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Would you like a side of gambling addiction with your Parkinson's medication? How about bouts of road rage and violence with your cholesterol meds? Or a pill that reduces your sense of empathy along with your headache?

A recent article on the BBC called "The Medications That Change Who We Are" exposes the little-mentioned serious personality-shifting side effects of many of the most popular medications in the world. While the negative side-effects of psychotropic meds are relatively well known (although downplayed in the mainstream press), few are aware that pill regimes seemingly unrelated to mood and personality could have such wide-ranging negative effects on how we relate to the world.

Join us on this episode of Objective:Health as we take a closer look at the medications that change who we are.


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Running Time: 00:31:26

Download: MP3 — 28.8 MB


Here's the transcript of the show:

Elliot: Hello everybody, and welcome to this week's edition of Objective Health. I'm your host Elliot and joining me in the virtual studio from all over the planet is Doug and Erica. We also have Damien on the wheels of steel today.

[Hellos]

Elliot: On this week's show, we are going to be talking about an interesting concept: the idea that pharmaceutical medications, aside from their intended effects, actually have certain adverse consequences or adverse effects: changing people's personalities.

Effectively, cases where people have taken drugs for some specific reason, maybe to lower cholesterol or to improve their blood pressure, and actually end up with the horrible unintended consequence whereby they notice dramatic shifts in how they feel and how they perceive the world, and in how others perceive them.

So, we are going to start with talking about an article that came out recently on the BBC (the British Broadcasting Agency). The article was titled The Medications that Change Who We Are. It is quite a long article actually and it gives several examples of cases where people have taken a drug and ended up noticing severe shifts in their personality.

It's a very good article. It fleshes out lots of different things. What do we think about this article guys?

Doug: I thought it was an excellent article actually. It was surprising that it was on the BBC. Generally you don't see a lot of bad-mouthing of pharmaceuticals happening in the mainstream press because the pharmaceutical industry is a big funder of mainstream media.

Maybe that is more the case in the US and maybe that's why the BBC can get away with it. I know that with a lot of the mainstream media in the US their bread and butter is basically pharmaceuticals, because the pharmaceutical companies run so many ads [and supply] a lot of funding.

I don't know if funding is the right word, but basically they are the engine that the mainstream media essentially runs on. So, it was nice to see that an article like this would come out on a mainstream publication. Kind of getting the word out, because I don't think that a lot of people [know this]. Everybody hears about side-effects from pharmaceuticals, but I don't think very many people realise that this kind of thing is an actual risk.

You could start taking medication for Parkinson's disease and end up with a gambling addiction, or end up engaging in risky behaviours and things like that. These kinds of things really aren't intuitive. I think it is good that the word is getting out on this.

Erica: Definitely. I noticed that in the article the author said we are all familiar with the mind-bending properties of psychedelic drugs, but it turns out that ordinary medications can be just as potent. It gives a list of the stuff, like you were doing Doug, like paracetamol - acetaminophen in the US - antihistamines, statins, asthma medications, and antidepressants.

He goes on to say that there is emerging evidence that they make us impulsive, angry, and restless. That they can diminish our empathy for strangers and even manipulate fundamental aspects of our personalities such as how neurotic we are.

It is interesting that when you get a prescribed medication they don't really go into the fact that there is a possibility this could change your personality. You always hear of other side-effects but not that it can completely alter your personality.

Doug: There was one case in particular where I was talking about the whole gambling addiction thing. There was actually a case back in 2011where a French father of 2 actually sued Glaxo-Smith-Klein saying that he was taking a medication for Parkinson's disease and it turned him into a gambler and a gay sex addict and it was responisble for risky behaviours that led him to being raped.

Wow! I mean, if it was a case in isolation you might be like "OK come on, whatever. The guy got into some crazy stuff and he is trying to blame his medication" but the fact of the matter is that it isn't an isolated case. There are other cases. There was another one that they talked about in the article: in 2015 there was a man who was targeting young girls on the internet but he used the argument that his anti-obesity drug Duromine actually made him do it.

It said that it reduced his ability to control his impulses. There are other cases where there were even murders and attempted suicides and a lot of times they will say that it is the medication that is making me do this.

Erica: We have seen that over the years, especially with SSRIs. Some of them have warnings about suicidality and violent behaviour, but you wouldn't think it would be in something like an obesity drug or a Parkinson's drug.

Doug: Or statins.

Elliot: What we have to remember is that the way that our brain is functioning at any given time is - not to be too reductionistic about this - at least partially determined by the composition of chemicals floating around in our brain or in our central nervous system. Many of the drugs that we take have very definite effects on those chemicals and actually oftentimes have unintended effects right?

For instance, L-dopa is the amino acid precursor to dopamine. So the concept is that someone who has Parkinson's actually has an autoimmune condition whereby their immune system is attacking the neurons in their brain which are responsible for producing dopamine.

The idea is, that to take L-dopa is to replace or provide the precursor which can effectively replace dopamine.

What we have to understand about dopamine is that it is not only involved in motor functions and other things that tend to become dysfunctional in Parkinson's. Dopamine plays a central role in how we feel and the kind of behaviours that we tend towards, so there's these thrill-seeking behaviors. There are numerous studies showing that chronic administration of this drug L-dopa [leads to that] because it is producing a bunch of dopamine.

We don't really know the effects that that is having on every other part of the brain and all the other neurotransmitters and brain chemicals. So actually there are people who are coming out and saying that some people are getting really anxious with it. Some people are developing weird cravings, craving things that they never had and thrill seeking behaviours; taking crazy risks that are completely abnormal for them. It makes other people depressed.

There is major intervariability, variability between different people in their response to these kinds of chemicals. We have to remember that they are psychoactive chemicals in many cases. People think that if you want to change how you are feeling and how your brain is working then take a recreational drug, well actually a lot of the times these are acting on the same biochemical systems that pharmaceutical drugs are, so it is a dangerous game when you are playing with things like this.

Doug: It is interesting. With that one you can see the connection there because dopamine is, like you were saying, very important for regulating mood and how you relate to the world. I think one of the really surprising ones is actually the cholesterol medications. Medications like statins where you take them to lower your cholesterol levels.

What they have found is that in some people at least, it is actually leading to violence and people having these fits of rage and things like that. It is interesting though because when you think about cholesterol you think about the heart and the circulatory system. You don't necessarily think about the brain and the mood. There have been studies where they found that when you put primates on a low cholesterol diet they become more aggressive. It is because lowering their cholesterol actually seems to affect their levels of serotonin which is another important brain chemical as far a mood is concerned.

Apparently even fruit flies will start fighting if you mess up their serotonin levels. They have studies where they have linked too-low cholesterol to violence, impulsivity, suicide and murder. It just seems really crazy to me because considering how many people are on cholesterol-lowering medication and how many people they want to put on cholesterol-lowering medication. The fact that it could have these kinds of effects is quite shocking really.

Elliot: Indeed. It is disturbing when you think about the sheer number. I think statins, at one time, were the best-selling drugs of all time. It really makes you wonder how many people are experiencing these kinds of personality changes just from taking a statin because their blood lipids were a little bit too high.

There was a really good review paper on PubMed called Mood, Personality and Behaviour Changes during Treatment with Statins: a Case Series. So they were basically looking at twelve different cases which had been reported in the literature of quite severe personality changes documented from the use of a statin. When they were sifting through the quality of the cases studies - of course when it is a case study it's observational - they were relatively strict on what they would allow in this review. They would say that it would only be documented cases of individuals who had no previous history or very limited previous history of this kind of behaviour.

All of a sudden, upon taking the statin they would dramatically change in their behaviour and in the kind of way that they were functioning, and then only improve when they came off the drug. In some of these case studies it was quite scary.

There was one individual in case number 1 where it said that 5-days after the initiation of the high-dose statin his wife noted the development of marked uncharacteristic behaviour changes including darker change in affect with relative loss of his previously bright personality and sense of humour. His wife describes him as having been an avid cook who also enjoyed substantive conversation. He lost interest in both following statin initiation.

His altered personality behavior characteristics progressed over the ensuing months with manifestations including irritability, detachment, attention problems, joylessness, anxiety, fatigue, impatience, insomnia, and reduced social interest in activities.

I mean, it completely ruined this guy's life essentially. It is really sad but 9-months after initiating the statin he committed what family members described as a completely unexpected suicide with a gunshot wound to the head and self inflicted wounds to the wrist and neck. The toxicology report reveals no alcohol or commonly abused drugs in his system at the time of death.

That was 9-months in. Previously, he was an emotionally healthy guy, then 5-days after this guy started taking a statin all of a sudden there were major personality changes and then 9-months later commits suicide; shot himself in the head out of nowhere. Now, that is pretty bizarre. There are multiple case studies.

There is one more I would like to read out. There was a woman - fortunately her case was not as tragic as this - who had been on a statin, I can't remember for how long. Some of the things that she experienced were wanting to leave her husband despite being with him for over 20-years in a happy marriage, joylessness, feeling that there was a veil between herself and others, the inability to feel happy at her daughter's wedding, desire for isolation, wanting to quit her job, and loss of appetite and energy.

After 3-months of statin treatment these mood and personality changes were noted by a doctor. They were stopped and then within a month they disappeared. It is not by chance, it was because of the statin.

Doug: That's a good case because it sounds like the doctor was relatively on top of it. It seems like in a lot of these cases the doctors will basically say that there is no way that the reaction is from the drug, they just will not accept that.

The patient will come to them and say "Listen, I think this drug is really messing with my personality", and they will be like "No, no, there is no way. Just stick with it, it's fine. It's not because of the drug, you just are just going through some stuff".

There was one guy in particular who was mentioned in the BBC article we were talking about previously who made the connection that his road rage and other outbursts of rage started when he got enrolled in a trial for statins and he went in there and said to the doctor "I really think that this is messing with me", and the doctor said to him "No, there is no way. That is not happening because of the medication. It is very important that you stay in the trial and keep taking the medication".

Well, the doctor got a taste of his own medicine because the guy lost it on him and raged. Then of course [the man] promptly stopped taking the medication and went back to normal.

Erica: As you were talking about, back in 2007 Dr. Mercola carried an article about statins called Why Doctors Often Dismiss Drug Side Effects and they were talking about statins, in particular Lipitor and Zocor. They did a survey of patients that were on these medications; I will read you some stats about what the survey revealed.

When people started to talk to their doctors about side-effects - things like muscle problems, memory and mood changes - 47% said their doctors dismissed their muscle or cognitive problems and said they weren't statin-related. 51% with the type of nerve pain called peripheral neuropathy said their doctors denied a connection with the drugs. 32% of them said their doctors denied a connection between their symptoms and their statins, and 29% said their doctors neither endorsed nor dismissed the possibility of symptom links to statins.

It sounds like even back then the doctors weren't really addressing this very serious possibility that these people are changing as a result just trying to lower cholesterol?

Elliot: I was interested in what could possibly drive this. Doug said that there is some evidence to point to the idea that cholesterol is involved in serotonin, but there are a couple of other ways that statins could potentially really influence how the nervous system and brain is functioning.

I didn't know this but cholesterol is really important for the nerves. We know that cholesterol basically makes up cell membranes but it has been shown that low cholesterol can affect how neurons are passing messages from one another. That is really important, but if we look at the action of a statin, a statin inhibits an enzyme called HMG-CoA reductase.

This enzyme is how we are synthesising our own cholesterol. When you take a statin it doesn't stop the cholesterol you are getting from the diet. All it does is it stops you from making your own from the raw material. Unfortunately, that enzyme is not only involved in how we make cholesterol, but that enzyme is also necessary for synthesising something else called Coenzyme Q10.

Coenzyme Q10 does all sorts of wonderful things. First of all, Coenzyme Q10 is really important for the heart. There is a very clear link between people who take statins and then develop a heart attack a couple of years later. Coenzyme Q10 is really important for the heart. It is an antioxidant for the cardiovascular system, so it protects the arteries, it protects the heart, it protects the entire vascular system. At the same time, Coenzyme Q10's potentially most important role in the body is as an electron carrier in the electron transport chain and in our mitochondria: how we are making energy. How we are taking food from the diet and then converting that into usable energy.

We run that through a part of the cell called the mitochondria. The mitochondria uses Coenzyme Q10 to do that. What happens is that when we become depleted in Coenzyme Q10 - for example if we take a statin which means that we actually reduce our synthesis of Coenzyme Q10 - that leads to something called mitochondrial dysfunction.

Interestingly, mitochondrial dysfunction is related to almost every disease, but particularly neuropsychiatric diseases and aggression and irritability. One of the main hypotheses in this paper we were talking about is that statins leading to such weird behavioural changes is related to the fact that they are disrupting mitochondrial function and causing a bunch of oxidative stress - remember that Coenzyme Q10 is also an antioxidant.

When you have a lack of energy in certain parts of the brain, those parts of the brain can't work as well. In the paper they talk about how mitochondrial dysfunction has been documented with a wide variety of psychiatric problems: behavioral changes, unwarranted aggression. These kinds of things can in some cases be tied back to a lack of energy in the regulatory parts of the brain - we are changing our behaviour. We are in control of our behaviour and our actions, but when you lack energy in those parts of the brain you become impulsive and erratic.

It's a complete mess. No one thought that this would ever happen. Maybe they did think it would happen but they didn't bother telling anyone because there were too many billions to be made.

Doug: Another one, which Erica I think you mentioned at the top of the show, was paracetamol which is acetaminophen in the US. It is a pain reliever; it is an over-the-counter medication. If you have got a headache you take a paracetamol/acetaminophen and it works by blunting physical pain. It blunts physical pain by reducing activity in certain brain areas such as the insular cortex which also happens to play an important role in our motions.

What they have found is that paracetamol significantly reduces our ability to feel positive empathy. They were talking about this before because they found that people who would take paracetamol actually found that they would get over things like break-ups easier or anything where they were feeling grief. If they took a paracetamol they were like "I actually don't feel so bad any more."

Empathy is actually really important [laughter] you don't want to just go around blunting your empathy like you would blunt a headache. It leads to more stable romantic relationships, better adjustment to children, and more successful careers. Some scientists have even suggested that actually is what made us human: our ability to empathise. It actually led us to be able to thrive in the natural environment.

It is just crazy that something as seemingly innocuous as a headache medication, a pain reliever, an over-the-counter drug that anybody can get at any drug store would have that kind of effect. Fortunately, it really only lasts as long as the drug is in your system. People aren't generally popping this stuff every day, but there might be some situations where you wouldn't want to have blunted empathy, like if you have to have a difficult conversation with your wife, your husband, a coworker, the boss or something like that.

In a situation where you would actually need to be relatively empathetic, you would probably want to avoid taking this medication. Unfortunately, this is never really publicised. It doesn't say anything, it doesn't say on the side of the box "may reduce empathy".

Erica: I would disagree with you, that people are actually taking a lot more than they think.

Elliot: Me too.

Doug: That is probably true.

Erica: In the US, they call it Tylenol - "just go home and take Tylenol." In the article that we started off the show with it said that in the US alone people are buying 49,000 tonnes of Paracetamol or Tylenol every year which is equivalent to about 298 tablets per person. Then it goes on to say that the average American is consuming about $1200 worth of prescription medication over the same period.

You even give it to children, they make children's Tylenol. If they have a toothache you give it to them. It's concerning because of that whole idea of affect flattening. It's not just negative emotions but positive as well. You can see that with continual use of it, because some people just gobble that stuff down. "I've got a headache, I'm going to take Tylenol." Then all of a sudden there's no highs or lows in people. They have talked in the past about psychiatric drugs doing that, but this is just an over-the-counter medication. Something that you can buy at the gas station if you need to.

Elliot: In the health world, it is easy to be in a bit of an echo chamber whereas some of the people I have consulted with in the past take paracetamol or Tylenol every day - every day for 8-years! Seriously, every single day! It is really, really common. It is quite disturbing when you think about it.

Especially for someone who is in chronic pain. Say you are in chronic pain because you have got rheumatoid arthritis or some other autoimmune condition because you are eating a SAD diet, and you are loaded up with toxins, or maybe it's a side effect to some other medication that you have taken in the past. Then, the only thing that you can use is Tylenol and you have to use it in really high doses because nothing else gets there and then you start realising that actually yes, there are no highs or lows and you start becoming depressed so you take an SSRI. You can see how polypharmacy is just a downhill spiral from there.

Erica: Is Tylenol the one that they have discovered causes damage to the liver?

Doug: Yes.

Erica: It seems like people know that now. "I don't want to take too much because it might damage my liver", but you never hear them say "I don't want to take too much because it might reduce my empathy and make me an automaton or a robot". [Laughter]

Doug: That's true.

Elliot: Is there anything else that we want to say?

Doug: This is such a huge topic that we could go into. We didn't even get into the actual psychotropic medications like ADHD medications and antidepressants. Maybe it would behoove us to do a show on those ones in particular in the future.

Erica: I think that it is great that this stuff is coming out. The fact that this is out there on mainstream media after how many years now? It is starting to get a little bit of attention and I'm always the optimist here so maybe some researchers will start to pick up these threads and start to do some more studies where they actually have people coming out and sueing these organisations.

I know GlaxoSmithKline has been sued for a lot of things. We won't go into it in this show but Paxil for one. That could be a whole show in and of itself: the pharmaceutical drugs that have limited testing. They don't go through the rigorous mental aspects of it. "We will cut your cholesterol so you may start gambling and have gay sex, but we are not going to deal with that".

Maybe people need to start asking their doctors "what are the emotional side-effects of this new medication that you are going to give me?"

Doug: If the doctor doesn't know then there is not going to be much hope.

Elliot: Like most things we talk about on this show, you can't rely on your doctor to take control of your health. You have to take responsibility and learn the kind of influences you expose yourself to. If you do need to take a drug then you need to learn about the side-effects and listen to your body and try to do the best that you can with that. Try to find a natural alternative where possible I think. That seems to be the safest way to go about it.

We could talk for hours on this topic, but it seems like we are getting to the end of our show. For any of our listeners, there are a bunch of interesting articles on this, and scientific literature as well. I definitely recommend to anyone who is interested in it to go and take a look at what is out there and then share it because that is doing your service to other people.

Chances are, everyone listening to this knows at least one or two people who regularly take these kinds of medications and aren't aware of these particular side-effects. At least some of those might be interested to learn about them.

If there is nothing else, thanks for tuning into this week's edition of Objective Health everyone. If you liked this video, then "like" and subscribe to our page because we are doing one of these every week. Again, share it if you found it helpful. For now, I think that's it. Anything else from my co-hosts?

Doug: No, I think that's it.

Elliot: Perfect. Ok, see you all next week guys!

[Goodbyes]