Antidepressants Will Alter Your Personality!

It’s been hours now and I think I’m beginning to regret starting this.  However, can I still resist? I’ll just rue the fact that it’s taken me all day when I should have been doing other things.

I was going through my Twitter Follows to do some “house cleaning” but after I stumbled across this, I had to stop.  I also began questioning the seriousness of Journal Publications.  However, we all have to play nice, don’t we? Therefore, I’m allowed to state my opinions, too!

Where shall I begin? Shall I link to my Follow? You know what? Hell, yes! At least to their website! When I went to their About Page to look at their “Staff Bios” all it did was open up Thunderbird, for me to send an email to a person! They’re huge on Twitter so who knows if they’ll read this and I don’t even care! Here they are and where I found the link to the study.

EDIT: It’s not the study but what is widely circulating around the Internet.  Even more reason.  What got me going and took me hours was staring at it, trying to justify its validity as a “study” much less a proper, Peer Reviewed, Journal Article.  I did realize that it was a real, chop shop, job, but it’s in a lot of places!

I started off on a pretty high horse myself stating this:

You don’t have to read the study of you don’t want to.  Again, we all have to play nice and there are some things that you can get past but not others!

I was going to save the best (worst?) for last but this study was done by a bunch of Psychologists regarding meds.  That may be a “minor point” that some may be able to skip over.  However, disregarding the fact that they are only working with perceived medical knowledge, it completely biases their own study! Why? Here is why.

How can I politely say they don’t really know what they are talking about regarding medicine and pharmacology.  They don’t really know what they are talking about regarding their own material and they couldn’t write a scientific paper to save their lives? Not to mention, if you Google some of these folks, you’ll find that they often write about a lot of stuff together–and it’s been published!

I still feel some of that is true, even though I found more.  Here’s a link that mentions more about the study and also states it was supported by GSK. I love to see that! Please admit that all of your studies are funded by Big Pharma! It was at least reviewed by some medical folks, too. Also, it links to the source!

On a bit more positive note, they do state some things that are “facts.”  The basics behind Trait Theory, Depression, serotonin all with genetic links.  Twin Studies regarding Trait Theory.  Not knowing SSRIs and how they work on the brain.  The theory of certain traits and people with them being more likely to develop Depression.  All of that good stuff.

I’m still going to work with “chop shop” but for some attempt at clarity (egad!) a bit of the other will be tossed in.

So, here’s the deal.  Also, is it just me or one grammatical nightmare:

Results of a study of antidepressant treatment for major depression suggest that changes in personality traits seen in patients taking the drug paroxetine (Paxil) may not be the result of the medication’s lifting of mood but may instead be a direct effect of this class of drugs and part of the mechanism by which they relieve depression.

Let’s look at the “Big Five.”  The traits they’ve offered up and the two they’re focusing on.  I have placed them in bold.

Neuroticism is one of five personality traits that psychologists use as an organizing scheme for understanding personality:  the other four traits are extraversion, openness, conscientiousness, and agreeableness.

Before I move on, just a few issues with Trait Theory.  There are more traits (although they said they were only using five.)  Of those five, Neuroticism and Extraversion which are “basically” polar opposites.  I’m watering down but: “I’m sad and all depressed” vs. “I’m more happy and feel upbeat!”  Of those five, you may find things that are not mutually exclusive.  Of all traits you may find that.  Does that matter?

Also, the results are gathered by self-reporting.  The study used the NEO Five-Factor Inventory.  Alright.

Just think about that for a bit.  If nothing hits you right off the bat, then hang on.  Traits are highly variable due to other factors: culture, gender, individual, age.  Due to self-reporting, I’d even go so far as time of day.  I’m not joking if you think about reporting scales and measurements, filling out pieces of paper regarding how you feel.

People who take anti-depressants report lower levels of neuroticism and increased extroversion, in addition to a lifting of depression.

Do you see from my paragraph, above? I didn’t know the widespread effect of Antidepressants and Trait Theory! Also, I didn’t know the increased power Antidepressants had over Depression…these days? The paper was written in 2009.  Perhaps I haven’t been keeping up with my research.  May I also alert you to the spelling mistake above: “extroversion.”

The assumption has been that these changes in personality measures were the result, not the cause, of a lifting of depression.

Wow.  And I thought the above was a sweeping statement.  Whatever happened to the word: “hypothesis?”

…randomly assigned patients with major depressive disorder (MDD) to receive paroxetine (120 patients), placebo (60 patients), or cognitive therapy (60 patients).

That’s the study.  Kind of interesting because the actual study from the Archives of General Psychiatry say the group ranged from moderate to severe MDD.  Also, no big deal to toss in some CB(T) as another control? Sure.

After 8 weeks, medication and cognitive therapy (CT) each proved more effective than placebo in reducing depression.  In addition, measures of neuroticism (based on standard surveys) in the groups receiving medication or cognitive therapy dropped, while extraversion scores rose.

First, I just had to remind you that this is all based on self-reporting again, right? So, now we have that patient bias! Sort of.  In fact, we don’t really know.  I think what anyone who has ever tried Antidepressants knows, is that it can take anywhere up to about a month for side effects to go away.  Could that have affected their states of mind? Could just the drug alone do that?

The changes were striking; while patients receiving placebo also reported small changes in both traits, the changes in patients on paroxetine were four to eight times as large.

Striking indeed! If you look at the numbers in the study, this isn’t a lie, though.  It’s just a matter of deciphering the statistics and figuring out what is really going on.  The measurements for Depression was the Hamilton Rating Scale.

Patients receiving paroxetine had much greater changes in personality traits than patients receiving placebo even when the degree of improvement in depression was the same.  This suggested that the effects on personality traits were not the result of the drug’s lifting of depression.  After accounting for decreases in depression in patients receiving CT, the improvement in extraversion, but not neuroticism, remained significant.

This follows the exact line above.  I don’t quite follow.  The last statement I can’t find in the study.  Well, just the part about the improvement in extraversion remaining significant.

So, if the traits are based upon (NEO) and the Depression was using Hamilton, how exactly do they stand apart from each other or sit beside each other in similarity? I wish I could get my hands on them while being freshly medicated to see how Depressed I still may have felt.

I also still call into question the bias of the Psychologists! Their entire intent here is to prove something in favour of the Big Five! Further, they are not doctors! Don’t get me started…  Maybe that’s why the “study” is so brief in the Archives of General Psychiatry.  “Archives” indeed!

How much of the placebo effect do we also consider? I’m getting even more confused as things are seeming a bit circular in my mind.  If there are so many possibles to Traits, and Depression and serotonin all being genitically linked.  Then Traits being precursors to Depression.  SSRIs getting tied in.

In further comparison of paroxetine with placebo, patients who had initially taken placebo were given the option after 8 weeks to take paroxetine.  During the placebo phase, there were small changes in neuroticism and extraversion; much greater changes occurred after 8 weeks on paroxetine.  Finally, those patients on paroxetine with the greatest degree of change in neuroticism (but not extraversion) were least likely to relapse to depression; the degree of changes in personality in those receiving CT did not affect the chances of relapse.

Oy.  I think I’d better stop.  So, the placebo folks now get their chance.  Well, guess what? Their Depression, Traits, whatever at this point, all improve? Also, what’s that about the CT and not having an issue with relapse? Check.  That’s correct as far as the study numbers.  But again, am I dense? Is this still rather circular?

While the neurochemical effects of SSRIs are known, how those changes act to reduce depression is not clear.  These results contradict the prevailing assumption that changes seen in personality traits in patients taking SSRIs are a result of the drugs’ effects on depression.  SSRIs may alter personality directly—and thus lift depression—or may act on a third factor that underlies both.  CT may alter personality by a different path.  Continued research on how these treatments work can provide a clearer understanding of the mechanism of action of SSRIs and how treatment can be best used to reduce depression and minimize relapse.

I think that sums it up.  We have no clue.

At least the other two links do make some attempt at following things up and/or tying things up.  They mention “regression analyses” with folks on Paxil and the fact that they still report they are better off “trait-wise” than the placebo group.  They then go on to say this bold as brass:

“This pattern of findings should not occur if personality change conformed to the state effect hypothesis,”…

People, nothing is static.  Most certainly not Depression.  I would also say Personality Traits are not as well, in that they are self-reported, already under weight of so much scrutiny, may show differences in cultural/gender/individual and many other areas.  These are just a few things.

Meds are not static either.  Tolerance, side effects.

So, just my opinion, here folks.  Not a professional in any manner, but I think this is completely bogus.

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