A third of antidepressants are prescribed for something else
It was when he became a father that Michael Briggs resolved to somehow bring his ulcerative colitis under control. He was determined to avoid what many people with the disease end up needing -- having part or all of their large intestine removed.
A trained scientist, manager of a physics lab at the University of New Hampshire, he began reading medical research papers, looking for anything that might help him.
He knew there wouldn't be just one single cure, just as he knew there was not one single cause behind this inflammatory bowel disease (IBD), which causes gut pain, bleeding and diarrhea. He had already been on a drug called Remicade (infliximab) for more than five years. This blocks the action of an inflammatory protein called tumor necrosis factor alpha (TNF alpha) in order to stop the immune system from attacking the colon wall.
The problem is that drugs like this can have significant side-effects, such as leaving patients more prone to infections and, in rare cases, cancer. Another problem is that the drugs stop working as people's immune systems develop antibodies against them.
Briggs knew he couldn't stay on infliximab for ever and he was tired of dealing with the cycle of flare-up and remission with his disease. Seeking a way to heal following a nasty flare-up during the summer of 2013, he sifted through more than 150 papers on anti-inflammatory supplements, diet and TNF blockers.
Eventually, he stumbled upon research suggesting that an antidepressant called bupropion had an effect on Crohn's disease, another type of IBD where the immune system attacks the lining of the gut. Studies on mice had shown that instead of blocking the action of inflammatory proteins, bupropion appeared to lower the production of those proteins in the first place.
Briggs decided to give it a try. It seems surprising that antidepressants should work on other diseases, but perhaps it's time to stop thinking of these drugs as 'antidepressants' and admit that they are not one-trick ponies, but jacks of all trades.
Antidepressants can all help relieve depression, but they do this in many different ways, acting on different chemical messengers in the brain and nervous system. Those same neurotransmitters have roles in controlling what happens in other organs and systems, so it's no wonder that antidepressants have other effects. Some are unwanted, which we call side-effects, and others are useful, which may be why almost a third of antidepressant prescriptions are off-label.
But the very nature of how we regulate and produce drugs means there are many obstacles to understanding everything that a drug might be capable of. And that means patients could be missing out on potentially beneficial treatments.
As Briggs had predicted, those side-effects quickly subsided. He estimates that, of the people with IBD who have contacted him about bupropion, 80% have had complete success, while the remaining 20% saw improvement.
Within two weeks of starting bupropion, Briggs was bleeding far less and had experienced almost no side-effects. Gradually, all his bleeding stopped. After using bupropion to get his disease under control, he added a variety of anti-inflammatory supplements and changes in diet to keep his ulcerative colitis from flaring up again.
He believes he has succeeded in creating a functional cure for his disease -- he's remained in remission since starting his 'protocol' in 2013. He's written about his research and experiences to help spread the word to others with colitis. And like any good researcher, he declares his interests: "In research papers, it is typical for the author to disclose any vested interests that might bias their views. In that vein, I want to clarify that I have a vested interest, which is that I hope to never crap blood again."