4 ms·

Ok but this isn't really true. The country with the most anti-depressant intake is Iceland, the US is around second or third place, yet the other countries in t

Ok but this isn't really true. The country with the most anti-depressant intake is Iceland, the US is around second or third place, yet the other countries in the "top ten" of antidepressant usage per capita are almost all european nations. The USA isn't an outlier, but I guess we really can't escape the "do americans really, really do X?" even when it is trivially easy to verify. The funny thing is that the reason Americans know the names of their medications is almost the exact same reason people seem to think the USA are always some sort of outlier; they hear about it more in the media! Branding for drugs is much more emphasized in the US.

nwoli 4y ago
Antidepressants and adderall are very different beasts
- augment002 4y ago
  It’s not clear how this is relevant.
- Spivak 4y ago
  Yeah, antidepressants are way more complicated, they have more side effects, and have to be monitored carefully to not make the underlying issues that caused the patient to take them worse. Suicidal thoughts plus antidepressants that give you energy can give you the motivation to go through it. And despite not being categorized as addictive you can't stop taking them without wrecking your mental health until your body readjusts. If you don't refill your Rx of antidepressants your doctor will be notified and reach out to you because stopping has such pronounced effects. While at the same time despite being a controlled substance because they're supposedly so addictive people with ADHD forget to take adderall and with normal use you don't take it every day. We got this this shit so unbelievably backwards because we haven't shook the puritanical bullshit of "oh no someone might experience euphoria if they go out of their way to abuse it." Like bro, people with real medical issues shouldn't suffer because of this crap. If everyone who is buying cocaine from their dealer switched to medically supervised stimulants we would be unquestionably better off.
  - PragmaticPulp 4y ago
    > While at the same time despite being a controlled substance because they're supposedly so addictive people with ADHD forget to take adderall and with normal use you don't take it every day. This is incorrect: Normal use of stimulant medication is to take it regularly every day. We also have evidence from studies showing that the brain adapts to consistent dosing in order to counter some of the damaging oxidative effects of amphetamine. Inconsistent dosing could undermine this adaptation and does not mirror the dosing protocol used in studies to determine long term safety. Sporadic dosing is also known to cause sensitization effects in studies, which can sensitize people to the negative side effects of a drug or exaggerate cravings. Some people do take medication holidays as recommended by doctors, but even those should be done on a pre-determined schedule. People get themselves into trouble when they start treating Adderall like an ad-hoc drug that they can take more or less of depending on how they feel that day or how much work they need to get done. This not only leaves the brain in a constant and unpredictable state of flux, it creates an association between “I need to do work” and “I need more Adderall”. Patients who go down this path often end up escalating doses, playing games with saving up pills to take more, or trying to talk their prescribers into extra dosages beyond what they need. It ultimately ends with higher tolerance and reduce effectiveness. > If you don't refill your Rx of antidepressants your doctor will be notified and reach out to you because stopping has such pronounced effects. This also isn’t true. There are many medications with withdrawal symptoms far worse than antidepressants. Some drugs can be potentially fatal if discontinued abruptly. Pharmacies don’t generally hunt down doctors when a patient doesn’t get a refill. Antidepressant withdrawal (without taper) can be difficult for some, but so can withdrawing from Adderall. There are entire subreddits acting as support groups for people tapering down Adderall and trying to get back to feeling normal after taking Adderall for years. Stimulants are definitely habit-forming and have a high abuse potential. Let’s not downplay it.
    - ziml77 4y ago
      Stopping antidepressants without tapering can be deadly too. Serotonin syndrome is a real issue.
    - Spivak 4y ago
- mardifoufs 4y ago
  I don't disagree, but stats are hard to come by for other types of psychiatric drug. I'd be interested to know if international studies have done on the subject, because it might very well not be an ideal "proxy" for general drug usage! But I also personally think that adderall has less side effects and better/smoother withdrawals. SSRIs and other antidepressants usually have a heavier impact on the brain too. Now I don't doubt that Adderall is probably over prescribed, but I think that it is better to look at entire families of drugs to compensate for differences between markets.
no_wizard 4y ago
In fact, the US[0] and New Zealand are the only countries were drug advertising like we see in the US are even legal. This absolutely will have an affect on perception [0]: https://www.health.harvard.edu/medications/do-not-get-sold-on-drug-advertising https://www.health.harvard.edu/medications/do-not-get-sold-o...
- refurb 4y ago
  Most antidepressants have been generic for decades. There hasnt been advertising for them for a long tkmr.
a_wild_dandan 4y ago
Great point. Another thought: prescriptions are often a healthcare provider's sole tool. They can't fix structural societal woes or make you exercise, eat healthy, pursue CBT with a therapist, etc. But taking a daily pill is a reachable stepping stone for many patients.
bluetomcat 4y ago
Iceland and the Scandinavian countries have, let's say, "weather-related" reasons for their depressions. They are introvert societies with the highest percentage of single-person households. The reason for the US being close to them could be the high prescription culture and the social aggression inherent in everyday US life, masked behind curteous words, customer-oriented interaction and polished looks.
- PragmaticPulp 4y ago
  > Iceland and the Scandinavian countries have, let's say, "weather-related" reasons for their depressions. Seasonal Affective Disorder also occurs in the United States. Much of the US population lives in areas with significantly shorter days in the winter.
  - loeg 4y ago
    Most of the US is significantly south of much of continental Europe (not just Scandinavia), as a point of comparison. We (broadly) experience longer days in the winter than Europeans.
    - systemtest 4y ago
      Stockholm has 1973 hours of sunshine a year, compared to 2100 hours in Seattle. The US has more sun, but not enough for a significant difference.
      - loeg 4y ago
        GP is talking about winter sunlight, not year-round numbers. (Longer summer days don't help seasonal affective disorder.) Stockholm sees about 6 hours of daylight at winter solstice, while Seattle sees 8.25. And Seattle is sort of cherry-picked -- it's one of the northern-most cities in the continental US, representing 1.2% of the US population (including the full metro area). LA sees 9.75 hours of daylight on the solstice. Honolulu sees 10.75 hours. The US population-weighted centroid is approximately Missouri[1], which sees 9.5 hours of daylight on the solstice -- more than 50% more than Stockholm. [1]: https://oceanservice.noaa.gov/news/mar22/center-population.html https://oceanservice.noaa.gov/news/mar22/center-population.h...

nwoli 4y ago

Antidepressants and adderall are very different beasts

augment002 4y ago
It’s not clear how this is relevant.
Spivak 4y ago
Yeah, antidepressants are way more complicated, they have more side effects, and have to be monitored carefully to not make the underlying issues that caused the patient to take them worse. Suicidal thoughts plus antidepressants that give you energy can give you the motivation to go through it. And despite not being categorized as addictive you can't stop taking them without wrecking your mental health until your body readjusts. If you don't refill your Rx of antidepressants your doctor will be notified and reach out to you because stopping has such pronounced effects. While at the same time despite being a controlled substance because they're supposedly so addictive people with ADHD forget to take adderall and with normal use you don't take it every day. We got this this shit so unbelievably backwards because we haven't shook the puritanical bullshit of "oh no someone might experience euphoria if they go out of their way to abuse it." Like bro, people with real medical issues shouldn't suffer because of this crap. If everyone who is buying cocaine from their dealer switched to medically supervised stimulants we would be unquestionably better off.
- PragmaticPulp 4y ago
  > While at the same time despite being a controlled substance because they're supposedly so addictive people with ADHD forget to take adderall and with normal use you don't take it every day. This is incorrect: Normal use of stimulant medication is to take it regularly every day. We also have evidence from studies showing that the brain adapts to consistent dosing in order to counter some of the damaging oxidative effects of amphetamine. Inconsistent dosing could undermine this adaptation and does not mirror the dosing protocol used in studies to determine long term safety. Sporadic dosing is also known to cause sensitization effects in studies, which can sensitize people to the negative side effects of a drug or exaggerate cravings. Some people do take medication holidays as recommended by doctors, but even those should be done on a pre-determined schedule. People get themselves into trouble when they start treating Adderall like an ad-hoc drug that they can take more or less of depending on how they feel that day or how much work they need to get done. This not only leaves the brain in a constant and unpredictable state of flux, it creates an association between “I need to do work” and “I need more Adderall”. Patients who go down this path often end up escalating doses, playing games with saving up pills to take more, or trying to talk their prescribers into extra dosages beyond what they need. It ultimately ends with higher tolerance and reduce effectiveness. > If you don't refill your Rx of antidepressants your doctor will be notified and reach out to you because stopping has such pronounced effects. This also isn’t true. There are many medications with withdrawal symptoms far worse than antidepressants. Some drugs can be potentially fatal if discontinued abruptly. Pharmacies don’t generally hunt down doctors when a patient doesn’t get a refill. Antidepressant withdrawal (without taper) can be difficult for some, but so can withdrawing from Adderall. There are entire subreddits acting as support groups for people tapering down Adderall and trying to get back to feeling normal after taking Adderall for years. Stimulants are definitely habit-forming and have a high abuse potential. Let’s not downplay it.
  - ziml77 4y ago
    Stopping antidepressants without tapering can be deadly too. Serotonin syndrome is a real issue.
  - Spivak 4y ago
mardifoufs 4y ago
I don't disagree, but stats are hard to come by for other types of psychiatric drug. I'd be interested to know if international studies have done on the subject, because it might very well not be an ideal "proxy" for general drug usage! But I also personally think that adderall has less side effects and better/smoother withdrawals. SSRIs and other antidepressants usually have a heavier impact on the brain too. Now I don't doubt that Adderall is probably over prescribed, but I think that it is better to look at entire families of drugs to compensate for differences between markets.

no_wizard 4y ago

In fact, the US[0] and New Zealand are the only countries were drug advertising like we see in the US are even legal. This absolutely will have an affect on perception [0]: https://www.health.harvard.edu/medications/do-not-get-sold-on-drug-advertising https://www.health.harvard.edu/medications/do-not-get-sold-o...

refurb 4y ago
Most antidepressants have been generic for decades. There hasnt been advertising for them for a long tkmr.

a_wild_dandan 4y ago

Great point. Another thought: prescriptions are often a healthcare provider's sole tool. They can't fix structural societal woes or make you exercise, eat healthy, pursue CBT with a therapist, etc. But taking a daily pill is a reachable stepping stone for many patients.

bluetomcat 4y ago

Iceland and the Scandinavian countries have, let's say, "weather-related" reasons for their depressions. They are introvert societies with the highest percentage of single-person households. The reason for the US being close to them could be the high prescription culture and the social aggression inherent in everyday US life, masked behind curteous words, customer-oriented interaction and polished looks.

PragmaticPulp 4y ago
> Iceland and the Scandinavian countries have, let's say, "weather-related" reasons for their depressions. Seasonal Affective Disorder also occurs in the United States. Much of the US population lives in areas with significantly shorter days in the winter.
- loeg 4y ago
  Most of the US is significantly south of much of continental Europe (not just Scandinavia), as a point of comparison. We (broadly) experience longer days in the winter than Europeans.
  - systemtest 4y ago
    Stockholm has 1973 hours of sunshine a year, compared to 2100 hours in Seattle. The US has more sun, but not enough for a significant difference.
    - loeg 4y ago
      GP is talking about winter sunlight, not year-round numbers. (Longer summer days don't help seasonal affective disorder.) Stockholm sees about 6 hours of daylight at winter solstice, while Seattle sees 8.25. And Seattle is sort of cherry-picked -- it's one of the northern-most cities in the continental US, representing 1.2% of the US population (including the full metro area). LA sees 9.75 hours of daylight on the solstice. Honolulu sees 10.75 hours. The US population-weighted centroid is approximately Missouri[1], which sees 9.5 hours of daylight on the solstice -- more than 50% more than Stockholm. [1]: https://oceanservice.noaa.gov/news/mar22/center-population.html https://oceanservice.noaa.gov/news/mar22/center-population.h...