

Anti-depressant study results 'disturbing' - imperio59
http://www.radionz.co.nz/news/national/237971/anti-depressant-study-%27disturbing%27

======
milesf
This isn't really news. The side effects were made known to me years ago, and
it was still better for me to take them. I used to have a mental illness
condition that messed up my life for over a decade. I've learned and relied on
a whole host of tools.

If you or someone you know is in need of help because of anxiety, depression,
mania, etc GET HELP! There is very, very good help out there.

Send me a message if you don't know who to talk to. I know all about how scary
it is to seek help, to admit that maybe you have a problem that might need
medication. You are not alone, and you're not the first person to go through
this. I know it can feel that way, but it's not.

Seriously, send me a message. I might be a stranger, but I don't want anyone
to have to endure what I had to.

~~~
bertil
(Hi-jacking the top comment, but yours is lacking that key detail:)

There are several molecules available, all have side effects, very different;
amusingly, _they are generally complementary_ : one makes you gain weight,
another loose — so talk about that kind of detail with your psychiatrist. Loss
of sexual appetite is common for the most popular; its non-existent (with
anecdotal mentions of improvement) for the second most popular. Any issue, any
secondary effect that you encounter, digestion, head-aches, can hopefully be
compensated for.

Don’t ask me for names, I couldn’t spell those for the life of me.

Source: dating a shrink; that’s my everyday dinner talk. Not sure I’m 100%
confortable with dudes detailing their limpness with my girl all day. However,
can 100% attest that she doesn’t remotely care, unless its publishable (it’s
not); more importantly, after loosing six close friends to suicide, all
medicated, each improperly, it’s not even a question to me: talk. Journal it
if you have to. Plus, it’s better than her second choice anyway (urologist).

~~~
kps

      > Don’t ask me for names, I couldn’t spell those for the life of me.
    

Sounds like escitalopram (Lexapro, Cipralex) and bupropion (Wellbutrin, etc),
often used together.

~~~
joesmo
That's how most doctors make the diagnosis too: with absolutely no
information.

This is a great combination for suicidal thoughts and numbness.

------
650REDHAIR
2 years ago I was struck by a car which resulted in a TBI that I still deal
with from time to time. Early on I was prescribed different anti-depressants
(and anti-seizure meds) as a prophylaxis and they were beyond terrible. I've
probably tried 1/2 dozen and each one made life a chore. Overall numbness,
sleeplessness, insomnia, minor depression, etc. In the end I decided I'd
rather deal with the occasional debilitating headache than be on that sort of
medication.

My heart goes out to the people with MDD that deal with these side effects as
part of their daily routine.

Sort of related-- wear a fucking helmet.

------
gizmo686
As is typical, I would like to complain about the poor coverage of scientific
papers, and lack of good referencing to the original publication.

I believe I have find the actual paper at [1]. This is the only paper that
google scholar reports the referenced researcher, Claire Cartwright, as having
published in 2014, and seems to be on topic.

EDIT: Re-reading the article, did they mention a single fact from the study
that is not part of the abstract?

[1] [http://www.psy-
journal.com/article/S0165-1781(14)00083-3/abs...](http://www.psy-
journal.com/article/S0165-1781\(14\)00083-3/abstract)

~~~
quasque
Nicely found. I was trying to look up the paper, but the article had named the
wrong journal - shoddy journalism indeed.

Full text here if anyone fancies a read:
[http://ge.tt/55GwqzO1/v/0](http://ge.tt/55GwqzO1/v/0)

------
Zenst
What I find worrying about anti-depressants and how used is the approach.
Somebody has low levels of serotonin and the anti-depressants increase this.
Soon as they stop taking them there body goes even lower than they were before
as no artificial stimulus.

So why they don't use controlled environment drugs to lower levels of
serotonin and when they stop taking them then they are naturally going to have
higher levels.

See in the past many people would at weekends go for a drink, this was the
norm, drink is a depressant, but in groups the effects balance out as your
amongst friends and you associate any negative feeling to a hangover/the
drink. Once you remove a logical reason for being down then people have no
crutch to blame it on other than themselves and that begins the downward
spiral.

Also many people who are depressed do not sleep well, be it pain of other
reasons and sadly those reasons get ignored as easier to give them the new
asprin known as anti-depressants.

Also serotonin is part of a cyclic system related to melatonin, which helps us
sleep so can see a correlation right there. But do they prescribe melatonin,
no. Why not - well because that is natural and hard to copyright, this means
no drug company wants to invest in a low-profit easy copyable approach and on
top of that nobody pays for medical trials so it does not get upon approved
prescription lists.

Sadly many natural approaches medicine wise are ignored as they have not gone
thru medical trials to get approval for prescription and that is all down to
no drug company can make profit out of them and none of them want to pay for a
trial that others can use as no copyright upon the drugs.

Rather sad situation when you step back and look into the details and very
depressing.

~~~
willcannings
People with depression do not generally have low serotonin levels, and it's
unlikely low serotonin is the cause of chronic depression. If it was,
serotonin agonists would be effective much faster than the 4-8 weeks they
currently take. There's some evidence that increased serotonin levels modulate
glutamate after about 4 weeks, and glutamate antagonists like Ketamine are
effective on depression more rapidly than serotonin agonists (as quick as 40m
in some studies).

Also the depression effect of alcohol is completely different to chronic
depression, any mood effects you feel during a hangover are likely related to
reduced dopamine.

Sleep is very important though, and, in Australia at least, melatonin is
commonly prescribed for sleep issues that have a psychiatric cause.

~~~
joesmo
"Blood levels of serotonin are measurable -- and have been shown to be lower
in people who suffer from depression – but researchers don't know if blood
levels reflect the brain's level of serotonin.

"Also, researchers don't know whether the dip in serotonin causes the
depression, or the depression causes serotonin levels to drop.

"Although it is widely believed that a serotonin deficiency plays a role in
depression, there is no way to measure its levels in the living brain." \--
([http://www.webmd.com/depression/features/serotonin](http://www.webmd.com/depression/features/serotonin))

------
tokenadult
"In the United Kingdom, talk therapies or counselling in conjunction with
medication are considered best practice. These therapies are not readily
available through the health system in New Zealand, Dr Cartwright said"

Well, there you have it from the article. New Zealand's health care system
doesn't provide best practice (as most health insurers in the United States
have for years, and now must do under the Affordable Care Act). The best
treatment plan for depression is some medicine that fits a particular patient
hand-in-hand with talk therapy. There is a new review article in Annual
Reviews of Psychology[1] that summarizes the research on best practices in
treatment of depression, and that is the main conclusion: use medicines AND
use talk therapy.

[1]
[http://www.annualreviews.org/doi/abs/10.1146/annurev.psych.1...](http://www.annualreviews.org/doi/abs/10.1146/annurev.psych.121208.131653)

~~~
veb
Actually, we do have free therapy. Anyone can go along to their free local
talky place. A GP can refer you to a psychologist if you're so much inclined.
Usually, a GP will strongly advice you to talk to someone whilst on
medication, and the GP receives feedback from a therapist/psychologist. I am
not sure what _exactly_ she means.

~~~
polemic
Woah there.. citation required. There is limited therapy available for free,
and often you have to convince someone that you are a high risk (ie likely
suicide) before you'll get help.

------
spiralpolitik
The anti-depressants in general act as a safety net to stop you cratering
while you go through the other therapy based treatments. They are just one
part of the holistic solution to depression and anxiety (therapy, dietary
changes, exercise and mindfulness being other parts).

Sadly too many doctor prescribe them as a cure without the additional steps
needed to actually treat the underlying condition and help the patient make a
recovery. Also insurance companies generally aren't willing to pay or will
only pay for a certain number of sessions which doesn't help the situation.

That said there are a number of doctors that are starting to take a more
holistic approach to the treatment of anxiety and depression so hopefully
things will change.

------
paul9290
While this may not be for everyone, I say skip these drugs. Instead talk about
the crazy things that bother you with your family, friends, peers, etc.

9 out of 10 times they too will tell you they have suffered from something
similar, which for me made me feel normal.

Overall this is what helped me deal with OCD, anxiety and depression. It
wasn't some whiz bang drug - one you hear about on a PSA years later, saying
"If you took this drug call us and we'll sue the pants off of the drug company
for their negligence."

------
RankingMember
It's really hard with anti-depressants to know if the reason you're feeling
better is because you think the drug is going to make you feel better or
because the drug is actually doing things. Then you feel worse and don't want
to cut out the depressant because you think it's propping you up. It screws
with your mind.

I can say with certainty, however, that if you ever want to make your johnson
have half the sensation, they absolutely do have an effect there.

------
brianpgordon
> 39 percent reported thoughts of suicide. In the 18 to 25 age group, 56
> percent reported suicidal thoughts.

Wow. Depressed people who were prescribed antidepressants for their depression
are depressed? What a shocking revelation.

------
MichaelGG
Those side effects are well-covered in the prescription information. There's a
reason so many mentally ill people choose to stop taking medication.

~~~
ditoax
Indeed. Zoloft certainly made my sex life more complex! One of the biggest
issues is that these medications take quite a while (8+ weeks) before you
start to see results and can often take up to 6 months for side effects to go
(if they go at all, they did for me thankfully).

~~~
MichaelGG
8+ weeks to get good results, 8 hours to get the negative ones :\\.

------
ditoax
Long time depression and PTSD sufferer here. Drugs help but are not the only
answer which seems to be how they are seen in New Zealand. Talking about my
problems (not just with professionals but also other sufferers) and my history
helps more than the medication. I am on Sertraline (Zoloft) and some other
meds and it certainly _does_ help me however it is more of a "it makes things
not so difficult" than "it makes me better". For example it makes me not get
so upset/angry about things that I would do before. I used to go from 0 to 10
in a second, now it is very, very difficult to get me above an 8 in the anger
scales. I am much calmer and that makes me happier.

Obviously these medications are still hugely unknown though and everyone does
react differently. My personal advice for those suffering with depression (and
any other mental health issue) is to get some talking therapy where you can.
As I said it doesn't have to be a professional, often just somebody who kind-
of-understands is a huge help!

~~~
flog
NZ'er point of view here: in general, culturally, drugs are not seen as an
answer; definitely not the "only answer", and probably more like the "last
resort".

------
jenn2013
This is not new news, but thankfully it is finally getting more attention. I
highly recommend a book to anybody who's interested in the topic of mental
illness: Anatomy of an Epidemic by Robert Whitaker. A very well-researched and
interesting read. Lays out the evidence that research actually supports that
antidepressants and antipsychotics (neuroleptics) actually cause worse long
term outcomes for patients, and almost in all cases cause what could be a one-
time episode to become a chronic problem for the patient. They change the
brain in such a way as to cause a dependency and increase the chance of
relapse if the drug is withdrawn. Its the reason patients are often told they
have to be on the drug for life, and why quitting the drugs is difficult.

~~~
rsweetland
I second this. This book should be required reading for anyone considering a
pharmaceutical approach to depression - a path that has apparently been
engineered to make life-long "customers". Changes in diet and exercise may not
be profitable enough to warrant mass advertising, but do the research on it,
and, most importantly, try that before walking through the revolving door of
the "mental health" system.

------
marincounty
He about efficacy? How about they just don't work? How about the worst kind of
data/study manipulation in the history of allopathical medicine?

Yes--I trusted drug companies to provide MD's with honest forthright studies.
Instead, they "cherry picked" studies, and did horrid research. I don't let
doctors off the hook either; what about .5% better than control was
impressive( I made that number up, but I don't think I'm that far off.

I took tri, heterocyclic drugs over the years and nothing even remotely worked
for my condition.(A panic attack that morphed into general anxiety--which
after years of failed treatments turned into Depression.

At this point--I am just livid over the deception. These drugs were expensive,
and so were the doctors visits. I am now on drugs that control anxiety, but
are extremely addictive. I am embarrassed to mention what I'm addicted too.

My point, beyond venting if you are clinicall depressed, these drugs might
work. I have never really been that depressed--or I was told.

I do know one thing though that most MD's won't tell you. If you have a
breakdown(very common in the twenties). Time will help your condition. Oh yea,
if you think you are Superman(physically and mentally) you probally have a
breaking point. I thought I could handle anything better than my peers; I was
wrong. Of yea, try to take it easy on the alcohol--it works, but you will
become addicted.

And honestly, I'm not sure I would step foot in a Psychiatrists office if I
could go back in time; at least a for profit Doctor. They will drag you back
in order to get you prescription filled(It should be illegial).

Remember though--The adage "Time cures all ill's" worked, at least for me.
Aging is a strong medicine. I didn't accomplish what I set out for, but my
interests changed as I got older. If you feel bad, like someone literally
yanked the rug from your feet--I understand completely. Your friends will have
just a vague notion of what you are going through, but there are people out
there who know just how difficult you life has become. Again--If you are
reading this, you will get better with time. I have no reason to lie.

~~~
refurb
_Instead, they "cherry picked" studies, and did horrid research._

You do realize how difficult it is to run clinical trials for psychiatric
diseases? There is little doubt that there are drugs out there that work, that
_didn 't_ have successful clinical trials and never made it to market?

------
joesmo
"60 percent complained of feeling emotionally numb" ... which is essentially
what major depression is, interestingly enough.

It isn't surprising that these drugs would cause depression and suicidal
thoughts / actions. What is surprising (or was at least) is the rate at which
doctors prescribe these drugs (SSRI, SSNRI, Wellbutrin) after barely knowing
someone for 15 to 20 minutes. Their insistence that they have an answer when
they have no idea what these drugs do or how they work is literally driving
people insane. These drugs should come with a warning (along with many other
"mental health" drugs like benzodiazepines) not only on the label, but from
every doctor who prescribes them.

But doctors and pharmaceutical companies make too much money to worry about
ineffective, unstudied drugs such as these killing people and ruining lives.
So forget that. Let's lie to people and tell them that help exists, it's in a
pill, and that's all they need to feel better.

If you want help, talk to a friend, not a doctor (psychiatrist usually) whose
main interest is to keep you hooked and coming back for more. After all, in
this case too, you are the product.

~~~
anigbrowl
Well, how can you really judge what that means without a control? For
example,it's one thing to say that 40% of people taking X experience suicidal
thoughts, quite another to say that 40% of people taking experience suicidal
thoughts _without having had them before_. 40% (a made-up # here) would be
quite good if it were lower than the rate of suicidal ideation among untreated
depressives.

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burnThis
This is an online survey so there is also the huge problem of selection bias.
This is news how?

------
rjurney
Study of depressed people indicates depressed people give negative answers.
Someone stop the presses.

A single survey of depressed people taking pills doesn't prove anything. Note
they did not do before/after. This is pseudo-science.

------
quasque
The side effect of sexual dysfunction is sometimes used therapeutically - for
example, citalopram (an SSRI) is also prescribed to treat premature
ejaculation.

------
NAFV_P
Never liked SSRI's (escitalopram especially), I prefer sex, drugs and systems
programming.

------
comrh
In my personal experience this is so true but people don't realize that every
medication is different and psychiatrists are relying on very little
information for your first prescription.

What worked for me was 2 weeks on a medication, gauge the symptoms (some were
absolutely terrible) and decide to move on to another one. After maybe 3 anti-
depressants I found the correct one.

I don't really think we know much about how some of these medications work
which can be unsettling but we do know they help some people. To me at least
it was worth it.

~~~
stan_rogers
Indeed. Fluoxetine (Prozac) was _exactly_ what I needed for depression.
Friends of mine, not so much. And for Parkinsonism, my personal cocktail is
probably (the pharmacological equivalent of) a little bit sweeter and not
quite so bubbly as what works for others with the "same" symptoms (which, by
the way, resemble Huntington's more than they do "classic" Parkinson's
disease). Brains are complicated.

