That seemed high to me, but it’s confirmed by the CDC site, which I consider holy writ on matters medical and empirical.
Cecil strongly implies that these meds are being overprescribed with insufficient oversight, and I am inclined to agree with him.
I feel certain that if I tallied all the people I know, then took account of all who have openly confessed to using psychiatric meds, I’d be around 5%. And that’s people who are seemingly proud of the fact; no doubt in my mind there are plenty more who aren’t willing to divulge to every passing acquaintance.
I’ve long thought the state of psychiatric medicine in America is horrific. My friends who’ve struggled with depression have suffered dearly at the hands of psychologists who overprescribed meds with abandon. Being a layperson, I don’t claim to know the answers to what’s ailing us here in America, whether depression is really becoming more commonplace or if we’re gradually deciding that even fleeting, situational sadness is too much to bear, but something’s gotta give.
One thing about those numbers. Anti-depressants have numerous so-called “off label” uses, in which they are prescribed for something other than depression. They’re used to control symptoms in Irritable Bowel Syndrome, e.g.
I don’t know how this compares to the primary use figures, but the statement “One American in 12 takes antidepressants despite having no depressive symptoms whatsoever” can probably be largely explained by this without having to look for physicians handling them out like candy. Doctors might, but I think those numbers exaggerate the real situation.
If anti-depressants have so many off label uses that that explains their being used by over 8% of the population, they’ve got to be among the most miraculous drugs ever created.
Given the hype from the legalization crowd, I’d say the same thing about cannabis.
What percentage of these people take antidepressants for other symptoms? such as anxiety, which is a perfectly cromulent usage. Any symptom causes by a dearth of serotonin and/or norepinephrine.
Is this the same as saying that 32% of the improvement is due to the effect of the antidepressant? Because, depending on the model, this sounds like it could be a very large effect size. Hardly something to be ashamed of.
If there were truly no difference, then countless studies all did improper research, or even more unlikely, all found results when they shouldn’t have, without poor research (the “rolling the dice” paragraph is telling, wish he went into that more). We’re not talking about non-FDA supplements like St. John’s Wort. They need to demonstrate a pretty clear effect. Whether they are as effective as advertised is another issue.
I have a problem with how they’re prescribed sometimes, and have had a spotty history with their efficacy in the past. But I’m inclined to believe that antidepressants work and that I’m not in league with Xenu. It boggles the mind though that many of these people aren’t regularly meeting with the psychiatrist, even if it’s a 15 minute session where the main questions are a) is it working, and b) any side effects?
The thing is, I just don’t believe medicine is enough. It may normalize people enough to deal with their issues but then they have to deal with their issues, too. A combination of drugs and therapy seems like the best option.
One has to be careful. Are antidepressants over prescribed in the US? You betcha. Way way overprescribed. But that wasn’t the question, which was, are antidepressants effective? And the answer to that, when prescribed for real actual serious clinical depression, is a very clear and unqualified yes. (Speaking as a social worker, and as a member of a family with some clinically depressed members.)
The depression has to be real, and serious, at a clearly diagnosable clinical level; not a normal depression caused by life events, where they won’t help you at all. If if you suffer from existential angst or 1st world over-entitlement syndrome, they and therapy may well have a strong placebo effect. But if you have a severe serotonin deficiency, there is nothing placebo about them, and all the therapy and salt pills in the world won’t help you.
And they don’t “make you feel good.” SSRI’s make you feel something like normal, when you feel unnaturally bad (and the “unnaturally” is the key point here-- ie serotonin deficiency). Cocaine, opiates, etc. make you feel unnaturally good (at a terrible price). SSRIs do NOT.
Speaking on a personal level, when I was (wrongly) put in the cuckoo’s nest, it took two-fucking-hours to get drugs, 14 hours to get food, and 38 hours to get soap and toothpaste. That explains all the skinny, dirty druggies in this country.
Seriously, if someone reports to the police that you are suicidal, you will be locked up and drugged. And that is just plain wrong.
This is exactly the kind of misunderstanding of antidepressants I was talking about.
High rates of off-label prescriptions for antidepressant, anticonvulsant and antipsychotic drugs
Another list from RXlist.com
Those are common problems that tens of millions have. You can certainly argue that drugs are misused for depression and related problems, but the drugs themselves are legitimate, work on numerous problems, and are wonderful if they work. I have IBS and an antidepressant is the only thing that controls the symptoms. Why? Probably serotonin uptake, just like a million other problems. Off-label drug use is as real as using aspirin.
“Antidepressants” aren’t one or two medications or even one or two medication classes. There are quite a few out there, they influence neurotransmitters in varying ways, and yes, they are frequently used off-label because they work for those indications. I took a low dose of one for months as a migraine preventative. It didn’t make me “high” or “hyper” or anything other than much less headachey, which in itself did make me happier.
You’re an instant second-class citizen. And that is wrong. But I can promise you that a lot of paranoid people who have never known a mentally ill person sleep better at night knowing that you are being denied your basic human needs, because they believe you are not human and need what they consider tough love. Crushing out what little humanity you call your own, they feel certain, will help make the world a better place.
Remember: 90% of Americans are on some type of psychotropic medication. Usually because of the 10% that should be but refuse. <-- my personal observation.
It’d be funny if cannabis turns out to the the one true anti-depressant that the majority of people who take anti-depressants need to calm down.
True biologically-based depression, however, as pointed out above, needs real anti-depressants. It’s wrong, wrong, wrong that any old doctor can prescribe these without doing a true mental health evaluation or full endocrinal evaluation of the patient. Wrong as in there should be laws to prevent it.
Situational and environmental depression needs to simply take a hit and relax. It’s the kind of self-medication people have been doing for ages with alchohol, but cannabis would be less problematic (mind you, I’m not saying unproblematic).
An even better solution would be teaching of better coping mechanism skills, relaxation exercises, proper nutrition and exercise, and life-style changes to reduce stressors, end dysfunctional relationships, and a change of social attitudes which encourage violence, revenge fantasies, hypersexuality, poor self- and body-image, consumerism and indulgence as panaceas, and the use of alcohol and harder drugs. And furthermore, developing social attitudes of patience and service, which have been shown to reduce depression.
^^ ITA Moriah.
This is important and I wish Cecil had been more granular in his analysis. I also wish he’d been more explicit about what symptoms the various studies were looking treat. Was he including the anti-psychotics or lithium? What did the studies show for people with a)personality disorders, b) bi-polar, c) delusions, d) suicidal impulses?
For an article titled, “Do antidepressants only work because of the placebo effect?”, I would have thought there would be more discussion of “What is an antidepressant?” and what do we mean by, “Work?”
Depends on the country. While type 1 errors are pernicious and hard to correct, there are plenty of type 2 errors too. I have a schizophrenic member of the family who’s threatened suicide and we’ve divulged this information to numerous professionals, none of whom have kept him in a ward for longer than two or three days.
It’s not a neutral cite, but the APA believes the fault lies with physicians not trained to deal with mental health issues. If you think about it, therapy is costly: psychiatrists and therapists stand to benefit from giving courses of therapy.
So why force a person to take dangerous mind altering drugs for two or three days, when it takes about a month for them to (supposedly) have any effect?
Well, I guess it makes money for the drug companies, particularly if you are convinced you need to take them for the rest of your life.:rolleyes:
this is the part I noticed:
From my experience, when people have multiple meds are likely to be taking an antidepressant.
You may be confusing antipsychotic meds (i.e. Haldol) which have a much quicker effect with antidepressants, which often themselves take maybe a couple of weeks to start showing effects.
This sounds lovely in theory, but in the first place clinical depression is commonly caused not by “issues” but by chemical deficiencies/alterations which antidepressants address. And while it may be helpful for some people to have psychiatric therapy, that has a dubious evidence-based success rate, and is expensive and time consuming - not a workable option for most.
While antidepressants are likely overused, in my opinion it’s a terrific thing they came along for clinical major depression as an alternative to plowing through long unproductive sessions with shrinks, getting ECT and losing big chunks of one’s memory, or suffering for years while being told to “get over it”.