After all this time the debate still rages abut the usefulness of antidepressant meds.
The bottom line is that for some people they are lifesavers. Others have modest or transient benefits. For a number of people they’re ineffective and/or have unpleasant or intolerable side effects.
Regarding claims that antidepressants work no better than placebo: placebos characteristically have efficacy for a relatively short period of time. The existence of a population that does well on an antidepressant for years (including those that relapse after discontinuing them) argues against mere placebo effect.
Agree that no one needing help for major depression should be scared away from potentially live-saving treatment by anecdotes and speculation in this thread.
The only perspective you get from most posters here is from “going on them.” And a fear of calling out the med profession. And name calling.
Has anyone tried to stop?
I will listen to such a person. But altering your brain is a risk and psychopharmcology is not a science. It’s an evolving art form. It’s no good to shoot the messenger. You take a risk with altering your chemistry. Don’t be insulted or upset. It’s not a radical claim. Some risks are worth taking. But you don’t know how much risk there is for you until you are on them and try to stop, usually by tapering the medication over months or even years.
If you are troubled enough in life to seek out meds, then you are really not going to be OK with taking a year to taper off of the med later on, while in crisis, and not knowing when or how the effects or anxiety will stop, or if they will. Before you respond to this post please consider this. There is no expiration date on your pain and no Dr will hold your hand through it all. Drs actually get sick of patients too, esp when they got you on the med and you are going to have a hard time getting off. It’s best to talk to people who have been though things before you embark on a journey. Due diligence.
Have you ever talked to someone who is anxious and depressed, while they are trying to get off these medications? Over the course of years? You should. Drugs may cause symptoms eventually, to do with acclimation and intradose withdrawal (benzos, but others too have a bite). That is the worst when you are trying to taper the med. And one never tries to get off it under good conditions. It’s always under stress and catastrophe in ones life.
Google Jordan Peterson. He is having a crisis over this stuff.
What do you suggest to do, when the radio starts sending you encrypted messages? When robots have taken over your brain functions and you don’t know if your thoughts belong to you or if they are secretly intercepted and twisted and re-broadcasted to you and your afraid of what they might command next?
Yeah, I’ve talked to my friend and Hope and belief in professionalism saved him. Thank god he didn’t read this horsehit at some point. 20 years and it’s a non-issue.
When has this board ever exhibited “a fear of calling out the med profession”?
If you’re faced with a “journey”* through the swamp of a major depression, it’s not a good idea to summarily reject a valid means of escape.*
*A bit OT, but my skeptical antennae go up anytime someone starts going on about a “journey” through a health situation, or even worse, “a healing journey”. Usually it means the person has entered the Land of Woo.
Very true, and as far as I can tell, there haven’t been any studies that managed to link serotonin levels to depression, at least in people that haven’t taken SSRI’s, I think one study found a minor correlation in women who have previously been treated with SSRI’s.
I think these drugs should be tested for effectiveness against an active placebo, I don’t think you get proper blinding with standard placebos. That means that instead of giving the control group a sugar pill, they get something with a mild psychoactive effect - a small dose of caffeine ( anti-depressant trials) or Benadryl (anti-anxiety trials). Because the way it’s done now, patients on the active drug usually KNOW they aren’t getting the placebo.
But they are extensively prescribed for patients with mild depression, or even no depression at all. And those little 7 or 9 question screening tests are a joke.
I recently made the mistake of seeing a doctor regarding some nerve pain I had in my feet. I went to a primary doctor, a specialist and a clinic. Every single one of those doctors started by trying to give me that stupid test, although I shut them down each time. Then they all tried to get me to take an anti-depressants for the foot pain anyway.
Because “there was no downside” or “it couldn’t hurt”. I thought they were being incredibly dismissive of the side effect profile, and that happens a lot with those drugs.
And one of them tried for gabapetin, but when pressed for details the doc told me It was only mildly effective in trials and then only at doses of 1200mg or more and I’d have to start with 100mg a few times a day and “build up” to that dosage.
At which point I basically said, “I get it, you don’t have anything that will fix this. I’m a big girl, just come out and say it”.
But it’s the “customer” model of healthcare that causes these drugs to be overprescribed. These services were really expensive, even with insurance this little exercise in getting my foot pain “checked out” cost me over 2K in copays and the doctors didn’t feel they could send me home empty-handed.
TL:dr While anti-depressants may be effective for serious depression, they are wildly overprescribed.
There are no good long term anti-depressant medications. They aren’t all that effective short term either but at least the potential damage can be kept to a minimum. I’ve heard from people who moved to SSRIs and considered them miracle drugs that greatly improved the quality of their life, all while knowing that long term it would be problematic. This is the choice many are left with, short term improvement or a life time of suffering. I don’t blame people for trying, but it’s horrifying to hear of doctors recommending anti-depressants to treat other problems just because depression may be a factor. But if you’re depressed because some other ailment is negatively impacting your life artificially trying to suppress that depression is a losing game in the end.
Psych drs. Are evil pill vendors only after your money…buy my book and I’ll tell you all about it. .
Again I’ll ask. What do you recommend to do when the robots are commanding your death? Read a book? Think of long term consequences? Or go to the hospital and be treated with what’s available now. There’s only a few minutes to decide…
Nurse here and almost all my adult life user of virtually every class of anti-depressant available at the time, sometimes with success, sometimes not, so I am speaking both from education and experience. Always worth trying to me to improve quality of my life by reducing psychic pain.
First, virtually every doctor/practitioner asks those questions regardless of why the person states they are seeking care because patients often don’t know that subclinical depression can contribute to many, many physical health problems. Especially pain. You may not have been doing yourself a service by ‘shutting down’ those screenings. When the doctor asks those 7-9 questions they are being diligent and thorough (plus most 2nd or 3rd party payers require it before reimbursing, also for defensible reasons).
Next: several classes of anti-depressants do have a clear medical indication for pain relief. They may be an adjunct to make lower doses of pain meds work better.
Pain perception happens in the brain, anti-depressants work on brain chemicals.
Suggesting gabapentin for pain is also very reasonable. It acts on the nervous system as a modulator of nervous system over-active neuro-impulses, which also can relieve pain as pain is often over-stimulation of nerves. Foot pain is often neurogenic, caused by nerves’ over stimulation. Gabapentin can calm that down, so are an excellent first response to pain, much better than pain medications, which can have far more serious side effects.
I have never known a doctor to prescribe anti-depressants for ‘no depression’. There is no reward for them to and several reasons not to.
According to the linked story, Jordan Peterson was on benzodiazepines, which are not anti-depressants but anti-anxiety meds (they can have other uses i.e. in treating seizures). Depression of course can have an anxiety component, but typically patients with major depression are not put on benzos*.
There are legitimate uses for antidepressants in conditions other than depression, for instance a low dosage tricyclic for insomnia.
*some antidepressants can be difficult to stop taking, but generally nowhere near as hard as stopping benzodiazepines.
I’d probably be a little more receptive to the argument if there was any…you know… evidence that those drugs were effective against subclinical depression.
While these drugs may be moderately effective in some cases, mostly major depression, they aren’t nearly as effective as they’ve been made out to be and the side effect profiles are serious and shouldn’t be taken lightly. I still think they are wildly overprescribed.
Back in the 1990’s, there was a stealth campaign of sorts to get the public to see these drugs as a miracle cure. It seemed like every series had a “very special episode” where someone’s mommy was in bed all day and neglecting her kids or job, then well-meaning friends got mommy to go to the doctor and the doctor gave mommy a magic pill that made her all better.
I was prescribed those drugs myself for almost no reason other than some situational issues but at the time. There was a perception that these drugs could make a healthy person “better than well” and I fell for it. Long story short, even at ridiculously small doses they fucked up my healthy brain and I was never the same after. I don’t like to think too much about it.
Yeah, I went through a half-dozen or so different ones back then. Each time I’d start taking and have the “I’m doing something that works, so I feel better” psych boost at the start, then realize it wasn’t really doing anything positive for me, but was causing a variety of side effects. Then I’d have to taper off because they’re “not addictive but have really bad effects if you stop taking them, definitely not addictive though”. All the while hearing how these are miracle drugs and we just need to find the right one to turn my life around. Eventually I stopped messing with drugs and did some significant CBT work, and got things under control.
As far as I can tell, they require it so they can offer you antidepressants instead of treating the condition you’re concerned about. If I’m in the office for foot pain, I really don’t want to waste time saying ‘yes, I have the same condition that should be listed in the chart and that I’ve dealt with for more than 30 years’. I mean, sure, I still meet the criteria depending on how you interpret the questions, but that doesn’t mean I want them suggesting the same drugs that caused only side affects worsening those symptoms and ‘not-addiction somehow but severe withdrawal’ when I finally decide to give them up, I want to treat the actual issue I came in to treat.
Most modern medical science is impressive, but my experience with SSRIs reminds me that this is the field of medicine that thought ice pick lobotomies were a grand idea.
True. But the crisis in his life brought other meds into it. it’s called poly drugged.
SSRIs can be hard to stop. You need to take potentially years. And there are other anti depressant meds which are sticky as hell, and some say harder to drop than benzos in their own way.
This is an article by a food journalist about her experience with the antidepressant Mirtazapine. Drs had no useful things to say to her about her experience, and she had to find out herself.
And the other thing about these depression screening questionnaires is they are so ridiculously simplistic and transparent that they have created a situation where anyone that wants these drugs can get them. I can’t think of any other medication where that is the case. If you could get a painkiller simply by answering 7 questions that were basically a rephrase of “how much does it hurt”, that doctor would be arrested for malpractice.
But the intent is to get as many people on those drugs for life as possible. The responsible thing would be for the drug companies to try and hone in on the similarities in patients that have a good response, maybe through genetic testing in order to increase the effectiveness rate and weed out patients that are likely to have no response or a bad response before they take them. But that’s bad for sales.
And as to the doctor who suggested that. I “work up” to a 1200mg dose of gabapetin - I told her I’d consider it if she could tell me exactly how my brain adapted to that drug. Since100mg whacked me out, what was happening that would cause me to eventually tolerate 12x that dose without being whacked out? Was it reducing or increasing the production of neurotransmitters, and, if so, which ones? Was it making my synapses more effective, or less? Was it making changes to neuronal density. Would those changes persist if I stopped taking the drug?
I’m sure you wouldn’t be surprised that I didn’t get good answers.
There used to be ads with a sad emoji suggesting people ask their Dr about meds. They were aimed at marginal customers and not the ones who are in a crisis, trying to expand the market.
I haven’t seen one of them in a long time. I have a feeling they won’t be back.
One other thing: SSRIs and many meds take days or weeks to work. The idea that they are life savers for crises is not a reality, in the crisis. Only later if you are strong and it’s the right med for you, will you be stable. if it’s not you will get off it and try another, which means more time under crisis conditions.
So from what I’ve read, it seems like it can be difficult and risky to try to stop taking SSRIs and other antidepressants. If you are on SSRIs then, is it better to just keep taking them indefinitely (preferably at the lowest dosages possible), if things are relatively stable? Obviously it can be kind of costly to keep doing them indefinitely, but is it more risky to try to stop taking them than to keep taking them?
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