Zoloft and prozac - take it though useless?

They have been demonstrated useless in controlled studies, no better than placebos for mildly depressed people. This was a news story and also documented in a book called Mad in America.

If this research is valid, and I believe it is, will you stop taking your valium or prozac and save you and or your insurance or medicare or medicaid lots of $$$$$.

I don’t know where you wanted this to go, but if I were to stop taking my clonazepam (pretty much the same thing as Valium), it would be an absolute disaster. I have generalized anxiety disorder, diagnosed by a psychiatrist (who knows what he’s doing), and have been on clonazepam for over three years. The difference it made was almost immediate. You’ll never know what anxiety boiling over into a panic attack feels like unless it happens to you.

I’m sorry, but I refuse to live that way. They’re not placebos - that’s evident because of their action. And they’re not expensive, either.

  • s.e.

I hope you don’t mean just suddenly stop taking them, without going through some sort of reduction regimen overseen by a doctor, berdollos.

Anything else, no matter what studies are done, is risking a lot as far as your health is concerned. As scott evil says, these drugs are not placebos. Valium is a major tranquilliser – I’ve seen, firsthand, the damage it can do when treated lightly.

could you give a url for the study? i’d be interested in reading that.

from what i’ve read, SSRIs (selective serotonin reuptake inhibitors: the class of drugs to which both prozac and zoloft belong) have moderate to strong effects in most users in studies of less than a year. also, the effectiveness is supposedly roughly-equal between different SSRIs (http://jama.ama-assn.org/issues/v286n23/abs/joc10747.html). the effectiveness rate of SSRIs isn’t demonstratively higher than that of tricyclics (http://www.infopoems.com/POEMs/JC109602.htm), but side effects are reduced and popular interest is greater in SSRIs.

i’m not a big fan of prescribing antidepressants for long-term mood maintenance, but i think that SSRIs have had a positive effect on people with a demonstrated depressive condition. i’m not sure where the line is being drawn between mild depression and more severe forms; even though mild depression is a clinically distinct diagnosis, most psychological diagnoses are largely guesswork and the same patient could be assessed in an entirely different manner by a different doctor on a different day.

a good deal of people with mild emotional distubances might be best served by non-pharmaceutical means, but sometimes it takes a nudge to get over the first set of hurdles.

I saw a news story sometime in the last few days that I suspect is what the OP refers to. That story reported that a recent study had found placebos as effective as the drugs mentioned; i.e., as many people in the control group (placebo) reported improvement as did in the study group. It is a misinterpretation of that result to say these drugs have been demonstrated useless.

One recent study which made the news reports said that placebos worked better than SSRIs. Several studies show that the SSRIs do work better than placebos, a minimum of two for each different SSRI. The FDA requires a minimum of two studies showing safety and effectiveness. While it might be worth having someone else repeating the new study, it does not yet trump the more established experiments.

You may want to read this thread, berdollos.

I’m take 40mg of fluoxetine (prozac) daily – for the side-effects.

I have Raynaud’s disease, and fluoxetine prevents the vasospasms that have been keeping me indoors for the last coupla years. Apparently, the vasodilating effect isn’t a common side-effect. (Fluoxetine affects less than 5% of people that way.) Ironically, I found this out by accident, after going on Prozac for depression. I think that my depression is more circumstantial than clinical – Fluoxetine didn’t seem to directly affect my mood one way or another, but being able to go outside without worries sure does. :slight_smile:

Taking. I wonder if inability to proof-read is an undocumented side-effect…

I find this so hard to believe. My mother is a new person since she started on anti-depressants a few years back. We’re talking 20+ years of fretful fears and worries vanishing six to eight weeks into the treatment, and a long term improvement in her outlook and disposition along with major lifestyle changes. For a placebo, they’re incredibly effective. I guess it’s possible that it was all psychological, but I’m skeptical. Mum took anti depressents as a teen, and they were extremely ineffective - so ineffective that she wanted to kill herself because she hated the way they made her feel. I can’t tell you how many times over the years that I heard the “Antidepressents made me more depressed” story. I think she only took the Prozac so she could tell her doctor that it didn’t work, and she was astonished when it did. I find it hard to understand how a placebo that she was convinced would make her much worse actually made her better.

about which I do not currently have the url, prozac and zoloft do not work better than placebos.

According to the C-Span lecture of the author of Mad in America,
the studies demonstrating effectiveness were on major depression. The studies indicating lack of effectiveness were of minor depression.

It seems that these drugs are useful for major depressive disorder, but for less severe depression, they may have no value, at least not more than placebos.

I’m referring this entire thread to a pharmacoligist friend of mine, from another board. Let’s see what an accredited expert has to say.

The problem is the definition of major depression vs. “minor depression”. It’s all pretty subjective, even with the DSM-IV criteria (which do not define any sort of “minor depression”–what we usually call depression in a clinical setting is called “Major Depressive Disorder”, as defined by Major Depressive Episodes).

It would be easy enough to shave off a tight enough sample of people who minimally qualify for MDD that they don’t show any improvement over placebo, statistically. Alternately, they might be taking people who don’t qualify for MDD but have depressive symptoms, for whom the drug is not indicated anyway.

It’s clear, to me, that SSRIs work for some people throughout the spectrum of depression. The side effects, while sometimes significant, are minimal enough that erring on the side of giving the drugs is not a bad idea.

It’s worth pointing out that you list Valium in your OP, which is a completely different drug from the others mentioned. Valium is generally not useful for depression. (And please, please, don’t stop taking any benzo without a doctor’s advice; benzo withdrawal can be life-threatening.)

Stopping an SSRI without a doctor’s advice is also a very bad idea; rebound depression is not at all uncommon.

Dr. J

(disclaimer- I am not opposed to people who take SSRIs. I am glad you found something that works for you, and as a person with severe depression, I understand what you have gone through)


Why do you all have to be so evangelical? The fact that the thought that these drugs might not be perfect for everyone inspires such ferverent opposition clues me in to the idea that there is more going on than mere medication. Let us look at some facts.

First off, we know jack about depression, and we only know slighly less than jack about SSRIs. We don’t know what causes depression. We do know that all depression is probably not caused by the same thing. “Depression” is as acurate a description for what goes on in one’s head as “Dizzy” is for something that goes on in your body. Yes, you are depressed and that is a medical condition. But like being dizzy, it could be caused by any number of things, which we don’t know and we certainly don’t understand. We know what SSRIs do chemically, but we don’t really know why that has any affect on depression. It is not a simple medical equation, as in “I don’t have enough of this so I’ll add this” or “this is not working right so I’ll do this to change how it works”. Depression is a medical condition, but it is not a medical condition that we can expect to cure at this point in the same way that we cure gangrene or pnemonia.

And let’s face it, SSRIs do not cure depression. They do something. They often help. But even for people that are affected positivly by SSRIs, they often stop working after a certain period of time, prompting them to switch drugs or tweak dosages. If you want to stop taking them you risk “rebound depression”. In other words, you get depressed again if you keep taking them. You get depressed again if you stop.

A lot of this seems to mirrior the natural cycles of depression anyway. I’ve lived with depression for 21 years (well I can’t exactly remember being depressed before I was about four years old, so we can shave that to 17 years). For me personally, my depression comes and goes, seemingly randomly. I do know that when I am at my worst there is no way I would be able to do something as positive and gutsy as seeing a doctor, nor would I be coherenet enough to explain my situation to a doctor. I have only been able to see doctors when I am on my way up, when things are lifting and I can want to feel better. I also know that the most random stuff can snap me out of it when I am on my way up (this is not to say that people with depression can make themselves snap out of it- they can’t- but that sometimes things can trigger them to feel better). A strawberry pizza once snapped me out of a month long bout of depression. There isn’t a lot of logic to it. I am sure for some people, some times, getting a nifty new perscription for a very popular drug that has a lot of media sensation surrounding it and legions of avid supporters can help. Even the ritual of taking a new drug every day can be enough of a change to trigger something. Or it could be talking to doctors and filling out forms. Any number of things could cause some people to feel better when they take SSRIs. And it is pretty likely that some of these things are not related to the stuff that SSRIs do to your head.

Personally SSRIs did one good thing for me- they made me so nasiated and exhausted and confused and twitchy that I was downright eager to get back to my old life, where at least the demons that plague me are familier.

Every single therapy for depression is “all in your head”. Your head is where these changes need to be made. The line between what a chemical objectivly does to your brain and what your brain does when one takes these chemicals is not a clear one. The brain/mind split is not a neat one. The brain is a strange, powerful, mysterious organ. It can regulate and change itself in drastic ways. Science doesn’t have all of the answers right now. When you are dealing with something as wierd and unfathomable as a sentient beings, science might never have the kind of neat answers that we’d like.

For now, I am glad that some people have found a way to feel better, but please understand and respect the fact that SSRIs are not the perfect cure for everyone, and that just because someone chooses not to take them or to challenge popular beliefs about SSRIs and depression does not mean that they are disparaging you or otherwise belittleing your pain or your happiness.

Well, I am assuming that this statement is not this thread, as the OP did not say that drugs might not be perfect for everyone. I believe that everyone would agree with that. Actually, the only post that makes any definitive statements about whether or not drugs should be an option is the OP;

OP then goes on to ask users to stop taking their prescriptions, as a blanket, across-the-board suggestion.
Therefore, I am not sure what your point is?

Sorry-should have read “this statement is not in response to this thread”…

I’m on Zoloft for borderline OCD and anxiety/panic disorder. Zoloft treats more than mild depression. It is also used for panic disorder, obsessive compulsive disorder, and post-traumatic stress syndrome. Going solely by the OP, it would seem that these other disorders were not included in the placebo research.

I don’t think that everyone who is on these drugs should immediately stop treatment on the basis on one study. In fact, I think it is irresponsible to even suggest it. Many drugs should only be stopped under medical supervision, and not on the advice of someone on a message board.

While much has been written about the placebo effect, it is still a not well understood. One thing that stands out - it is powerful.

I believe that the way the OP was worded implied that anyone who takes medication for depression, particularly the medication used in the study, is merely deluded. The medications were described as “useless”. I believe this is an inflammatory statement. Perhaps this topic would be better discussed in Great Debates.

I, for one, found a tremedous difference in the weeks and months following my prescription to Zoloft. Would I have found such a dramatic change using a sugar pill? I don’t know, but I do know that my day to day life is better, and I don’t want to meddle with success.