SSRIs can give you digestive problems… and make you MORE depressed

Another hat-tip to the Truthman for this story from the Daily Mail.

As I’ve said before, the truth is slowly drip, drip, dripping out – one day I’m sure my children will be appalled that so many prescriptions were written for drugs like Seroxat that turned out to be so harmful to so many patients, much like the Thalidomide and Benzo scandals of the past.

What compounds matters for me is the role of the drug companies, like GlaxoSmithKline, that continued to aggressively market Seroxat, even when company insiders knew the drug was defective, dangerous and ineffective.

There was money  to be made and GSK wasn’t going let anything like negative trial results get in the way of profit. Especially not when Key Opinion Leaders could be relied on to say whatever a drug company told them to say – providing the KOLs were paid enough.

Anyway, I’ll get off my soapbox now and let you read the article from the Daily Mail:

Depression levels in Britain continue to spiral.

Last year alone, more than 43 million prescriptions for antidepressants were handed out — 25 per cent more than three years before.

But are antidepressants the panacea we hope them to be?

Drugs such as Prozac [and Seroxat] were hailed in the early Nineties as wonder pills that would banish depressive blues for good.

But in the past five years, growing scientific evidence has shown these drugs work for only a minority of people.

And now controversial research in a respected journal claims that these antidepressants can make many patients’ depression worse.

This alarming suggestion centres on the very chemical that is targeted by antidepressants — serotonin.

Drugs such as Prozac [and Seroxat] are known as selective serotonin reuptake inhibitors (or SSRIs).

Their aim is to boost the level of this ‘feel-good’ chemical in the brain.

But the new research, published in the journal Frontiers In Evolutionary Psychology, points out that serotonin is like a chemical Swiss Army knife, performing a very wide range of jobs in the brain and body.

And when we start deliberately altering serotonin levels, it may cause a wide range of unwanted effects.

These can include digestive problems, sexual difficulties and even strokes and premature deaths in older people, according to the study’s lead researcher Paul Andrews. 

‘We need to be much more cautious about the widespread use of these drugs,’ says Andrews, an assistant professor of evolutionary psychology at McMaster University in Ontario, Canada.

Previous research has suggested that the drugs provide little benefit for most people with mild and moderate depression, and actively help only a few of the most severely depressed.

Eminent psychologist Irving Kirsch has found that for many patients, SSRIs are no more effective than a placebo pill.

Two years ago, the Canadian Medical Association Journal reported a 68 per cent increase in risk of miscarriage in women on antidepressants.

Drugs such as Prozac [and Seroxat] are known as selective serotonin reuptake inhibitors (or SSRIs). Their aim is to boost the level of this ‘feel-good’ chemical in the brain

And research in 2009 on Danish children found a small, but significant, increase in the risk of heart defects among babies whose mothers had used SSRIs in early pregnancy.

There is also growing evidence that long-term use in adults is linked to bleeding in the gut and increased risk of stroke.

The key to understanding these side-effects is serotonin, says Andrews. Serotonin is also the reason why patients can often end up feeling still more depressed after they have finished a course of SSRI drugs.

He argues that SSRI antidepressants interfere with the brain, leaving the patient vulnerable to a ‘rebound’ depression of even greater intensity than before.

‘After prolonged use [when a patient stops taking SSRIs], the brain compensates by lowering its levels of serotonin production,’ he says, adding that it also changes the way receptors in the brain respond to serotonin, making the brain less sensitive to the chemical.

These changes are believed to be temporary, but studies indicate that the effects may linger for up to two years.

Relapsing is not exclusive to SSRI drugs — it is, in fact, seen in all the classes of antidepressant medications — but Andrews believes that the risk is particularly strong with SSRI drugs.

Moreover, he warns that antidepressants can disrupt all the physical processes that are normally regulated by serotonin, adding that animal studies show only about 5  per cent of the body’s serotonin resides in the brain. Most is housed in the gut.

It is used, among other things, to control digestion, form blood clots at wound sites, and regulate reproduction and growth.

So a drug that interferes with serotonin may cause developmental problems in infants, problems with sexual stimulation and sperm development in adults, digestive problems such as constipation, diarrhoea, indigestion and bloating, and abnormal bleeding and stroke in the elderly.

The drugs may also raise the risk of dementia.

Most disturbingly of all, Andrews’ review features three recent studies which, he says, show that elderly antidepressant users are more likely to die prematurely than non-users, even  after taking other important variables into account.

One study, published in the British Medical Journal last year, found patients given SSRIs were more than 4 per cent more likely to die in the next year than those not on the drugs.

‘Serotonin is an ancient chemical,’ says Andrews.

‘It is intimately regulating  many different processes, and when you interfere with these things, you can expect that it is going to cause some harm.’

Stafford Lightman, professor of medicine at the University of Bristol, and a leading UK expert in brain chemicals and hormones, says Andrews’ review highlights some important problems, yet it should also be taken with a pinch of salt.

‘This report is doing the opposite of what drug companies do,’ he says.

‘While drug companies selectively present all the positives in their research, this selectively presents all the negatives that can be found.

Both approaches are simplistic. And while SSRIs might possibly cause rebound depression, it is also sadly natural to expect that people with severe depression will see their illness come back, and often in a worse state.

‘Nevertheless, the study is useful in that it is always worth pointing out that there is a downside to any medicine.’

Professor Lightman adds that there is still a great deal we don’t know about SSRIs — not least what they actually do in our brains.

‘It’s a bit embarrassing, but the bottom line is that we don’t really know how they work,’ he says.

‘Basically, we started using these drugs before we understood what they do, because they showed some effectiveness.’

When it comes to understanding why the drugs work only for a limited proportion of patients, U.S. scientists think they might now have the answer.

They think that in many clinically depressed patients, it’s not only the lack of feel-good serotonin causing their depression, but also a failure in the area of the brain that produces new cells throughout our lives.

This area, the hippocampus, is also responsible for regulating mood and memory. Research suggests that in patients whose hippocampus has lost the ability to produce new cells, SSRIs do not bring any benefit.

But why the hippocampus should do this — and how it should be treated — is not clear.

And even if those answers were found, they might still not produce a cure for many cases of depression, because the condition varies so widely in its causes and is so little understood.

What should be sure is that the days of doctors habitually prescribing SSRIs to all and sundry on the basis that they might work, and won’t do any harm anyway, really should be behind us.

GlaxoSmithKline avoided £34m tax in 2011

GlaxoSmithKline, what a bunch of…

Drugs giant GlaxoSmithKline avoided up to £34m in UK corporation tax last year through a deal with Luxembourg, according to an investigation by the BBC.

The UK firm set up a new company in the European tax haven in 2009 and the next year the subsidiary lent the parent £6.34bn.

In return, the UK firm paid nearly £124m in interest back to the Luxembourg unit – meaning it did not have to pay British corporation tax of 28 per cent on the money.

The Luxembourg tax authorities charged a levy of less than 0.5 per cent – costing GSK just over £300,000, according to Panorama. ‘As a result, GSK potentially avoided up to £34m in UK corporation tax,’ the BBC claimed.

Chancellor George Osborne is trying to crack down on tax avoidance in the UK by major corporations and wealthy individuals. Tax avoidance by big business is reckoned to cost between £1.5bn and £6bn a year.

Former HMRC investigator Richard Brooks said: ‘We’re seeing…exactly how companies avoid tax through a jurisdiction that wants to help them do it.’

GSK struck a deal with HMRC in 2011 and closed down the £6.34bn loan operation through Luxembourg.

Tax expert Richard Murphy said the scheme was ‘absolutely, without a shadow of a doubt, legal’. But he added: ‘I’m still able to ask the question, is this acceptable?

‘Look, this is purely artificial structuring which is designed to undermine the tax revenues of the UK.’

Thanks to Truthman for the story.

Can you really believe they said this – 2012 reprise

They say hindsight is 20/20 vision.

Well, here are a bunch of quotes I’ve posted over the years for you to consider with the gift of hindsight.

 

It’s not possible really to measure total serotonin. We do not know with absolute certainty about how any of the antidepressants work. 
Alan Metz 
Glaxo Vice President for Clinical Development
source: Generation RX

No, we are not misleading them [patients]. The information in the patient leaflet and in the information we supply to doctors, is based on fact. 
Dr. Alastair Benbow 
Head of European Psychiatry for GlaxoSmithKline
10/13/02

….there have been a number of systematic studies in humans looking at the potential for Paxil for abuse, tolerance and physical dependence. So actually, there is data to date to negate the statement that it has not been systematically studied, because, in fact, it has been. 
Dr. David Wheadon 
Senior Vice President
GlaxoSmithKline Regulatory Affairs and Product Professional Services
10/19/2000

Physical and Psychologic Dependence: PAXIL has NOT been systematically studied in animals or humans for its potential for abuse, tolerance or physical dependence. While the clinical trials did not reveal any tendency for any drug-seeking behavior, these observations were not systematic…
GSK Patient Information Leaflet

If ‘discontinuation reactions’ occur in patients stopping [Paxil], the majority will experience symptoms that are mild to moderate in intensity, and are usually limited to two weeks. 
Mary Anne Rhyne 
GlaxoSmithKline spokesperson
2005

Drugs like Seroxat [Paxil] have been around for almost a decade and help millions of people fight depression. There’s no reliable scientific evidence to show they cause withdrawal symptoms or dependency. 
Alan Chandler 
GlaxoSmithKline spokesperson

These problems [’discontinuation reactions’] are just the body’s adjustment when you stop taking medicines. It takes more than that to be addictive. 
Mary Anne Rhyne 
GlaxoSmithKline spokesperson
8/21/2002

The side effects [of Paxil “discontinuance”] are things like dizziness, nausea, headache, um, and are clearly labeled in the information made available to doctors and patients. 
Dr. Alastair Benbow 
GlaxoSmithKline’s European Medical Director
Source: GSK’s web site 2004

I think patients have nothing to fear from taking Seroxat. 
Dr. Alastair Benbow
GlaxoSmithKline’s European Medical Director
6/13/2002

Experts including the FDA and leading physician and mental health organizations agree that antidepressant medications like Paxil are non-habit-forming. 
David Stout President
US Pharmaceuticals
GlaxoSmithKline
10/10/2002

It was quite clear from talking to patients and as a doctor that’s very, very important to me, it’s quite clear that the phrase “Seroxat is not addictive” was poorly understood by them. 
Dr. Alastair Benbow 
Head of European Psychiatry for GlaxoSmithKline
5/11/03

I think you have to develop a culture where if there is bad news you don’t sit on bad news. Bad news does not get any better. It can only get better if it’s admitted, understood and addressed.
Robert (Bob) Ingram
Vice Chairman, GlaxoSmithKline Pharmaceuticals
8/25/2002

We’re reviewing every single process at the company. The environment of the business has changed after Enron. I believe that there was a lack of trust [on the part of] the public for big business, and that lack of trust has been amplified by a few bad apples in the cart. And because of that, there has been a tremendous loss of trust in all big business not just pharma and that has implications to me as a CEO.
Jean-Pierre Garnier
Chief Executive Officer, GlaxoSmithKline
10/4/2004

Obviously doctors are very busy people, and their day is packed with patients. The question is how do doctors get information about medicines and new research into treatments and disease, and one of the easiest ways is this kind of presentation [”dine and dash”]. We think this is a benefit to both physicians and patients.”
Mary Ann Rhyne
GlaxoSmithKline spokesperson
11/11/2002

We don’t want to be accused of anything about the way we deal with trials.
Jean-Pierre Garnier
Chief Executive Officer, GlaxoSmithKline
6/21/2004

As a knowledge-based industry we understand full well the value of information, and we want to create a climate of openness where the evidence for prescribing our products is clear.
Richard Sykes
Chairman of Glaxo Wellcome
6/19/2004

I think if, if we’ve been guilty of anything over the past few years, perhaps, um, emphasizing entertainment over education, um, we know that’s what patients really want.
Christopher Viehbacher
GlaxoSmithKline U.S. President
8/16/05

Seroxat does have side effects, but these are clearly stated in the information that’s made available to doctors and to patients.
Dr. Alastair Benbow
Head of European Psychiatry for GlaxoSmithKline
10/13/02

My wife thinks J.P. [Garnier] is the best thing since sliced bread. 
Christopher Viehbacher
GlaxoSmithKline U.S. President
7/21/03

We are a high-integrity company. We know what the rules are and we follow them.
Jean-Pierre Garnier
Chief Executive Officer, GlaxoSmithKline
6/6/2004

The vast majority of drugs more than 90 per cent only work in 30 or 50 per cent of the people, I wouldn’t say that most drugs don’t work. I would say that most drugs work in 30 to 50 per cent of people. Drugs out there on the market work, but they don’t work in everybody. 
Dr. Allen Roses 
GlaxoSmithKline Senior V.P.
Genetics Research
12/8/2003

If anyone thought drugs were without side-effects, hopefully that’s over. All drugs have side-effects. We are having to spend hundreds of millions of dollars on lawyers.
Jean-Pierre Garnier 
Chief Executive Officer
GlaxoSmithKline
4/23/2005

We follow the law, and we follow government guidelines. 
Mary Anne Rhyne 
GlaxoSmithKline spokesperson
8/26/2005

This is a company that is reinventing itself … possibly creating a model for pharma companies. 
Jean-Pierre Garnier 
Chief Executive Officer
GlaxoSmithKline
7/21/03

The evidence, however, is clear, these medicines are not linked with suicide, these medicines are not linked with an increased rate of self harm. 
Dr. Alastair Benbow 
GlaxoSmithKline’s European Medical Director
10/3/2004

So we always want to make sure we are serving the good, the right purpose…. 
Dr. David Wheadon 
Senior Vice President
GlaxoSmithKline Regulatory Affairs and Product Professional Services
9/9/2004

I’ll be a hero in three years. 
Jean-Pierre Garnier 
Chief Executive Officer GlaxoSmithKline
4/5/2004

I am sure it happens because academics are very, very busy people, and they prefer to do research than spend a lot of time writing papers. If the industry puts forward a method of relieving them of that chore, then I am sure that that does happen throughout the industry. That would be true generally. Is it a good idea? I think it can be, as long as everybody is in agreement with what is written at the end of the day, the results and what they are. 
Sir Richard Sykes 
former Chairman of GlaxoSmithKline
On the industry practice of “ghostwriting medical reports” and “gift authorship.” 12/7/2004

We have acted responsibly in conducting clinical studies in pediatric patients and the dissemination of the results. We would strongly disagree with any allegation that we have done otherwise. 
Dr. Tadataka Yamada 
Chairman of Research and Development
GlaxoSmithKline
6/19/2004

You can experience symptoms, as you can with other SSRIs and as you can with other kinds of medicines as well. 
Mary Anne Rhyne
GlaxoSmithKline spokesperson
12/13/2003

What we have seen in terms of the anecdotal reports [of Paxil withdrawal] is that it happens very rarely. 
Dr. David Wheadon 
Senior Vice President
GlaxoSmithKline Regulatory Affairs and Product Professional Services
8/25/2000

While GlaxoSmithKline strives to produce medications that safely and effectively treat medical conditions, we’re also committed to protecting the environment. 
Dr. Anne Phillips 
Chief Medical Officer of GlaxoSmithKline
source: GlaxoSmithKline

As you can see here, few numbers of patients experienced any adverse event after being randomized off [Paxil] into the placebo group and the percentages are certainly very small. But these were the common adverse events seen in that small population in our attempt to systematically assess a discontinuation syndrome. 
Dr. David Wheadon 
Senior Vice President
GlaxoSmithKline Regulatory Affairs and Product Professional Services Excerpt from a transcript of the FDA Review of Paxil
10/5/1992

I have my iPod and my Bose headphones. You can run anywhere. I’m in a bubble. When I go home I don’t talk about my job. It drives my wife crazy because when we go out she doesn’t know anybody. Socially we see politicians we have to and she knows nothing about the issues. But that’s the way I like it. I want to go home and say, ‘hey what happened to you?’ I have a very demanding job and I don’t want to go home and discuss the same stories. 
Jean-Pierre Garnier 
Chief Executive Officer
GlaxoSmithKline
4/23/2005

We feel strongly that we have an obligation to speak up both for the millions of patients that Seroxat allows to lead a normal life, and for our employees whose commitment to this important medicine has made such a positive difference to so many people. 
Eddie Gray 
General Manager
GlaxoSmithKline UK
10/10/2002

My mum, you know, she thinks her son walks on water….. 
Jean-Pierre Garnier
Chief Executive Officer, GlaxoSmithKline
4/23/2005

….recognize that in the final analysis success rests on selecting the right people to work with. If you have the right people, the rest will follow. 
Jan Leschly 
Former CEO of SmithKline Beecham

It’s becoming too easy for many people to attack the pharma industry and hold the pharma industry to standards that are higher than anywhere else. I don’t have a problem with the standards….

Jean-Pierre Garnier 
Chief Executive Officer
GlaxoSmithKline
6/6/2004

Of course we didn’t follow this advice. Of course we didn’t selectively publicize the data. This is not a smoking gun. It’s a stupid memo and there are lots of stupid memos in every company’s file and it is really unfair to look at the company’s action through the small hole of one memo written among thousands and thousands in 1998. I do regret that those memos exist but I’m not going to lose sleep over the fact.
Jean-Pierre Garnier 
Chief Executive Officer
GlaxoSmithKline
6/6/2004

I utterly refute any allegations we are sitting on data, that [we] have withheld data or anything like that. We have provided all the data both relating to safety and efficacy in the pediatric population to the regulatory authorities around the world and have hidden nothing.
Dr. Alastair Benbow 
Head of European Psychiatry for GlaxoSmithKline
6/15/2003

Corporate responsibility is not just a job for selected people at GSK, it defines the way we do business. Our ten corporate responsibility principles set thestandard for everyone, since responsible business is only a reality if it is practised by all employees at all times. 
Christopher Gent
GlaxoSmithKline Chaiman
Jean-Pierre Garnier
GlaxoSmithKline CEO
GlaxoSmithKline 2004 “Corporate Responsibility Report”

The overwhelming view of independent medical experts and regulatory bodies around the world who have seen the data, is that Seroxat has a well established safety profile and is an effective treatment with experience in tens of millions of patients worldwide since launch in the UK over ten years ago. 
Dr. Alastair Benbow
Head of European Psychiatry for GlaxoSmithKline 10/10/2002

Human behavior is we know so little about it, and therefore, to try to speculate on a mechanism for human behavior is very difficult. 
Dr. Tadataka Yamada 
Chairman of Research and Development GlaxoSmithKline 1/24/2001

Sometimes a system indeed hinders your rise up the ladder but you also have to accept personal responsibility. That translates into realizing that it’s not always someone else’s fault that you didn’t get promoted. You have to ask some serious questions of yourself before you point the finger at someone else. Ask yourself, `What have I done?’ ‘What is my role in this?’ ‘What am I willing to do?’ 
Dr. David Wheadon 
Senior Vice President
GlaxoSmithKline Regulatory Affairs and Product Professional Services
10/26-27/1995

If we meet the test of our highest purpose nothing less than making historic contributions to human welfare then we will surely meet our important responsibilities to other GlaxoSmithKline stakeholders, to the investors who put their trust in our performance, to the communities in which we operate, to our colleagues and to ourselves. 
Dr. Tadataka Yamada 
Chairman of Research and Development
GlaxoSmithKline from GSK’s web site

We are all in favour of this being scrutinized all the time, because it is not in our interests to have a product on the market that is not safe or effective. 
Jean-Pierre Garnier 
Chief Executive Officer
GlaxoSmithKline 2/15/2002

I think fundamentally the public needs to be reassured that multinational companies and globalisation are not bad quite the reverse. 
Jean-Pierre Garnier
Chief Executive Officer
GlaxoSmithKline
2/18/2003

We take the safety of our medicines extremely seriously…. 
Dr. Alastair Benbow
GlaxoSmithKline’s European Medical Director
Source: GSK’s web site 2004

First of all let me say that we, as a manufacturer of pharmaceutical products and vaccines, take any report of an adverse event on any of our products, seriously. 
Dr. David Wheadon 
Senior Vice President
GlaxoSmithKline Regulatory Affairs and Product Professional Services
1/31/2001

Great [GSK] products, however, are not the whole story society expects companies to act responsibly in their pursuit of success. If anything, the fact that our business is about human health makes it even more important that we operate to the highest standards.
Christopher Gent
GlaxoSmithKline Chaiman
Jean-Pierre Garnier
GlaxoSmithKline CEO
GlaxoSmithKline 2004 “Corporate Responsibility Report”

I think to focus on safety is important.
Dr. Tadataka Yamada
Chairman of Research and Development
GlaxoSmithKline
3/01/05

….my experience is that most physicians don’t look at the [a drug safety] label very carefully. And I’m not certain. I personally am not certain whether it would make a difference whether something was in a black box or in a warning section or in a precaution section….
Dr. Tadataka Yamada
Chairman of Research and Development
GlaxoSmithKline
1/24/2001

Responsible business practices are also the key to a good reputation. In 2004, the pharmaceutical industry and GSK continued to come under public scrutiny on how medicines are developed, tested and marketed. To meet this challenge we must act with integrity and be open about our approach to these important issues.
Christopher Gent
GlaxoSmithKline Chaiman
Jean-Pierre Garnier
GlaxoSmithKline CEO
GlaxoSmithKline 2004 “Corporate Responsibility Report”

Our concern is people’s safety.
Jean-Pierre Garnier
Chief Executive Officer, GlaxoSmithKline
3/1/2003

Anybody who suffers side effects of any sort I feel every sympathy for….
Dr. Alastair Benbow
Head of European Psychiatry for GlaxoSmithKline
5/11/03

Everybody who has looked at this the FDA, American Psychiatric Association, National Mental Health Association all those groups agree that SSRIs, like Paxil, are not addicting and not habit forming.
Andrew T. Bayman
attorney for GlaxoSmithKline
King & Spalding

GSK strongly stands behind the safety and efficacy of Paxil. Physician organizations, like the American Psychiatric Association, have stated that antidepressants are not habit-forming.
David Stout
President of U.S. Pharmaceuticals, GlaxoSmithKline

GlaxoSmithKline is proud to offer physicians Paxil CR the latest treatment advance in the SSRI class.
David Stout
President, US Pharmaceuticals, GlaxoSmithKline
4/19/2002

We missed something big we missed the fact that the public wasn’t going to necessarily trust us.
Jean-Pierre Garnier
Chief Executive Officer, GlaxoSmithKline
8/13/2005

 

Family double death horror

I’ve just seen this terrible story in the Daily Mirror:

A father is believed to have returned home yesterday evening to find his two young children murdered and his wife with her wrists slit.

Emergency services were called to the home in Wandsworth, south west London, but the 10-week-old baby boy and one-year-old girl were pronounced dead at the scene.

A post mortem is due to take place today although reports have suggested the children showed no signs of injury and may have been smothered.

A woman in her mid-30s, believed to be the man’s wife, was arrested over the deaths and is being questioned by detectives today.

She is understood to have self-harmed but did not require hospital treatment.

Police are believed to be investigating the possibility that the mother was suffering from post-natal depression.

In cases like this, I believe one of the first things to establish is what (if anything) the woman was being treated with for her depression…

The authorities simply must start to take notice about this issue and the public deserves to know if there is a connection between acts of extreme violence and drug treatment – I believe that antidepressants can cause extreme violence.

All too often in the past, it seemed that the only other people in the world who would ever begin to entertain the possibility were people such as Michael Moore and Dr Peter Breggin in the USA – and in England David Healy, Andrew Herxheimer and David B. Menkes, who co-authored a paper on the subject in 2006 – Antidepressants and Violence: Problems at the Interface of Medicine and Law.

If you want more information, then you can read follow up with these links (or just type ‘Violence’ in the search box on the left of your screen:

What made Raoul Moat do it

Nebraska shooting – antidepressant connection yet again?

Lost in translation – were Anti-Depressants Involved In Finland School Massacre?

A brief history of school shootings

The Finland Massacre

SSRI stories

Antidepressants and violence

As I’ve said, there has to be a proper investigation into this issue – and I believe that the drug companies (such as Glaxo) know the problem exists, but have done nothing about it as it would have affected their profits.

 

Glaxo – a simple challenge for you…

It’s been a while since I wrote anything as I’ve been very busy with my day job.

Happily, others have continued to write – I’ve just read a post over at Seroxat Suffers about Glaxo in New Zealand and the Patient Information Leaflet that comes with Aropax (Seroxat).

According to Glaxo (only in New Zealand, though):

Depression is longer lasting or more severe than the low moods that everyone has from time to time. It is thought to be caused by a chemical imbalance in parts of the brain.

AROPAX corrects the chemical imbalance and so helps relieve the symptoms of depression.

Sorry, but I have to throw the gauntlet down to Glaxo on this one… I think in 2012 it’s fair to say that the chemical imbalance story has been discredited completely.

But, Glaxo, if you can tell me what the correct level of Serotonin is in a human brain, then I’ll listen.

If you can measure how much Serotonin I currently have in my brain, then I’ll listen.

If you can then demonstrate how much 20mgs of Seroxat will raise my brain serotonin level by, then I’ll listen.

But the problem is that Glaxo can’t do any of those – the idea of a ‘chemical imbalance’ causing depression – and even the term ‘SSRI’ – was invented by marketing and PR companies, simply to sell a drug.

To use a technical term, it’s complete bollocks.