4 ms·

Fascinating, but not incredibly surprising considering that many commonly prescribed antidepressant drugs fail to beat a placebo. https://www.ncbi.nlm.nih.gov/

Fascinating, but not incredibly surprising considering that many commonly prescribed antidepressant drugs fail to beat a placebo. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4592645/pdf/wps0014-0294.pdf https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4592645/pdf/wps... (Compare the black bar under ‘antidepressants’ to the placebo bar.) This isn’t to say you shouldn’t take antidepressants if you have MDD; it’s worth a shot. However, it should make us curious as intelligent consumers of research of what the actual remediation of depressive symptoms is caused by(in both placebo and AD groups). Personally, I’d say it’s likely that the individual is the one making a difference in recovery from MDD, not the chemical. All that said, this post is absolutely not meant to shame antidepressant use: Depression is a potentially life threatening illness. I’m very happy for those who have over come it and I am not against antidepressant use in any way. It’s the best we’ve got (and they works quite well in conjunction with therapy btw! Far above placebo). But from a scientific perspective, it’s experimentally unclear if antidepressant drugs are anywhere near as efficacious as major pharmaceutical companies (with major financial incentives) say they are. It’s worth noting this is being currently debated in the field. There does seem to be a somewhat consistent effect of AD drugs performing slightly above placebo (see study linked above). However, it’s not clear if that effect is due to recognizable side effects that antidepressants have (allowing participants to ‘unblind’ themselves), or if antidepressants are indeed slightly more effective than a place I. Due to the nature of the illness, it’s been assumed that it’s worth it to keep prescribing these drugs to those who suffer from depression. Edit: If you are dealing with depression, please seek help. Doing so will improve your life, and the lives of those around you. Life is too short to suffer without help.

Perenti 4y ago
I live with depression, and have taken SSRI and SNRI medication for about 30 years. It took a very long time to find the drug and dosage and dosing regime that works for me. I still get way down, but not _too_ dark and since going on current meds 3 years ago have had no issues with suicidal ideation. Depression is a complex set of problems, and it is in my experience unreasonable to expect a "complete cure in a box" when dealing with Major Depression. In my case there is little doubt that my current SNRI is life extending. To be honest, I sometimes think that maybe pointing out how weak the evidence is for AD meds in general may dissuade some people from trying them - and they may work, as may a placebo. I really appreciate the way you worded this, it's really rare to find a balanced and informed opinion like you have shared.
- FollowingTheDao 4y ago
  Disabled with mood disorders here. The issue I have for your reasoning is that you have no idea that if you stoped taking them things would be any different. This is the purpose of these studies. They find, on the whole, that it is not worth taking antidepressants.
  - ncmncm 4y ago
    That is not, in fact, what they find, whatever they claim. Science has no objective means to diagnose depression, or more importantly to distinguish among many fundamentally different kinds, other than by noting what responds to different medications. It should be easy to understand why designing a valid RCT of an antidepressant is practically impossible. But there is a continuous demand for RCTs, so people run, instead, invalid RCTs. Running invalid RCTs is pointless. Reporting their results as if valid is, at best, misleading. At worst, dishonest.
AtlasBarfed 4y ago
What are the sample sizes of studies that show exercise outperforms antidepressant drugs?

Perenti 4y ago

I live with depression, and have taken SSRI and SNRI medication for about 30 years. It took a very long time to find the drug and dosage and dosing regime that works for me. I still get way down, but not _too_ dark and since going on current meds 3 years ago have had no issues with suicidal ideation. Depression is a complex set of problems, and it is in my experience unreasonable to expect a "complete cure in a box" when dealing with Major Depression. In my case there is little doubt that my current SNRI is life extending. To be honest, I sometimes think that maybe pointing out how weak the evidence is for AD meds in general may dissuade some people from trying them - and they may work, as may a placebo. I really appreciate the way you worded this, it's really rare to find a balanced and informed opinion like you have shared.

FollowingTheDao 4y ago
Disabled with mood disorders here. The issue I have for your reasoning is that you have no idea that if you stoped taking them things would be any different. This is the purpose of these studies. They find, on the whole, that it is not worth taking antidepressants.
- ncmncm 4y ago
  That is not, in fact, what they find, whatever they claim. Science has no objective means to diagnose depression, or more importantly to distinguish among many fundamentally different kinds, other than by noting what responds to different medications. It should be easy to understand why designing a valid RCT of an antidepressant is practically impossible. But there is a continuous demand for RCTs, so people run, instead, invalid RCTs. Running invalid RCTs is pointless. Reporting their results as if valid is, at best, misleading. At worst, dishonest.

AtlasBarfed 4y ago

What are the sample sizes of studies that show exercise outperforms antidepressant drugs?