Posted on 01/24/2010 1:28:55 AM PST by PghBaldy
Some widely prescribed drugs for depression provide relief in extreme cases but are no more effective than placebo pills for most patients, according to a new analysis released Tuesday.
The latest study may settle a debate about drugs like Prozac. The findings could help settle a longstanding debate about antidepressants. While the study does not imply that the drugs are worthless for anyone with moderate to serious depression — many such people do seem to benefit — it does provide one likely explanation for the sharp disagreement among experts about the drugs’ overall effectiveness.
(Excerpt) Read more at nytimes.com ...
And, if at its worst, they only met the restrictive usefulness described in this headline, medications that helped with moderate and severe depression would be a uncomplicated good.
That said, many of all of the medications pushed out by PharMA are marginally helpful and sold because equally effective but much less profitable compounds are off of patent protection. The first question you have to ask anymore is, "Is this name brand yuck any better than something on the Walmart $4 list?" many times the shocking answer is no.
Prozac that is one of the drugs targeted in this article has been proven over and over and over as safe and effective against numerous specific problems but is not a silver bullet and no drug will cure the underlying problem of the "cause" of the depression they treat.
Anti-depressants treat the symptom of depression rather than the cause, which can be as varied as human suffering. Talk Therapy can be more helpful because someone can suggest on a regular basis.. "If you whack your hand it hurts, so perhaps lets not do that this time."
Also, anti-depressants are not the only or best way to treat especially mild depressions which may yield much better to exercise, social interaction, and "dare I say it?", a trip to your local church or synagog.
My Cardiologist put me on Paxil and within 2 weeks I was arrested and spending money like a fool. I and my family told him that it was affecting me badly but because he was getting kickbacks for writing prescriptions he kept me on it.
I will never take another drug ever again unless I am going to die without it.
My semi-professional (a little knowledge is a dangerous thing though) and personal opinion about SSRIs is that for the person going through a life event that is intensely difficult and has them questioning life, a short term prescription of one of the SSRIs will help them avoid suicidal ideation, and allow them to place one foot in front of the other temporarily. Short term means 3-6 months.
Then one needs to wean off these drugs very carefully. Quitting them is hell.
Long term, one should NOT mess with serotonin reuptake at all. If at all possible, avoid these drugs. But there may be some short term usefulness in certain situations with mentally healthy people going through a crisis.
these medicines do help severe cases of depression but nowadays they’re being prescribed all over the map. Life wil deal bad ones as well as good ones. Sometimes you just take your lumps and move on.. no need to mess with your brain chemistry just because of a bad day.
You should respect your judgment about keeping your opinions to yourself until you know what you are talking about. Many SSRI's are as non-addictive as any drug available. The great foolishness of talking about these medications as a class is that they are wildly different. This is not a good place for generalizations and especially not especially ignorant generalizations.
Long term, one should NOT mess with serotonin reuptake at all. If at all possible, avoid these drugs. But there may be some short term usefulness in certain situations with mentally healthy people going through a crisis.
It is my guess that you are not even a semi-professional from this bizarre comment.
It sounds like to me that you have had one or more bad experiences with anti-depressant medications. Some of the newer meds being pushed are bad news and you only need to read the literature to see the mountains of negative side effects reported, but all medications have the possibility of side effects. But so do foods, one taste of mango and my daughter needs to go to the Hospital. I can swim in them. Generalizations are the great enemy of understanding in this. Meds like Xanax, not an SSRI, are to be avoided and only taken for a very short term much like you describe for the "short term relief scenario, but in most situations Xanax should just plain be avoided because it is primarily an addictive depressant (anti-anxiety med) rather than an anti-depressant.
Physicians are now looking more to anti-histamines as anti-anxiety meds because they don't have the addictive properties of the prior anti-anxiety meds such as Xanax and Ativan.
But, Doctors still prescribe Oxycontin for pain knowing it is nearly a sentence to addiction and ruin, I don't know why. But, folks have their own agenda with respect to Anti-depressants. First and foremost, many people are not screened for depression mimickers before being treated for psychological depression. Cancer, Vitamin and Mineral deficiencies and many more things cause Depression as a symptom. Anti-depressants are completely ineffective in treating a Vitamin D deficiency.
I personally have suffered what is identified as Seasonal Affective Dysthemia every fall. But, I finally got a Doctor worth their salt and found that I was actually like completely lacking Vitamin D primarily because I live like a Vampire awake at night and sleeping during the day.
My skin could produce quite sufficient Vitamin D if I were to get into the Sunlight daily but I just don't do that enough. A Vitamin D supplement made a big difference.
Still with all of this, anti-depressants have their place. Prozac is one of the very best, but a few percent of folks have extreme side effects. When you first start taking these meds you should be monitored by family and your physician. Also, effective dose is everything with SSRI's. If your dosage is too low, it is completely useless. In my experience 95% of all prescriptions for SSRI's are not accompanied by any confirmation that the dosage is in the effective range, even though these medications are being prescribed in life or death situations.
People who are disposed to Bi-Polar affective mood swings are at the greatest risk when taking any Anti-depressant because they can suffer a period of Mania like the person who was prescribed Paxil. Its not the Paxil so much as their systems dysregulation of mood that is disposed to bi-polar response. For folks like this, many anti-depressants are extremely dangerous. This is why your Doctor or Psychiatrist is involved in making the choice to use these medications.
Competent Doctors are available but as in anything you have to be the judge of who you choose as your Doctor. Ultimately, you and your family are the ones to confront any mental illness. One needs to first understand Mental illness perhaps in terms of software and hardware. A hardware problem such as Bi-polar, Schizophrenic, or Organic illness or hormone, Vitamin, or mineral deficiency based depression requires dealing with the underlying Organic problem and the depression can or cannot be treated with anti-depressants based on whether this will just complicate the situation.
Software problems, such as excessive use of Cognitive distortions, Alcoholism, Drug Dependency, Compulsive-Addictive behaviors, PTSD, and Personality Disorders create depressive symptoms and to the extent that the depression is an attempt to repress or deny reality, anti-depressants are helpful as they force this processing. But, the underlying issues still exist and cause the individual to suffer depression over and over as the consequences of these conditions mount.
Talk therapy helps on some level, but Religion and 12 Step groups have provided much more effective long term solutions for most Human Software problems with the exception that your religious system and teacher matter. Folks who sell insanity in the guise of religion are not that helpful. But, good old praying to God once a week or more is.
I used to take Prozac for depression. It helped but I now think the biggest contribution to getting relief was moving my office from a mold infested building.
I didn’t have any common cold like symptoms from mold but I was affected mentally. Once I moved, the depression like symptoms disappeared.
If others with mild depression have a similar mold allergy to mine, they may not be helped much with Prozac. I do however believe it helped me at first because the mild depression caused a very real deeper depression.
I don't think we are talking about "addictive" here. I may not know what I'm talking about, but I can speak from personal experience. Quitting them IS hell. I don't know if they affect everyone the same, but a close friend of mine had the same experience with Paxil. To this day, I am convinced I really didn't need to be taking the stuff, but my doctor insisted at the time. Quitting Paxil was the mos maddening experience of my life. Not to mention, it made me lazy, fat, I couldn't sleep while taking it, the side effects were quite troublesome. But above all and the one thing I will never forget above all is the 2 months of hell going cold turkey. The only escape from it was sleep, and that doesn't work too well when you have a job.
Obviously, I can't critiqu every anti-depressany on the markey, but I think there are really only a couple of classes that have only mildy different formulas among the class itself.
I surely won't sit here and tell someone not to take it if their doctor is insisting, but I can sit here and tell you that getting off of this stuff is not a pleasant experience; it's an outright living nightmare. In my case, 15 years ago I would classify myself as moderately to severely depressed at the time and the medication either helped only in a minor way or I'm giving the drug credit for the natural course of healing... who knows. I decided to quit after sitting down and doing my own research. The placebo results from the drug testing are what prompted me to quit... they were exactly as this article stated, no better than placebo.
But I will say this, personally I'd rather be depressed and drug free if I'm ever in such a position again, that's how bad it was.
geez, i need to work on that spelling, that was horrendous.
Excellent post, my FRiend.
“no drug will cure the underlying problem of the “cause” of the depression they treat.”
Absolutely true. As you stated, talk therapy, behavioral changes and social interaction will provide a bigger part of the solution to getting through depression.
The best analysis I heard came from a shrink friend, who said the anti-deps will alleviate perhaps 20-30% of the depression symptoms, but will not “cure” depression. it takes more than swallowing a pill.
There have been a number of complaints about the newer SSRI's and Paxil has had more than it's share... one site covering this issues of Paxil withdrawal that I found is Quitpaxil.org and these folks report experiences much like yours. And Paxil seems to have a particularly bad rap. So, if your Dr. isn't paying attention to this.. perhaps it is time to find another. Just understand that your experience with Paxil is not remotely similar to the normal reaction to other commonly prescribed anti-depressants. Your physician should know what they are doing or refer you to someone who does.
I surely won't sit here and tell someone not to take it if their doctor is insisting, but I can sit here and tell you that getting off of this stuff is not a pleasant experience; it's an outright living nightmare. In my case, 15 years ago I would classify myself as moderately to severely depressed at the time and the medication either helped only in a minor way or I'm giving the drug credit for the natural course of healing... who knows. I decided to quit after sitting down and doing my own research. The placebo results from the drug testing are what prompted me to quit... they were exactly as this article stated, no better than placebo.
Long term use of any drug leads to an effect called resistance. The effectiveness of the medication decreases as the body adapts to removing it from your bloodstream before it can have its effect, and the sites of action become resistant to the level of neurotransmitter produced by this dose because often depression is the result of the mind attempting to suppress processing specific information, so it can increase its resistance over time.. by redoubling the mechanism it used in the first place to create your depression.
Ultimately, if your depression has a cause, you have to deal with that cause, the drugs just treat the symptoms.
I don't know what your specific issues are and it is inappropriate to discuss such in an open forum.
You sound like you are finding your way, and becoming a more informed traveler on this path. There is lots of hope, and a great deal of hype to sort through. Modern Psychology is on one hand making great strides, but on another hand is greatly limited by the very core assumptions that this work is built upon. But, like all things psychology is not standing still. Often the problem of the patient is sorting through too much contradictory information rather than too little information.
But, the first words that come out of any professional dealing with non-organic Mental illness should be go to church, ask God for help, read the Bible and learn to live a good life, and finally stop by for help and assistance as you work toward that goal. Granted, such advice is nearly pointless as the individual having such problems is very likely to be the last person to choose what is the most effective solution or they wouldn't be needing the help in the first place. Such is the nature of all difficult problems.
Two separate doctors wanted to prescribe me an anti-depressant. I took it the first time. HATED it and gained weight. The second time I said no. Turns out my thyroid was/is screwed up. Second doc knew it but wanted to prescribe Zoloft anyway.
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