4 ms·

Were you experiencing side effects that made you want to get off? For the vast majority of people there really are none.

by krupan 2mo ago

erkt 2mo ago
You think the vast majority of people do not experience side effects from anti-depressants? Wild.
- orangedog 2mo ago
  What's wild about that? What does the science say? I've tried a variety and I can't say whether I've experienced side effects. That's just an anecdote but that's the thing with this discussion, that's all you will get. If people don't suffer side effects, they're not likley to get on HN and post about them, etc. The bigger issue is the person dealing with these issues is taking them because they are not well-off. If you deal with reduced desire, for example, is that a side effect of the medication or is that a side effect of being depressed. I think your "wild" is a little flippant or telling because it just points back to anecdotes.
  - hirako2000 2mo ago
    They don't post on HN but a cousin post references an entire subreddit dedicated to it. They are also anecdotal, hundreds, thousands of people suffering side effects. Given dozen of millions people in the U.S alone are prescribed those things daily, that a drop in the ocean. But not everyone post on Reddit either
    - orangedog 2mo ago
      Yes but again this is the exact example of anecdotes. Those not suffering aren't going to seek out subreddits to post about their non-problems. You can find a subreddit about everything, whether that's representative of anything or not.
      - hirako2000 1mo ago
        I did mention they were anecdotes. I never found a sub reddit talking about the side effects of mineral water, how eating apples regularily lowered their libidos, on that sleeping on a mattress made them senile. At some point common sense primes over what funded science wants people to believe. The side effects exist since some doctors do warn about them, one may also find them in the counter indications mentioning those things. It isn't unfounded. What's taboo today is to criticize SSRIs over prescriptions. Odd, given that over 25% of the U.S population are taking them, or some other form of legal psycho active substance, just to be able to "function".
- stoorafa 2mo ago
  FWIW findings about adverse events vary considerably: > The proportion of patients reporting adverse events ranged from 16% to 98% (median 80%) under SSRI treatment and from 17% to 94% (median 70%) under placebo [1] So the answer IMO depends on whether we can attribute adverse effects to treatment, which is difficult to disentangle from adverse effects of disease I’m open to being shown more certainty if available from the literature but meta-analyses are high-strength evidence [1] https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/efficacy-of-selective-serotonin-reuptake-inhibitors-and-adverseevents-metaregression-and-mediation-analysis-of-placebocontrolledtrials/A887520460D404B7E64001E264B041E9 https://www.cambridge.org/core/journals/the-british-journal-...
micromacrofoot 2mo ago
This is the same myth that women get told about hormonal birth control, it's not an "if" with side-effects of SSRIs, it's a "how much" and "when"
- orangedog 2mo ago
  I don't to my knowledge suffer side-effects. Why are you certain about this?
  - micromacrofoot 2mo ago
    chemistry of complex systems you don't experience side-effects now, but you will if you need to stop taking it
    - orangedog 2mo ago
      I have stopped taking it, I didn't have side effects.
    - in_cahoots 2mo ago
      Been on hormonal birth control for 20 years. I've stopped twice to get pregnant. No side effects. I don't know why you're so confident here.
      - micromacrofoot 2mo ago
        I already answered why, it's chemistry. Everyone has side effects, not everyone notices them. You can not introduce a medication, or any substance for that matter, into the human body that does not have any side effects — it's impossible.
        in_cahoots 2mo ago
        Normally when people say side effects they mean things that you can actually observe. Hence your earlier point about going off the meds and noticing a difference. If I don't notice any difference other than I don't think your point really stands.
deinonychus 2mo ago
I experienced a lot of stuff I didn't really notice how bad they were until I was off of them. Anhedonia, apathy, lack of volition, and sexual side effects. I also have trouble remembering parts of my life when I was on SSRIs. I don't regret trying or even taking them for extended periods. They make the bad thoughts go away and raised the floor for my mood. But they also put a pretty low ceiling on it, too. I was probably on them for too long but clearly medicine doesn't have a perfect framework for handling every corner of this space, so I don't really blame anyone. There's a goldilocks zone for drug, dosage, and treatment length and I don't think I was always in it. I've talked to many people who have bad things to say about SSRIs. On the other hand, my girlfriend is on one right now and seems very satisfied.
RankingMember 2mo ago
> Despite considerable improvements in side-effect profiles, antidepressants continue to be associated with a significant burden of side effects that affect, treatment adherence and quality of life. Hu et al1 studied 401 patients with depression who had recently been prescribed an SSRI, and found that, after 75 to 105 days of treatment, 86% of patients reported at least, one side effect, and 55% experienced one or more bothersome side effects. https://pmc.ncbi.nlm.nih.gov/articles/PMC3181894/ https://pmc.ncbi.nlm.nih.gov/articles/PMC3181894/
- orangedog 2mo ago
  > In both research and clinical contexts, an important challenge is presented by the phenomenological overlap between side effects and residual symptoms of depression. Thus, fatigue, cognitive impairment, apathy, jitteriness and irritability, and sleep and appetite changes are core features of depression, but may also be related to antidepressant, treatment. In a small study of 43 depressed inpatients,6 which investigated the rate of somatic symptoms and complaints that were present before and after treatment, many symptoms often considered to be side effects of drugs were also present prior to treatment, including dry mouth, lightheadedness, sweating, tremors, and constipation. The distinction between residual symptoms and side effects is crucial, as they call for very different responses.
WhitneyLand 2mo ago
So, this is not supported by the data when people are asked. Sexual effects alone hit about 50–70% people. Then you could face nausea, insomnia, profuse sweating when you’re still, emotional blunting, and weight gain. I don’t want to discourage anyone, they can save lives. It is a net benefit for some people, but even then most people will experience side effects and wish they didn’t have to take them.
- orangedog 2mo ago
  > The most common side effects reported by patients in the study by Hu et al1 of 401 outpatients taking SSRIs were drowsiness (38%), dry mouth (34%), and sexual dysfunction (34%) > which was conducted in 1999-2000, questioned patients about side effects via phone interviews within 75 to 105 days of starting antidepressant therapy. The side effects deemed most bothersome were sexual dysfunction (17%) It's no where near those numbers. https://pmc.ncbi.nlm.nih.gov/articles/PMC3181894/ https://pmc.ncbi.nlm.nih.gov/articles/PMC3181894/ You notice how the scientific numbers get inflated in anecdotes from 17-34% to 50-70%?
  - pessimizer 2mo ago
    Do you think the one 25 year old short-term study that you found by yourself is the only study that has been done, and that anything that deviates from it is a distortion?
  - oasisaimlessly 2mo ago
    > phone interviews within 75 to 105 days of starting antidepressant therapy. Different thing entirely from long-term effects.
    - orangedog 2mo ago
      Do you have anything which shows long-term effects are 50-70%?
  - WhitneyLand 2mo ago
    “It's no where near those numbers” “get inflated in anecdotes” Just because one study has the number 34% in it, does not prove the numbers I gave were wrong and does not mean they are anecdotal. This is something that’s been studied from many angles and there’s more than one number that’s defensible based on the context and dataset. For example, even the study you cited says: “In a study of 344 patients by Montejo-Gonzalez et al, 58% of patients reported sexual dysfunction when physicians directly inquired”, and “14% with spontaneous reporting”. In another example, a 1,000 patient study found 57.7–72.7% for common SSRIs. https://pubmed.ncbi.nlm.nih.gov/11229449/ https://pubmed.ncbi.nlm.nih.gov/11229449/ The “scientific numbers” you allude to are not one value. It’s a body of research not one definitive number. Taken a whole I don’t think anyone is being that mislead when it’s suggested more than half of people may experience these side effects.
y-c-o-m-b 2mo ago
Not OP, but my primary side effect being on Sertraline from 2002-2012 was lack of control over my anger or violent outbursts. I was primarily ok if things were good, but if something upset me, it would go from 0 to 10 in an instant. I did not even notice this as unusual until I got off the drug and it was a night and day difference how much more mellow I became. I have not been on any SSRI since then. I was on a very low dose of Bupropion for about 5 years and did mostly well; it only made my existing brain fog slightly worse. I usually recommend that one over SSRIs due to my experiences. EDIT: I forgot to mention the damn brain zaps on SSRIs. Even if I missed a dose by 18 hours, I would get the zaps.
movespebp 2mo ago
That's not true. https://pmc.ncbi.nlm.nih.gov/articles/PMC2719451/ https://pmc.ncbi.nlm.nih.gov/articles/PMC2719451/ places the figure experiencing side effects at 40%, with 25% reporting those effects as serious. It's also telling that only just under half of those experiencing side effects ever reported those side effects to their providers - likely contributing to doctors getting a skewed perception of the real adverse effects risk. What's missing is also follow up - for some those effects don't resolve after stopping the drug.

Were you experiencing side effects that made you want to get off? For the vast majority of people there really are none.

by krupan 2mo ago

Were you experiencing side effects that made you want to get off? For the vast majority of people there really are none.

erkt 2mo ago

You think the vast majority of people do not experience side effects from anti-depressants? Wild.

orangedog 2mo ago
What's wild about that? What does the science say? I've tried a variety and I can't say whether I've experienced side effects. That's just an anecdote but that's the thing with this discussion, that's all you will get. If people don't suffer side effects, they're not likley to get on HN and post about them, etc. The bigger issue is the person dealing with these issues is taking them because they are not well-off. If you deal with reduced desire, for example, is that a side effect of the medication or is that a side effect of being depressed. I think your "wild" is a little flippant or telling because it just points back to anecdotes.
- hirako2000 2mo ago
  They don't post on HN but a cousin post references an entire subreddit dedicated to it. They are also anecdotal, hundreds, thousands of people suffering side effects. Given dozen of millions people in the U.S alone are prescribed those things daily, that a drop in the ocean. But not everyone post on Reddit either
  - orangedog 2mo ago
    Yes but again this is the exact example of anecdotes. Those not suffering aren't going to seek out subreddits to post about their non-problems. You can find a subreddit about everything, whether that's representative of anything or not.
    - hirako2000 1mo ago
      I did mention they were anecdotes. I never found a sub reddit talking about the side effects of mineral water, how eating apples regularily lowered their libidos, on that sleeping on a mattress made them senile. At some point common sense primes over what funded science wants people to believe. The side effects exist since some doctors do warn about them, one may also find them in the counter indications mentioning those things. It isn't unfounded. What's taboo today is to criticize SSRIs over prescriptions. Odd, given that over 25% of the U.S population are taking them, or some other form of legal psycho active substance, just to be able to "function".
stoorafa 2mo ago
FWIW findings about adverse events vary considerably: > The proportion of patients reporting adverse events ranged from 16% to 98% (median 80%) under SSRI treatment and from 17% to 94% (median 70%) under placebo [1] So the answer IMO depends on whether we can attribute adverse effects to treatment, which is difficult to disentangle from adverse effects of disease I’m open to being shown more certainty if available from the literature but meta-analyses are high-strength evidence [1] https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/efficacy-of-selective-serotonin-reuptake-inhibitors-and-adverseevents-metaregression-and-mediation-analysis-of-placebocontrolledtrials/A887520460D404B7E64001E264B041E9 https://www.cambridge.org/core/journals/the-british-journal-...

micromacrofoot 2mo ago

This is the same myth that women get told about hormonal birth control, it's not an "if" with side-effects of SSRIs, it's a "how much" and "when"

orangedog 2mo ago
I don't to my knowledge suffer side-effects. Why are you certain about this?
- micromacrofoot 2mo ago
  chemistry of complex systems you don't experience side-effects now, but you will if you need to stop taking it
  - orangedog 2mo ago
    I have stopped taking it, I didn't have side effects.
  - in_cahoots 2mo ago
    Been on hormonal birth control for 20 years. I've stopped twice to get pregnant. No side effects. I don't know why you're so confident here.
    - micromacrofoot 2mo ago
      I already answered why, it's chemistry. Everyone has side effects, not everyone notices them. You can not introduce a medication, or any substance for that matter, into the human body that does not have any side effects — it's impossible.
      - in_cahoots 2mo ago
        Normally when people say side effects they mean things that you can actually observe. Hence your earlier point about going off the meds and noticing a difference. If I don't notice any difference other than I don't think your point really stands.

deinonychus 2mo ago

I experienced a lot of stuff I didn't really notice how bad they were until I was off of them. Anhedonia, apathy, lack of volition, and sexual side effects. I also have trouble remembering parts of my life when I was on SSRIs. I don't regret trying or even taking them for extended periods. They make the bad thoughts go away and raised the floor for my mood. But they also put a pretty low ceiling on it, too. I was probably on them for too long but clearly medicine doesn't have a perfect framework for handling every corner of this space, so I don't really blame anyone. There's a goldilocks zone for drug, dosage, and treatment length and I don't think I was always in it. I've talked to many people who have bad things to say about SSRIs. On the other hand, my girlfriend is on one right now and seems very satisfied.

RankingMember 2mo ago

> Despite considerable improvements in side-effect profiles, antidepressants continue to be associated with a significant burden of side effects that affect, treatment adherence and quality of life. Hu et al1 studied 401 patients with depression who had recently been prescribed an SSRI, and found that, after 75 to 105 days of treatment, 86% of patients reported at least, one side effect, and 55% experienced one or more bothersome side effects. https://pmc.ncbi.nlm.nih.gov/articles/PMC3181894/ https://pmc.ncbi.nlm.nih.gov/articles/PMC3181894/

orangedog 2mo ago
> In both research and clinical contexts, an important challenge is presented by the phenomenological overlap between side effects and residual symptoms of depression. Thus, fatigue, cognitive impairment, apathy, jitteriness and irritability, and sleep and appetite changes are core features of depression, but may also be related to antidepressant, treatment. In a small study of 43 depressed inpatients,6 which investigated the rate of somatic symptoms and complaints that were present before and after treatment, many symptoms often considered to be side effects of drugs were also present prior to treatment, including dry mouth, lightheadedness, sweating, tremors, and constipation. The distinction between residual symptoms and side effects is crucial, as they call for very different responses.

WhitneyLand 2mo ago

So, this is not supported by the data when people are asked. Sexual effects alone hit about 50–70% people. Then you could face nausea, insomnia, profuse sweating when you’re still, emotional blunting, and weight gain. I don’t want to discourage anyone, they can save lives. It is a net benefit for some people, but even then most people will experience side effects and wish they didn’t have to take them.

orangedog 2mo ago
> The most common side effects reported by patients in the study by Hu et al1 of 401 outpatients taking SSRIs were drowsiness (38%), dry mouth (34%), and sexual dysfunction (34%) > which was conducted in 1999-2000, questioned patients about side effects via phone interviews within 75 to 105 days of starting antidepressant therapy. The side effects deemed most bothersome were sexual dysfunction (17%) It's no where near those numbers. https://pmc.ncbi.nlm.nih.gov/articles/PMC3181894/ https://pmc.ncbi.nlm.nih.gov/articles/PMC3181894/ You notice how the scientific numbers get inflated in anecdotes from 17-34% to 50-70%?
- pessimizer 2mo ago
  Do you think the one 25 year old short-term study that you found by yourself is the only study that has been done, and that anything that deviates from it is a distortion?
- oasisaimlessly 2mo ago
  > phone interviews within 75 to 105 days of starting antidepressant therapy. Different thing entirely from long-term effects.
  - orangedog 2mo ago
    Do you have anything which shows long-term effects are 50-70%?
- WhitneyLand 2mo ago
  “It's no where near those numbers” “get inflated in anecdotes” Just because one study has the number 34% in it, does not prove the numbers I gave were wrong and does not mean they are anecdotal. This is something that’s been studied from many angles and there’s more than one number that’s defensible based on the context and dataset. For example, even the study you cited says: “In a study of 344 patients by Montejo-Gonzalez et al, 58% of patients reported sexual dysfunction when physicians directly inquired”, and “14% with spontaneous reporting”. In another example, a 1,000 patient study found 57.7–72.7% for common SSRIs. https://pubmed.ncbi.nlm.nih.gov/11229449/ https://pubmed.ncbi.nlm.nih.gov/11229449/ The “scientific numbers” you allude to are not one value. It’s a body of research not one definitive number. Taken a whole I don’t think anyone is being that mislead when it’s suggested more than half of people may experience these side effects.

y-c-o-m-b 2mo ago

Not OP, but my primary side effect being on Sertraline from 2002-2012 was lack of control over my anger or violent outbursts. I was primarily ok if things were good, but if something upset me, it would go from 0 to 10 in an instant. I did not even notice this as unusual until I got off the drug and it was a night and day difference how much more mellow I became. I have not been on any SSRI since then. I was on a very low dose of Bupropion for about 5 years and did mostly well; it only made my existing brain fog slightly worse. I usually recommend that one over SSRIs due to my experiences. EDIT: I forgot to mention the damn brain zaps on SSRIs. Even if I missed a dose by 18 hours, I would get the zaps.

movespebp 2mo ago

That's not true. https://pmc.ncbi.nlm.nih.gov/articles/PMC2719451/ https://pmc.ncbi.nlm.nih.gov/articles/PMC2719451/ places the figure experiencing side effects at 40%, with 25% reporting those effects as serious. It's also telling that only just under half of those experiencing side effects ever reported those side effects to their providers - likely contributing to doctors getting a skewed perception of the real adverse effects risk. What's missing is also follow up - for some those effects don't resolve after stopping the drug.