6 ms·

I have many bad things to say about many antidepressant. E.g., they all have very annoying side effects, at least for me, and some of the side-effects (e.g., vi

I have many bad things to say about many antidepressant. E.g., they all have very annoying side effects, at least for me, and some of the side-effects (e.g., vivid dreams) require benzos to counter. And then benzo addiction is really no fun at all. Other side effects I experienced were clearly under-reported by the pharmaceutical companies. E.g., negative sexual side effects for Prozac that my doctor wouldn't even believe were real and not psychosomatic, until it later turned out that 25%-50% of all patients suffered these side effects, and the pharmaceutical company had neglected to inform anyone. On other other hand, Remeron surely saved my life. I have no doubt about this. I had been in the most miserable state you could ever possibly imagine and then some, and had been this way for months, and then within a day or two of starting Remeron, I was utterly fine. (Though ironically, it may have been another antidepressant that put me in this terrible state to begin with, as I had to go off it cold turkey due to it causing a different dangerous side effect.) As for diagnosing depression, it may certainly be the case that many cases are difficult to diagnose correctly. And there may be cases where there is no fact of the matter as to whether the particular symptoms count as depression. On the other hand, there are certainly cases where there is no question at all as to whether it's depression. I have been there quite a few times, and it's been as cut and dried as anything can be in this world.

lutusp 14y ago
> On the other hand, there are certainly cases where there is no question at all as to whether it's depression. Yes, absolutely, but saying "it was depression" is not the same as saying "depression is a disease with a proximate cause that can be identified, diagnosed and treated." The present debate surrounding depression is global in scope. No one knows whether depression is a disease in the way that a cold is a disease, or is an extreme case of normal emotion, not amenable to any kind of diagnosis or treatment. None of this is meant to argue that depression isn't a disease in the way that a cold is a disease -- only to say there's no reliable science behind the claims. But we do know this -- in controlled scientific studies, antidepression drugs don't actually work for the majority of patients: Link: http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.0050045 http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fj... Title: "Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration" Quote: "Meta-analyses of antidepressant medications have reported only modest benefits over placebo treatment, and when unpublished trial data are included, the benefit falls below accepted criteria for clinical significance." [Emphasis added] Comment: Drug companies have been only publishing studies that supported their drugs, and discarding those that didn't. This study compares the outcomes for all the studies, published and unpublished, and the result is that antidepression drugs do not work for the majority of patients.
- darius42 14y ago
  >the result is that antidepression drugs do not work for the majority of patients. I suspect that this is because most patients don't have the patience or wherewithal to try enough different kinds, or a doctor who is willing to combine them with benzos. The patient's patience is especially relevant since when you are depressed, the last thing in the world that you need is to add extra suffering from side-effects to your list of woes. Or at least that has been my personal experience. After a few bad experiences, I was very reluctant to try additional antidepressants, and after having become dependent on Ativan once, I vowed to never allow that to happen again either. Ultimately though, I tried just about every modern antidepressant before finding one that worked, and I know people who had to go to tricyclics, which has caused them to become fat, but happy. Each of the antidepressants I tried affected me differently. But at this point, I am very relieved to know that if I become depressed again, there is a drug that I know for sure works for me. Knowing that is a huge weight off of my shoulders. Though having to look forward to weaning off of benzos again puts some of that weight back. More recently I tried ketamine when I was worried that I was going to become depressed due to an unfortunate life circumstance. I'm here to say that it apparently worked as well as hyped since I never became at all depressed during a situation that would typically have sent me into a downward spiral. And with no ill side effects too boot. Too bad it's not legal.... Of course, trying many different antidepressants is not without its risks, as I alluded to previously.
  - lutusp 14y ago
    > I suspect that this is because most patients don't have the patience or wherewithal to try enough different kinds, or a doctor who is willing to combine them with benzos. No, no, we're talking about controlled studies overseen by scientists, not psychologists or psychiatrists in ordinary clinical practice. Typically, such a study has an experimental and control group. The experimental group gets the drug under test and the control group gets a placebo. To minimize the possibility of bias, during the study neither the experimenters nor the subjects know which subjects are controls. After the study, the histories of the subjects are compared, and the groups to which they belong are finally revealed. Every precaution is taken to limit bias and emotional attachments to any outcome. As it turns out, when such studies are conducted and compared to other similarly disciplined studies, the efficacy of antidepressants evaporates. In plain English, they do not work. That's the scientific finding. It's not an opinion, like much of psychology, it is a scientific result. > But at this point, I am very relieved to know that if I become depressed again, there is a drug that I know for sure works for me. Yes -- and so does astrology, but only if you sincerely believe it does.

lutusp 14y ago

> On the other hand, there are certainly cases where there is no question at all as to whether it's depression. Yes, absolutely, but saying "it was depression" is not the same as saying "depression is a disease with a proximate cause that can be identified, diagnosed and treated." The present debate surrounding depression is global in scope. No one knows whether depression is a disease in the way that a cold is a disease, or is an extreme case of normal emotion, not amenable to any kind of diagnosis or treatment. None of this is meant to argue that depression isn't a disease in the way that a cold is a disease -- only to say there's no reliable science behind the claims. But we do know this -- in controlled scientific studies, antidepression drugs don't actually work for the majority of patients: Link: http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.0050045 http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fj... Title: "Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration" Quote: "Meta-analyses of antidepressant medications have reported only modest benefits over placebo treatment, and when unpublished trial data are included, the benefit falls below accepted criteria for clinical significance." [Emphasis added] Comment: Drug companies have been only publishing studies that supported their drugs, and discarding those that didn't. This study compares the outcomes for all the studies, published and unpublished, and the result is that antidepression drugs do not work for the majority of patients.

darius42 14y ago
>the result is that antidepression drugs do not work for the majority of patients. I suspect that this is because most patients don't have the patience or wherewithal to try enough different kinds, or a doctor who is willing to combine them with benzos. The patient's patience is especially relevant since when you are depressed, the last thing in the world that you need is to add extra suffering from side-effects to your list of woes. Or at least that has been my personal experience. After a few bad experiences, I was very reluctant to try additional antidepressants, and after having become dependent on Ativan once, I vowed to never allow that to happen again either. Ultimately though, I tried just about every modern antidepressant before finding one that worked, and I know people who had to go to tricyclics, which has caused them to become fat, but happy. Each of the antidepressants I tried affected me differently. But at this point, I am very relieved to know that if I become depressed again, there is a drug that I know for sure works for me. Knowing that is a huge weight off of my shoulders. Though having to look forward to weaning off of benzos again puts some of that weight back. More recently I tried ketamine when I was worried that I was going to become depressed due to an unfortunate life circumstance. I'm here to say that it apparently worked as well as hyped since I never became at all depressed during a situation that would typically have sent me into a downward spiral. And with no ill side effects too boot. Too bad it's not legal.... Of course, trying many different antidepressants is not without its risks, as I alluded to previously.
- lutusp 14y ago
  > I suspect that this is because most patients don't have the patience or wherewithal to try enough different kinds, or a doctor who is willing to combine them with benzos. No, no, we're talking about controlled studies overseen by scientists, not psychologists or psychiatrists in ordinary clinical practice. Typically, such a study has an experimental and control group. The experimental group gets the drug under test and the control group gets a placebo. To minimize the possibility of bias, during the study neither the experimenters nor the subjects know which subjects are controls. After the study, the histories of the subjects are compared, and the groups to which they belong are finally revealed. Every precaution is taken to limit bias and emotional attachments to any outcome. As it turns out, when such studies are conducted and compared to other similarly disciplined studies, the efficacy of antidepressants evaporates. In plain English, they do not work. That's the scientific finding. It's not an opinion, like much of psychology, it is a scientific result. > But at this point, I am very relieved to know that if I become depressed again, there is a drug that I know for sure works for me. Yes -- and so does astrology, but only if you sincerely believe it does.