Prof. Dr. Tarhan said, "It is an extremely mental distortion to bill antidepressants for situations that arise as a result of misuse."
Üsküdar University Rector, Psychiatrist Prof. Dr. Nevzat Tarhan made statements regarding the recent debates in the media about the use of antidepressants.
Depression is a serious disease
Prof. Dr. Nevzat Tarhan said, "Depression is increasing all over the world, this is a known fact," and added, "The World Health Organization warns that it will be the world's most important health problem in 2020 if no measures are taken. Depression causes loss of sensation. The disease does not cause death, but it makes people unable to work. It disrupts the functionality of the person, makes them dysfunctional. Therefore, it carries a much greater risk.
There is a distortion of information in the recent discussions. There is a saying: 'The most dangerous lie is an exaggerated truth'. It is correct to say that antidepressants are used like bread and cheese. Saying that my aunt's son died because of antidepressants is speaking without evidence. There is a situation that does not befit a scientist. What is said needs to be based on evidence. If 99 studies give a positive result and one study does not match this result, taking that study and presenting it as conclusive evidence distorts perceptions. Just like saying sugar syrup is as harmful as cocaine. " he said.
Prof. Dr. Nevzat Tarhan stated that antidepressant drugs undergo very detailed examinations and researches before they are put on the market, and that studies to determine the level of drug evidence last for years: "Before antidepressants are released, first phase studies are conducted, even pre-phase studies are conducted. Then animal experiments are conducted. After animal experiments, they are tested on healthy volunteers. This is not enough, they are tested on sick volunteers. After these are tested, the third phase is started. After that, the effect of the drug is checked while it is being used in the market. All these phases of a drug take 15-20 years. During this process, there are some publications, there are 95 positive publications on this subject, if there are 5 negative publications, it is an extremely erroneous point of view to take that 5 information and replace it with 95 information."
The level of evidence for antidepressants is determined by studies lasting for years
Stating that the level of evidence for antidepressant drugs is also determined in various stages, Prof. Dr. Tarhan said, "There is evidence at the first lower level. There are clinical cases, they say I used this drug, it was good for this person, everyone publishes it. Then this becomes a clinical series and is applied on dozens of people, which is not enough. Then clinical trials are conducted: Open-scale, placebo-controlled two-way studies. These studies check whether this drug, substance or herb works or not. If the results are positive, larger studies are conducted on a larger scale. After that, meta-analyses are formed, with 4 thousand people. It is now said that the level of evidence has increased," he said.
Generalizing is extremely inconvenient
Stating that antidepressants emerged 30-40 years ago, Prof. Dr. Nevzat Tarhan said, "Antidepressants are used in vain. It is not true to say that antidepressants do not work. There is a lie here that we can call exaggerated truth. It is extremely inconvenient to generalize based on a few sample cases.
Antidepressant use should be personalized
Prof. Dr. Nevzat Tarhan also drew attention to the mistake of using antidepressants on the advice of friends without a doctor's recommendation and emphasized the importance of personalized treatment. Prof. Dr. Tarhan said the following: "Depression is a brain disease. Depression is a disease related to the disruption of chemical transmission in the brain, this is not only about serotonin. Nearly 10 chemicals are held responsible. If one of them is absent, neuroadrenaline becomes neurotransmitter, dopamine becomes dopamine, endorphins become endorphins. Many chemicals play a role in the brain. For this reason, personalized medicine is now being emphasized. It is called Precision Medicine. They are trying to find the perfect medicine. Personalized treatment, according to the individual needs of that person, we make a genetic profile. According to the genetic profile, we try to determine the most accurate, the most appropriate, the right dose, the right drug, the right duration."
You cannot bill antidepressants for the consequences of misuse
Prof. Dr. Nevzat Tarhan emphasized that life-threatening side effects can occur if drugs are taken randomly on the advice of acquaintances without doing these, and said, "Serotonins in the brain of a person who takes three antidepressants together increase excessively, and the person may enter mania. The person may start to have thoughts of death. The person may have suicidal thoughts. These are all related to the misuse of antidepressants. Not with the use of antidepressants. Blaming antidepressants for the conditions that occur as a result of misuse is an extremely mental distortion. It is an extremely wrong behavior. It is a situation that will affect the society in the wrong way. Antidepressants are drugs like chemical weapons, they are produced to destroy the disease. If this weapon is misused, if it is used randomly, of course there will be a price. For this reason, the random use of drugs at home is seriously risky and dangerous."
Should be used under doctor control
Pointing out that antidepressant drugs should be discontinued under the supervision of a doctor, Prof. Dr. Nevzat Tarhan said, "As physicians, there are cross methods in drug discontinuation according to the type of drug. A substitute drug is put in its place, while one is reduced, the other is increased. This is usually the most commonly used method. This is given according to the individual needs of the person, according to the needs of the body, according to the side effects. What he/she will gain or lose if he/she takes the medicine, what he/she will gain or lose if he/she does not take it. If the risk is higher than if the person does not take it, risk management is carried out. Those risks are monitored. Therefore, medications should be stopped gradually. If the drugs are stopped suddenly, other side effects such as rebound effect, which we call rebound effect, occur. After all, these drugs are like knives. If used well, they cut bread, if used incorrectly, they injure a man."