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Suicidality and aggression during antidepressant treatment: systematic review and meta-analyses based on clinical study reports

BMJ 2016; 352 doi: https://doi.org/10.1136/bmj.i65 (Published 27 January 2016) Cite this as: BMJ 2016;352:i65

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Re: Suicidality and aggression during antidepressant treatment: systematic review and meta-analyses based on clinical study reports

Antidepressants block flexible but often nutrient deficient amine pathways

It is not surprising that selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) double the risk of aggression and suicidality in children and adolescents.1 Results of epidemiological trials with adults would be more likely to be confounded by use of contraceptive progestogens, smoking the usefulness and alcohol.

What is surprising is the continuing disregard of biochemical investigations needed to diagnose and treat common neuro-biochemical perturbations. Essential nutrient deficiencies, of zinc, copper, magnesium, B vitamins and polyunsaturated fatty acids prevent normal flexibility of amine pathways and increase adverse reactions to foods and chemicals.2 Stress also lowers zinc levels.

Contraceptive progestogens increase monoamine oxidase activities in the endometrium, and also in platelets and brain, matching the incidence of depression with different doses of hormonal contraceptives.3-5 In contrast, low platelet monoamine oxidase activities are found in migraine attacks and schizophrenia.6-7 Blocking indolamine and catecholamine metabolic pathways prevents the biochemical flexibility needed for physical and mental health.

Use of higher potency progestogens has also resulted in more depression and obesity. In a Swedish study of a million women, progestogen-only takers in all age groups had increased risks for antidepressant use with the highest risk in 16-19 year olds. Combined hormonal contraceptives also increased antidepressants use in 16-19 year-olds.8

www.harmfromhormones.co.uk

1 Sharma T, Guski LS, Freund N, Gøtzsche P C. Suicidality and aggression during antidepressant treatment: systematic review and meta-analyses based on clinical study reports. BMJ 2016;352:i65

2 Grant ECG. The pill, hormone replacement therapy, vascular and mood over-reactivity and mineral imbalance. J Nutr Environ Med 1998:8:789-91. DOI:10.1080/13590849862131

3 Grant ECG, Pryse Davies J. Effect of oral contraceptives on depressive mood changes and on endometrial monoamine oxidase and phosphatases. BMJ 1968;3:777-80.

4 Southgate J, Grant ECG, Pollard W, Pryse Davies J, Sandler M. Cyclical variations in endometrial monoamine oxidase: Correlations of histochemical and quantitative biochemical assays. Biochemical Pharmacology 1968;17:21-26

5 Robinson DS, Davies JM, Nies A, Ravaris CL, Sylwester D. Relation of Sex and Aging to Monoamine Oxidase Activity of Human Brain, Plasma, and Platelets. Arch Gen Psychiatry 1971;24(6):536-539.
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6 Glover V, Sandler M, Grant ECG, Rose FC, Orton D, Wilkinson M. Transient decreases in platelet monoamine oxidase activity during migraine attacks. Lancet 1977;309:391-93.

7 Grant ECG. Allergies, smoking and the contraceptive pill. In Biological aspects of Schizophrenia and Addiction. 1982 Ed G. Hemmings, John Wiley & Sons Ltd, New York pp263-272.

8 Wiréhn AB, Foldemo A, Josefsson A, Lindberg M. Use of hormonal contraceptives in relation to antidepressant therapy: A nationwide population-based study. Eur J Contracept Reprod Health Care 2010;15:41-.

Competing interests: No competing interests

03 February 2016
Ellen C G Grant
Physician and medical gynaecologist
Retired
Kingston-upon-Thames, KT2 7JU, UK