Antidepressants advice to be taken with a pinch of salt
http://www.indymedia.org.uk/en/2003/11/281795.html
"Seriously hazardous chemicals can be found in the tissue of nearly every person alive. It is a frightening thought, but exposure to such toxic substances has been linked to a higher incidence in several cancers, reproductive complications, a continuing decline in fertility rates and birth defects." - The Scotsman 2003.
Ref: "In sickness and in health: Chronic Fatigue"
Could antidepressants help those with ME after all, asks Dr James Le Fanu. Sunday
Telegraph 16/11/2003
Dr Le Fanu writes: "Chronic Fatigue, it has been alleged, is either a
psychological disorder such as hypochondriasis, or even a "malingerer's
charter", an unprovable pseudo-scientific diagnosis much favoured by the
indolent and work-shy." (1)
Firstly it should be pointed out that "Chronic Fatigue" and
"Myalgic Encephalomyelitis/Chronic Fatigue Syndrome" are classified
as different illnesses in the World Health Organisations International
Classification of Diseases. "Chronic Fatigue" is classified under
mental illness, whilst Myalgic Encephalomyelitis/Chronic Fatigue Syndrome is
classified under neurological disease (2), hence the apparent confusion created
by the terms "Chronic Fatigue" and "Chronic Fatigue
Syndrome" especially when used interchangeably ! It could therefore be
argued that Dr Le Fanus' article heavily relies on semantics to avoid
deliberately misinforming his readers.
The heart of the problem lies in the fact that ME/CFS is not an unprovable
pseudo-scientific diagnosis much favoured by the indolent and work-shy, and
treatable with SSRI antidepresants. Nor are we dealing with mere tiredness, as
experienced by low paid immigrant workers, or young single mothers living in
high rise council flats, as Le Fanu also suggests. (3) The association of which
will surely breed contempt from those readers with right wing ideologies
towards such subjects. More likely is the fact that "seriously hazardous
chemicals can be found in the tissue of nearly every person alive. It is a
frightening thought, but exposure to such toxic substances has been linked to a
higher incidence in several cancers, reproductive complications, a continuing
decline in fertility rates and birth defects." (4)
In a Testimony to the Flemish Parliament (Belgium), the well respected
international ME/CFS researcher, Professor Kenny De Meirleir explains:
"..During an attempt to describe what exactly is going on in the patients,
we discovered a subgroup. We discovered in about ten families with at least two
patients that someone had been exposed to pentachlorophenol (PCP). Fifteen to
twenty years later, all these people suffered from the Chronic Fatigue
Syndrome. Following PCP poisoning, we notice changes in the immune system that
increase the risk of infection. Therefore, there is a relationship between toxins
and the Chronic Fatigue Syndrome. Several publications have already shown that
zinc, cadmium, chromium, lead, mercury and nickel affect the immune system, so
that infections are no longer eliminated. In a family who have built their home
on a site where arsenic has been dumped in the past, we notice that the immune
system is similarly affected. This has already been shown in animal experiments
as well.
Then the connection between the Chronic Fatigue Syndrome and opportunistic
infections needs to be shown. We examined the incidence of chronic mycoplasma
infections in a group of 272 patients and found this to be 68.7 percent. In two
control groups the incidence was less than 10 percent. We find all kinds of
infections. In some people, two or even three infections occur and in 17
percent of cases we find multiple infections. There are 7 trigger factors that
may lead to the Chronic Fatigue Syndrome, specifically pregnancy, a number of
isotropic viruses, long-term stress, excessive physical activity, various
infections, transfusions, allergic reactions and heavy metals, phosphates and
PCBs. These factors also lead to a deterioration of immune system function. Once
a cellular dysfunction has appeared, infections occur that perpetuate a defect
in the immune system and make a return to the normal situation impossible. A
number of abnormalities develop which lead to the symptoms of the Chronic
Fatigue Syndrome, so that additional infections occur and cancer risk
increases.
In long-term cases of the Chronic Fatigue Syndrome, the incidence of cancer is
five times higher than normal. It is, therefore, possible to indirectly
implicate chemicals in cancer, especially in immune system disorders where P53
(the protective factor against cancer) disappears. If one has one or more
factors and gets an infection one cannot get rid of, one enters a vicious
circle that is very hard to break. In the 1984 Lake Tahoe epidemic, where 9
percent of the population develops the Chronic Fatigue Syndrome after
infections, the incidence of cancer is higher than normal. Certain lymphotropic
and brain cancers occur up to a million times more often in the American
population. There is a large statistical increase. This means that specific
cancers can develop, which in turn will be related to changes in the immune
system. Therefore, the Chronic Fatigue Syndrome can be explained. One of its
inducing factors can be found in the environment..." (5)
Here are just a few examples of the many articles about the link between ME/CFS
and Chemicals:
'A preliminary investigation of chlorinated hydrocarbons and chronic fatigue
syndrome' - (R H Dunstan et al - Med J Aust 1995; 163: 294-297)
'Chronic fatigue syndrome following a toxic exposure' Racciatti D. et al. - The
Science of The Total Environment Volume 270, Issues 1-3, Pages 27-31 April 10,
2001
'Four Cases of Pesticide Poisoning, Presenting as ME, Treated with a Choline
and Ascorbic Acid Mixture' John Richardson - J of CFS, Vol. 6 No. 2, 2000, pp.
11-21
'Three Babuska Clusters of Enteroviral Associated Myalgic Encephalomyelitis' -
Paper Presented by Byron Marshall Hyde M.D.: New South Wales, February 1998 -
The Nightingale Research Foundation: (quote:)
"..It should be remembered, that the period when polio virus claimed most
victims, and most increase in incidence in the United States, was the same
period when large scale introduction of the pesticide DDT came into
circulation. Obviously, this is just one of many stressors. Many environmental
stressors can decrease the circulating interferon and thus increase the risk of
individuals falling ill with a chronic viral infection. In neurotropic viruses
such as the enterovirus, there is evidence that the site of injury in some
cases may be the blood brain barrier of the small arterioles and capillaries of
the brain..."
Indeed Professor Malcolm Hooper of Sunderland University writes: "There is
convincing evidence that when combined with physical trauma, chemical or
biological insult, stress potentiates the condition and that the disorder may
be due in part to multiple chemical and / or biological exposures which have
been shown to increase the permeability of the blood brain barrier (BBB),
leading to a significant brain injury. Evidence of BBB breakdown in ME /
ICD-CFS was presented at the international conference held in London in April
1999: scientists in Israel have shown that severe stress (physical or mental)
can produce breakdown of the BBB; if that barrier is broken, small amounts of
substances which are normally outside the brain could produce brain injury. It
is postulated that in the case of ME / ICD-CFS, a person already under physical
or mental stress is exposed to an agent (viral or chemical) which crosses the
BBB, enters the brain, and produces long-term dysfunction." (6)
One of the world's leading exponents on ME/CFS, Dr Paul Cheney, Professor of
Medicine at Capital University; Medical Director of the Cheney Clinic, North
Carolina, warns us that drugs such as SSRIs "fry the brain" of ME/CFS
patients. SSRIs and stimulants work by increasing the firing of neurons. The
body views any neuron that fires excessively over time as damaged, and destroys
it (7). Therefore the suggestion patients be given SSRIs is highly
inappropriate.
Does this mean that Le Fanu is actively promoting potentially harmful
pharmaceuticals regardless of the consequences to individuals health ? Who
knows for sure ? But alas I personally don't think so given his highly
commendable and outspoken beliefs over the effects of the MMR jab in relation
to autism. (8)
I suggest the reason for Le Fanus' ignorance of ME/CFS can be found in his book
'The Rise and Fall of Modern Medicine' in which Le Fanu says: "The
environmentalist theory is invalidated by the biological necessity that the
human organism be resilient and not readily injured by minuscule levels of
pollutants in air and water." This argument may be true when applied to
naturally-occurring toxins, such as tannins. But today's humans are exposed to
a whole soup of artificial toxins that people were rarely or never exposed to
before in their evolutionary history. There is no reason to believe our biology
should be so resilient that it can even handle radically new toxins never
before encountered ! (9)
Thus, with the denial that environmental toxin cause so much damage to public
health, the gap in Le Fanus' knowledge is not merely unbridged, but in
principle unbridgable and subsequently his ignorance will remain ineluctable. Antidepressant-type
drugs such as SSRIs may well work for some forms of chronic fatigue, but the
detrimental effects of SSRIs on ME/CFS sufferers (myself included) and attested
to by so many patients as harmful, surely renders Le Fanu as intellectually
disconnected from the facts.
Sincerely,
Paul Lynch
References:
(1) 'In sickness and in health: Chronic Fatigue' by Dr James Le Fanu, Sunday
Telegraph. 16 November 2003.
http://www.telegraph.co.uk/health/main.jhtml?xml=/health/2003/11/17/hdoc16.xml&sSheet=/health/2003/11/17/ixhfeatures.html
(2) The Countess of Mar, House of Lords Debate 16 April 2002
http://www.meactionuk.org.uk/House_of_Lords_Debates_160402.htm
(3) Dr James Le Fanu, Telegraph. Saturday 18 July 1998.
http://www.in.nl/sites/me-cvs/E1998/CFS_ENGE.635
(4) 'Enough to make the blood boil' by James Reynolds, Environment
Correspondent, The Scotsman Fri 14 Nov 2003
http://www.news.scotsman.com/index.cfm?id=1257142003
(5) Testimony of Prof. Kenny De Meirleir in the Flemish Parliament. 6 June
2001.
http://listserv.nodak.edu/scripts/wa.exe?A2=ind0203d&L=co-cure&F=&S=&P=3931
(6) 'What is ME? What is CFS? - INFORMATION FOR CLINICIANS AND LAWYERS, by E.P.
Marshall, M. Williams, M. Hooper. December 2001
http://www.meactionuk.org.uk/What_Is_ME_What_Is_CFS.htm
(7) Cheney - Antidepressants & stimulants can fry your brain: eye
twitching. By Carol Sieverling. 30 December 2000
http://www.cfsresearch.org/cfs/cheney/24nf.htm
(8) 'When friends ask should children be immunised, my answer is no' Dr James
Le Fanu, Telegraph. 21 January 2001.
http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2001/01/21/nmmr221.xml
(9) Book Review: James Le Fanu, 'The Rise and Fall of Modern Medicine', Carroll & Graf, New York, 2000. Review by Jeffrey Shallit Department of Computer Science University of Waterloo, Waterloo, Ontario, Canada, N2L 3G1.
http://www.math.uwaterloo.ca/~shallit/lefanu.html
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Related article - http://www.indymedia.org.uk/en/2003/11/280430.html