1 00:00:00,840 --> 00:00:04,080 Speaker 1: Welcome to the Tutor Dixon Podcast. We have a podcast 2 00:00:04,120 --> 00:00:06,640 Speaker 1: for you today that is very timely because right now, 3 00:00:06,720 --> 00:00:09,840 Speaker 1: I think the entire world is looking at the Health 4 00:00:09,880 --> 00:00:14,040 Speaker 1: and Human Services Secretary and saying what exactly is going on? 5 00:00:14,680 --> 00:00:16,919 Speaker 1: And what we're seeing right now seems almost like a 6 00:00:17,000 --> 00:00:22,560 Speaker 1: battle of the pharma giants against the Maha movement, and 7 00:00:23,480 --> 00:00:27,320 Speaker 1: there's like this black and white line. It's like you're 8 00:00:27,360 --> 00:00:30,160 Speaker 1: either on the black and one side or the other 9 00:00:30,240 --> 00:00:32,599 Speaker 1: of this issue. You cannot cross that line. And that's 10 00:00:32,640 --> 00:00:34,720 Speaker 1: what we're seeing in these hearings right now is that 11 00:00:35,240 --> 00:00:38,199 Speaker 1: people who haven't been in the medical profession feel like 12 00:00:38,520 --> 00:00:41,880 Speaker 1: there's yes and no to everything, that there's no gray area. 13 00:00:41,920 --> 00:00:44,120 Speaker 1: And I think the Maha movement has come in and 14 00:00:44,159 --> 00:00:47,240 Speaker 1: said there is a big gray area that we haven't 15 00:00:47,240 --> 00:00:49,839 Speaker 1: been able to talk about for a long time. And 16 00:00:49,960 --> 00:00:53,120 Speaker 1: suddenly we're able to say, you know what, maybe this 17 00:00:53,280 --> 00:00:56,400 Speaker 1: isn't working for everybody, and maybe this doesn't work for everybody, 18 00:00:56,640 --> 00:01:00,040 Speaker 1: and there's a massive backlash against the idea that some 19 00:01:00,400 --> 00:01:03,240 Speaker 1: pharmaceuticals might not work for everybody. I mean, one of 20 00:01:03,280 --> 00:01:05,959 Speaker 1: them is the COVID vaccine, where you have the Health 21 00:01:06,000 --> 00:01:09,240 Speaker 1: and Human Services Secretary saying not every kid has to 22 00:01:09,280 --> 00:01:12,520 Speaker 1: have it. In fact, in Germany it shows that kids 23 00:01:12,600 --> 00:01:15,920 Speaker 1: didn't that didn't have any other underlying symptoms, didn't die 24 00:01:16,000 --> 00:01:19,200 Speaker 1: from COVID. They don't really get sick from it. So 25 00:01:19,280 --> 00:01:23,840 Speaker 1: I am excited today because we have doctor Adam Jurato 26 00:01:23,959 --> 00:01:26,480 Speaker 1: with me. You've heard me talk about what he has 27 00:01:26,760 --> 00:01:30,440 Speaker 1: worked on. I've written an op ed on some of 28 00:01:30,480 --> 00:01:33,959 Speaker 1: his work. He is a fetal and maternal medicine specialist 29 00:01:34,000 --> 00:01:37,400 Speaker 1: serving as the chief of the Maternal Fetal Medicine at 30 00:01:37,480 --> 00:01:41,679 Speaker 1: Metro west At Medical Center in Massachusetts, and he specializes 31 00:01:41,760 --> 00:01:45,200 Speaker 1: in high risk pregnancies. Thank you so much for being 32 00:01:45,240 --> 00:01:45,720 Speaker 1: on today. 33 00:01:46,280 --> 00:01:48,400 Speaker 2: Well, it's a real pleasure to join you, and I 34 00:01:48,440 --> 00:01:51,240 Speaker 2: really appreciate your bringing attention to this issue. 35 00:01:51,880 --> 00:01:55,120 Speaker 1: It's to me, it's something that I think, like I said, 36 00:01:55,200 --> 00:01:57,360 Speaker 1: everybody feels like they have to be on one side 37 00:01:57,440 --> 00:02:00,600 Speaker 1: or the other. And there's a few doctors right now 38 00:02:00,640 --> 00:02:03,360 Speaker 1: who are coming out and saying, you know what, there 39 00:02:03,400 --> 00:02:07,960 Speaker 1: are times when this medication might be necessary, but we 40 00:02:08,040 --> 00:02:11,320 Speaker 1: should be very cautious about who we use medications with. 41 00:02:11,520 --> 00:02:14,040 Speaker 1: And I think that kind of is spanning a lot 42 00:02:14,120 --> 00:02:17,000 Speaker 1: of different types of medications right now. I think one 43 00:02:17,040 --> 00:02:19,160 Speaker 1: of the most powerful things I've heard you say is 44 00:02:19,240 --> 00:02:20,720 Speaker 1: chemicals have consequences. 45 00:02:22,000 --> 00:02:24,799 Speaker 2: Yeah. I think their points a very good one, which 46 00:02:24,840 --> 00:02:27,560 Speaker 2: is that there's not a one size fits all answer 47 00:02:27,600 --> 00:02:30,040 Speaker 2: to all of this. And this is particularly true in 48 00:02:30,040 --> 00:02:32,600 Speaker 2: the area that I talk about, which is depression and 49 00:02:32,639 --> 00:02:35,760 Speaker 2: antidepressants and pregnancy. Before I start, I just want to 50 00:02:35,800 --> 00:02:38,839 Speaker 2: say that this topic that I try to raise attention to, 51 00:02:38,919 --> 00:02:42,160 Speaker 2: this issue about chemicals, which I'm going to address that issue. 52 00:02:42,760 --> 00:02:45,080 Speaker 2: The idea is to try to inform the public, and 53 00:02:45,120 --> 00:02:47,960 Speaker 2: so that's really the key, that's really my goal. It's 54 00:02:48,000 --> 00:02:51,680 Speaker 2: been cast, particularly after the FDA conference. It's been cast 55 00:02:51,760 --> 00:02:55,440 Speaker 2: as is it designed to be pill shaming pregnant women 56 00:02:56,040 --> 00:03:00,680 Speaker 2: or disregarding their depression, or making light of it, pill shaming, 57 00:03:00,760 --> 00:03:03,480 Speaker 2: guilt tripping, things like that. From my standpoint, it's none 58 00:03:03,520 --> 00:03:06,679 Speaker 2: of that. What it's all about is just getting proper 59 00:03:06,720 --> 00:03:10,720 Speaker 2: information out to patients and the public. Depression can be awful, 60 00:03:10,880 --> 00:03:15,000 Speaker 2: human suffering is awful, and these patients deserve compassionate care. 61 00:03:15,400 --> 00:03:17,960 Speaker 2: But I always make the point that part of compassionate 62 00:03:18,040 --> 00:03:22,760 Speaker 2: care is proper information, accurately informing patients in the public, 63 00:03:23,360 --> 00:03:26,519 Speaker 2: and part of that accurate information informing the patients in 64 00:03:26,560 --> 00:03:30,200 Speaker 2: the public is getting people to understand that medications by 65 00:03:30,240 --> 00:03:36,000 Speaker 2: and large are chemicals, and they're synthesized in chemical manufacturing 66 00:03:36,040 --> 00:03:39,360 Speaker 2: facilities and they have consequences in the body. That's what 67 00:03:39,440 --> 00:03:42,320 Speaker 2: chemicals do. They have chemical effects. I tell people when 68 00:03:42,360 --> 00:03:45,280 Speaker 2: I lecture on this. They're not like growing on trees. 69 00:03:45,400 --> 00:03:48,720 Speaker 2: They're being made in chemical plants. And then when they 70 00:03:48,800 --> 00:03:51,720 Speaker 2: go into the body, for example, in pregnancy, they go 71 00:03:51,800 --> 00:03:54,040 Speaker 2: into the mom, they cross over the placenta, they go 72 00:03:54,080 --> 00:03:55,880 Speaker 2: into the baby, and what they do is they have 73 00:03:55,960 --> 00:03:59,800 Speaker 2: chemical effects. Now it doesn't mean we can't use medication, 74 00:04:00,200 --> 00:04:02,440 Speaker 2: but it means we have to always be aware of 75 00:04:02,520 --> 00:04:05,800 Speaker 2: the chemical effects and the consequences. That's where I started 76 00:04:05,880 --> 00:04:08,040 Speaker 2: using that phrase that chemicals have consequences. 77 00:04:08,400 --> 00:04:11,520 Speaker 1: And so you recently had a panel on this, and 78 00:04:11,560 --> 00:04:15,120 Speaker 1: I think that one of the compassionate care issue is 79 00:04:15,400 --> 00:04:19,440 Speaker 1: what is really the controversy here, because people do get 80 00:04:19,480 --> 00:04:22,640 Speaker 1: concerned if you say, well, we've looked at this and 81 00:04:22,720 --> 00:04:25,440 Speaker 1: potentially there are risks that we didn't know and we 82 00:04:25,480 --> 00:04:28,200 Speaker 1: shouldn't be so quick to give out this medication. Not 83 00:04:28,240 --> 00:04:30,440 Speaker 1: to say that it's not right for some people, but 84 00:04:30,800 --> 00:04:33,279 Speaker 1: maybe we're too quick to give it to all people, 85 00:04:33,960 --> 00:04:37,240 Speaker 1: and people who have been on the medication or doctors 86 00:04:37,240 --> 00:04:39,520 Speaker 1: who have given it out. You can see that there 87 00:04:39,600 --> 00:04:45,040 Speaker 1: is a hesitancy or even kind of a strong reaction 88 00:04:45,200 --> 00:04:47,600 Speaker 1: to say, please, don't say that I was wrong in 89 00:04:47,640 --> 00:04:50,400 Speaker 1: what I did. And I can feel that as a 90 00:04:50,440 --> 00:04:52,680 Speaker 1: mom who's been pregnant. And now you hear you know, 91 00:04:53,360 --> 00:04:56,240 Speaker 1: there's this new study coming out that says pregnant mothers 92 00:04:56,240 --> 00:04:58,680 Speaker 1: shouldn't take tail and all. And when I was pregnant, 93 00:04:58,680 --> 00:05:01,359 Speaker 1: it was pregnant mothers shouldn't take you should take tailanel. 94 00:05:01,839 --> 00:05:04,880 Speaker 1: And now we're there's all these news articles coming out 95 00:05:05,480 --> 00:05:07,400 Speaker 1: and I go in my head, I go, gosh, how 96 00:05:07,400 --> 00:05:09,400 Speaker 1: many times did I take Talald? Did I take tailant? 97 00:05:09,600 --> 00:05:12,760 Speaker 1: You know, so it's a very personal it's a very 98 00:05:12,800 --> 00:05:13,839 Speaker 1: personal discussion. 99 00:05:14,480 --> 00:05:16,599 Speaker 2: Yeah. I tell the moms I take care of that. 100 00:05:17,000 --> 00:05:19,240 Speaker 2: I'm a clinician. I take care of pregnant women every day. 101 00:05:19,400 --> 00:05:21,520 Speaker 2: I tell them not to blame themselves. That's what they 102 00:05:21,560 --> 00:05:23,960 Speaker 2: always do. Whenever something comes out of a new story 103 00:05:24,200 --> 00:05:27,479 Speaker 2: or whenever something occurs in the pregnancy, they first blame themselves. 104 00:05:27,640 --> 00:05:29,560 Speaker 2: That you know, we're all on the same team. We're 105 00:05:29,560 --> 00:05:32,400 Speaker 2: not trying to blame anybody here except we're just trying 106 00:05:32,440 --> 00:05:35,080 Speaker 2: to get the proper information and then get that out 107 00:05:35,120 --> 00:05:38,920 Speaker 2: to pregnant women in the public. What I think is happening, though, 108 00:05:39,000 --> 00:05:40,760 Speaker 2: is that we are all on the same team in 109 00:05:40,760 --> 00:05:44,760 Speaker 2: a sense. But the pharmaceuticals industry's main goal is actually 110 00:05:44,880 --> 00:05:47,880 Speaker 2: not to be getting out proper information to patients in 111 00:05:47,920 --> 00:05:52,080 Speaker 2: the public. The pharmaceutical industry's main goal pharma wants to 112 00:05:52,200 --> 00:05:56,920 Speaker 2: increase sales and profits and return to shareholders. So what 113 00:05:56,960 --> 00:06:00,160 Speaker 2: they do in these various subjects, whatever the medication is 114 00:06:00,240 --> 00:06:02,840 Speaker 2: or the pharmaceutical is, is that they try to kind 115 00:06:02,880 --> 00:06:05,640 Speaker 2: of roll out the product, and they typically roll it 116 00:06:05,680 --> 00:06:10,320 Speaker 2: out with like basically a sales pitch, and that sales 117 00:06:10,360 --> 00:06:14,040 Speaker 2: pitch almost always follows the same routine. And what that 118 00:06:14,240 --> 00:06:18,400 Speaker 2: is is is they create fear about the condition, whether 119 00:06:18,480 --> 00:06:22,120 Speaker 2: that's an infection or whether that's depression, they create fear 120 00:06:22,120 --> 00:06:24,600 Speaker 2: about that, and then they sell what they have as 121 00:06:24,640 --> 00:06:28,080 Speaker 2: the cure, and they roll their drug out as being 122 00:06:28,279 --> 00:06:32,359 Speaker 2: almost entirely safe and very effective. And then what we 123 00:06:32,480 --> 00:06:35,680 Speaker 2: learn over time is people are using it, is that 124 00:06:35,760 --> 00:06:38,799 Speaker 2: it wasn't as safe, it's not as safe as originally built, 125 00:06:38,839 --> 00:06:41,600 Speaker 2: and it's not as effective. What people have to remember 126 00:06:42,160 --> 00:06:46,360 Speaker 2: is that the sales pitch is designed to increase sales, 127 00:06:46,800 --> 00:06:49,400 Speaker 2: but it's not the truth. And what we need to 128 00:06:49,440 --> 00:06:51,440 Speaker 2: do as a human community is to try to get 129 00:06:51,440 --> 00:06:53,680 Speaker 2: at the truth, and the way we do that is 130 00:06:53,720 --> 00:06:57,440 Speaker 2: with studies, with research, et cetera. In this particular case, 131 00:06:57,480 --> 00:07:03,000 Speaker 2: with the ssrintidepressants, the sales pitch is that depression is 132 00:07:03,040 --> 00:07:07,080 Speaker 2: harmful in pregnancy, leads to poor outcomes, so the moms 133 00:07:07,120 --> 00:07:13,000 Speaker 2: should take these SSRI chemicals, these antidepressants, thus reducing their 134 00:07:13,480 --> 00:07:18,800 Speaker 2: depression and leading to better pregnancy outcomes. That's the sales pitch, 135 00:07:18,920 --> 00:07:22,520 Speaker 2: but that's actually not supported by the scientific evidence. What 136 00:07:22,600 --> 00:07:26,840 Speaker 2: we see with the actual scientific evidence are poorer outcomes 137 00:07:26,920 --> 00:07:30,000 Speaker 2: in the moms who are taking SSRIs. That's simply what 138 00:07:30,040 --> 00:07:33,280 Speaker 2: the science shows. We see, and I'll march through quickly, 139 00:07:33,760 --> 00:07:36,960 Speaker 2: is that we see increased rates, for example, of miscarriage, 140 00:07:37,520 --> 00:07:41,640 Speaker 2: of birth defects, increased rates of pre term birth and 141 00:07:41,720 --> 00:07:44,440 Speaker 2: low birth weight. We see increase rates of a condition 142 00:07:44,520 --> 00:07:47,280 Speaker 2: called pre aclamsia, which can be quite dangerous. It's a 143 00:07:47,320 --> 00:07:50,960 Speaker 2: significant cause of morbidity immortality. And we see increased rates 144 00:07:51,040 --> 00:07:54,400 Speaker 2: of postpartum hemorrhage, for sure, that's very clear that these 145 00:07:54,480 --> 00:07:58,240 Speaker 2: SSRIs lead to increased rates of hemorrhage. After the babies 146 00:07:58,280 --> 00:08:02,520 Speaker 2: are born, we see increased newborn problems including nick you 147 00:08:02,600 --> 00:08:05,560 Speaker 2: admissions and other issues. And then the big question is 148 00:08:05,600 --> 00:08:08,920 Speaker 2: long term what the effects are here? And this is 149 00:08:08,960 --> 00:08:12,080 Speaker 2: being studied now, but we are finding that children who 150 00:08:12,120 --> 00:08:16,360 Speaker 2: were exposed in utero are showing in studies some studies 151 00:08:16,560 --> 00:08:21,239 Speaker 2: increased rates of depression, increase rates of speech and language disorders, 152 00:08:21,280 --> 00:08:27,080 Speaker 2: increased rates of neuro behavioral issues ADHD, autism. So this 153 00:08:27,280 --> 00:08:29,960 Speaker 2: is the truth of what we're actually seeing in the 154 00:08:30,120 --> 00:08:34,360 Speaker 2: science as opposed to this sales pitch as I was saying, 155 00:08:34,400 --> 00:08:37,360 Speaker 2: which a lot of these drugs and pharmaceuticals get rolled 156 00:08:37,400 --> 00:08:40,360 Speaker 2: out with. But what the public needs to understand is 157 00:08:40,400 --> 00:08:43,240 Speaker 2: that the sales pitch, what the pitch that's designed to 158 00:08:43,320 --> 00:08:46,959 Speaker 2: sell the pharmaceutical products, the drugs and otherwise is not 159 00:08:47,080 --> 00:08:49,600 Speaker 2: going to actually be the truth reality for when they're 160 00:08:49,720 --> 00:08:51,360 Speaker 2: used in the human populations. 161 00:08:51,679 --> 00:08:55,160 Speaker 1: So let me give a little background from my experience 162 00:08:55,240 --> 00:08:58,480 Speaker 1: with this, because I had a friend who was involved 163 00:08:58,520 --> 00:09:02,079 Speaker 1: with getting drugs pro by the FDA, and then they 164 00:09:02,120 --> 00:09:04,320 Speaker 1: would they would fund the lab, and then you know 165 00:09:04,400 --> 00:09:06,240 Speaker 1: that that is just a cash cow. Once you get 166 00:09:06,240 --> 00:09:09,559 Speaker 1: it approved, then you bring in hundreds of millions or 167 00:09:09,600 --> 00:09:13,640 Speaker 1: billions of dollars. And it was kind of like the 168 00:09:13,679 --> 00:09:16,600 Speaker 1: way it worked was you go in front of almost 169 00:09:16,640 --> 00:09:18,960 Speaker 1: like you know, the FDA panels like the Wizard of Oz, right, 170 00:09:19,040 --> 00:09:20,760 Speaker 1: you go in front of them, and you're like, can 171 00:09:20,840 --> 00:09:23,800 Speaker 1: I get through this? Can I get them to say, 172 00:09:23,960 --> 00:09:26,320 Speaker 1: you know what, we bless you? You can go on 173 00:09:26,440 --> 00:09:29,680 Speaker 1: and sell this drug. And there's a lot that goes 174 00:09:29,720 --> 00:09:31,640 Speaker 1: through and sometimes you get kicked back and you have 175 00:09:31,679 --> 00:09:33,800 Speaker 1: to get some more information, and there's a lot that 176 00:09:33,840 --> 00:09:36,600 Speaker 1: goes through this. But it seems the as though from 177 00:09:36,600 --> 00:09:38,760 Speaker 1: my experience with these folks, and you can correct me 178 00:09:38,800 --> 00:09:41,720 Speaker 1: if I'm wrong, once you get that wave of approval, 179 00:09:42,360 --> 00:09:45,480 Speaker 1: no one goes back afterward and says, actually, what we're 180 00:09:45,920 --> 00:09:48,640 Speaker 1: Rarely do they go back afterwards, or it takes years 181 00:09:48,640 --> 00:09:51,959 Speaker 1: for them to go back afterwards and say, hey, this 182 00:09:52,000 --> 00:09:54,680 Speaker 1: isn't doing what it is it's supposed to be doing. 183 00:09:54,920 --> 00:09:57,120 Speaker 1: You were one of the early voices that came out 184 00:09:57,240 --> 00:10:00,800 Speaker 1: against a drug called I Think it's McKenna and said, 185 00:10:00,920 --> 00:10:03,559 Speaker 1: I don't think this is having the effects that it's 186 00:10:03,600 --> 00:10:07,079 Speaker 1: supposed to have. And that was not welcomed feedback. 187 00:10:08,440 --> 00:10:11,880 Speaker 2: Yeah, And and McKenna was a drug used for preterm 188 00:10:11,960 --> 00:10:15,240 Speaker 2: birth or to prevent recurrent preterm birth, and we started 189 00:10:15,320 --> 00:10:17,760 Speaker 2: using that around two thousand and three and obstetrics to 190 00:10:17,880 --> 00:10:20,720 Speaker 2: prevent a woman who'd had a preterm birth from having 191 00:10:20,800 --> 00:10:25,120 Speaker 2: another preterm birth. But the study that the approval was 192 00:10:25,160 --> 00:10:27,480 Speaker 2: based on at the FDA, and I like the way 193 00:10:27,520 --> 00:10:30,400 Speaker 2: you explained that going before the Wizard of Oz, the 194 00:10:30,440 --> 00:10:33,800 Speaker 2: study that that was based on was very shaky. There 195 00:10:33,800 --> 00:10:36,480 Speaker 2: were a lot of a lot of limitations of that study. 196 00:10:36,559 --> 00:10:38,240 Speaker 2: So from the get go, I thought that I had 197 00:10:38,240 --> 00:10:41,240 Speaker 2: real concerns about the drug. But then it got adopted 198 00:10:41,679 --> 00:10:45,920 Speaker 2: and readily and rapidly used, and again it was rolled 199 00:10:45,920 --> 00:10:49,320 Speaker 2: out with the sort of pharmaceutical rollout of it's safe, 200 00:10:49,440 --> 00:10:52,679 Speaker 2: it's effective, it prevents a recurrent preterm birth. But as 201 00:10:52,720 --> 00:10:55,120 Speaker 2: we studied it more and more over time, it was 202 00:10:55,160 --> 00:10:59,559 Speaker 2: shown to actually not be effective. And I was an 203 00:10:59,600 --> 00:11:02,200 Speaker 2: active voice against that, which is another issue here, which 204 00:11:02,240 --> 00:11:04,640 Speaker 2: is a lot of people have just heard me talking 205 00:11:04,640 --> 00:11:08,560 Speaker 2: about antidepressants, but my interest here is in actually just 206 00:11:08,679 --> 00:11:12,120 Speaker 2: informing pregnant women in the public about the medications they're 207 00:11:12,120 --> 00:11:15,560 Speaker 2: taking and I did play a role with McKenna, so 208 00:11:15,600 --> 00:11:18,920 Speaker 2: we petitioned the FDA about this. When the second trial 209 00:11:19,040 --> 00:11:22,280 Speaker 2: came out, which was the confirmatory trial, which took years 210 00:11:22,320 --> 00:11:24,160 Speaker 2: to do, but when it came out, it was shown 211 00:11:24,160 --> 00:11:26,800 Speaker 2: that it actually was not effective, which is what many 212 00:11:26,840 --> 00:11:29,880 Speaker 2: of us had been saying all along, and so it 213 00:11:29,920 --> 00:11:31,800 Speaker 2: was pulled off. The market was pulled off in twenty 214 00:11:31,840 --> 00:11:34,920 Speaker 2: twenty three. But it's a great example of this sort 215 00:11:34,960 --> 00:11:38,319 Speaker 2: of classic pharm of playbook where they get the approval 216 00:11:38,559 --> 00:11:41,280 Speaker 2: and then they start the rollout, and the rollout is 217 00:11:41,720 --> 00:11:45,400 Speaker 2: to scare the population about the condition, which in this 218 00:11:45,480 --> 00:11:50,120 Speaker 2: case was preterm birth, and then to oversell essentially that 219 00:11:50,240 --> 00:11:55,320 Speaker 2: they're safe, that they're effective, not mentioned risks, and highlight benefits. 220 00:11:55,559 --> 00:11:57,640 Speaker 2: But then over time it's often shown, as I was 221 00:11:57,640 --> 00:12:00,720 Speaker 2: saying earlier, to be not to have more risks than 222 00:12:01,679 --> 00:12:04,080 Speaker 2: we were being told about, and to be less effective 223 00:12:04,080 --> 00:12:06,760 Speaker 2: than we were told about. This is the typical trajectory 224 00:12:06,800 --> 00:12:09,120 Speaker 2: of a lot of the medications that the patients use. 225 00:12:09,640 --> 00:12:12,440 Speaker 1: So and I want to be clear, I don't talk 226 00:12:12,480 --> 00:12:15,440 Speaker 1: about these things because I think everybody should question every 227 00:12:15,440 --> 00:12:18,560 Speaker 1: medication from now on. I mean, certainly, you know I've 228 00:12:18,600 --> 00:12:20,880 Speaker 1: had enough times where you get an infection and you 229 00:12:20,960 --> 00:12:23,080 Speaker 1: take an antibiotic, and if we didn't have those, we 230 00:12:23,120 --> 00:12:25,640 Speaker 1: would not be alive today. Many of us would not 231 00:12:25,679 --> 00:12:30,160 Speaker 1: survive a simple infection. There are medications that are great, 232 00:12:30,200 --> 00:12:33,960 Speaker 1: that do great things and save lives, and I think 233 00:12:34,000 --> 00:12:37,760 Speaker 1: that's why there's been this societal push that anytime there's 234 00:12:37,760 --> 00:12:40,880 Speaker 1: a new medication, you accept it, because you don't want 235 00:12:40,920 --> 00:12:44,360 Speaker 1: people to start to become skeptical of all medications, and 236 00:12:44,880 --> 00:12:48,280 Speaker 1: so there is a delicate balance there. We actually had 237 00:12:49,360 --> 00:12:53,520 Speaker 1: an author on who was exposing some of the products 238 00:12:53,559 --> 00:12:55,720 Speaker 1: that had come out of Johnson and Johnson, and there 239 00:12:55,800 --> 00:12:59,080 Speaker 1: was one in particular that was a vaginal mesh that 240 00:12:59,280 --> 00:13:02,160 Speaker 1: came out and it was on the market for twenty years, 241 00:13:02,200 --> 00:13:06,040 Speaker 1: and people had been saying, you know, this is causing 242 00:13:06,160 --> 00:13:10,000 Speaker 1: these women severe problems, and I mean the problems were 243 00:13:10,080 --> 00:13:14,679 Speaker 1: devastating problems, devastating in a third of women. So it's like, well, 244 00:13:14,720 --> 00:13:16,720 Speaker 1: it's not all of women, but a third of women 245 00:13:16,760 --> 00:13:18,960 Speaker 1: who have this. There's a lot of women, you know. 246 00:13:19,360 --> 00:13:21,800 Speaker 1: And it took twenty years, more than twenty years to 247 00:13:21,840 --> 00:13:24,320 Speaker 1: get that off the market because I do think that 248 00:13:25,120 --> 00:13:27,920 Speaker 1: even doctors seem afraid to push back when they see 249 00:13:27,920 --> 00:13:29,000 Speaker 1: something that's not right. 250 00:13:30,440 --> 00:13:33,960 Speaker 2: Yeah, I think that there's a certain self censorship that 251 00:13:34,040 --> 00:13:37,040 Speaker 2: goes on where people are afraid to rock the boat. 252 00:13:37,480 --> 00:13:42,760 Speaker 2: I think that a conventional wisdom develops, or a scientific consensus, 253 00:13:43,120 --> 00:13:47,600 Speaker 2: and then people physicians become afraid to be seen as 254 00:13:47,760 --> 00:13:51,920 Speaker 2: running against that consensus for a variety of reasons, and 255 00:13:51,960 --> 00:13:54,920 Speaker 2: so then they self censor and we end up with censorship, 256 00:13:54,960 --> 00:13:58,959 Speaker 2: which is not good because oftentimes the dissenting voices are 257 00:13:59,120 --> 00:14:01,800 Speaker 2: correct on issue. So I always make that point, whether 258 00:14:01,840 --> 00:14:02,640 Speaker 2: it's with me, I mean. 259 00:14:02,600 --> 00:14:05,319 Speaker 1: Isn't that what science is really about, is to have discussion. 260 00:14:06,240 --> 00:14:12,040 Speaker 2: Absolutely, that's exactly right, Tutor. Descent is essentially the heart 261 00:14:12,120 --> 00:14:17,640 Speaker 2: of science, and so really we want to encourage dissenting voices. Unfortunately, 262 00:14:17,920 --> 00:14:20,280 Speaker 2: our society has taking a turn for the worse on 263 00:14:20,400 --> 00:14:25,040 Speaker 2: this before, maybe before COVID or since COVID, with this 264 00:14:25,200 --> 00:14:30,760 Speaker 2: idea of trying to censor and basically not allowed dissenting voices, 265 00:14:31,000 --> 00:14:33,640 Speaker 2: saying that they're dangerous, et cetera. They're harmful to patients, 266 00:14:33,680 --> 00:14:37,120 Speaker 2: harmful to public health. But that's a real turn in 267 00:14:37,160 --> 00:14:39,840 Speaker 2: the wrong direction, because, as you were just saying, it's 268 00:14:39,880 --> 00:14:42,360 Speaker 2: the heart and soul of the scientific method. Descent is 269 00:14:42,400 --> 00:14:44,760 Speaker 2: like the essence of science, and we need to hear 270 00:14:44,800 --> 00:14:47,800 Speaker 2: dissenting voices and that's often where the new ideas and 271 00:14:47,840 --> 00:14:49,600 Speaker 2: where the correct ideas are coming from. 272 00:14:49,720 --> 00:14:52,440 Speaker 1: Let's take a quick commercial break. Will continue next on 273 00:14:52,480 --> 00:14:58,560 Speaker 1: a Tutor Dixon podcast. I saw an article that came 274 00:14:58,600 --> 00:15:01,040 Speaker 1: out in response to your f panel. So there was 275 00:15:01,080 --> 00:15:04,680 Speaker 1: recently an FDA panel on SSRIs in pregnant women and 276 00:15:04,760 --> 00:15:07,680 Speaker 1: the effects, and you had multiple different voices up there 277 00:15:07,720 --> 00:15:12,800 Speaker 1: speaking about this. And I saw a recent editorial on this, 278 00:15:12,960 --> 00:15:15,560 Speaker 1: and it was a woman who is I believe pregnant 279 00:15:15,560 --> 00:15:18,200 Speaker 1: now has two little kids, and talked about the importance 280 00:15:18,240 --> 00:15:21,720 Speaker 1: of her antidepressants, and it was, you know, she's very 281 00:15:21,760 --> 00:15:25,600 Speaker 1: upset about the fact that there were some questions as 282 00:15:25,640 --> 00:15:27,440 Speaker 1: to whether or not this was safe for the baby. 283 00:15:27,480 --> 00:15:30,920 Speaker 1: And I get that. I read it, and I was like, man, 284 00:15:31,000 --> 00:15:34,280 Speaker 1: I feel her. I feel exactly what she's saying. But 285 00:15:34,480 --> 00:15:38,400 Speaker 1: I also understand what you're saying, and that is that 286 00:15:38,840 --> 00:15:41,880 Speaker 1: you are starting to see changes. And I think the 287 00:15:41,920 --> 00:15:47,040 Speaker 1: most significant issue that has sat in my chest and 288 00:15:47,080 --> 00:15:49,880 Speaker 1: sat on my heart ever since I saw what you 289 00:15:49,920 --> 00:15:53,680 Speaker 1: guys were talking about was that you can actually tell 290 00:15:53,720 --> 00:15:57,040 Speaker 1: by looking at an ultrasound if the baby's mother is 291 00:15:57,080 --> 00:15:57,840 Speaker 1: on an SSRI. 292 00:15:59,600 --> 00:16:03,000 Speaker 2: Yeah, to get back to her. I did read that article, 293 00:16:03,040 --> 00:16:05,200 Speaker 2: and I do applaud women who come forward and tell 294 00:16:05,240 --> 00:16:07,440 Speaker 2: their story, and I think that they should be heard, 295 00:16:07,480 --> 00:16:10,520 Speaker 2: and I applaud her for doing that. I think that 296 00:16:11,440 --> 00:16:14,280 Speaker 2: I think that some people mistake, you know what I'm saying. 297 00:16:14,440 --> 00:16:17,880 Speaker 2: I try to explain to people that there's two separate issues. 298 00:16:18,480 --> 00:16:21,200 Speaker 2: One issue, the issue that I'm focused on is do 299 00:16:21,360 --> 00:16:27,040 Speaker 2: the SSRI antidepressants chemically affect the pregnancy? What are the risks? 300 00:16:27,760 --> 00:16:31,280 Speaker 2: Do they chemically alter fetal brain development? And should the 301 00:16:31,280 --> 00:16:34,280 Speaker 2: public be informed about that? And I think the answer 302 00:16:34,320 --> 00:16:37,200 Speaker 2: to both aspects of that question are yes. I think 303 00:16:37,240 --> 00:16:39,880 Speaker 2: they do impact the pregnancy. I do think they do 304 00:16:39,960 --> 00:16:42,400 Speaker 2: alter fetal brain development, and I do think that the 305 00:16:42,400 --> 00:16:45,840 Speaker 2: public should be warned about that. The second question about 306 00:16:45,840 --> 00:16:49,880 Speaker 2: whether a given patient should stay on her antidepressant or 307 00:16:49,960 --> 00:16:55,080 Speaker 2: not during her pregnancy is a very individual and complex 308 00:16:55,240 --> 00:16:58,680 Speaker 2: question that requires a discussion in the office, and I 309 00:16:58,760 --> 00:17:02,160 Speaker 2: do this every day with patients, and so I think 310 00:17:02,200 --> 00:17:06,600 Speaker 2: sometimes people mistake my answer to the first question, which 311 00:17:06,640 --> 00:17:10,720 Speaker 2: is that I think these chemicals are impacting the pregnancy 312 00:17:10,760 --> 00:17:13,080 Speaker 2: and the developing brain, and the patient in that the 313 00:17:13,119 --> 00:17:15,719 Speaker 2: patients in the public should be warned. They mistake that 314 00:17:15,800 --> 00:17:19,119 Speaker 2: as thinking I'm talking about them and their pregnancy and 315 00:17:19,160 --> 00:17:23,520 Speaker 2: a specific patient. That's not the case. That requires individualized counseling. 316 00:17:24,200 --> 00:17:26,879 Speaker 2: So I think it's important to keep those issues separate. 317 00:17:26,880 --> 00:17:30,080 Speaker 2: As far as the chemical impact that you're talking about, yes, 318 00:17:30,840 --> 00:17:35,359 Speaker 2: serotonin plays a crucial role in fetal development, particularly fetal 319 00:17:35,359 --> 00:17:40,239 Speaker 2: brain development, and the SSRIs disrupt the serotonin system, so 320 00:17:40,280 --> 00:17:42,880 Speaker 2: it just stands to reason that they would impact development 321 00:17:42,880 --> 00:17:45,800 Speaker 2: of the brain. So when we're giving it during pregnancy 322 00:17:45,920 --> 00:17:49,080 Speaker 2: and we're looking, for example, by ultrasound. There have been 323 00:17:49,119 --> 00:17:51,879 Speaker 2: a couple of studies that have done this. One was 324 00:17:51,920 --> 00:17:54,480 Speaker 2: done by Malder in twenty eleven and another one by 325 00:17:54,520 --> 00:17:57,240 Speaker 2: Salisbury I believe in twenty twenty three or twenty twenty four, 326 00:17:57,640 --> 00:18:02,840 Speaker 2: and they looked at fetal movement after giving or when 327 00:18:02,880 --> 00:18:05,520 Speaker 2: the women were on antidepressants, and what they found is 328 00:18:05,560 --> 00:18:09,600 Speaker 2: that it alters fetal movement. The fetuses of the SSRI 329 00:18:09,840 --> 00:18:15,080 Speaker 2: exposed moms are moving much more, They're less quiescent, they 330 00:18:15,119 --> 00:18:18,200 Speaker 2: don't have the same quiescent periods that we would normally 331 00:18:18,280 --> 00:18:21,560 Speaker 2: see it's kind of like jittery or they described as 332 00:18:21,640 --> 00:18:25,320 Speaker 2: jittery or agitated movements. So these were two studies that 333 00:18:25,359 --> 00:18:29,359 Speaker 2: were done ultrasound studies that showed this. Now, this corresponds 334 00:18:29,400 --> 00:18:32,720 Speaker 2: to what we see after birth, where the newborns that 335 00:18:32,760 --> 00:18:37,040 Speaker 2: have been exposed to SSRIs tend to be jittery and agitated. 336 00:18:37,320 --> 00:18:40,360 Speaker 2: So this makes sense that we're seeing a direct chemical 337 00:18:40,400 --> 00:18:44,760 Speaker 2: effect of the SSRI chemicals on the developing fetal brain. 338 00:18:45,560 --> 00:18:47,679 Speaker 2: Interestingly enough, a study just came out to it, or 339 00:18:47,800 --> 00:18:50,280 Speaker 2: just I'll wrap up this. A study just came out 340 00:18:50,960 --> 00:18:54,800 Speaker 2: looking at the length of the umbilical cord in babies 341 00:18:54,840 --> 00:19:00,840 Speaker 2: exposed to SSRIs and it found that the chords are long. Now, 342 00:19:00,880 --> 00:19:03,760 Speaker 2: this is the second study also showing this. The first 343 00:19:03,760 --> 00:19:06,399 Speaker 2: study on this came out in twenty sixteen and the 344 00:19:06,440 --> 00:19:09,040 Speaker 2: second one just came out now. But they think that 345 00:19:09,119 --> 00:19:12,280 Speaker 2: the length of the umbilical cord has to do with 346 00:19:12,560 --> 00:19:16,480 Speaker 2: fetal motion fetal activity. So all of this information would 347 00:19:16,520 --> 00:19:19,880 Speaker 2: hang together. The moms are taking ssrity to press sants 348 00:19:19,920 --> 00:19:22,720 Speaker 2: as in the SSRIs are crossing the placenta, they're going 349 00:19:22,720 --> 00:19:25,359 Speaker 2: into the baby, they're going into the baby's brain. They're 350 00:19:25,359 --> 00:19:29,600 Speaker 2: having an impact of agitation or jitteriness or motor impacts, 351 00:19:29,600 --> 00:19:32,439 Speaker 2: which is what we can see these medications do. And 352 00:19:32,480 --> 00:19:37,440 Speaker 2: we're seeing that as reflected on fetal ultrasound with increased movements, 353 00:19:37,680 --> 00:19:40,600 Speaker 2: and we're also seeing it with a result at birth 354 00:19:40,640 --> 00:19:44,720 Speaker 2: of a longer umbilical cord, possibly due to the increased movements. 355 00:19:44,920 --> 00:19:48,040 Speaker 2: And then also this jitteriness and agitation that we see 356 00:19:48,240 --> 00:19:51,120 Speaker 2: during the newborn period, which has been called the newborn 357 00:19:51,160 --> 00:19:55,080 Speaker 2: behavioral syndrome or newborn withdrawal or poor neonatal adaptation. 358 00:19:56,200 --> 00:19:58,320 Speaker 1: So I'm going to go to a place that is 359 00:19:58,440 --> 00:20:01,680 Speaker 1: kind of controversial. One of the things that you, I 360 00:20:01,760 --> 00:20:04,920 Speaker 1: mean very controversial. I think that the country has been 361 00:20:04,960 --> 00:20:08,879 Speaker 1: looking at the impacts of mental health and the changes 362 00:20:08,920 --> 00:20:11,840 Speaker 1: in the mental health of our children for a couple 363 00:20:11,920 --> 00:20:12,520 Speaker 1: of decades. 364 00:20:12,560 --> 00:20:12,720 Speaker 2: Now. 365 00:20:12,760 --> 00:20:15,879 Speaker 1: If you look back, I will tell you there's a 366 00:20:15,920 --> 00:20:18,840 Speaker 1: stunning difference to me between the kids that are in 367 00:20:18,880 --> 00:20:21,679 Speaker 1: class with my children as compared to the children I 368 00:20:21,720 --> 00:20:24,520 Speaker 1: went to school with when I was young, and I 369 00:20:25,520 --> 00:20:27,680 Speaker 1: and most of my friends I've noticed this too. There's 370 00:20:27,760 --> 00:20:32,800 Speaker 1: just different behaviors. There are different ways that they metabolize 371 00:20:32,920 --> 00:20:36,280 Speaker 1: their food. I mean, so many changes in what the 372 00:20:36,359 --> 00:20:38,720 Speaker 1: kids of today look like as compared to the kids 373 00:20:39,560 --> 00:20:43,399 Speaker 1: that I grew up with behavior and everything. And I 374 00:20:43,440 --> 00:20:46,280 Speaker 1: think that as a society we have been saying, why 375 00:20:46,320 --> 00:20:50,000 Speaker 1: are we experiencing these higher levels of autism, higher levels 376 00:20:50,080 --> 00:20:55,080 Speaker 1: of adhd add all of these things. And you mentioned 377 00:20:55,119 --> 00:20:57,760 Speaker 1: that there have been studies in animals that show that 378 00:20:57,960 --> 00:21:02,399 Speaker 1: as these feed, as these babies grow up, if they 379 00:21:02,400 --> 00:21:06,760 Speaker 1: are you know, in animals, rats, rats, sheep, mice, as 380 00:21:06,880 --> 00:21:12,200 Speaker 1: those animals grow up, they show signs of autistic type behaviors. 381 00:21:13,080 --> 00:21:16,080 Speaker 1: And I know this is very sensitive because of course 382 00:21:16,560 --> 00:21:19,800 Speaker 1: you talked about maternal blame and all of that, and 383 00:21:19,880 --> 00:21:23,040 Speaker 1: I think that this is an area where it's very 384 00:21:23,040 --> 00:21:26,080 Speaker 1: hard for us to have this discussion. But isn't it 385 00:21:26,200 --> 00:21:29,400 Speaker 1: critical if this could be playing a role in some 386 00:21:29,480 --> 00:21:32,680 Speaker 1: of the mental illness we're seeing in children, that this 387 00:21:32,800 --> 00:21:36,080 Speaker 1: is made aware to doctors and to mothers. 388 00:21:37,000 --> 00:21:41,359 Speaker 2: Yeah. Absolutely. I think you're raising a really good point, though, Tutor, 389 00:21:41,400 --> 00:21:44,639 Speaker 2: about how much medication use is going on. And I 390 00:21:44,640 --> 00:21:47,800 Speaker 2: think a lot of people nowadays just take this for granted. 391 00:21:47,840 --> 00:21:51,680 Speaker 2: Everybody is on several medications, but this is not how 392 00:21:51,720 --> 00:21:55,520 Speaker 2: it's been I mean, we currently are the most heavily 393 00:21:55,680 --> 00:22:03,359 Speaker 2: medicated humans in human history Americans, modern day Americans. I 394 00:22:03,400 --> 00:22:07,439 Speaker 2: would say the most heavily medicated human beings that have 395 00:22:07,520 --> 00:22:10,600 Speaker 2: ever lived on the planet. And that's going to have 396 00:22:10,640 --> 00:22:14,240 Speaker 2: an impact when you're giving that many chemicals, that many 397 00:22:14,280 --> 00:22:17,960 Speaker 2: medications to pregnant women, to moms and babies, and then 398 00:22:18,000 --> 00:22:23,280 Speaker 2: to children. I'm seeing this in my office regularly. I'm 399 00:22:23,320 --> 00:22:27,720 Speaker 2: talking now about SSRI antidepressants, but I'm seeing it with adderall, 400 00:22:27,840 --> 00:22:32,320 Speaker 2: I'm seeing with ADHD medications. I'm seeing it with a 401 00:22:32,400 --> 00:22:36,560 Speaker 2: variety of different pharmaceuticals. So it's throughout our entire population. 402 00:22:37,680 --> 00:22:40,240 Speaker 2: And then to get to your specific question, are we 403 00:22:40,280 --> 00:22:45,320 Speaker 2: seeing impacts in terms of behaviors? Yes? Absolutely. The animal 404 00:22:45,400 --> 00:22:51,680 Speaker 2: studies show fairly clearly that if you expose pregnant rats, mice, etc. 405 00:22:52,320 --> 00:22:57,399 Speaker 2: To SSRIs, the offspring will behave differently. They'll have different 406 00:22:57,520 --> 00:23:02,320 Speaker 2: they say, different like social behaviors, different play seeking activities, 407 00:23:02,320 --> 00:23:05,920 Speaker 2: things like that. They'll have different behaviors, and they also 408 00:23:05,960 --> 00:23:09,639 Speaker 2: have different sexual behaviors. Several studies have looked at the 409 00:23:10,080 --> 00:23:15,080 Speaker 2: male offspring who we're exposed to SSRIs during development, and 410 00:23:15,160 --> 00:23:20,840 Speaker 2: they behave differently sexually when they're studied. They have different 411 00:23:21,240 --> 00:23:24,880 Speaker 2: populatory behavior, they mount less they put them in in 412 00:23:25,000 --> 00:23:30,160 Speaker 2: cages with females and they behave differently than the unexposed 413 00:23:30,200 --> 00:23:30,760 Speaker 2: males do. 414 00:23:31,560 --> 00:23:34,160 Speaker 1: So should let this be a five alarm fire? I mean, 415 00:23:34,200 --> 00:23:38,080 Speaker 1: I know this is, like I said, it's so controversial 416 00:23:38,160 --> 00:23:41,440 Speaker 1: to say, but come on, I mean, at what point 417 00:23:41,480 --> 00:23:45,760 Speaker 1: do we say we have got to immediately start looking 418 00:23:45,800 --> 00:23:49,760 Speaker 1: at this. And I've had there's this SSRI conversation going 419 00:23:49,800 --> 00:23:52,880 Speaker 1: on right now, and there's this radical battle, and I've 420 00:23:52,880 --> 00:23:55,080 Speaker 1: seen people go on the news and say, can you 421 00:23:55,160 --> 00:23:58,359 Speaker 1: imagine people saying that folks need to get off of SSRIs? 422 00:23:58,400 --> 00:24:01,280 Speaker 1: Everybody would be killing themselves left and right. And then 423 00:24:01,320 --> 00:24:04,200 Speaker 1: there's another side that goes, man, if people get off 424 00:24:04,200 --> 00:24:06,960 Speaker 1: of an SSRI and they start killing themselves, like, should 425 00:24:07,000 --> 00:24:11,119 Speaker 1: we be worried about that? This is big stuff. 426 00:24:12,280 --> 00:24:14,840 Speaker 2: Yeah, And I think people are now drawing attention to it. 427 00:24:14,920 --> 00:24:18,320 Speaker 2: People are now focusing more on this. This is why 428 00:24:18,400 --> 00:24:21,119 Speaker 2: I'm speaking out about it, because I agree with you. 429 00:24:21,240 --> 00:24:22,879 Speaker 2: I think this is big stuff. I think this is 430 00:24:23,080 --> 00:24:27,639 Speaker 2: very big stuff. We're talking about the development of the brain, 431 00:24:27,760 --> 00:24:31,119 Speaker 2: of the baby's brain. And I made the point during 432 00:24:31,160 --> 00:24:34,000 Speaker 2: the FDA meeting that never before in human history have 433 00:24:34,080 --> 00:24:38,880 Speaker 2: we chemically altered developing baby's brains in this way, and 434 00:24:39,240 --> 00:24:42,320 Speaker 2: we're doing that now, and we need to really raise 435 00:24:42,359 --> 00:24:46,239 Speaker 2: attention to what the studies are showing. It's not just 436 00:24:46,280 --> 00:24:49,720 Speaker 2: the rat in my studies, it's the human studies as well. 437 00:24:49,840 --> 00:24:52,159 Speaker 2: So we talked a little bit about the ultrasound studies. 438 00:24:52,160 --> 00:24:55,920 Speaker 2: There's twelve MRI studies. I mean, it's not one or two, 439 00:24:56,040 --> 00:24:58,760 Speaker 2: it's not well, maybe they got the study wrong. It's 440 00:24:58,920 --> 00:25:03,520 Speaker 2: twelve mr eye studies now showing in humans that SSRI 441 00:25:03,760 --> 00:25:08,640 Speaker 2: exposure during pregnancy leads to alterations of the brain. These 442 00:25:09,160 --> 00:25:14,119 Speaker 2: are MRI studies showing this. There's three EEG studies. EEGs 443 00:25:14,160 --> 00:25:16,920 Speaker 2: are done typically in patients that have seizures, looking at 444 00:25:16,960 --> 00:25:20,119 Speaker 2: brain waves, but they do these EEG studies now to 445 00:25:20,359 --> 00:25:24,720 Speaker 2: on expose newborns and expose children, and they're finding that 446 00:25:24,760 --> 00:25:27,480 Speaker 2: the brain wave patterns and the connectivity of the brain 447 00:25:27,680 --> 00:25:31,679 Speaker 2: is different in those exposed to the SSRI antidepressants. And 448 00:25:31,760 --> 00:25:35,600 Speaker 2: this just makes sense to most people looking at this 449 00:25:36,400 --> 00:25:40,800 Speaker 2: because of what a crucial role serotonin plays in brain development. 450 00:25:41,080 --> 00:25:43,520 Speaker 2: So if you tinker with that, if you interfere with that, 451 00:25:43,960 --> 00:25:47,119 Speaker 2: you'd expect that you'd get downstream effects. And that's in 452 00:25:47,160 --> 00:25:49,800 Speaker 2: fact what we are seeing. So I agree with you. 453 00:25:50,040 --> 00:25:52,480 Speaker 2: I don't want to be accused of fear mongering or 454 00:25:52,560 --> 00:25:57,000 Speaker 2: talking about five alarm fires or diminishing the importance of depression. 455 00:25:57,359 --> 00:25:59,960 Speaker 2: But I think your point is a very good one, 456 00:26:00,080 --> 00:26:03,920 Speaker 2: which is we're now collecting data. We've got information from 457 00:26:04,000 --> 00:26:08,880 Speaker 2: MRI studies, from studies on depression and language problems and autism. 458 00:26:09,160 --> 00:26:12,200 Speaker 2: We've got this whole wealth of data that's showing these things, 459 00:26:12,359 --> 00:26:14,560 Speaker 2: and we really need to get this information out to 460 00:26:14,640 --> 00:26:17,879 Speaker 2: pregnant women in the public. And we really need to, 461 00:26:18,119 --> 00:26:20,120 Speaker 2: as I was making that point at the FDA meeting, 462 00:26:20,160 --> 00:26:22,560 Speaker 2: is to change the label and to have the FDA 463 00:26:22,640 --> 00:26:26,040 Speaker 2: make a public statement on what the research is actually saying, 464 00:26:26,440 --> 00:26:30,160 Speaker 2: again the research versus what the sales pitch is, which 465 00:26:30,200 --> 00:26:34,679 Speaker 2: is that these drugs are essentially completely safe, very review 466 00:26:34,760 --> 00:26:37,480 Speaker 2: or no risks, and very effective, which is just not 467 00:26:37,600 --> 00:26:39,320 Speaker 2: what that scientific evidence is showing. 468 00:26:39,480 --> 00:26:42,240 Speaker 1: Well, I just don't understand why the discussion of side 469 00:26:42,240 --> 00:26:46,480 Speaker 1: effects is then interpreted it as not caring about depression. 470 00:26:48,240 --> 00:26:52,280 Speaker 2: Yeah, I think that some people that are doing this 471 00:26:52,440 --> 00:26:57,320 Speaker 2: are doing this as a distraction method, to distract from 472 00:26:57,320 --> 00:26:59,960 Speaker 2: the conversation. I don't want to blame all of that 473 00:27:00,119 --> 00:27:01,840 Speaker 2: for this, I think some of them are well meaning, 474 00:27:01,920 --> 00:27:05,520 Speaker 2: but this is sort of a pharmaceutical technique, a big 475 00:27:05,560 --> 00:27:09,520 Speaker 2: pharma industry technique, to divert attention away from the issue 476 00:27:09,560 --> 00:27:12,800 Speaker 2: at hand. So, for example, when the opioid crisis was 477 00:27:12,920 --> 00:27:16,520 Speaker 2: raging with OxyContin and people were raising issues, look, this 478 00:27:16,560 --> 00:27:20,280 Speaker 2: is a big problem, what's going on, they would often say, 479 00:27:20,320 --> 00:27:23,360 Speaker 2: we need to talk more about the crisis of untreated 480 00:27:23,440 --> 00:27:27,760 Speaker 2: pain in our country, focusing on pain rather than the 481 00:27:27,840 --> 00:27:31,880 Speaker 2: specific question that was at hand, which is is your 482 00:27:32,040 --> 00:27:36,639 Speaker 2: drug or is oxy conton causing these harms? But the 483 00:27:36,680 --> 00:27:40,920 Speaker 2: pharmaceutical industry moves away from the question about the drug 484 00:27:41,400 --> 00:27:44,200 Speaker 2: to the question about the condition in order to divert 485 00:27:44,280 --> 00:27:46,600 Speaker 2: your attention, to make you take your eye off the ball. 486 00:27:46,960 --> 00:27:50,320 Speaker 2: I actually saw this during McKenna. When I would argue 487 00:27:50,359 --> 00:27:53,040 Speaker 2: about it not being an effective pre term birth drug, 488 00:27:53,400 --> 00:27:56,600 Speaker 2: I would get feedback that, well, pre term birth is 489 00:27:56,640 --> 00:28:00,520 Speaker 2: an important issue and we can't ignore the women that 490 00:28:00,560 --> 00:28:03,600 Speaker 2: have had a preterm birth and diminish preterm birth. And 491 00:28:03,680 --> 00:28:05,800 Speaker 2: they would spend, you know, half the time talking about 492 00:28:05,800 --> 00:28:09,439 Speaker 2: pre term birth. That's more of a diversionary tactic. What 493 00:28:09,520 --> 00:28:11,359 Speaker 2: you're seeing, actually you're seeing a lot of this in 494 00:28:11,400 --> 00:28:14,760 Speaker 2: the subsequent media, the corporate media, and some of the 495 00:28:14,920 --> 00:28:18,600 Speaker 2: editorials written by some of the perinatal psychiatrists. They spend 496 00:28:18,640 --> 00:28:22,200 Speaker 2: most of it talking about depression. Not the depression is 497 00:28:22,240 --> 00:28:26,199 Speaker 2: not important, but you need to answer the question what 498 00:28:26,359 --> 00:28:28,800 Speaker 2: are the risks of the drugs and what is the 499 00:28:28,840 --> 00:28:32,120 Speaker 2: evidence of their effectiveness? And that's the question that needs 500 00:28:32,160 --> 00:28:35,439 Speaker 2: to be answered. The public needs to laser focus on that. 501 00:28:35,480 --> 00:28:38,760 Speaker 1: And some of these some of these situations are creating 502 00:28:38,880 --> 00:28:44,320 Speaker 1: even deeper problems for people or or more people with problems. 503 00:28:44,560 --> 00:28:47,560 Speaker 1: That's the other issue when you have a pregnant mother 504 00:28:47,640 --> 00:28:49,520 Speaker 1: taking these. The last thing I want to get to 505 00:28:50,680 --> 00:28:53,880 Speaker 1: is the PSSD, which is the sexual dysfunction, and you 506 00:28:53,960 --> 00:28:57,400 Speaker 1: talked about that in these animals. We've heard that there 507 00:28:57,520 --> 00:29:01,000 Speaker 1: is potential that some of these children get to adolescents 508 00:29:01,080 --> 00:29:04,720 Speaker 1: and they don't have interest in sex, or they can't 509 00:29:04,880 --> 00:29:09,040 Speaker 1: perform sexually, or there are other sexual dysfunctions. One of 510 00:29:09,120 --> 00:29:12,440 Speaker 1: your colleagues had an interview recently and he went into 511 00:29:12,520 --> 00:29:15,320 Speaker 1: kind of graphic detail about this and said, there are 512 00:29:15,400 --> 00:29:21,280 Speaker 1: people who take these and sometimes they are permanently. Sometimes 513 00:29:21,400 --> 00:29:24,880 Speaker 1: there's permanent sexual dysfunction. Sometimes they can get off of 514 00:29:24,920 --> 00:29:27,640 Speaker 1: the drug and that can be reversed, but too often 515 00:29:27,720 --> 00:29:30,840 Speaker 1: they are not told ahead of time that this could happen. 516 00:29:30,920 --> 00:29:33,800 Speaker 1: And he said that some people have described it as 517 00:29:33,960 --> 00:29:36,680 Speaker 1: they can touch their genitals and it's like touching the 518 00:29:36,720 --> 00:29:39,520 Speaker 1: back of their hand. They have no reaction whatsoever, that 519 00:29:39,600 --> 00:29:43,800 Speaker 1: all of those receptors are no longer having any type 520 00:29:43,800 --> 00:29:47,160 Speaker 1: of reaction to another person. In fact, men are even 521 00:29:47,200 --> 00:29:49,360 Speaker 1: coming out and saying, women who I used to have 522 00:29:49,400 --> 00:29:52,320 Speaker 1: this great relationship with I was completely sexually attracted to, 523 00:29:52,560 --> 00:29:54,840 Speaker 1: I don't have that at all. I'm questioning if I'm 524 00:29:54,840 --> 00:29:58,720 Speaker 1: even a sexual person anymore. To me, this is such 525 00:29:58,760 --> 00:30:03,200 Speaker 1: a critical part of relationships, and I cannot express enough 526 00:30:03,560 --> 00:30:08,280 Speaker 1: that if you suddenly have a marriage and you have 527 00:30:08,480 --> 00:30:11,880 Speaker 1: the one spouse that no longer has any interest in sex, 528 00:30:12,040 --> 00:30:15,960 Speaker 1: you're destroying that relationship. If you have a child that 529 00:30:16,360 --> 00:30:20,200 Speaker 1: gets to adolescence and they don't understand that relationship, what 530 00:30:20,400 --> 00:30:21,320 Speaker 1: is the future. 531 00:30:22,320 --> 00:30:25,880 Speaker 2: Yeah, I think you're raising really important issues. I think 532 00:30:25,920 --> 00:30:28,720 Speaker 2: we need to exercise, just as a general point, more 533 00:30:28,800 --> 00:30:34,800 Speaker 2: humility about tinkering with the chemicals that make our brains 534 00:30:34,840 --> 00:30:39,040 Speaker 2: and our bodies. Sarah, why do we behave sexually the 535 00:30:39,040 --> 00:30:41,520 Speaker 2: way we do, or why do we develop in that fashion? 536 00:30:41,560 --> 00:30:44,160 Speaker 2: Why do our brains develop that way? A lot of 537 00:30:44,200 --> 00:30:46,600 Speaker 2: it probably has to do with the way the tracks 538 00:30:46,640 --> 00:30:50,960 Speaker 2: are laid down in utero during development, and a lot 539 00:30:51,000 --> 00:30:54,520 Speaker 2: of the way those brain tracks are formed in the 540 00:30:55,000 --> 00:31:00,920 Speaker 2: brain is because of serotonin and other neurotransmitters. Put medications 541 00:31:00,960 --> 00:31:04,480 Speaker 2: in there, like the SSRI, antidepressants and others that alter 542 00:31:04,720 --> 00:31:08,880 Speaker 2: those neurotransmitters. Can you alter the development of those parts 543 00:31:08,880 --> 00:31:11,720 Speaker 2: of the brain or those tracks that then show up later? 544 00:31:12,320 --> 00:31:16,360 Speaker 2: The answer from the animal studies looks like yes, absolutely, 545 00:31:16,960 --> 00:31:19,840 Speaker 2: it appears to do that, and that just makes common sense. 546 00:31:20,240 --> 00:31:26,520 Speaker 2: And then does that have major implications and major ramifications? Absolutely? Yeah. 547 00:31:26,520 --> 00:31:29,400 Speaker 2: I agree with you. I agree with you wholeheartedly. And 548 00:31:29,440 --> 00:31:33,600 Speaker 2: that's why I think it's important that patients and the 549 00:31:33,640 --> 00:31:38,480 Speaker 2: public get this information so they can make an informed choice, 550 00:31:38,960 --> 00:31:42,760 Speaker 2: and that the information gets out not just to pregnant women, 551 00:31:42,880 --> 00:31:45,200 Speaker 2: because really that's not the time to make the choice 552 00:31:45,240 --> 00:31:47,320 Speaker 2: on this. It really needs to get out to women 553 00:31:47,320 --> 00:31:51,160 Speaker 2: of child bearing age because a lot of times the 554 00:31:51,240 --> 00:31:54,239 Speaker 2: patients that I see have been on the medications for 555 00:31:54,440 --> 00:31:57,000 Speaker 2: years and many of them can't come off of them 556 00:31:57,120 --> 00:31:59,680 Speaker 2: or would have great difficulty coming off of them. And 557 00:31:59,760 --> 00:32:02,440 Speaker 2: this is another aspect to this, the issue of withdrawal 558 00:32:02,480 --> 00:32:06,120 Speaker 2: and problems withdrawing from the drugs, difficulties in coming off. 559 00:32:06,960 --> 00:32:09,200 Speaker 2: So I think that it needs to get out to 560 00:32:09,560 --> 00:32:12,640 Speaker 2: pregnant to women of child bearing age, specifically with the 561 00:32:12,680 --> 00:32:16,640 Speaker 2: PSSD question. I think that many people are looking at 562 00:32:16,640 --> 00:32:19,440 Speaker 2: this as a chemical injury, which takes me full circle 563 00:32:19,480 --> 00:32:21,480 Speaker 2: now to what I started off with with these chemicals 564 00:32:21,520 --> 00:32:24,960 Speaker 2: half consequences. If you're putting these chemicals into your brain, 565 00:32:25,040 --> 00:32:28,680 Speaker 2: into your body, you can get chemical impacts. And then 566 00:32:28,800 --> 00:32:31,720 Speaker 2: even when you're not taking them anymore, if there's been 567 00:32:31,800 --> 00:32:35,920 Speaker 2: chemical toxicity, which chemicals often do have toxicity, it can 568 00:32:35,960 --> 00:32:39,200 Speaker 2: have long term effects, and in that case with PSSD, 569 00:32:39,360 --> 00:32:41,640 Speaker 2: long term sexual effects which can be devastated. 570 00:32:41,800 --> 00:32:44,479 Speaker 1: Let's take a quick commercial break. We'll continue next on 571 00:32:44,520 --> 00:32:50,280 Speaker 1: a Tutor Dixon podcast. I will tell you so many 572 00:32:50,280 --> 00:32:53,480 Speaker 1: people that I know that have taken medications or on 573 00:32:53,560 --> 00:32:57,200 Speaker 1: medications have said to me, if I had known these 574 00:32:57,200 --> 00:33:00,479 Speaker 1: were the side effects, I wouldn't have originally agreed to take. 575 00:33:00,760 --> 00:33:03,600 Speaker 1: And even some side effects that are just really a pain. 576 00:33:03,840 --> 00:33:07,960 Speaker 1: Some side effects like sweat, constant sweating constant sweating. I 577 00:33:08,000 --> 00:33:11,080 Speaker 1: have some friends who've taken these medications and they're like, 578 00:33:11,760 --> 00:33:13,600 Speaker 1: and now it doesn't go I got off the medication, 579 00:33:13,640 --> 00:33:16,160 Speaker 1: but it doesn't go away. But that's your point is 580 00:33:16,280 --> 00:33:20,160 Speaker 1: people should be informed. There's so little information about how 581 00:33:20,280 --> 00:33:23,360 Speaker 1: these medications are going to affect people. And that's what 582 00:33:23,400 --> 00:33:25,720 Speaker 1: I want to bring attention to, is that there are 583 00:33:25,880 --> 00:33:30,600 Speaker 1: other consequences to taking these medications. And is there another answer. 584 00:33:30,680 --> 00:33:33,600 Speaker 1: It's not that we don't take the other issues seriously. 585 00:33:33,960 --> 00:33:36,000 Speaker 1: It's that you have to make sure that there is 586 00:33:36,560 --> 00:33:39,320 Speaker 1: enough information out there for people to know what they're 587 00:33:39,320 --> 00:33:41,800 Speaker 1: putting into their bodies. I'll just end on. When your 588 00:33:41,800 --> 00:33:44,600 Speaker 1: colleague was interviewed, they also gave an example of a 589 00:33:44,640 --> 00:33:49,120 Speaker 1: young woman twenty one years old was very suffering from 590 00:33:49,160 --> 00:33:53,120 Speaker 1: severe anxiety, and he said, she went on this medication 591 00:33:53,480 --> 00:33:57,880 Speaker 1: and there is an instant reaction. Well sometimes it takes 592 00:33:57,920 --> 00:33:59,720 Speaker 1: a couple of weeks, but there's a reaction of okay, 593 00:34:00,000 --> 00:34:02,760 Speaker 1: and I feel calm now, I feel better. I needed 594 00:34:02,800 --> 00:34:06,200 Speaker 1: this medication, but your body adjusts and then you need more. 595 00:34:06,680 --> 00:34:09,360 Speaker 1: And as she took more, she ended up with the 596 00:34:09,400 --> 00:34:14,400 Speaker 1: sexual dysfunction, and she started to get very upset about that, 597 00:34:14,520 --> 00:34:16,799 Speaker 1: and she went to her doctor and they admitted her 598 00:34:16,840 --> 00:34:19,120 Speaker 1: to a hospital and said, you have some sort of 599 00:34:19,480 --> 00:34:21,960 Speaker 1: you're having a mental break. And she was trying to 600 00:34:21,960 --> 00:34:25,120 Speaker 1: tell her parents, I'm not having a mental break. There's 601 00:34:25,120 --> 00:34:27,080 Speaker 1: something happening to me. I'm not the person I used 602 00:34:27,120 --> 00:34:30,960 Speaker 1: to be, and the system was telling her you're broken, 603 00:34:31,320 --> 00:34:33,880 Speaker 1: not even coming back to her and saying, actually, the 604 00:34:33,920 --> 00:34:37,120 Speaker 1: medication you're taking is wrong. And I think that in 605 00:34:37,160 --> 00:34:39,759 Speaker 1: some cases even the doctors don't know that that's what 606 00:34:39,800 --> 00:34:41,880 Speaker 1: the medication does, and they're like, oh man, this is 607 00:34:41,960 --> 00:34:44,040 Speaker 1: just a new thing. You're even worse now. 608 00:34:45,000 --> 00:34:48,000 Speaker 2: Yeah, there's a real lack of knowledge, absolutely to there's 609 00:34:48,000 --> 00:34:50,440 Speaker 2: a real lack of knowledge about side effects. And I 610 00:34:50,440 --> 00:34:53,000 Speaker 2: think now particularly sensitive to the points that you're making 611 00:34:53,080 --> 00:34:57,520 Speaker 2: because I practice in my hometown. I was born, I practice, 612 00:34:57,560 --> 00:35:00,120 Speaker 2: I work in the hospital I was born at. I 613 00:35:00,160 --> 00:35:03,480 Speaker 2: work in my community, and I never want my patients 614 00:35:03,520 --> 00:35:06,080 Speaker 2: to come back to me five years from now, ten 615 00:35:06,160 --> 00:35:08,680 Speaker 2: years from now, twenty years from now and say, boy, 616 00:35:08,719 --> 00:35:12,759 Speaker 2: you didn't really counsel us about those drugs, those medications 617 00:35:12,760 --> 00:35:16,719 Speaker 2: and what you were seeing in the research literature. So 618 00:35:16,960 --> 00:35:20,000 Speaker 2: I feel an obligation to care for my community and 619 00:35:20,040 --> 00:35:23,760 Speaker 2: to correctly counsel. So again, this is not about pill shaming, 620 00:35:23,800 --> 00:35:27,600 Speaker 2: making anyone feel guilty taking anyone's medications away. It's just 621 00:35:27,680 --> 00:35:30,720 Speaker 2: about getting proper information out to patients in the public. 622 00:35:31,520 --> 00:35:33,160 Speaker 2: The last thing I want to just comment on is 623 00:35:33,200 --> 00:35:36,880 Speaker 2: what you mentioned about doing other things. Many much of 624 00:35:36,920 --> 00:35:40,360 Speaker 2: the discussion since the FDA meeting has been about is 625 00:35:40,400 --> 00:35:44,919 Speaker 2: it should it be ssrized or untreated depression? But it's 626 00:35:44,960 --> 00:35:47,480 Speaker 2: not a choice just between those things. I don't think 627 00:35:47,480 --> 00:35:51,160 Speaker 2: anyone's arguing for ignoring pregnant women, not treating them, making 628 00:35:51,239 --> 00:35:54,400 Speaker 2: them feel bad. There's just there are other methods that 629 00:35:55,000 --> 00:35:58,239 Speaker 2: can be considered in that in terms of how to 630 00:35:58,280 --> 00:36:05,160 Speaker 2: address depression, whether it's exercise, psychotherapy, diet, job counseling, relationship counseling, 631 00:36:05,239 --> 00:36:08,399 Speaker 2: taking other approaches. And so I think that looking at 632 00:36:08,400 --> 00:36:11,880 Speaker 2: the whole or counseling patients about all of the options 633 00:36:12,280 --> 00:36:15,000 Speaker 2: and then letting them make the best choice for themselves 634 00:36:15,000 --> 00:36:16,920 Speaker 2: and then supporting them, which is what I end up 635 00:36:16,920 --> 00:36:20,200 Speaker 2: doing every day in my community, is the is the 636 00:36:20,360 --> 00:36:22,879 Speaker 2: is the best way to go, But the key there 637 00:36:23,000 --> 00:36:24,640 Speaker 2: is to actually get them the information. 638 00:36:25,360 --> 00:36:28,960 Speaker 1: Yeah, absolutely, and I so appreciate what you're doing there's 639 00:36:28,960 --> 00:36:31,120 Speaker 1: so much more that we could talk about on this, 640 00:36:31,200 --> 00:36:33,000 Speaker 1: and I'm sure we'll have to have you back to 641 00:36:33,000 --> 00:36:36,000 Speaker 1: talk about it. But as we see the country kind 642 00:36:36,040 --> 00:36:38,920 Speaker 1: of changing, and I do I get your point about 643 00:36:39,040 --> 00:36:40,840 Speaker 1: this is a time when people are really saying you 644 00:36:40,880 --> 00:36:43,560 Speaker 1: can't push back. But I think it's also because this 645 00:36:43,680 --> 00:36:46,959 Speaker 1: is the first time people have said, maybe these three 646 00:36:47,040 --> 00:36:50,319 Speaker 1: letter agencies don't know everything and we should push back. 647 00:36:50,440 --> 00:36:53,120 Speaker 1: So we are also seeing a lot of strong people 648 00:36:53,160 --> 00:36:56,359 Speaker 1: stand up and say, actually, I had a bad experience too, 649 00:36:56,640 --> 00:36:59,000 Speaker 1: And it's been amazing to me the number of patients 650 00:36:59,040 --> 00:37:02,000 Speaker 1: who have said, even on social media. I never wanted 651 00:37:02,040 --> 00:37:04,480 Speaker 1: to admit this before because I was so personally embarrassed. 652 00:37:04,480 --> 00:37:06,680 Speaker 1: I thought I was the only one. But I've had 653 00:37:06,719 --> 00:37:08,799 Speaker 1: this happen too. I've had this happen too, So I 654 00:37:08,880 --> 00:37:13,040 Speaker 1: encourage people to keep talking in doctor Doctor Adam Errado, 655 00:37:13,200 --> 00:37:15,160 Speaker 1: thank you so much for being out there and being 656 00:37:15,200 --> 00:37:16,120 Speaker 1: a voice for all of us. 657 00:37:16,560 --> 00:37:18,279 Speaker 2: Well. Thank you, and you're a big part of this 658 00:37:18,360 --> 00:37:21,879 Speaker 2: push this pushing back through the podcast, through writing as 659 00:37:21,880 --> 00:37:25,360 Speaker 2: you did recently, through having guests on like myself, to 660 00:37:25,440 --> 00:37:26,600 Speaker 2: keep getting the message out. 661 00:37:26,920 --> 00:37:28,919 Speaker 1: Thank you, Thank you so much, and thank you all 662 00:37:29,000 --> 00:37:31,759 Speaker 1: for joining us on the Tutor Dixon podcast for this 663 00:37:31,880 --> 00:37:35,240 Speaker 1: episode and others. Go to the iHeartRadio app, Apple Podcasts, 664 00:37:35,360 --> 00:37:38,239 Speaker 1: or wherever you get your podcasts and join us next time. 665 00:37:38,440 --> 00:37:39,160 Speaker 1: Have a blessing.