Wednesday, April 3, 2013

Is Dr. Oz Reliable? You Decide

On Dr. Oz's show today, Oz sounded an alarm about the misuse of anti-depressants by primary care doctors for treating their patients' depression and the off-label use for other psychological illnesses, such as anxiety and insomnia.  He explicitly made the statement that no patient should be prescribed an anti-depressant by anyone other than a psychiatrist. He made that point emphatically. (By the way, I actually agree with him on this one  However, because I find that psychiatrists are often quick to prescribe, I prefer to send a patient first to a psychologist for a proper evaluation.)

To quote his own blog, "On today’s show, we’re addressing the growing problem of the over-prescription of antidepressants in our health-care system. In order to treat common medical conditions, many physicians have resorted to unnecessarily prescribing medications to patients who don’t need them. We’ve already seen this issue with pain medications and antibiotics. Not only does it cost a lot of money, it carries risks as well."

Oz goes on to write in regards to the fact that most anti-depressant prescriptions are written without a psychiatric diagnosis that, "This can lead to dangerous results. Recently published research suggests that antidepressants may make one more prone to depression later in life. They also may increase your risk of suicide. In 2004, the FDA required a label on antidepressants, warning of the risk of increased suicidal thinking and behavior among children and adolescents who take antidepressants.

He adds, "There’s also research that suggests that antidepressants may not even work at all. Most antidepressants work by increasing levels of serotonin in the brain. However, there’s very little evidence that shows that depression is caused by a serotonin imbalance alone. Usually, there are other psychosocial or medical factors that play a factor in someone’s depression."

So to be clear, Oz is saying that raising serotonin levels in the brain may have nothing to do with treating depression as there is scarce evidence, according to him, to support that conclusion.

So why is Oz a hypocrite you may ask? I'll let you be the judge.

Two weeks ago, the Dr. Oz show featured a trio of practitioners, two MDs, and one naturopath declaring the great value of using a compound called 5-HTP to treat depression among other disorders.  5-HTP is an over the counter, virtually unregulated dietary supplement that has had no major clinical trials to support its effective, safe, and long-term use in depression. In fact, a number of organizations warn against its use for any indication, such as weight loss.

I can't make this stuff up. Here's Oz's own website material.

A Q&A posted on his website.

Can 5-HTP be used to treat depression? 5-HTP is typically used to treat mild depression based on the theory that as a precursor to serotonin, a neurotransmitter that has a calming effect, these supplements can increase serotonin levels and influence mood, sleep patterns and pain control. 5-HTP effectively increases the central nervous system (CNS) synthesis of serotonin. Serotonin levels have been implicated in depression, anxiety, pain sensation, and sleep regulation.   

Here's a quote from his blog.

"5-HTP is a chemical compound that is naturally produced in your body as it makes serotonin, an important hormone for regulating your mood...In addition to suppressing your appetite, there is some research that suggests that 5-HTP can also help treating headaches, insomnia, depression... [bold added for emphasis]." end of quote. 

So let's make sure we all got Oz right. If a primary care physician who knows a patient well prescribes an anti-depressant for his or her patient, that's bad because the patient hasn't been evaluated by a psychiatrist. But it's okay for Dr. Oz and a couple of doctors on his show to tell a national TV audience of patients they know nothing about, including any medical history whatsoever, that it's proper to use 5-HTP to treat depression because it apparently increases serotonin, the brain hormone.  Wow!  

When it comes to supplements that may screw with your brain, he doesn't flinch in telling you to take them even when the science is iffy. But when it comes to other doctors, particularly primary care doctors and internists, prescribing approved medications he doesn't hesitate to throw them under the bus.  

If that's not inconsistency, then I don't know what is. What do you think?

2 comments:

  1. You are a lot more diplomatic than I am! I find Dr. Oz to be a politician and he will say anything for the ratings!

    ReplyDelete
  2. New Diet Taps into Pioneering Plan to Help Dieters Lose 12-23 Pounds in Just 21 Days!

    ReplyDelete