Do antidepressants work?

  • auryn

    Posts: 2061

    Apr 24, 2010 6:12 PM GMT
    I've never had to take them, but know quite a few people that have, and a few that are continually on them. Thoughts?

    I'm only posting this cuz I'm curious about the affect of the info in the article.


    Why antidepressants don't work

    Excerpt:

    .Here's some depressing recent medical news: Antidepressants don't work. What's even more depressing is that the pharmaceutical industry and Food and Drug Administration (FDA) have deliberately deceived us into believing that they DO work. As a physician, this is frightening to me. Depression is among the most common problems seen in primary-care medicine and soon will be the second leading cause of disability in this country.

    The study I'm talking about was published in The New England Journal of Medicine. It found that drug companies selectively publish studies on antidepressants. They have published nearly all the studies that show benefit -- but almost none of the studies that show these drugs are ineffective. (1)

    That warps our view of antidepressants, leading us to think that they do work. And it has fueled the tremendous growth in the use of psychiatric medications, which are now the second leading class of drugs sold, after cholesterol-lowering drugs.

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    Apr 26, 2010 1:01 AM GMT
    The most recent article, that I'm aware of, was published in the Journal of the American Medical Association this past January...
    The conclusion: The magnitude of benefit of antidepressant medication compared with placebo increases with severity of depression symptoms and may be minimal or nonexistent, on average, in patients with mild or moderate symptoms. For patients with very severe depression, the benefit of medications over placebo is substantial.
    http://jama.ama-assn.org/cgi/content/short/303/1/47?home

    Not all experts believe that antidepressants are ineffective for mild or moderate depression, and they are critical of the JAMA article.

    There are many types of antidepressants available with varying side effects.
    Antidepressants can be used to treat other psychiatric disorders. OCD or obsessive- compulsive disorder can respond. Antidepressants can be used to treat anxiety disorders like panic attacks or social anxiety disorder.

    At times, depression can be treated without medications. Studies have shown that exercise can be as effective as medications for some forms of depression. I rarely found this to be a viable option. Many Americans are not like the guys on RJ. They have little desire to exercise and this is more so when depressed. Many depressed individuals may be older and have physical impairments that preclude exercise. Psychotherapy can be effective, and psychotherapy should be a part of the treatment. Fish oil may lessen the mood swings in bipolar disorder. UV light can be used to treat seasonal affective disorder. Medical problems like an underactive thyroid and B12 deficiency can cause depression and need treated.

    The physician that wrote the article practices alternative medicine not mainstream medicine; therefore, his strong opposition to medications.
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    Jun 01, 2010 5:13 AM GMT
    Even if they don't physically work, they would be able to due to the placebo effect, or people who are taking the drug thinking that it is working, thus, making them less depressed. But, especially with psychoactive drugs, there needs to be care as to not induce tardive dyskenesia.
  • HorrorHound

    Posts: 1435

    Jun 01, 2010 5:15 AM GMT
    Yes they do. Some folks do need the help of said types of medications to even out the chemicals/hormones in the brain.

    Different for everyone though. && Just like ALL medications - alot o' times its 'trial & error'!

    But yes they do work, & even some combos work well together : Anti depressant w/ a Anti Anxiety &/or a anti psychotic (mood modifier)
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    Jun 11, 2010 4:37 AM GMT
    Auryn saidI've never had to take them, but know quite a few people that have, and a few that are continually on them. Thoughts?

    I'm only posting this cuz I'm curious about the affect of the info in the article.


    Why antidepressants don't work

    Excerpt:

    .Here's some depressing recent medical news: Antidepressants don't work. What's even more depressing is that the pharmaceutical industry and Food and Drug Administration (FDA) have deliberately deceived us into believing that they DO work. As a physician, this is frightening to me. Depression is among the most common problems seen in primary-care medicine and soon will be the second leading cause of disability in this country.

    The study I'm talking about was published in The New England Journal of Medicine. It found that drug companies selectively publish studies on antidepressants. They have published nearly all the studies that show benefit -- but almost none of the studies that show these drugs are ineffective. (1)

    That warps our view of antidepressants, leading us to think that they do work. And it has fueled the tremendous growth in the use of psychiatric medications, which are now the second leading class of drugs sold, after cholesterol-lowering drugs.



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    Jun 11, 2010 4:40 AM GMT
    Yes they do! You just have to find the right ones...
    I'm actually taking Cymbalta and Lamictal--- with out them I'm a mess. icon_sad.gif
  • Delivis

    Posts: 2332

    Jun 11, 2010 4:43 AM GMT
    My reading of the medical literature would sum it up like this: for severe depression the evidence of efficacy is strong. For mild to moderate depression the effect beyond placebo is questionable and there is a strong chance that antidepressants may be overprescribed in the US at least.
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    Jun 11, 2010 5:17 AM GMT
    Actually, there is plenty of evidence that long-term use of antidepressants is harmful, and I mean beyond the usual side effects and withdrawal symptoms. For example, there's reliable data that people who take the drugs long-term are much more likely to end up bipolar than those who take them for a couple of months (when they are most effective during a severe episode).

    I think I've mentioned it here before, but anyone investigating psychiatric drugs should read Robert Whitaker's new book, "Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs and the Astonishing Rise of Mental Illness in America." Another good read is "Crazy Like Us: The Globalization of the American Psyche" by Ethan Watters. It is in part about the way big pharma has marketed our mental illnesses to the rest of the world in order to sell drugs.

    By the way, A1EX, Lamictal is a waste of money. It has absolutely no value as an antidepressant. My associate attended a seminar recently and that drug in particular was cited by researchers as an example of the way the pharmaceutical industry can get permission to market a drug that has no clinical value in this respect.

    Here's an interview with Whitaker:
    http://www.salon.com/books/feature/2010/04/27/interview_whitaker_anatomy_of_an_epidemic





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    Jun 11, 2010 5:33 AM GMT
    Oh really? I'm going to have to talk to my psychiatrist the next time I see him... I think it's next week. I get if for free anyways. icon_cool.gif
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    Jun 11, 2010 5:51 AM GMT
    While I was working in public health research, at my office there was an article passed around about how the placebo effect is increasing. Food for thought. Of course, these drugs change your brain chemistry, so they are doing something, but whether or not it's curing your depression, who knows.

    In my experience, antidepressants kind of shut of the negative feelings, but they did nothing to promote positive feelings... just kind of left me in a state of nothingness. I also think doctors are bought out by the pharmaceutical industry (actually I know that mine was!), and really don't know anything about the drugs except that the effects are quantified by the scientific literature, whereas treatments involving exercise and natural supplements/diet can't be quantified. Mine also gave me the wrong advice on how to go off the meds. Good thing I know how to do a lit review myself. I'll never take them again.
  • BronxvilleNY3...

    Posts: 101

    Jun 11, 2010 1:33 PM GMT
    They work!!
    As a physician I have so many patients on antidepressant therapy, and I can tell you that so many people are beneficiated form them. There are multiple randomized studies that support their effect not only in depression, also in PTSD, OCD, just to name some.

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    Jun 11, 2010 1:41 PM GMT


    They absolutely work.

    Like other have said the power of exercise is immense also, and shouldn't be overlooked.

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    Jun 11, 2010 1:45 PM GMT
    MuchMoreThanMuscle saidNo one has yet to mention how some of them can kill a man's sex drive. That would REALLY make me depressed.


    So true, my doctor tried some on me in the treatment of ADHD. I told her that I wasn't going to take them anymore because they killed my sex drive so bad that I didn't even want to play with myself!
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    Jun 14, 2010 7:26 AM GMT
    They worked for me as a kid when i got pretty bad and the few times when I needed them as an adult, however, I cant remain on them for very long because one, the side effects can be irritating and two once I've reached a certain point i naturally seem to go off them (I stop being so focused on the crap and generally ween off without any actual intention of doing it)

    I've seen people on them for long term and I've never seen anyone with good long term success, but, many have good overall short term response with them.. But I also think you have to want to get outta the pit your in.. But that could very well just be me!
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    Jun 14, 2010 7:39 AM GMT
    I didn't feel any different when I took them. After trying 3 types at about 3 month intervals I just stopped since it was a waste of money.
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    Jun 14, 2010 1:55 PM GMT
    It is simplistic to say they do or don't work. There are so many types of depression caused by many things. While moving forward, psychology is still a pre-paradigmatic science. Tools like brain imaging are rarely used since insurance won't pay for it. Some people can "will" themselves out of depression, others exercise themselves out of it. For me, take me off of my prozac and my OCD kicks in like clolckwork; off the wellbutrin, depression kicks in, yet too much wellbutrin, mania kicks in. (Having been on well over 30 types of meds over 40 years, these are the only two that work for me with tolerable side effects.) Being bipolar and having been exposed as a kid and younger man to abuse my the mental health industry with about 40 ECT's, I can say in my case the meds are essential. Making a blanket statement that they are or are not needed is ill-informed. What one needs is a skilled professional who is willing to work with someone and that is a rare thing. My meds, including mood stablizers and anti-depressants kept me fully functioning while working and I have been able to reduce them now that I am retired, but I cannot elimate them. Still, the high I get from exercise and good nutrition are also essential in keeping my mental balance.
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    Jun 23, 2010 8:57 PM GMT
    A drug is a drug. It would be like saying does alcohol make us happy? Well of course it does. But there is always a down side. Whether that be addiction or no actual benefit or whatever. It makes a new equilibrium. But I am just talking from experience. I am no physician. But everything I read tells me something is up with the excessive labeling of humans. Over half of us our obese and over half of us, us meaning americans are depressed. There is clearly a fallacy within the system. Maybe depression is just a sign that we are not living our lives correctly. How many countless hours do we spend inside instead outside now a days. Trees are proven to make you happy. As is any nature. But so many of us find ourselves inside on a good looking day becuase of our responsibilities. YAy rants are fun to write. but no tso much to read.

    goodasgay.blogspot.com
  • JJ_Atoli

    Posts: 295

    Aug 26, 2010 11:47 PM GMT
    They totally don't work...at least for me anyway.

    Anti-depressants usually make me feel worse! Some of the bad thoughts and negative emotion go away sure - but then I'm left feeling a strange nothingness - which I actually think is worse. I'll be off them until someone can find me some Soma. lmao
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    Aug 27, 2010 12:04 AM GMT
    It's been a sucky year for me so far with multiple things going on at one time. It was suggested that I might need an anti-depressant. Never used one before. From what I understand they help to even out the "lows". Is that the case? Can you suggest one that doesn't interfere with ones libido?
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    Aug 27, 2010 12:07 AM GMT
    ObsceneWish saidActually, there is plenty of evidence that long-term use of antidepressants is harmful, and I mean beyond the usual side effects and withdrawal symptoms. For example, there's reliable data that people who take the drugs long-term are much more likely to end up bipolar than those who take them for a couple of months (when they are most effective during a severe episode).

    I think I've mentioned it here before, but anyone investigating psychiatric drugs should read Robert Whitaker's new book, "Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs and the Astonishing Rise of Mental Illness in America." Another good read is "Crazy Like Us: The Globalization of the American Psyche" by Ethan Watters. It is in part about the way big pharma has marketed our mental illnesses to the rest of the world in order to sell drugs.

    By the way, A1EX, Lamictal is a waste of money. It has absolutely no value as an antidepressant. My associate attended a seminar recently and that drug in particular was cited by researchers as an example of the way the pharmaceutical industry can get permission to market a drug that has no clinical value in this respect.

    Here's an interview with Whitaker:
    http://www.salon.com/books/feature/2010/04/27/interview_whitaker_anatomy_of_an_epidemic



    This.
  • UFJocknerd

    Posts: 392

    Aug 27, 2010 12:41 AM GMT
    Research overwhelmingly supports what FirstKnight and others have said-- meds help more the more severe the depression. For severe depression (i.e., the kind people will be seeing their primary care physician to deal with because they're nearly unable to get out of bed), meds can be important or even vital to recovery.

    But, for normative depression (the kind nearly everyone has sometimes), cognitive behavioral therapy is the far better option. Even with severe depression, combined meds and therapy far outperform meds alone. And, without therapy, the patient may not even be able to recover from the depression--you might be the guy stuck in his room all day to feel like he can get out of bed in the morning, but that isn't going to help either (a) his incessant self-defeating negative thoughts, which have likely become habitual and need to be replaced or (b) his social skills that have been damaged through lack of practice while suffering symptoms of depression.

    Plus, with depression, the goal should be to get the patient off meds eventually rather than keep them on indefinitely (owing to long-term damage potential as mentioned by ObsceneWish.
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    Aug 27, 2010 12:42 AM GMT
    I used to take anti-depressants. I believe they were incorrectly prescribed to me, but can be effective for other people.

    I tried Prozac, Zoloft, Wellbutrin, and a handful of others whose names I don't remember. They totally killed my sex drive and just made me feel numb. Depression, as my doctor described to me, is largely situational. I was going to a college I didn't want to go to, living in a place I didn't want to, and dealing with shit I couldn't handle. Of course I was depressed. A pill wasn't going to fix that.
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    Aug 27, 2010 3:22 AM GMT

    I was prescribed anti-depressants during a really rough patch that led to a sustained and disabling depression. As it was explained to me, medicines can act as a scaffold you stand on while you do the work of psychotherapy, cognitive behavioral therapy, and education on using diet, exercise and scheduling of activity to push back against the depression. It took longer than I thought it would, but that approached worked and in time I was tapered off of the meds.

    The downside of antidepressants is that most have side effects, which hit you before you feel any beneficial effect (and when you already feel really bad) and it can take a few tries to find the right medicine (or medicines). The good news is that the worst of the side effects are often transient.

    In any case, you would do well to work with a psychiatrist who specializes in using psych meds and keep in touch with a good pharmacist too.
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    Aug 27, 2010 3:24 AM GMT
    The comments here are dangerous. I hope this does not lead anyone reading this who is depressed or may think they are depressed not to seek medical attention. Don't make a decision about your well being based on anything you read here from people who are not legitimate professionals in the field.

    If you are depressed, find a good doctor. Remember, as in life there are people who are really good doctors and people who are really bad doctors. If a psychiatrist cannot resolve your depression, find another one who can. Seek out a recommendation.

    Not all drugs lower your sex drive. Also, with any drug in this class there is a period of adjustment which may be as long as two months. There are many substitute drugs that can be switched to help. Everyone's body chemistry is different so not every drug will work the same even for the same condition.

    I come from a family of mental health professionals and I have seen many, many times, first hand people's whose lives have been either saved or completely turned around from medication.

    Good news for Jocks, frequent excercise is an important therapy for depression whether you are on medication or not.
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    Aug 27, 2010 6:19 AM GMT
    MuchMoreThanMuscle saidNo one has yet to mention how some of them can kill a man's sex drive. That would REALLY make me depressed.


    I have suffered from PTSD and depression for years and have been taking effexor for about 3 years. Placebo or not, they have dramatically helped me but yes, they do have a sexual downside. Now, i'm always horny so they don't affect my drive, what they do affect is the ability to reach orgasm and ejaculate. They also affect the amount of ejaculate. I have found that it takes forever to reach orgasm, which would be fine if i was a porn star and is probably great for the partner (don't have one to ask) but is just frustrating and causes tennis elbow. keithicon_cool.gif