As a Registered Nurse, I love WebMD. It’s a great resource for people on both sides of healthcare, and it doesn’t usually let me down. I even subscribe to the e-newsletter.

The slideshow I received in my inbox, with the attention-grabbing title 10 Ways to Wreck Your Liver: Is Your Liver in Danger? as a part of the special Your Most Pressing Health Concerns, could not have been more perfectly timed. It was a day filled with candy, food and a booze-soaked Raclette at my house, while my in-laws were visiting for the holidays. When I saw the subject line I thought maybe it was a sign and I leaned in closer.

As it turns out, I was disappointed after following and viewing the link in the e-mail (if clicking and waiting for a slideshow to load isn’t less than impressive already) so I dropped WebMD a little shit-o-gram to express my views.

I was a little annoyed to see antidepressants on the list of “Ways to Wreck Your Liver” in the newsletter just sent out.

The list seemed to include mostly elective lifestyle choices like consuming sugar and MSG – things a patient can safely reduce on their own. Antidepressants on the other hand are oftentimes life-saving prescriptions and should not be stopped abruptly unless a doctor is supervising. They are not an herbal supplement a patient can just ‘quit’.

True, they are known to rarely cause hepatotoxicity, particularly with the older MAOIs and tricyclics that are less prescribed. In fact many medications for serious chronic conditions can cause liver damage, but I didn’t see them on this list. And I feel that listing antidepressants here may cause unnecessary alarm in a group of patients already known to struggle with compliance.

I suspect antidepressants’ special mention is a residue left over from the attitude that those taking these drugs are just participating in cosmetic psychopharm and are not really ill.

Can we stop the out-of-proportion reporting of the adverse effects of antidepressants where it is not warranted? Information is power, but finger-wagging just creates more shame. Thank-you.

Acetaminophen toxicity is the leading cause of acute liver failure in the Western world. That’s Tylenol.

Overdose on Tylenol may be intentional or accidental, especially if you are an older adult, or your liver is already compromised. This is something all nurses and doctors know because it is one of the more common medication-related injuries seen in hospitals. It continues to be a major problem in ERs and, in the case of accidental overdose, people are not warned nearly enough of the dangers of taking more than what is recommended.

Liver failure from a daily antidepressant medication? I would have to argue is less common. If a publication was to cover the adverse effects of one drug, why would the subject of focus be a prescription medication for a serious, chronic condition over and above a non-prescription pain reliever that the public has universal access to from infancy through adulthood in their medicine cabinet? Editorial bias? Bad journalistic priorities?

My tone here mirrors my reactionary thoughts I had to the well-covered findings of a recent study which showed a weak but statistically significant link between SSRIs taken in pregnancy and autism.

And this article sums up in a more accurate, cool-headed manner why we all don’t need to start freaking out and tut-tutting at other moms.

You may have heard this study reported in early December on your local news or radio station while you were driving. It probably was squeezed in at the end of the program and went something like this: “And a recent study has shown a significant link between SSRIs taken in pregnancy and childhood autism…. And that’s all we have for today, folks….” This type of quick-digest reporting is not harmless. It creates misunderstanding, alarm, and guilt.

I guess what I’m trying to say here is, if you smell bullshit, it’s best to call it out. No one is arguing where the smell is coming from, but its placement in the middle of the sidewalk may not be appropriate.


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