Antidepressants may not help many patients

[moshquerade]

I'm not a rocket scientist, and still I've been saying this time and time again: Antidepressants aren't a help for most people. In fact, they make the situation worse.

Another thing I firmly believe is that regular docs should not be able to prescribe antidepressants only Psychiatrists should. This would cut down on SSRIs being dispensed like a cure all for any little crisis someone is going through. I read and update medical histories and I see first hand how many people are on antidepressants. The amount of people taking them has exploded. It's not a good thing.

Antidepressants may not help many patients
Researchers find placebos work just as well, except in severe cases

updated 2:22 p.m. ET, Tues., Feb. 26, 2008

Antidepressant medications appear to help only very severely depressed people and the drugs work no better than placebos in many patients, British researchers said Tuesday.

Their findings raise questions about the use of antidepressants, the most commonly prescribed drugs in the U.S. The study, led by Irving Kirsch of the University of Hull, concludes that less severely depressed patients might benefit just as much from therapy, exercise or other non-medical interventions.

"There is little reason to prescribe new-generation antidepressant medications to any but the most severely depressed patients unless alternative treatments have been ineffective," wrote researchers in the latest issue of the public Library of Science Medicine.

Researchers reviewed published and unpublished U.S. Food and Drug Administration studies of the four of the most commonly prescribed new generation antidepressants to learn whether patients' response depended on how depressed they were to begin with.

The studied drugs included Prozac, Effexor, Paxil and Serzone, which are all so-called selective serotonin reuptake inhibitors, or SSRIs. About 118 million antidepressant prescriptions were issued in 2005 in the U.S., according to the National Center for Health Statistics.

The researchers found that compared with placebo, the antidepressant medications did not yield clinically significant improvements in depression in patients who initially had moderate or even very severe depression. The study found that significant benefits occurred only in the most severely depressed patients.

"Although patients get better when they take antidepressants, they also get better when they take a placebo, and the difference in improvement is not very great. This means that depressed people can improve without chemical treatments," Kirsch said in a statement.

Placebo effect common in depression
The study provides valuable insight to researchers, patients and, most important, primary care doctors who prescribe most of the antidepressants, said David Barlow, founder and director emeritus for the Center for Anxiety and Related Disorders at Boston University.

"The take-home message is there are probably too many people on medications who might not need to be on these medications," Barlow said.

Patients taking the drugs should not stop without consulting a doctor, Barlow cautioned, but they might consider non-medical therapies before beginning or continuing the medication.

Mary Ann Rhyne, a spokeswoman for Paxil maker GlaxoSmithKline, said the study only looked at data submitted prior to the drug's U.S. approval.

"The authors have failed to acknowledge the very positive benefit these treatments have provided to patients and their families who are dealing with depression and they are at odds with what has been seen in actual clinical practice," Rhyne said.

"This analysis has only examined a small subset of the total data available, while regulatory bodies around the world have conducted extensive reviews and evaluations of all of the data available," she said.

http://www.msnbc.msn.com/id/23...wid/11915773?GT1=10914

 

[JohnCU]

they just make you emotionless. or they do for me. if i don't take mine for a couple of days my emotions go haywire and come out all at once - like crying at a stupid sad song. also, paxil makes my cravings for alcohol go haywire.

i also told my dr about the sexual side effects and he said "just take viagra"

 

[IGBT]

Originally posted by: moshquerade
I'm not a rocket scientist, and still I've been saying this time and time again: Antidepressants aren't a help for most people. In fact, they make the situation worse.

Another thing I firmly believe is that regular docs should not be able to prescribe antidepressants only Psychiatrists should. This would cut down on SSRIs being dispensed like a cure all for any little crisis someone is going through. I read and update medical histories and I see first hand how many people are on antidepressants. The amount of people taking them has exploded. It's not a good thing.

Antidepressants may not help many patients
Researchers find placebos work just as well, except in severe cases

updated 2:22 p.m. ET, Tues., Feb. 26, 2008

Antidepressant medications appear to help only very severely depressed people and the drugs work no better than placebos in many patients, British researchers said Tuesday.

Their findings raise questions about the use of antidepressants, the most commonly prescribed drugs in the U.S. The study, led by Irving Kirsch of the University of Hull, concludes that less severely depressed patients might benefit just as much from therapy, exercise or other non-medical interventions.

"There is little reason to prescribe new-generation antidepressant medications to any but the most severely depressed patients unless alternative treatments have been ineffective," wrote researchers in the latest issue of the public Library of Science Medicine.

Researchers reviewed published and unpublished U.S. Food and Drug Administration studies of the four of the most commonly prescribed new generation antidepressants to learn whether patients' response depended on how depressed they were to begin with.

The studied drugs included Prozac, Effexor, Paxil and Serzone, which are all so-called selective serotonin reuptake inhibitors, or SSRIs. About 118 million antidepressant prescriptions were issued in 2005 in the U.S., according to the National Center for Health Statistics.

The researchers found that compared with placebo, the antidepressant medications did not yield clinically significant improvements in depression in patients who initially had moderate or even very severe depression. The study found that significant benefits occurred only in the most severely depressed patients.

"Although patients get better when they take antidepressants, they also get better when they take a placebo, and the difference in improvement is not very great. This means that depressed people can improve without chemical treatments," Kirsch said in a statement.

Placebo effect common in depression
The study provides valuable insight to researchers, patients and, most important, primary care doctors who prescribe most of the antidepressants, said David Barlow, founder and director emeritus for the Center for Anxiety and Related Disorders at Boston University.

"The take-home message is there are probably too many people on medications who might not need to be on these medications," Barlow said.

Patients taking the drugs should not stop without consulting a doctor, Barlow cautioned, but they might consider non-medical therapies before beginning or continuing the medication.

Mary Ann Rhyne, a spokeswoman for Paxil maker GlaxoSmithKline, said the study only looked at data submitted prior to the drug's U.S. approval.

"The authors have failed to acknowledge the very positive benefit these treatments have provided to patients and their families who are dealing with depression and they are at odds with what has been seen in actual clinical practice," Rhyne said.

"This analysis has only examined a small subset of the total data available, while regulatory bodies around the world have conducted extensive reviews and evaluations of all of the data available," she said.

http://www.msnbc.msn.com/id/23...wid/11915773?GT1=10914

..people aren't advised that the side effects are as equally powerful as the primary desired effect.

They are unconscionably over prescribed.

 

[Pepsei]

i just read that. however... it is dangerous for people to just quit taking their medication after reading this article, might make them go out and do crazy things.

 

[chuckywang]

Guess Tom Cruise was right ....

 

[JohnCU]

Originally posted by: Pepsei
i just read that. however... it is dangerous for people to just quit taking their medication after reading this article, might make them go out and do crazy things.

yeah, you get all these kind of crazy brain zaps and fog, it's really weird.

 

[zinfamous]

over-prescribed? definitely

ineffective or even dangerous for most people? no way

the problem with linking suicide to antidepressant use is that the victim was suicidal to begin with. uncontrolled situations like this make each case completely irrelevant to antidepressant use.

I do agree that the prescriptions should be limited among doctors, but SSRIs do have benefits beyond depression.

I see the primary problem as drug reps pushing this crap on physicians and whoring out incentives for it. Certainly, physicians are equally to blame for colluding with incentives; but when the major psychiatry conventions are sponsored by Drug Companies, we have a serious issue.

 

[WraithETC]

Originally posted by: chuckywang
Guess Tom Cruise was right ....

Nah I got my pez dispenser in hand and I feel fine.

 

[theMan]

jesus, they didn't help me with my meth addiction, that's for sure.

 

[alkemyst]

Originally posted by: zinfamous
over-prescribed? definitely

ineffective or even dangerous for most people? no way

the problem with linking suicide to antidepressant use is that the victim was suicidal to begin with. uncontrolled situations like this make each case completely irrelevant to antidepressant use.

I do agree that the prescriptions should be limited among doctors, but SSRIs do have benefits beyond depression.

I see the primary problem as drug reps pushing this crap on physicians and whoring out incentives for it. Certainly, physicians are equally to blame for colluding with incentives; but when the major psychiatry conventions are sponsored by Drug Companies, we have a serious issue.

QFT...most posting here I think have no clue and just buy into whatever new tidbit floats their way.

 

[moshquerade]

Originally posted by: alkemyst

Originally posted by: zinfamous
over-prescribed? definitely

ineffective or even dangerous for most people? no way

the problem with linking suicide to antidepressant use is that the victim was suicidal to begin with. uncontrolled situations like this make each case completely irrelevant to antidepressant use.

I do agree that the prescriptions should be limited among doctors, but SSRIs do have benefits beyond depression.

I see the primary problem as drug reps pushing this crap on physicians and whoring out incentives for it. Certainly, physicians are equally to blame for colluding with incentives; but when the major psychiatry conventions are sponsored by Drug Companies, we have a serious issue.

QFT...most posting here I think have no clue and just buy into whatever new tidbit floats their way.

you think you have a clue? or are you of the "most posting" here?
if you do think you are more knowledgeable than "most posting" please... please do elaborate.

 

[Vic]

Yeah, like people should listen to a medical transcriptionist and the media before their doctor and the FDA.... :roll:

SSRI's might be overprescribed, but they do help people. I would even argue that they save lives. They are not a "happy pill," they are not some kind of narcotic.

True colors are showing, not that I'm surprised. The drug warriors don't even trust peoples' doctors anymore. :roll:

 

[moshquerade]

Originally posted by: Vic
Yeah, like people should listen to a medical transcriptionist and the media before their doctor and the FDA.... :roll:

SSRI's might be overprescribed, but they do help people. I would even argue that they save lives. They are not a "happy pill," they are not some kind of narcotic.

True colors are showing, not that I'm surprised. The drug warriors don't even trust peoples' doctors anymore. :roll:

hey Skippy, who are you calling a medical transcriptionist? that is the first thing you are off on by a long shot.

it was never said that SSRI's don't help some people. please read carefully before you criticize.

next.

 

[IGBT]

..I've read that fishoil caps can have a ssri/prozac like effect with regular use and none of the pharm/chem side effects.

 

[Vic]

Originally posted by: zinfamous
over-prescribed? definitely

ineffective or even dangerous for most people? no way

the problem with linking suicide to antidepressant use is that the victim was suicidal to begin with. uncontrolled situations like this make each case completely irrelevant to antidepressant use.

I do agree that the prescriptions should be limited among doctors, but SSRIs do have benefits beyond depression.

I see the primary problem as drug reps pushing this crap on physicians and whoring out incentives for it. Certainly, physicians are equally to blame for colluding with incentives; but when the major psychiatry conventions are sponsored by Drug Companies, we have a serious issue.

Beyond the fact that the patient was already suicidal to begin with, the link between antidepressants and suicides is ironically the fact that the pill worked. The severely depressed are frequently too incapacitated by depression or anxiety to take their own lives.

The drug reps are a problem, for sure, but I think that in this particular issue it's more complex than that. Perhaps if some kind of test were developed to detect the brain imbalances causing depression, then doctors could prescribe these drugs more discriminately. At this point, all they can do is write the script and see if the patient improves.

 

[moshquerade]

Originally posted by: IGBT
..I've read that fishoil caps can have a ssri/prozac like effect with regular use and none of the pharm/chem side effects.

You read right.

http://www.ncbi.nlm.nih.gov/pubmed/11870016

Even though they don't want to exactly state that omega-3 fatty acid has antidepressive properties they won't disclaim it either.

"Studies have reported that countries with high rates of fish oil consumption have low rates of depressive disorder."


"CONCLUSIONS: It is not possible to distinguish whether E-EPA augments antidepressant action in the manner of lithium or has independent antidepressant properties of its own."

 

[alkemyst]

Originally posted by: moshquerade
you think you have a clue? or are you of the "most posting" here?
if you do think you are more knowledgeable than "most posting" please... please do elaborate.

go look up some more 'news' to repost. I think having a mother in nursing my whole life, having 7 years college level biological/zoological study, and being a pharmacy major puts me a little more in the 'know' than you.

Not to mention I know people on anti-depressants who are definitely 'off' when they don't take them.

Much of those on anti-depressants don't really need them though, it's like those taking viagra as well. It's a crutch people think they need to have and doctors are more than happy to write out prescriptions for a buck as long as they can.

However; you go girl.

It seems a news article and a quick trip to wiki has you thinking you are the EXPERT though.

 

[redgtxdi]

Originally posted by: Vic
Yeah, like people should listen to a medical transcriptionist and the media before their doctor and the FDA....

SSRI's might be overprescribed, but they do help people. I would even argue that they save lives. They are not a "happy pill," they are not some kind of narcotic.

QFT (minus any flame bait)


The fact of the matter is that GOOD doctors prescribe AD's using PROPER PROTOCOL and that protocol goes VERY deep in diagnosing.

I used to laugh at the idea of depression/anxiety and in 1998, 2003 and 2006 (3 separate multi-month bouts) I learned how VERY real it is. Even in 2008 there is A LOT of ignorance on the matter.

There are many very detailed double-blind studies that show the exact opposite of this study's (media motivated?) findings.

I won't write a book, but suffice to say that SSRI's effectively help a great many people, but overprescription causes people to scrutinize inaccurately!

 

[moshquerade]

Originally posted by: alkemyst

Originally posted by: moshquerade
you think you have a clue? or are you of the "most posting" here?
if you do think you are more knowledgeable than "most posting" please... please do elaborate.

go look up some more 'news' to repost. I think having a mother in nursing my whole life, having 7 years college level biological/zoological study, and being a pharmacy major puts me a little more in the 'know' than you.

Not to mention I know people on anti-depressants who are definitely 'off' when they don't take them.

Much of those on anti-depressants don't really need them though, it's like those taking viagra as well. It's a crutch people think they need to have and doctors are more than happy to write out prescriptions for a buck as long as they can.

However; you go girl.

It seems a news article and a quick trip to wiki has you thinking you are the EXPERT though.

again... the article, nor myself, stated that antidepressants are useless for everyone.

but you go ahead.... keep critiquing everyone on the board cause we all know nothing and you're an expert in everything with bullshitting being top of the list.

 

[Jeff7]

Originally posted by: zinfamous
over-prescribed? definitely

ineffective or even dangerous for most people? no way

the problem with linking suicide to antidepressant use is that the victim was suicidal to begin with. uncontrolled situations like this make each case completely irrelevant to antidepressant use.

I do agree that the prescriptions should be limited among doctors, but SSRIs do have benefits beyond depression.

I see the primary problem as drug reps pushing this crap on physicians and whoring out incentives for it. Certainly, physicians are equally to blame for colluding with incentives; but when the major psychiatry conventions are sponsored by Drug Companies, we have a serious issue.

I've read that with some who are suicidal, the antidepressants finally make them feel confidence for the first time in years. The person will then use this newfound confidence to finally take his own life.

I had my time with antidepressants.
Celexa made me tired all the time, and I yawned literally once a minute while I was standing up. It felt like someone had just turned my mind to "Low." Everything was just dulled, and it obviously didn't make me feel any better.
Wellbutrin - after one week on it, I had a grand-mal style seizure. 1-in-1000 chance. Yay, do I win anything? Like maybe a refund?
No more brain pharmaceuticals for me.

What helped considerably: Graduating high school and getting away from the daily stressors associated with the nightmare that was my time in public school. Being belittled every single day by peers in all age groups, for over a decade, without knowing either its cause or a way to make it stop, it can really take a toll on someone.

 

[redgtxdi]

Originally posted by: Jeff7
I've read that with some who are suicidal, the antidepressants finally make them feel confidence for the first time in years. The person will then use this newfound confidence to finally take his own life.

I had my time with antidepressants.
Celexa made me tired all the time, and I yawned literally once a minute while I was standing up. It felt like someone had just turned my mind to "Low." Everything was just dulled, and it obviously didn't make me feel any better.
Wellbutrin - after one week on it, I had a grand-mal style seizure. 1-in-1000 chance. Yay, do I win anything? Like maybe a refund?
No more brain pharmaceuticals for me.

What helped considerably: Graduating high school and getting away from the daily stressors associated with the nightmare that was my time in public school. Being belittled every single day by peers in all age groups, for over a decade, without knowing either its cause or a way to make it stop, it can really take a toll on someone.

Well, since nobody's commenting on this, I'll go........

Celexa was well known for side effects (thus Lexapro) and if it didn't work for you and the side effects were too great, then getting off of it was a good idea. (Again, good pdocs know this)

Wellbutrin.......(me no like).......works for some people, but doesn't for others and if you suffered a side effect like a seizure, then obviously, no bueno.

Congrats on getting control of your depression...................HOWEVER...........

If/when depression wants to get hold of you again........it will. Drugs, confidence a red cape coming out of the back of your blue tights or not..........it WILL have its way unless you're never due for another bout again in your life.

And the "No more brain pharms for me" would drastically change to.... "Please, God, help me by any means necessary!"

 

[Whisper]

The studies on antidepressants that I've read seem to widely support the idea that they are efficacious in many different levels of depression. As such, I'd like to see the actual report itself, and subsequently examine the methodology used, before jumping to any conclusions.

That being the case, cognitive-behavioral therapy has indeed been shown to alleviate depressive symptoms as well as medication in a variety of populations. Both have consistently also been shown to reduce depressive symptoms beyond what could be accounted for via placebo.

 

[AmdEmAll]

I took Lexapro for about a year. I feel much better now, I think not from the drug but because of changes I needed to make in my life.

I now take 5-HTP 5-hydroxytryptophan which the body naturally converts to serotonin. From my experience it has helped me a lot.

 

[Geekbabe]

Originally posted by: Vic

Originally posted by: zinfamous
over-prescribed? definitely

ineffective or even dangerous for most people? no way

the problem with linking suicide to antidepressant use is that the victim was suicidal to begin with. uncontrolled situations like this make each case completely irrelevant to antidepressant use.

I do agree that the prescriptions should be limited among doctors, but SSRIs do have benefits beyond depression.

I see the primary problem as drug reps pushing this crap on physicians and whoring out incentives for it. Certainly, physicians are equally to blame for colluding with incentives; but when the major psychiatry conventions are sponsored by Drug Companies, we have a serious issue.

Beyond the fact that the patient was already suicidal to begin with, the link between antidepressants and suicides is ironically the fact that the pill worked. The severely depressed are frequently too incapacitated by depression or anxiety to take their own lives.

The drug reps are a problem, for sure, but I think that in this particular issue it's more complex than that. Perhaps if some kind of test were developed to detect the brain imbalances causing depression, then doctors could prescribe these drugs more discriminately. At this point, all they can do is write the script and see if the patient improves.

I agree, a lot of the newer anti-depressants are what's known as "drugs of activation" which is why a lot of people on meds like Zoloft take them in the morning so as to not interfer with sleep.


I think all medications should be taken only after careful review and consideration with your doctor but untreated depression can be life destroying in more ways than one.

 

[Jeff7]

Originally posted by: redgtxdi
Well, since nobody's commenting on this, I'll go........

Celexa was well known for side effects (thus Lexapro) and if it didn't work for you and the side effects were too great, then getting off of it was a good idea. (Again, good pdocs know this)

Wellbutrin.......(me no like).......works for some people, but doesn't for others and if you suffered a side effect like a seizure, then obviously, no bueno.

Congrats on getting control of your depression...................HOWEVER...........

If/when depression wants to get hold of you again........it will. Drugs, confidence a red cape coming out of the back of your blue tights or not..........it WILL have its way unless you're never due for another bout again in your life.

And the "No more brain pharms for me" would drastically change to.... "Please, God, help me by any means necessary!"

Yeah, I know that "any means necessary" mindset. I also got out of the mindset that many people have in school - trying to fit in with any social circle, or niche, whatever you want to call it. I've tended not to do well around people for any length of time. I can work with people perfectly well, but I need alone time. Dorm/shared-apartment living was a big stressor, as I was always a little on edge; I never had alone time, as roommates could be around at any time, without warning. At home, my parents respected and understood this, so it was fine then. And now again, I have my own apartment off campus, without neighbors. Being here, alone, finally, it can be the most serene times I've ever known.

And working with people who have their own little petty feuds with one another, I just don't get involved. They're just that - petty. So-and-so never works hard enough, he takes too many breaks, etc etc, blah blah.
The sad part is, it's the same kind of childish behavior I put up with growing up - I'd hoped for all those years that once I got into the adult world, I wouldn't have to deal with it anymore. Turns out, the idiocy remains, but now the stakes are higher. Talk about dashed hopes for the future.:Q Heh.

I also know that it waits in the wings, and that it can take hold - if I let it. There are nights when it all just seems utterly pointless, when all the mistakes and regrets of the past seem so vividly apparent. But this feeling eventually erodes away. It's more of a frequent visitor now, rather than a permanent resident.

It's one of the interesting things about psychological illnesses - they require the patient to cooperate. A pathological illness can be eliminated with or without the cooperation of the patient. Bacteria and (theoretically) viruses can be killed off without the patient's consent. Psychological problems are software issues, issues in a sentient mind which can, at some level, be aware of this problem. Not only that, that mind may want to preserve the problem.
I actually worried about leaving the realm of depression. I didn't know what to expect. It was so familiar, it was a place I'd been for over a decade. Leaving it was like leaving a.....I don't know, a web blanket - it's cold and unpleasant, but it's all you've got. What lies beyond might not be worth the trouble.

Now, true there are some cases where a chemical problem is truly to blame. I think that the problem more frequently lies in the software of the mind, and you can't cure that with a hardware fix of a hormone concoction.

One other, and possibly final, thing to add: sleep. I find that feeling lousy comes far more easily when I'm tired. I usually go on about 4-5hrs of sleep a night during the week, unless I have a test. College generally remains quite exceedingly boring and tedious, despite what I've been told about upper-level courses being more interesting. (Thus far, they're just more work - more tedious, boring assignments piled on top of each other, but nothing that's truly mentally stimulating. Maybe I'm in the wrong major. Again.) So, I see no sense in wasting my valuable time (home time) sleeping. Now for the weekends, when I'm at home the entire time, I like to be well-rested so that I'm in a fine-and-dandy mood.
Of course, I'm also aware that a lack of sleep stands to make me a little mentally sluggish and irritable, though it doesn't seem to be manifested in a way that others see as a deficit; only I perceive it to be one. I guess I'm just that awesome that my idea of "deficient" qualifies as "sufficient" for anyone else. :laugh: And use of the term "irritable" is pretty loose here. It's like Mr. Rogers having a shitty day - it's still really not all that bad. It's not like I'm ever even close to lashing out at anyone.

How the general population gets when sleep deprived, I don't know. Maybe this antidepressant binge is one manifestation of it. We want sleep in a pill. That, or Diskeeper needs to get into pharmaceuticals and make a brain defragmenter.