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Antidepressants Target the Wrong Thing, and Only Work 50% of the Time (machineslikeus.com)
22 points by dstorrs on Oct 24, 2009 | hide | past | web | favorite | 11 comments

The rats, after decades of development, are believed to be the most depressed in the world.

I'm not against animal testing in general or this sort of thing in particular, but I found that sentence strangely evocative.

My first thought was that at least one of them should be named Marvin.

I'm imagining a lot of tiny emo makeup in the cages.

Didn't want to make a new submission, but I read this yesterday: 'Anti-depressants cut suicides', http://www.thelocal.se/22842/20091023/

Also includes the origin of the Swedish "suicide myth" at the end.

The article is interesting, but the conclusion that all antidepressants on the market are flawed is not correct, mostly because different antidepressants target different systems in different ways. I took Celexa for over a year, it worked OK but not great, and then after reading the wikipedia article on treatment of depression, I tried SAM-e, which works much better (200mg Jarrows in the morning with a B-complex supplement to break down the homocysteine). Prior to Celexa, I tried Zoloft, which was completely useless.

The SSRI-class antidepressants' efficacy also appears to be somewhat linked to genetic factors (despite their all being, in theory, quite similar in action). Zoloft seems to be the only thing besides benzodiapenes that will keep my panic disorder in remission; I chose this drug because a blood relative was already using it successfully to treat much more severe problems.

So I can't speak to its effectiveness as an antidepressant, but they can work quite well on anxiety in many cases. I am also taking fish oil supplements to see if that helps improve things further, but I can say that low-dose fish oil for a couple of months on its own wasn't enough for me. From a nootropic standpoint, it might have some benefits regardless.

One of the odd things about SSRIs that I learnt recently...

I was reading up on peripheral neuropathy, since I'm suffering some nasty nerve damage in my feet due to diabetes, and discovered that SSRIs are one of the most effective treatments for peripheral neuropathic pain. (which probably didn't help with my diabetes diagnosis, since I've been on a SSRI (paroxetine) for anxiety for the last 3 years, and it was the pains in my feet that led to testing for diabetes...)

The current Scientific American has an article you may find interesting on the biology behind certain kinds of chronic pain. In particular there is a certain kind of cells called glia whose job is to heal hurt neurons. They consider active pain neurons to be hurt, try to "heal" them, and increase the sensitivity, leading to a nasty feedback loop as anything will cause pain.

There are treatments being developed for this kind of pain. But one of the more effective existing ones is marijuana. Marijuana dials down the glia, which breaks the feedback loop. If you live in a state that allows medical marijuana, you may wish to look into this.

I'm kind of against a pharmaceutical regimen for most people. I understand that there are SOME things that people cannot fix themselves, but a lot of the cases, I don't believe drugs are necessary. Let's face it. People take pills because it's easier than eating a healthy diet to make your blood pressure go down.

Depression, in my opinion, is something most people can overcome. Rather than looking within and learning about themselves, most people would rather just pop a feel-good pill every morning.

And the drugs themselves. They're essentially a bunch of random chemicals that big pharma shoves down the throats of test subjects and looks for good things that could happen. I would rather deal with my mild depression than take pills that could make me nauseous, give headaches, make me bleed from strange places or even kill me. Most people don't weigh the costs and benefits of taking prescription drugs... because it's easier.

Now, I'm not a cheerleader for modern-day psychopharmaceuticals; I often liken antidepressants to kicking a television and hoping that the picture clears up. They often don't work, or mysteriously work for some time, then stop, and there doesn't seem to be a ton of rhyme or reason to it.

That all having been said, from what I've read, for most people with chronic depression, the most effective treatment is a combination of antidepressant drugs and behavioral therapy. For a lot of people, one or the other alone doesn't work very well, and I certainly hope that no one would be unwilling to get help because people would think them weak or lazy for relying on antidepressants.

Put simply, if you have chronic depression, you can use all the help you can get. Sometimes drugs don't work, many have awful side effects, or may just not work for any given person, but it's often worth the trouble in order to fight clinical depression. If people can effectively manage it with behavioral therapy, then great, but for all the people out there who've tried and for whom that's not enough, I hope you reconsider the idea that for the most part, antidepressants are for the lazy.

I kind of agree with both of the above thoughts. I've made very drastic lifestyle and dietary changes to get myself well. I am not particularly prone to depression. If I am "depressed" for more than three days, it is usually bad anemia. I had no idea how bad my anemia was until it got better and my body just worked differently. Being anemic was my norm and I just didn't know one's body could feel different and work different.

On the one hand, I think that if one goes far enough with dietary and lifestyle changes, more can be done to address the underlying physiological problems than most people realize. On the other hand, I am aware that depression can be a response to feeling helpless about your life. Drugs won't fix that. Making different choices does more for that kind of depression.

Again: I'm not very prone to depression. I am prone to getting angry in the face of stuff like that. But the same principle applies: Stewing about things isn't healthy and doesn't make one feel better. I have found that the best antidote to my tendency get angry about stuff is to DO something, no matter how small. Since I tend to be the "bounce off the walls" type, I tend to make good friends with folks who are prone to depression. (Two bounce off the walls types can be a very destructive combination whereas depressed folks find I liven things up and I find they help ground me.) So I have assisted a couple of people with both the behavioral and dietary stuff the promotes their depression.

For me, getting healthier has been a fascinating study in using negative outcomes of life as feedback for what I need to correct in my own thought processes and behavior. I don't even know how to adequately put it into words. I think the best I can do is the explanation I once gave my son when he was younger: That life is like a video game and you either learn from your mistakes or Game Over, only we don't have a reset button. So life-threatening events are a big wake-up call that "hey, stupid, you can't keep doing that". The trick is to figure out what things you can't keep doing.

I think I have dug my grave deep enough and should probably just clam up now. :-D

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