, neglect, parental dying and bullying — and subsequent danger of psychosis:

“There have been vital associations between adversity and psychosis throughout all analysis designs … Sufferers with psychosis have been 2.72 occasions extra more likely to have been uncovered to childhood adversity than controls … The estimated inhabitants attributable danger was 33% (16%-47%). These findings point out that childhood adversity is strongly related to elevated danger for psychosis.”

Financial system of Affect in Psychiatry

A associated article,15 written by investigative journalist Robert Whitaker in 2017, addresses the “financial system of affect” driving using antidepressant medicine in psychiatric remedy — and the “social damage” that outcomes. As famous by Whitaker, psychological issues have been initially categorized based on a illness mannequin in 1980 by the American Psychiatric Affiliation.

“We’re all accustomed to the second ‘financial system of affect’ that has exerted a corrupting affect on psychiatry — pharmaceutical cash — however I consider the guild affect is basically the larger drawback,” he writes.

Whitaker particulars the corruption inside the APA in his ebook “Psychiatry Underneath the Affect,” one side of which is “the false story advised to the general public about medicine that fastened chemical imbalances within the mind.” Different types of corrupt conduct embrace:

  • The biased designs of medical trials to realize a predetermined end result
  • Spinning outcomes to help preconceived conclusions
  • Hiding poor long-term outcomes
  • Increasing diagnostic classes for the aim of economic achieve
  • Creating medical trial tips that promote drug use

In his article, Whitaker goes on to dissect a 2017 evaluation16 revealed within the American Journal of Psychiatry, which Whitaker claims “defends the career’s present protocols for prescribing antipsychotics, which incorporates their common long-term use.”

As Whitaker factors out, there’s ample proof displaying antipsychotic medicine worsen outcomes over the long run in these recognized with psychotic issues comparable to schizophrenia.

The evaluation in query, led by Dr. Jeffrey A. Lieberman, was aimed toward answering persistent questions raised by the mounting of such proof. Alas, their conclusions dismissed considerations that the present drug paradigm is perhaps doing extra hurt than good.

“In a subsequent press launch and a video for a Medscape commentary, Lieberman has touted it as proving that antipsychotics present an amazing profit, psychiatry’s protocols are simply advantageous, and that the critics are ‘nefarious’ people intent on doing hurt,” Whitaker writes.17

The Scientific Bias of Psychiatric Remedy

5 of the eight researchers listed on the evaluate have monetary ties to drug corporations, three are audio system for a number of drug corporations and all eight are psychiatrists, “and thus there’s a ‘guild’ curiosity current on this evaluate, provided that they’re investigating whether or not considered one of their remedies is dangerous over the long-term,” Whitaker notes.18

Not surprisingly, the evaluate ignored research displaying adverse results, together with research displaying antipsychotics have a detrimental impact on mind quantity. What’s extra, whereas withdrawal research help using antipsychotics as upkeep remedy over the long run, these research don’t tackle how the medicine have an effect on sufferers’ long-term well being.

“They merely reveal that when an individual has stabilized on the treatment, going abruptly off the drug is more likely to result in relapse,” Whitaker writes.19 “The give attention to long-term outcomes, no less than as introduced by critics, offers proof that psychiatry ought to undertake a selective-use protocol.

If first-episode sufferers usually are not instantly placed on antipsychotics, there’s a vital proportion that may recuperate, and this ‘spontaneous restoration’ places them onto a great long-term course. As for sufferers handled with the drugs, the aim can be to attenuate long-term use, as there’s proof that antipsychotics, on the entire, worsen long-term outcomes.”

Huge Majority of Psychotic Sufferers Are Harmed, Not Helped

In his deconstruction of Lieberman’s evaluation, Whitaker particulars how biased considering influenced the assessment’s conclusions. It’s a moderately lengthy article, however properly value studying by means of if you wish to perceive how a scientific evaluate may be skewed to accord with a preconceived view.

Particulars I need to spotlight, nevertheless, embrace findings referring to the quantity wanted to deal with (NNT) and the share of sufferers harmed by the routine use of antipsychotic medicine as a first-line remedy.

As famous by Whitaker, whereas placebo-controlled research reveal the effectiveness of a drug in comparison with an inert substance, they don’t successfully reveal the ratio of profit versus hurt among the many affected person inhabitants. NNT refers back to the variety of sufferers that should take the drug in an effort to get one constructive response.

A meta-analysis cited in Lieberman’s assessment had an NNT of 6, which means that six sufferers should take the drug to ensure that one to profit from the remedy. The remaining 5 sufferers — 83% — are probably harmed by the remedy. As famous by Whitaker:20

“The purpose … is that this: reviewers in search of to advertise their drug remedy as efficient will look solely at whether or not it produces a superior response to placebo. This results in a one-size-fits-all protocol.

Reviewers that need to assess the benefit-harm impact of the remedy on all sufferers will take a look at NNT numbers. On this occasion, the NNT calculations argue for selective use of the medicine …”

Antidepressants Are Not Useful within the Lengthy Time period

Whereas sometimes not as damaging as antipsychotics, antidepressants additionally depart a path of destruction of their wake. A scientific evaluation21 by Gøtzsche revealed in 2019 discovered research assessing hurt from selective serotonin reuptake inhibitors (SSRIs) fail to offer a transparent and correct image of the harms, and subsequently “can’t be used to research persistent harms of antidepressants.”

On this evaluation, Gøtzsche and colleagues sought to evaluate “harms of SSRIs … that persist after finish of drug consumption.” The first outcomes included mortality, useful outcomes, high quality of life and core psychiatric occasions. In all, 22 papers on 12 SSRI trials have been included. Gøtzsche discovered a number of distinct issues with these trials. For starters, solely two of the 12 trials had a drop-out price under 20%.

Gøtzsche and his staff additionally word that “Consequence reporting was much less thorough throughout follow-up than for the intervention interval and solely two trials maintained the blind throughout follow-up.” Importantly, although, all the 22 papers got here to the conclusion that “the medicine weren’t useful in the long run.”

One other essential discovering was that each one trials both “reported harms outcomes selectively or didn’t report any,” and “Solely two trials reported on any of our main outcomes (faculty attendance and variety of heavy consuming days).”

Antidepressants Are Extra Addictive Than Admitted

In a June Four, 2019, article,22 “The Melancholy Capsule Epidemic,” Gøtzsche writes that antidepressant medicine:

“… shouldn’t have related results on melancholy; they improve the danger of suicide and violence; they usually make it harder for sufferers to stay regular lives.23 They need to subsequently be prevented.

We’ve been fooled by the drug business, corrupt docs on business payroll, and by our drug regulators.24 Certainly, many sufferers and docs consider the drugs are useful, however they can’t know this, as a result of individuals are likely to turn out to be a lot better with time even when they don’t seem to be handled.25

This is the reason we’d like placebo-controlled trials to seek out out what the medicine do to individuals. Sadly, nearly all trials are flawed, exaggerate the advantages of the medicine, and underestimate their harms.26“

Addictive Nature of Antidepressants Skews Outcomes

In his article,27 Gøtzsche critiques a number of of the methods utilized in antidepressant drug trials to magnify advantages and underestimate the harms. One little-known fact that helps skew research leads to the drug’s favor is the truth that antidepressants are typically much more addictive than formally admitted. He explains how this conveniently hides the skewing of outcomes as follows:28

“Nearly all sufferers within the trials are already on a drug just like the one being examined towards placebo. Subsequently, because the medicine are addictive, a few of the sufferers will get abstinence signs … when randomized to placebo …

These abstinence signs are similar to these sufferers expertise once they attempt to cease benzodiazepines. It’s no marvel that new medicine outperform the placebo in sufferers who’ve skilled hurt because of chilly turkey results.

To learn how lengthy sufferers have to proceed taking medicine, so-called upkeep (withdrawal) research have been carried out, however such research are also compromised by chilly turkey results. Main psychiatrists don’t perceive this, or they fake they don’t.

Most interpret the upkeep research of melancholy drugs to imply that these medicine are very efficient at stopping new episodes of melancholy and that sufferers ought to subsequently proceed taking the medicine for years and even for all times.”

Scientific Literature Helps Actuality of Consumer Complaints

Through the years, a number of research on the dependence and withdrawal reactions related to SSRIs and different psychiatric medicine have been revealed, together with the next:

In a 2011 paper29 within the journal Habit, Gøtzsche and his staff seemed on the distinction between dependence and withdrawal reactions by evaluating benzodiazepines and SSRIs. Benzodiazepines are recognized to trigger dependence, whereas SSRIs are stated to not be addictive.

Regardless of such claims, Gøtzsche’s workforce discovered that “discontinuation signs have been described with comparable phrases for benzodiazepines and SSRIs and have been very comparable for 37 of 42 recognized signs described as withdrawal reactions,” which led them to conclude that:

“Withdrawal reactions to selective serotonin re‐uptake inhibitors look like just like these for benzodiazepines; referring to those reactions as a part of a dependence syndrome within the case of benzodiazepines, however not selective serotonin re‐uptake inhibitors, doesn’t appear rational.”

Two years later, in 2013, Gøtzsche’s group revealed a paper30 within the Worldwide Journal of Danger & Security in Drugs, by which they analyzed “communications from drug businesses about benzodiazepine and SSRI withdrawal reactions over time.”

By looking the web sites of drug businesses in Europe, the U.S., UK and Denmark, they discovered that it took years earlier than drug regulators lastly acknowledged the truth of benzodiazepine dependence and SSRI withdrawal reactions and commenced informing prescribers and sufferers about these dangers.

A big a part of the issue, they discovered, is that drug businesses depend on spontaneous reporting of antagonistic results, which “results in underestimation and delayed details about the issues.”

In conclusion, they state that “Given the expertise with the benzodiazepines, we consider the regulatory our bodies ought to have required research from the producers that would have elucidated the dependence potential of the SSRIs earlier than advertising authorization was granted.”

A 2019 paper31 within the Epidemiology and Psychiatric Sciences journal notes “It took virtually 20 years after the SSRIs entered the marketplace for the primary systematic evaluate to be revealed.” It additionally factors out that critiques claiming withdrawal results to be delicate, temporary in period and uncommon “was at odds with the sparse however rising proof base.”

In actuality, “What the scientific literature reveals is in shut settlement with the hundreds of service consumer testimonies out there on-line in giant boards. It means that withdrawal reactions are fairly widespread, that they could final from a couple of weeks to a number of months and even longer, and that they’re typically extreme.”

Antidepressants Improve Your Danger of Suicide and Violence

In his June Four article,32 Gøtzsche additionally stresses the truth that antidepressants could be deadly. In considered one of his research,33 revealed in 2016, he discovered antidepressants “double the prevalence of occasions that may result in suicide and violence in wholesome grownup volunteers.”

Different analysis34 has proven they “improve aggression in youngsters and adolescents by an element of two to three — an essential discovering contemplating the various faculty shootings the place the killers have been on melancholy tablets,” Gøtzsche writes.

In middle-aged ladies with stress urinary incontinence, the selective serotonin and norepinephrine reuptake inhibitor (SNRI) duloxetine, which can also be used to deal with incontinence, has been proven to double the danger of a psychotic episode and improve the danger of violence and suicide 4 to 5 occasions,35 main the authors to conclude that harms outweighed the advantages.

“I’ve described the soiled tips and scientific dishonesty concerned when drug corporations and main psychiatrists attempt convincing us that these medicine shield towards suicide and different types of violence,36” Gøtzsche writes.37 “Even the FDA was pressured to provide in when it admitted in 2007, no less than not directly, that melancholy drugs may cause suicide and insanity at any age.

There isn’t any doubt that the huge use of melancholy tablets is dangerous. In all nations the place this relationship has been examined, the sharp rise in incapacity pensions as a result of psychiatric issues has coincided with the rise of psychiatric drug utilization, and melancholy tablets are these that are used probably the most by far. This isn’t what one would anticipate if the medicine have been useful.”

Drugmaker Lied About Paxil’s Suicide Danger

In 2017, Wendy Dolin was awarded $Three million by a jury in a lawsuit towards GlaxoSmithKline, the maker of Paxil. Dolin’s husband dedicated suicide six days after taking his first dose of a Paxil generic, and proof introduced forth within the case convincingly confirmed his suicide was the results of the drug, not emotional stress or psychological sickness.38

The authorized workforce behind that victory, Baum Hedlund Aristei Goldman, can also be representing different victims of Paxil-induced violence and demise. On the time, lawyer R. Brent Wisner stated:39

“The Dolin verdict despatched a transparent message to GSK and different drug producers that hiding knowledge and manipulating science won’t be tolerated … In case you create a drug and know that it poses critical dangers, no matter whether or not shoppers use the model identify or generic model of that drug, you have got an obligation to warn.”

GSK’s personal medical placebo-controlled trials truly revealed topics on Paxil had almost 9 occasions the danger of trying or committing suicide than the placebo group. To realize drug approval, GSK misrepresented this surprising knowledge, falsely reporting a better variety of suicide makes an attempt within the placebo group and deleting a few of the suicide makes an attempt within the drug group.

An inner GSK evaluation of its suicide knowledge additionally confirmed that “sufferers taking Paxil have been almost seven occasions extra more likely to try suicide than these on placebo,” Baum Hedlund Aristei Goldman studies, including:40

“Jurors within the Dolin trial additionally heard from psychiatrist David Healy, one of many world’s foremost specialists on Paxil and medicines in its class … Healy informed the jurors that Paxil and medicines like it could create in some individuals a state of utmost ’emotional turmoil’ and intense inside restlessness generally known as akathisia …

‘Individuals have described it like a state worse than dying. Demise might be a blessed aid. I need to leap out of my pores and skin,’ Dr. Healy stated. Wholesome volunteer research have discovered that akathisia can occur even to individuals with no psychiatric situation who take the drug …

One other Paxil aspect impact recognized to extend the danger of suicide is emotional blunting … apathy or emotional indifference … [E]motional blunting, mixed with akathisia, can result in a psychological state through which a person has ideas of harming themselves or others, however is ‘numbed’ to the results of their actions. Medicine within the Paxil class can even trigger somebody to ‘go psychotic, develop into delirious,’ Dr. Healy defined.”

A whole lot of Hundreds of Toddlers on Psychiatric Medicine

Contemplating the various critical psychological and bodily dangers related to psychiatric medicine, it’s surprising to study that tons of of hundreds of American toddlers are on them. In 2014, the Residents Fee on Human Rights, a psychological well being watchdog group, highlighted knowledge displaying that in 2013:41

  • 274,000 infants aged 1 and youthful got psychiatric medicine — Of those, 249,699 have been on anti-anxiety meds like Xanax; 26,406 have been on antidepressants comparable to Prozac or Paxil, 1,422 have been on ADHD medicine akin to Ritalin and Adderall, and 654 have been on antipsychotics corresponding to Risperdal and Zyprexa
  • Within the toddler class (2- to Three-year-olds), 318,997 have been on anti-anxiety medicine, 46,102 have been on antidepressants, 10,000 have been prescribed ADHD medicine and three,760 have been on antipsychotics
  • Amongst youngsters aged 5 and youthful, 1,080,168 have been on psychiatric medicine

These are surprising figures that problem logic. How and why are so many youngsters, infants even, on addictive and dangerously mind-altering drugs? Contemplating these statistics are 6 years previous, likelihood is they’re even larger at this time. Simply what is going to occur to all of those kids as they develop up? As talked about within the article:42

“In relation to the psychiatric medicine used to deal with ADHD, these are known as ‘kiddie cocaine’ for a purpose. Ritalin (methylphenidate), Adderall (amphetamine) and Concerta are all thought-about by the federal authorities as Schedule II medicine — probably the most addictive.

ADHD medicine even have critical unwanted side effects resembling agitation, mania, aggressive or hostile conduct, seizures, hallucinations, and even sudden demise, in accordance with the Nationwide Institutes of Well being …

So far as antipsychotics, antianxiety medicine and antidepressants, the FDA and worldwide drug regulatory businesses cite unwanted side effects together with, however not restricted to, psychosis, mania, suicidal ideation, coronary heart assault, stroke, diabetes, and even sudden demise.”

Youngsters More and more Prescribed Psych Medicine Off-Label

Making issues even worse, current analysis exhibits the variety of youngsters being prescribed treatment off-label can also be on the rise. An instance provided by,43 which reported the findings, is “a physician recommending antidepressant treatment for ADHD signs.”

The research,44 revealed within the journal Pediatrics, checked out tendencies in off-label drug prescriptions made for youngsters underneath the age of 18 by office-based physicians between 2006 and 2015. Findings revealed:

“Physicians ordered ≥1 off-label systemic drug at 18.5% of visits, often (74.6%) due to unapproved circumstances. Off-label ordering was commonest proportionally in neonates (83%) and in absolute phrases amongst adolescents (322 orders out of 1000 visits).

Off-label ordering was related to feminine intercourse, subspecialists, polypharmacy, and continual circumstances. Charges and causes for off-label orders assorted significantly by age.

Relative and absolute charges of off-label orders rose over time. Amongst widespread courses, off-label orders for antihistamines and a number of other psychotropics elevated over time …

US office-based physicians have ordered systemic medicine off label for youngsters at growing charges, most frequently for unapproved circumstances, regardless of current efforts to extend proof and drug approvals for youngsters.”

The researchers have been stunned by the findings, and expressed critical concern over this development. Whereas authorized, most of the medicine prescribed off-label haven’t been correctly examined to make sure security and efficacy for younger youngsters and adolescents.

As famous by senior writer Daniel Horton, assistant professor of pediatrics and pediatric rheumatologist at Rutgers Robert Wooden Johnson Medical Faculty, “We don’t all the time perceive how off-label drugs will have an effect on youngsters, who don’t all the time reply to drugs as adults do. They could not reply as desired to those medicine and will expertise dangerous results.”

Educate Your self Concerning the Dangers

Should you, your youngster, or one other member of the family is on a psychiatric drug, I urge you to teach your self concerning the true dangers, and to think about switching to safer options. In terms of youngsters, I can’t fathom a state of affairs by which a toddler would wish a psychiatric drug and I discover it surprising that there are such a lot of docs on the market that, based mostly on a subjective analysis, would deem a psychiatric drug essential.

You possibly can study extra concerning the analysis and remedy of melancholy and nervousness within the following articles: “How Train Treats Melancholy,” “Various Remedies Efficient for Melancholy,” “Nervousness Might Be an Inherited Trait” and “Nervousness Overtakes Melancholy as No. 1 Psychological Well being Drawback.”

Learn the complete article at


1, 2 Main Melancholy Statistics Final Replace: February 1, 2019

Three Psychother Psychosom. 2013;82(Three):161-9

Four JAMA Inner Drugs 2017;177(2):274-275

5, 41, 42 PR Net Might 21, 2014

6 Richard Smith Non-Medical Blogs

7, eight, 11 June 28, 2019

9, 13, 23, 24, 25, 26, 36 Gøtzsche PC. Lethal psychiatry and organised denial 2015 (PDF)

10 Gøtzsche P.C. (2017) Psychopharmacology Is Not Proof-Based mostly Drugs. In: Davies J. (eds) The Sedated Society. Palgrave Macmillan, Cham, Pages 23-49

12 Nervousness — The Inside Story: How Organic Psychiatry Obtained It Incorrect, by Niall McLaren

14 Schizophr Bull. 2012 Jun;38(Four):661-71

15, 17, 18, 19, 20 Might 21, 2017

16 American Journal of Psychiatry Revealed on-line Might 5, 2017

21 Int J Danger Saf Med. 2019;30(2):59-71

22, 27, 28, 32, 37 June Four, 2019

29 Habit October 12, 2011; 107(5)

30 Worldwide Journal of Danger & Security in Drugs 2013; 25(Three): 155-168

31 Epidemiology and Psychiatric Sciences August 22, 2019

33 Journal of the Royal Society of Drugs October 2016; 109(10): 381-392

34 BMJ January 2016; 352: i65

35 CMAJ 2017 Feb 6;189(5):E194-E203

38, 39, 40 Paxil Lawsuit

43 September 16, 2019

44 Pediatrics September 12, 2019

Revealed on September 20, 2019

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