Skip to main content

View Diary: Read About The AntiDepressant Scandal In "The Emperor’s New Drugs", And Research One Old Drug (49 comments)

Comment Preferences

  •  Andtidepressents (3+ / 0-)

    They don't claim to cure depression.  They claim to treat it.  My daughter has been taking an SSRI for over a year now to treat anxiety and the treatment has been very helpful to her.  While ketamine might provide additional hope for people who are not helped by SSRI's, the need for IV administering, plus its potential for overdose make it a very impractical choice right now.  

    I would also urge anyone to approach scientific information scientifically.  More study is needed before leaping to conclusions.

    "You must be the change you wish to see in the world." -Gandhi

    by Triscula on Mon Nov 26, 2012 at 06:06:08 AM PST

    [ Parent ]

    •  ketamine does not need to be administered (5+ / 0-)

      via IV.  if that were true, nobody would be taking it at parties.

      Please don't dominate the rap, Jack, if you got nothin' new to say - Grateful Dead

      by Cedwyn on Mon Nov 26, 2012 at 06:12:26 AM PST

      [ Parent ]

      •  Well, according to the diary (0+ / 0-)

        IV administration is what is being recommended by the author of the book.  Also, recreational IV drug use isn't unheard of.

        "You must be the change you wish to see in the world." -Gandhi

        by Triscula on Mon Nov 26, 2012 at 06:13:56 AM PST

        [ Parent ]

    •  I never said antidepressants don't work... (3+ / 0-)
      Recommended by:
      gzodik, The Marti, jplanner

      ... i said they only work a little better than a placebo.  you may have thought like many, that a placebo has no benefit, but that is not true.  The question a patient has to ask is if the side effects of antidepressants are worth the slight improvement in performance over a placebo or non-drug treatment.

      •  Answer: (3+ / 0-)
        Recommended by:
        gzodik, blueoasis, ER Doc
        The question a patient has to ask is if the side effects of antidepressants are worth the slight improvement in performance over a placebo or non-drug treatment.
        Yes.

        I don't think a  'spoonful of sugar' or therapy that I can't afford anyway will do the trick.

        And the improvement is more than "slight."

        ************************************************* "Stifling an urge to dance is bad for your health — it rusts your spirit and your hips." - Terri Guillemets

        by BitterEnvy on Mon Nov 26, 2012 at 06:40:28 AM PST

        [ Parent ]

        •  study the data, even from pharma... (1+ / 0-)
          Recommended by:
          jplanner

          ...antidepressants improve depression by an average of 1.8 points on the Hamilton depression scale, which is significant by very slight.

          as i've said elsewhere, the placebo effect is real, not imagined, and patients can benefit from it through belief in medicines, therapy, self help, etc. It's the patients' belief, not the treatment, that makes the difference.

        •  Not in my case. n/t (0+ / 0-)

          "Mitt Romney has more positions than the Kama Sutra." -- me "Social justice is love, made public." -- Cornel West

          by billlaurelMD on Mon Nov 26, 2012 at 10:18:44 AM PST

          [ Parent ]

        •  perhaps in that particular case (0+ / 0-)

          diarist said it worked in 33% of patients...so one of the lucky ones.
          Placebo effect is real if it works for you...it's just that in studies say 28% of those on Placebo get better.
          if something works on an individual, that is the criterea anyway.
          doesn't see like diarist disagrees.

      •  In my very extensive experience, (4+ / 0-)
        Recommended by:
        The Marti, mithra, billlaurelMD, qofdisks

        They don't work.

        GOP: Bankers, billionaires, suckers, and dupes.

        by gzodik on Mon Nov 26, 2012 at 06:40:47 AM PST

        [ Parent ]

        •  ok, here's the data, as well as i can tell.... (3+ / 0-)
          Recommended by:
          gzodik, The Marti, billlaurelMD

          ... 1/3 of patients get better on an antidepressant, with therapy, with exercise, basically with any attention that the patient believes is beneficial.  Most of that effect is due to the placebo effect, although there is a measurable, but slight advantage for some solutions over using a placebo.

          so 2/3 of people see no improvement with antidepressants, which would fit your experience.

        •  They work short term! (3+ / 0-)
          Recommended by:
          gzodik, AZ Desert Rat, qofdisks

          They are highly addictive. The only difference is the abscence of 'seeking behavior' which is prominent in other forms of addiction.  I did not know this before I started taking them for 5 years. I have been drug free for 3months but it's a living hell but its getting better. It's going to take 1 to 2 year before my body starts to make its own seretonin.

          Antidepressant Addiction

          How the antidepressant addiction develops

          How the antidepressant addiction develops

          There is an ongoing debate about whether or not antidepressants are addictive. The argument is fuelled by the fact that most antidepressants do not produce cravings. However, when the use of certain antidepressants is discontinued, withdrawal symptoms (fatigue, dizziness, nausea, confusion, low mood, flu like symptoms etc.) similar to that experienced with other drugs often occur. The physical and mental discomfort that some individuals experience when trying to stop using antidepressants can cause them to continue taking the drug, even when the initial reason for their prescription has passed, in order to avoid these unpleasant withdrawal symptoms.

          Additionally, any drug that we rely on to produce false emotions can become psychologically addictive; some individuals feel that they cannot function effectively without taking antidepressants and even go as far as ‘demanding’ repeat prescriptions from their GP; they are now addicted to their medication.

          Unfortunately, not all medical practitioners take sufficient heed of the 'discontinuation syndrome' (official terminology for antidepressant withdrawal symptoms) and the patient is often at a loss as to how to stop taking antidepressants without experiencing withdrawal. Devoid of appropriate support, the cycle of psychological addiction can establish itself quickly and individuals find themselves relying on antidepressants years after they were first prescribed.

          It is evident that many people are prescribed antidepressants for very valid reasons – depression and post traumatic stress disorder are common examples. For some people antidepressants are a vital part of recovery from a psychological trauma or persistent low mood. Conditions like these, however, should be treated with a dual approach; if medication is involved so should therapy.

          Whilst antidepressants may provide appropriate chemically induced stability, the patient needs to get to a state of mind where they can address the underlying reasons prompting the use of antidepressants.

          Any individual who abuses antidepressants or takes them beyond the manufacturer’s recommended time limit (often 6-12 weeks) places themselves at risk.
           

      •  You said: (1+ / 0-)
        Recommended by:
        ER Doc

        "To the degree that antidepressants do work, it is because of the placebo effect in which people believe themselves into health, combined with a small and incidental drug effect."

        This statement is way too definitive and unqualified to be accurate.

        So let me say:  It is beyond clear that ADs are overprescribed and wrongly, very wrongly, interpreted by many people (including too many doctors) as "happy" pills -- and that this wrongheadedness is implicitly fomented by manufacturers ("Depression hurts").

        That doesn't mean their impact on depression in many people is "incidental" or no better than a placebo.  

        For one thing, the placebo effect tends to wear off over time; the placebo effect of the medication might be 100% if  your depression is situational (triggered by recent emotional trauma like divorce) such that your mood would have stabilized over time anyway.  I am sure this explanation holds for many, many people.

        But for people who have real, extended depression during the course of their lives (think David Foster Wallace), the placebo effect of a drug is unlikely to be durable enough to explain the enhanced functioning they achieve using ADs, which can (not always and not perfectly) provide significant relief.  Likewise, for people whose deperssion is pretty clearly biochemical (post partum depression) treating biochemical pathways might be the best way to address it.

        I don't know anything about Ketamine, I have a lot of issues with using the FDA drug approval process as a proxy for advancing public health but I still find your post to be misleading in material ways.

        •  good questions, good answers (1+ / 0-)
          Recommended by:
          jplanner

          Unless you are an expert on placebos, I'd suggest you trust the  country's expert in the subject at harvard university, or do a little more reading.

          placebo effect does not wear off over time, and it does have a real and positive effect, FOR SOME PEOPLE, like 1/3.

          you are right that some people have a type of depression that a placebo won't help.  those appear to be the same people that anti-depressants don't work.

          everybody that is depressed has "real" depression, and yes, placebo can relieve the symptoms of depression indefinitely.

    •  NY Times, 2006: (2+ / 0-)
      Recommended by:
      AZ Desert Rat, qofdisks
      The results of two new studies may signal a substantial shift in the way psychiatrists and researchers think about treatment for severely depressed patients.

      In one, government researchers found that an injection of a powerful anesthetic drug dissolved feelings of despair in a small group of severely depressed patients in a matter of hours, and that the effect lasted for up to a week in some participants.

      http://www.nytimes.com/...

      This was six years ago.

      How many more lives must be ruined - ended? - while this is being "approached scientifically"?

      GOP: Bankers, billionaires, suckers, and dupes.

      by gzodik on Mon Nov 26, 2012 at 07:31:56 AM PST

      [ Parent ]

    •  Anxiety and depression are different things (0+ / 0-)

      Related, but different. My anxiety disappeared literally overnight when I took Paxil, but my depression was a different issue. I'm not sure how well it worked, but it was better than nothing.

      "A cynical, mercenary, demagogic press will produce in time a people as base as itself." - Joseph Pulitzer

      by CFAmick on Mon Nov 26, 2012 at 09:27:11 AM PST

      [ Parent ]

Subscribe or Donate to support Daily Kos.

Click here for the mobile view of the site