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I'm very much concerned that rather than traditional psychotherapy where a person has to confront the issues and trauma of their life we're moving towards the i

I'm very much concerned that rather than traditional psychotherapy where a person has to confront the issues and trauma of their life we're moving towards the idea that if you drug someone enough they won't commit suicide. I should also point out that the anecdote given makes reference to Prozac, a prescription drug which some users have claimed has caused their suicidal ideation.

ZeroFries 8y ago
A drug that actually works is far preferable. Talk therapy is expensive, hard work, tough to scale, and it's difficult to find a qualified therapist who is right for you.
gnulinux 8y ago
Sorry, but this bizarre. Psychotherapy is just one tool in the toolbox against treating mental illnesses. If there is evidence this drug helps treating mental illnesses, what's the reason not to use it? This is not some alternative medicine that is offered instead of or in addition to scientific practice. This is part of the usual treatment that involves psychotherapy, if it's useful. There is nothing inherently bad with drugs; you don't hesitate to use drugs when your liver chemistry breaks, why hesitate it when your brain chemistry breaks?
- nickbarnwell 8y ago
  The problem is that the effect sizes for most anti-depressants is quite small and the role of pharmaceutical companies in advancing their use has been quite a bit larger. The difference between psychotherapy and medication and psychotherapy alone is small. I would also point out that dialysis, chemotherapy, etc are also quite expensive, time consuming, and difficult to scale. We still consider them valid, life-saving treatments.
  - cc-d 8y ago
    >The problem is that the effect sizes for most anti-depressants is quite small and the role of pharmaceutical companies in advancing their use has been quite a bit larger. The difference between psychotherapy and medication and psychotherapy alone is small. Ketamine is not your traditional SSRI. You're making the same error as the other poster in grouping all "antidepressants" under the same umbrella, which is particularly egregious when discussing ketamine.
    - nickbarnwell 8y ago
      I am referring to traditional agents, not ketamine. There is insufficient evidence to draw conclusions about Ketamine's usefulness as a rapidly acting agent for treatment of depression. I lack training in psychopharmacology or neuroscience and thus my interpretation of the research is that of a layperson, but my understanding from talking with psychiatrists on the matter is that it is unlikely that ketamine will become a frontline treatment but its mechanism of action will be explored and lead to the development of new drugs that activate the same pathways in the brain but lack or have lessened anesthetic effect.
- faissaloo 8y ago
  You don't use a nuke if you only need to kill one guy. I'm not against it being used but we need to be careful, we don't want another opiod crisis.
  - gnulinux 8y ago
    I think opioids are in a very special spot. There are very few drugs that are as intensely addictive and as harmful as opioids and are used in medical profession. In particular, ketamine is nowhere near as addictive or harmful as opioids. Your point is valid, we should be careful, but we should also recognize the special status of opioids.
  - cc-d 8y ago
    >I'm not against it being used but we need to be careful, we don't want another opiod crisis. This is a horribly ignorant statement. Ketamine therapy is in no way comparable to widespread opioid prescription in risk. You are once again comparing drugs with entirely different mechanisms of action.
cc-d 8y ago
>I'm very much concerned that rather than traditional psychotherapy Why on earth would you be concerned about a tool which allows clinically depressed individuals to see immediate, significant improvement in their condition with relatively few side effects? You should also not group ketamine therapy with prozac, they are completely different drugs with completely different mechanisms of action, grouping them under a broad "antidepressant!" umbrella is borderline negligent. Psychotherapy is often a long, drawn out process which doesn't necessarily always guarantee results. Not to mention the large amount of variance between individual therapists. Psychotherapy is useful as an adjunct to psychiatric drugs, and vice versa. They are both useful tools when fighting mental illness, and are even more efficacious when combined. Drawing a line between the two for ideological reasons, instead of purely evidence-based results, is a mistake.
- faissaloo 8y ago
  Because I feel it may encourage existing harmful behaviours that are causing the ideation to persist and end up fueling a cycle of dependancy.
  - cc-d 8y ago
    > fueling a cycle of dependancy. Similar to how diabetics are dependent on insulin, or schizophrenics dependent on their anti-psychotic medication? You're also implying that people with severe, clinical depression can assuredly be helped by psychotherapy. I'm sorry, but the literature is far more abysmal than that. Many patients don't even respond to psychotherapy, and need psychiatric intervention in the same way a schizophrenic does.

ZeroFries 8y ago

A drug that actually works is far preferable. Talk therapy is expensive, hard work, tough to scale, and it's difficult to find a qualified therapist who is right for you.

gnulinux 8y ago

Sorry, but this bizarre. Psychotherapy is just one tool in the toolbox against treating mental illnesses. If there is evidence this drug helps treating mental illnesses, what's the reason not to use it? This is not some alternative medicine that is offered instead of or in addition to scientific practice. This is part of the usual treatment that involves psychotherapy, if it's useful. There is nothing inherently bad with drugs; you don't hesitate to use drugs when your liver chemistry breaks, why hesitate it when your brain chemistry breaks?

nickbarnwell 8y ago
The problem is that the effect sizes for most anti-depressants is quite small and the role of pharmaceutical companies in advancing their use has been quite a bit larger. The difference between psychotherapy and medication and psychotherapy alone is small. I would also point out that dialysis, chemotherapy, etc are also quite expensive, time consuming, and difficult to scale. We still consider them valid, life-saving treatments.
- cc-d 8y ago
  >The problem is that the effect sizes for most anti-depressants is quite small and the role of pharmaceutical companies in advancing their use has been quite a bit larger. The difference between psychotherapy and medication and psychotherapy alone is small. Ketamine is not your traditional SSRI. You're making the same error as the other poster in grouping all "antidepressants" under the same umbrella, which is particularly egregious when discussing ketamine.
  - nickbarnwell 8y ago
    I am referring to traditional agents, not ketamine. There is insufficient evidence to draw conclusions about Ketamine's usefulness as a rapidly acting agent for treatment of depression. I lack training in psychopharmacology or neuroscience and thus my interpretation of the research is that of a layperson, but my understanding from talking with psychiatrists on the matter is that it is unlikely that ketamine will become a frontline treatment but its mechanism of action will be explored and lead to the development of new drugs that activate the same pathways in the brain but lack or have lessened anesthetic effect.
faissaloo 8y ago
You don't use a nuke if you only need to kill one guy. I'm not against it being used but we need to be careful, we don't want another opiod crisis.
- gnulinux 8y ago
  I think opioids are in a very special spot. There are very few drugs that are as intensely addictive and as harmful as opioids and are used in medical profession. In particular, ketamine is nowhere near as addictive or harmful as opioids. Your point is valid, we should be careful, but we should also recognize the special status of opioids.
- cc-d 8y ago
  >I'm not against it being used but we need to be careful, we don't want another opiod crisis. This is a horribly ignorant statement. Ketamine therapy is in no way comparable to widespread opioid prescription in risk. You are once again comparing drugs with entirely different mechanisms of action.

cc-d 8y ago

>I'm very much concerned that rather than traditional psychotherapy Why on earth would you be concerned about a tool which allows clinically depressed individuals to see immediate, significant improvement in their condition with relatively few side effects? You should also not group ketamine therapy with prozac, they are completely different drugs with completely different mechanisms of action, grouping them under a broad "antidepressant!" umbrella is borderline negligent. Psychotherapy is often a long, drawn out process which doesn't necessarily always guarantee results. Not to mention the large amount of variance between individual therapists. Psychotherapy is useful as an adjunct to psychiatric drugs, and vice versa. They are both useful tools when fighting mental illness, and are even more efficacious when combined. Drawing a line between the two for ideological reasons, instead of purely evidence-based results, is a mistake.

faissaloo 8y ago
Because I feel it may encourage existing harmful behaviours that are causing the ideation to persist and end up fueling a cycle of dependancy.
- cc-d 8y ago
  > fueling a cycle of dependancy. Similar to how diabetics are dependent on insulin, or schizophrenics dependent on their anti-psychotic medication? You're also implying that people with severe, clinical depression can assuredly be helped by psychotherapy. I'm sorry, but the literature is far more abysmal than that. Many patients don't even respond to psychotherapy, and need psychiatric intervention in the same way a schizophrenic does.