Careful: whether SSRIs and SNRIs work is unrelated to whether hallucinogenics do or don't. hallucinogenics being shit doesn't make SSRI/SNRIs a good bet. Als

Careful: whether SSRIs and SNRIs work is unrelated to whether hallucinogenics do or don't. hallucinogenics being shit doesn't make SSRI/SNRIs a good bet. Also, those exact studies you refer to show that SNRIs work very poorly and are very limited. Usually studies have fewer than 100 participants: * people are dropped from the study arbitrarily * they are not double blind * they are not representative of the population (overwhelmingly participants are white, male, well off or young with no other health complaints and few serious problems) * studies are usually very short (<100 days) for medicines that are prescribed for years They then find drugs are less than 15%ppts more effective than placebos. In exchange you get quite extreme side effects for a significant number of users from impotence to suicide... The lancet picked this up and did. meta-study. Their conclusions: >We identified 28 552 citations and of these included 522 trials comprising 116 477 participants. In terms of efficacy, all antidepressants were more effective than placebo, with ORs ranging between 2·13 (95% credible interval [CrI] 1·89–2·41) for amitriptyline and 1·37 (1·16–1·63) for reboxetine. For acceptability, only agomelatine (OR 0·84, 95% CrI 0·72–0·97) and fluoxetine (0·88, 0·80–0·96) were associated with fewer dropouts than placebo, whereas clomipramine was worse than placebo (1·30, 1·01–1·68). When all trials were considered, differences in ORs between antidepressants ranged from 1·15 to 1·55 for efficacy and from 0·64 to 0·83 for acceptability, with wide CrIs on most of the comparative analyses. In head-to-head studies, agomelatine, amitriptyline, escitalopram, mirtazapine, paroxetine, venlafaxine, and vortioxetine were more effective than other antidepressants (range of ORs 1·19–1·96), whereas fluoxetine, fluvoxamine, reboxetine, and trazodone were the least efficacious drugs (0·51–0·84). For acceptability, agomelatine, citalopram, escitalopram, fluoxetine, sertraline, and vortioxetine were more tolerable than other antidepressants (range of ORs 0·43–0·77), whereas amitriptyline, clomipramine, duloxetine, fluvoxamine, reboxetine, trazodone, and venlafaxine had the highest dropout rates (1·30–2·32). 46 (9%) of 522 trials were rated as high risk of bias, 380 (73%) trials as moderate, and 96 (18%) as low; and the certainty of evidence was moderate to very low. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32802-7/fulltext https://www.thelancet.com/journals/lancet/article/PIIS0140-6... I think even assuming good faith for all those studies, those are poor results when you include the low acceptability. If you don't assume good faith you're left wondering if these drugs work at all. It should go without saying that NO ONE should stop or change their medication (especially highly addictive ones like these) based on a HN comment. Please speak to your doctors dear readers.