4 ms·

I have an awful lot to say about this comment, but I'll leave it at this: The cited study included six drugs. There are currently more than 20 available on the

I have an awful lot to say about this comment, but I'll leave it at this: The cited study included six drugs. There are currently more than 20 available on the US market. One of these 6 is no longer used (nefazodone - see the black box warning if you're curious). The study only looked at serotonin modulation. We have drugs that don't even affect serotonin now, and ones that do it much better than the old ones. [Venlafaxine is an SNRI but at low doses acts as an SSRI. To get the NE effects, one must go to the upper dosage range. Most patients can't do this because of intolerable GI discomfort. Since you're obviously negative on the subject, I'll mention that the GI upset is caused by nonspecific serotonin activity at 5HT3 and 5HT4, if I remember my receptors correctly]. The study, published in 2008, only looked at 1987-1999. Very strange. Recency is in fact important with drug trial data. PLOS Medicine is not exactly a respected medical journal... if you want good data, try Lancet, BMJ, NEJM, AJP, etc. Just because it got published definitely doesn't mean it's reliable. Very few people are actually trained to properly evaluate medical literature.

steve-howard 15y ago
There's still no denying that the placebo effect plays a substantial role in the efficacy of antidepressant medications. It's part of the reason that fewer new medications are making it onto the market. Additionally, the SNRIs are marginally more effective, at best, than SSRIs in the treatment of depression. They are usually more expensive though! Fibromyalgia is a different story. I'm negative on the subject because I have been on six different antidepressants and they did nothing but cause me intense discomfort. I took desvenlafaxine at a non-noradrenergic dosage level, and it still made me insomniac, gained weight fast, triggered manic symptoms, and caused intense withdrawal symptoms. I was also on an NDRI (non-sertonergic) and a tetracyclic. I am not a doctor, but given how a doctor is responsible for putting me on a carousel of medications that screwed up my body for over six months, I don't particularly care who's considered qualified to read papers.

steve-howard 15y ago

There's still no denying that the placebo effect plays a substantial role in the efficacy of antidepressant medications. It's part of the reason that fewer new medications are making it onto the market. Additionally, the SNRIs are marginally more effective, at best, than SSRIs in the treatment of depression. They are usually more expensive though! Fibromyalgia is a different story. I'm negative on the subject because I have been on six different antidepressants and they did nothing but cause me intense discomfort. I took desvenlafaxine at a non-noradrenergic dosage level, and it still made me insomniac, gained weight fast, triggered manic symptoms, and caused intense withdrawal symptoms. I was also on an NDRI (non-sertonergic) and a tetracyclic. I am not a doctor, but given how a doctor is responsible for putting me on a carousel of medications that screwed up my body for over six months, I don't particularly care who's considered qualified to read papers.