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Major New Study Confirms Antidepressants Really Do Work (theguardian.com)
According to authors of a groundbreaking study, antidepressants really do work in treating depression, though some are more effective than others. "Millions more people around the world should be prescribed pills or offered talking therapies, which work equally well for moderate to severe depression, say the doctors, noting that just one in six people receive proper treatment in the rich world -- and one in 27 in the developing world," reports The Guardian. From the report: "Antidepressants are an effective tool for depression. Untreated depression is a huge problem because of the burden to society," said Andrea Cipriani of the NIHR Oxford Health Biomedical Research Centre, who led the study. The debate over antidepressants has unfortunately often been ideological, said Cipriani. Some doctors and patients have doubts over whether they work at all and point to the big placebo effect -- in trials, those given dummy pills also improve to some degree. Some people suspect drug companies of fiddling trial results. Some patients simply do not want to take pills for a mental health condition. The study published in the Lancet took six years, Cipriani said, and included all the published and unpublished data that the scientists could find. It was carried out by a team of international experts. They looked at results after eight weeks of more than 500 trials involving either a drug versus placebo or comparing two different medicines. The most famous antidepressant of them all, Prozac -- now out of patent and known by its generic name, fluoxetine -- was one of the least effective but best tolerated, measured by a low drop-out rate in the trials or fewer side-effects reported. The most effective of the drugs was amitriptyline, which was the sixth best tolerated.
It might seem like the one that is out of patent is the most useless (and least profitable) but don't worry, no actually worry and then we will medicate you to stop.
You can't handle the truth! - Because I don't post left all my comments get modded down, bye bye Karma.
- between chronic depression, caused by imbalances in neurotransmitter production or reuptake, and depression caused by living in depressing circumstances. Antidepressants are routinely prescribed for both cases.
I guess if your life sucks, it's easier to take pills so you won't bother anyone with suicide attempts, rather than address the problems of your circumstances. I'm glad I stopped taking them; my life sucks, but I can acknowledge that, and I'd rather deal with that knowledge than be a po-faced zombie again.
Only 2% of studies showing antidepressants aren't effective get published:
https://www.ted.com/talks/ben_goldacre_what_doctors_don_t_know_about_the_drugs_they_prescribe
This is a meta-analysis. Back when I was in grad school, we'd throw these in the garbage. You cannot account for controls across tens of studies, much less hundreds of studies. Unless the authors legitimately did a replication study writing before the meta-analysis, they're next to useless.
Beware of things that say things are confirmed without a doubt. Doubt is essential in all things involving science and research. You must continually doubt your axioms and question things; replication the true you think you know to be true.
https://khanism.org/science/doubt/
I know for me personally, anti-depressants were awful. The side effects were bad and I never liked taking them. I feel like regular behavioral therapy and talking with a good psychologist who'd help me see my options and my negative ways of thinking helped significantly more than anything else.
That being said, I know they help some people too, either real of placebo, with major depression. Doctor's are afraid to try therapy without drugs because of the liability if the patient harms themselves. I think this is really sad and that these drugs are way over prescribed. It's a tough issue to balance, but claiming crap like this study does (which is probably funded by the industry anyway) just leads to more confirmation bias and less incentive to come up with more effective treatments.
Who cares?
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The counter to Developing World isn't "Rich". There's a vast middle ground between rich and developing. So, what's the agenda behind calling what's not developing rich, other than giving those living there a guilt trip?
Just another day in Paradise
These researchers didn't see a single patient.
All they did was put a bunch of studies on a pile and say: hey...this is significant.
Anyone else have a problem with studies that simply study the results of other studies? It would be like a news channel that only reports the news stories that other news channels provide, then based on analysis of trends seen offers an opinion on what is fact or fiction. While convenient, as one does not have to get out and do actual reporting, (or research in this case), I find it leaves much to be desired. It would be better in my opinion to research available data, summarize it, offer an opinion as to its cause, develop a methodology to test this opinion, and perform a carefully thought out study to test if this opinion is supported or refuted by this study.
Anti-depressants are like being told oh, you're sad, here's a pil, now shut the fuck up and get back to work.
After having to tolerate a sibling on antidepressants for over 25 years, I'm in the camp who's experiences differ from what the study says, I see no difference and in reality deterioration. Having also had to deal with a somatic and a cerebral narcissist, I can also tell you no matter how strong you think you are, other peoples mental illness *will* cause you to have a mental illness. In my case PTSD, which made me somewhat dangerous.
In other words, mental illness is contagious.
What I learned is it is essential for your sovereign individuality to minimise contact with mentally ill people in your life before you can begin to recover your own sanity. Then you do the last thing you want to do, face the pain. Face what the deceitful actions of what others did to you and write it all down event by troubling event. What this does is help you process the emotions in a controllable way, this is difficult if you are living with an abuser. What this helps with is state control, preventing Amygdala hijack and re-regulate your HPA axis. You can die if you end up in a state of adrenal failure.
I was on the receiving end of two narcissists because of the child abuse I endured. When I claim that, I'm refering to the DSM and mean they both exhibited 5 of the nine traits of a cluster B abuser and are probably diagnosable by a trained professional. Trouble is, they don't think anything is wrong with them and they lie lie lie all the time. One was a covert narcissist and destroyed my life twice before I figured it out.
Worst thing about it though is realising that it made me attracted to these type of people and opened me up for further abuse by other anti-social people and one probable occupational psychopath. I was part of the problem. In writing it all down I processed the emotions and that made me a lot harder to manipulate because it is the unprocessed emotions that 'Those people' can detect in you and use to manipulate you. Once you clear that, you are less prone to abuse and you can start to develop boundaries and coping strategies. If you are depressed, check to see if you have too many assholes in your life. Chances are there are more than one. You know the ones who constantly stoke anger in you - "Those People" who get their thrills by trying to put you into a state of Amygdala hyjack. That want to show everyone how crazy you are so they can indulge in being right. That's all they have and they are usually losers - no you can't fix them.
So, what I am saying here is it's all too easy to just take a pill, it's bullshit. Face the pain and become a fully functional human being before you become as damaged as I was. You will feel fucking terrible while you do it, however a few weeks afterwards you will be amazed at the good things that start happening to you. The narcissists will still be losers.
If you are hurting and you are reading this, please know, it's possible to escape. It's not easy but you owe it to yourself.
My ism, it's full of beliefs.
Amitriptyline can have side effects for people with urinary problems and should be used with caution as with any drug. For example, if you have a swollen prostate it could make urination much more difficult.
How about instead of pills we put depressed folks on a strict healthy diet, and light excersise program and provide guidance or help socially. This could take the form of counseling or psychotherapy, or perhaps something as simple as joining a club or something to make friends and break you out of the âoerutâ that contributed to depression.
For anyone reading the comments, you should listen to your doctor and trust your experiences. There are different types of depression, and the stigma that you can see prevalent in these comments that you should 'just stop being sad' is a plague in of itself. I am bipolar, and spent the majority of my life being a useless piece of shit who would wake up one day and start training to be an engineer and fall asleep that night alone under a bridge trying to kill myself. I would miss a bus and decide that was a sign that I was a failure in life. None of this is normal, and none of it was my fault. It is a genetic condition, and I spent years telling myself the medication would be a crutch that would make it worse, and that I was strong enough to 'do it on my own'. I didn't want to be one of these pathetic people that everyone talks about.
But then I found a job I loved, and I didn't want to ruin it like I had so many times before. I decided to get help. I saw a doctor. I started seeing a therapist. I started taking my medications. I wake up now and take my pills and sometimes I forget how hard life used to be, and I can never say enough how amazing it is to be in that position. Not everyone will find the right combination of medications. Maybe your therapist or doctor sucks. Keep fighting. Get a new one. Ignore these trolls who don't struggle the way we struggle and keep pushing yourself.
There are communities out there to support, help, and guide you. Become a part of those communities and don't let the ignorance of the masses tell you that you can't get better. If you are still reading this, the odds are that you have a voice in the back of your mind that keeps tell you that, anyway.
So a study of a bunch of studies (run by industry insiders) that showed antidepressants work showed that after analyzing these studies that antidepressants work.
So studies that individually come to a positive result also collectively come to a positive result? I think this is a phenomenon we need to study!
How about a novel approach. Have people who understand statistics, medicine and psychology (but have no links to drug companies or reason for bias) try to recreate the results of past studies or run large-scale, carefully controlled new studies. And don't use drug company money to fund the study.
What I rarely see in these studies is comparing the outcomes with other things, like aerobic exercise. There have a been a couple of studies that showed at least for mild depression, aerobic exercise was just as effective as an anti-depressant or talk therapy. Even more so for folks who joined groups.
So, for the price of a pair of great running shoes ($150) you saved a lot of money and time. One session with a therapist will cost you the price of a pair of running shoes and running doesn't have those pesky side effects that anti-depressants have - like somnolence, weight gain, sexual dysfunction......
They appear to be working GRRRREAT! (/Sarcasm off)
This independent study brought to you by Big Pharma.
I don't believe in karma, I just call it like I see it.
"Study A", referenced in the article notes that only one in six Americans are treated for depression. And here "Study B" observes that one in six Americans already take anti-depressants. Therefore we can conclude that the authors of Study A will be satisfied when 100% of Americans take anti-depressents.
Yet I say that's not going far enough. Something that I learned in college is that if one pill is good, three pills are better, and that American Society will only reach its potential when 300% of its members are taking anti-depressents.
If it acquires resources on instantiation like a duck, then its a shared_ptr<Duck>
At creating basket-cases who like to go on mass-murdering sprees, that's for sure.
Antidepressants should be banned.
Of course most antidepressant side affects are suicidal tendencies. Seems to be a major flow in the drugs.
Certainly it does cost society, but what about the burden to the people suffering? Should not that be the paramount factor in treatment rather than profits for Pharmas?
Six out or eight mass shooters agree !
The only thing that makes me more sad than how ignorant Amaricans are about guns, is how ignorant Amaricans are about mental health.
Laws are rules for the court, but merely a bottom bar to hit for life. Think beyond laws in your actions always.
a) Long term side-effects. I do not have a full study BUT nearly every person I have known has had terrible long term effects (prozac family) iincluding addiction.
b) People who are depressed often respond very well to attention. This study will get them plenty.
c) who is funding this study?
Only 2% of studies showing antidepressants aren't effective get published:
From TFS:
We did a systematic review and network meta-analysis. We searched Cochrane Central Register of Controlled Trials, CINAHL, Embase, LILACS database, MEDLINE, MEDLINE In-Process, PsycINFO, the websites of regulatory agencies, and international registers for published and unpublished, double-blind, randomised controlled trials from their inception to Jan 8, 2016.
I know for me personally, anti-depressants were awful.
Study is not about antidepressants being good or bad - it's about them being effective. It's about antidepressants not being placebos.
The side effects were bad and I never liked taking them.
That WAS a part of the study.
Primary outcomes were efficacy (response rate) and acceptability (treatment discontinuations due to any cause).
As for...
Beware of things that say things are confirmed without a doubt. Doubt is essential in all things involving science and research.
...they know that.
We assessed the studies' risk of bias in accordance to the Cochrane Handbook for Systematic Reviews of Interventions, and certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation framework.
Mit der Dummheit kämpfen Götter selbst vergebens
The majority of mass shooters have been under the influence of - or withdrawing from - SSRI based anti-depressants.
One of the (side) effects of SSRI's is "emotional blunting" which, in essence, causes sociopathy.
While SSRI's may not directly cause people to become mass murderers (there would be thousands of mass shootings as opposed to dozens), there is certainly a link here.
It is also interesting to note that stated side effects of SSRI based anti-depressants are "violent and/or suicidal behaviour".
These side effects were added to anti-depressant labels after the Columbine shooters' legal defense unsuccessfully sued the phamaceutical industry claiming that SSRI's contributed to the murderous behaviour of the shooters.
It's something that is very difficult to understand for people who have never had it.
Laws are rules for the court, but merely a bottom bar to hit for life. Think beyond laws in your actions always.
Kurt Cobain?
If builders built buildings the way programmers wrote programs, then the first woodpecker would destroy civilization.
A lot of people here need to take a good read on what depression is. Too many people here are confusing sadness with real depression and it's not even worthwhile having a conversation. If you can change something about a person's life and they become happy, then they were never depressed in the first place.
Laws are rules for the court, but merely a bottom bar to hit for life. Think beyond laws in your actions always.
It is clear that using these drugs for any period of time increases the chances of suicide or violent behavior (as with the recent school shooting) among the users. They may not be depressed any more, but their behavior certainly is not normal or desirable. The US military services have found this to be true as well, with service people taking the drugs showing very high suicide rates. I would never take this stuff.
Well-posted. Of course, no one will respond to you. I have an uncle that went through the same thing. Of course no one will reply to you because you make too much sense. I'm glad you found your way.
Laws are rules for the court, but merely a bottom bar to hit for life. Think beyond laws in your actions always.
NO! NO! NO! NO!!!
They're already handing out SSRIs like candy for everything imaginable. People with PTSD do not need anti depressants. Also, MANY people who are put on these things are NOT monitored for behavioral and mental changes. The more we hand these things out without FREQUENT monitoring, the more problems we're going to have with grandiose suicides. According to things I keep reading, nearly ALL of the mass murderers (especially the ones that suicide) are on SSRIs.
I have a friend that was put on SSRIs for depression. Yeah, she was depressed. After starting those damn things, she went positively suicidal. To the point that we were all taking turns checking on her to make sure that she hadn't offed herself. She told the doctor about it and he said to "let the meds settle in". Seriously! She told the doctor that she was feeling VERY suicidal and he told her to basically "ride it out". Finally, she just quit the damn things and after a couple of weeks was back to her normal self.
I realize that SSRIs *may* help a lot of people, but it doesn't take very many bad experiences to do some serious damage... My friend was ready to take herself out in a spectacular way. Can anybody guess where the school shooters are coming from?
So now they're saying that *5 times* as many people need to be on these things. Really!? Of course, Big Pharma (tm) makes boatloads of money on them and we have more suicides and murders.
By the way, my friend wasn't a teen. She was in her late 40s. The bad effects are not just limited to teenagers...
Wiki says:
Several studies have associated paroxetine with suicidal thinking and behavior in children and adolescents.[10]
and
GlaxoSmithKline has paid substantial fines, paid settlements in class-action lawsuits, and become the subject of several highly critical books about its marketing of paroxetine, in particular the off-label marketing of paroxetine for children, the suppression of negative research results relating to its use in children, and allegations that it failed to warn consumers of substantial withdrawal effects associated with use of the drug.
The smoking gun :
Published in July 2001 in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP), which listed Keller and 21 other researchers as co-authors, study 329 became controversial when it was discovered that the article had been ghostwritten by a PR firm hired by SmithKline Beecham; had made inappropriate claims about the drug's efficacy; and had downplayed safety concerns.
Yet the United States continues to hand out SSRIs like candy to children. Many school shooters were taking SSRIs, yet the topic is censored in mainstream media.
From what I've read about sleep deprivation therapy, that's effective. Spend three weeks, and 70% of people are cured of their depression. The problem with it, is it's not patentable, so there aren't any market forces to push it.
The PHQ-9 test doctors give people was designed by Pfizer to give you a score that indicates you are depressed and need to be on antidepressants. Many people get worse because they think popping a pill will fix their problem, when in fact many problems such as marital problems or issues on the job can not be fixed by chemicals. People think popping a pill with fix many of their problems and then it doesnt always help and they get more depressed/ I asked a psychiatrist if depression was _really_ a problem and he said it was really only a problem when it made it hard to function, go to work, or consider self harm. That was about the most realistic advice a doctor has given me in a long time.
Doctors prescribe antidepressants as a lifesaving measure. A person suffering depression has an absurdly higher probability of committing suicide than somebody who doesn't. In fact, an overwhelming majority of people who commit suicide suffer from depression. When a doctor prescribes antidepressants, they aren't rubbing their hands together waiting for a big payout from big pharma. They are doing it because they want the patient to not die, which is a noble gesture on behalf of a doctor. Antidepressants "don't work" for a lot of people. I've known people who have been on them for several decades and have remained perpetually miserable. The probability of somebody eventually managing to correct the problems causing their depression is grim, but it's no where near as grim as the probability that they would commit suicide without the medication. Antidepressants are like floatation devices for people lost at sea. You are much less likely to drown with one, but you still need to paddle ashore yourself. Some people just float there getting knocked back and forth by the ocean forever. That's a pretty glum way to be. But at least society doesn't have to deal with the weight of that person's death.
Quote from the actual study:
"We excluded quasi-randomised trials and trials that were incomplete or included 20% or more of participants with bipolar disorder, psychotic depression, or treatment-resistant depression". (emphasis mine)
So yeah, it works, unless it doesn't, in which case we'll exclude those instances. No true Scotsman indeed.
Doctors generally won't comment on this particular side-effect of some anti-depressants, because nobody wants to admit that it could actually cause other types of problems... but some anti-depressants could be more accurately described as "anti-emotion" pills. This means that they actually cause you to feel less emotion than you would otherwise, both negative and positive. I've personally observed the impact that this can have; someone that I used to know who was incredibly empathetic, selfless and loving, but also prone to occasional bouts of depression, was put on a pill... which essentially eliminated all of those things. It certainly eliminated her depression, but it also quite literally changed her entire personality, and I would argue that it wasn't all for the better, for her or for those around her.
Always be careful, when substituting pills for real problem solving. Sometimes, you will end up losing the person you loved, in the process.
These kind of comments is what really matters. Only anti-science crowd would think antidepressants does not "work". What matters is whether the result of those pills is what we truly desire.
Aside from the effect of the pills, another matter is do we want ourselves or who we love be drug dependent.
DISCLAIMER: This is JUST MY OPINION. Agree or disagree all you like.
READ EVERY WORD CAREFULLY BEFORE YOU COMMENT.
Cognitive therapy, and learning how to deal with the shit that life hands you, is a better long-term strategy than taking pills.
Furthermore: the pharmaceutical industry dearly loves people buying medication from them forever. They've been pushing antidepressants for decades now, and HMOs would rather give you a bottle of pills than have you sit down with an expensive counselor or psychiatrist and talk your way through problems, learn how to deal with things on your own.
Antidepressant medications have a place for the clinically depressed, and as a short-term stop-gap while you're learning to deal with things on your own. But otherwise I do not think people should be taking them long-term.
Another issue with antidepressants is that they get an undeserved bad reputation for promoting violent behavior - because some people committing horrendous crimes turn out to have recently been put on a course of them.
What's happening there is that psychopathy and depression are separate issues and a few people have both. So you have this handful of psychopaths who'd commit atrocities but are too bummed out to get around to it. Treat their depression and you have a fully functional psychopath. Oops! (Thus there is some debate among mental health professionals about whether it's more ethical to treat, or withhold treatment, of violent psychopaths for depression.)
Depressives, though, even when treated, average FAR less likely to commit, or attempt, improper violence than the general population - by enough to bury the excesses of this handful of re-enabled bad guys.
Bantam Dominique roosters crow a four-note song. Once you've heard it as "Happy BIRTHday" you can't NOT hear it that way
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Psychiatry and psychology involve extreme pseudoscience (lack of objective science) and are directly responsible for the prescrip drug crisis we have. Too many people drugged up and side effects being downplayed constantly. Lack of objective diagnosis and treatment. Studies greatly skewed subjectively. Scientific sources cited: https://ultratechlife.com/scie... We cannot keep throwing pills at everything, especially when they cause more problems than solutions. We also never solve the problem, pills just cover it and give you more side effects. Pretty soon everyone will be drugged and even if the claimed extreme side effects percent is "low", having millions of people on them means a large group of people will do something crazy/hurt someone because of the pills they are on. How many school shooters were on these "mental health" pills? Do your research. This industry and big pharma want your money and that's it. Take care of yourselves. Very few people have chemical imbalances compared to the entire population. There is no reason why 75% of Americans (and toddlers) should be on "mental health" medications. That is ridiculous!
100% Convincing Point! Excellent and Rational. Well done sir, you've convinced me!
Agent K: A *person* is smart. People are dumb, stupid, panicky animals, and you know it.
You know? I've always been such an advocate for technology and science that I would have immediately been on-board 100% with everything you said there. But as I've gotten older, I've experienced things that make me question some of that. For example, I've never been a "morning person", always preferring to sleep in until my body wants to get up (usually by 11AM or thereabouts), and like to stay up until 1AM or so. But I recently visited with some friends of mine who have a small house on a bunch of land out in the country, and live a pretty "simple" lifestyle compared to what I've designed for myself. Sure, they have "Internet" -- but their only connection consists of a Sprint LTE hotspot. For them, most of their Internet usage is Facebook on their cellphones or small games or apps downloaded onto them. They own exactly 1 Windows laptop, that sits on a small desk in the living room and gets used randomly by whoever needs it for something. (Typically - they seem to use it to download photos off their digital cameras.)
They spend most of their free time doing outdoorsy things. They have a swimming pool, 4-wheelers they can drive around on all the land out there, etc. They build bonfires when it's cool and invite neighbors and friends over for meals, to drink and just to have conversations. The guy's wife likes to do a lot of arts and crafts using "found" materials from a local junk yard they visit and scour through regularly.
It's the type of lifestyle I always said was "NOT for me!" ... but I found within hours of spending time with them, my stress levels just dropped off. They went to bed earlier than I would have normally called it a night, but I had no problem getting right to sleep since we had done a lot of more physical activity with all the outdoors stuff that day. They woke up bright and early and I found it just felt "right" to be up with the sun like that.
I guess what I found more enlightening was how quickly I adapted to that "farmer's schedule" they kept, even though it had NOTHING to do with farming!
Don't get me wrong.... When I got back home from that trip, I was content to fall right back into my usual patterns and was happy to have all my technology back. But it made me ask myself if a lot of our struggles are just the result of our choices -- and not so much a case of "worshiping that false god, nature"? The more things you own, the more the things begin to own you. That's a quote I read someplace and I see a lot of truth to it. How much additional stress and hassle is in my life because I have "to do" lists filled with errands to runs or items to buy to maintain my stuff? And how often are we eating poorly because time has become such a precious commodity for us, with our artificially busy schedules we've created? I'm not really ready to throw it all away and become the next Luddite, living in a secluded log cabin. But I'm realizing we're paying the price, in many ways, for trying to enhance our lives with all the tech we surround ourselves with. It gives but it takes away too. Maybe it's more of a "wash" than we think, compared to not living this way?
I prescribe you a week without Slashdot, you will feel much better.
Laws are rules for the court, but merely a bottom bar to hit for life. Think beyond laws in your actions always.
There is TWO part to depression treatment. The first is anti depressive, the second is a psychotherapy. If you take/get only the pill then somebody in the health care dropped the ball. A pill without therapy is nearly worthless.
C. Sagan : A demon haunted world:
http://www.amazon.com/gp/product/0345409469/
visit randi.org
However, with the proper applicator for the 9mm anti-stupidity pill, it doesn't matter that much if they resist.
I'm mostly non-violent, but some things are just too satisfying not to daydream about.
"When you have eliminated the unacceptable, whatever is left, however improbable, must be the truthiness" - Holmes
You know what happened to me a few years ago? I felt unhappy for the first time in maybe twenty years. Something unpleasant happened, I was unable to help, and I just felt sad and unhappy. It was an unfamiliar feeling at first, because for decades I'd been depressed instead of feeling when things like that happened. "Depressed" and :"sad" are two different things.
"When you have eliminated the unacceptable, whatever is left, however improbable, must be the truthiness" - Holmes
We also didn't have a prevalence of easily available right-wing fake news. Or as much carbon dioxide in the air. Just sayin'.
"When you have eliminated the unacceptable, whatever is left, however improbable, must be the truthiness" - Holmes
Your friend had a really crap doctor, and apparently no proper talk therapy. There's very little in this world that can't be screwed up by incompetents. Anti-depressants can be prescribed to people with situational depression or no real depression. People can be given pills without any other sort of support because they're cheap and therapy is expensive.
As far as I can tell, right-wing sites say mass shooters are on SSRIs, left-wing sites don't, and what little I could find in the middle said that we don't know about everybody's drug use, and lots of the drugs the right-wing sites call SSRIs aren't.
"When you have eliminated the unacceptable, whatever is left, however improbable, must be the truthiness" - Holmes
From my unfortunately detailed and lengthy experience, I generally agree with you. I had an HMO that did do talk therapy, with a very short list of people available to talk to. I talked to four therapists, and found one I could actually connect with and who could help me, and she wasn't working for an HMO.
"When you have eliminated the unacceptable, whatever is left, however improbable, must be the truthiness" - Holmes
Psychology is a science, and psychiatry is medicine, and they do scientific testing. They aren't perfect, but they're very, very far from being pseudoscience. If you think that way, I can only encourage you to get your medicine from whatever the heck stupid website you want to use, because I'm annoyed at all the assholes pontificating on other people's problems without bothering to learn anything first.
"When you have eliminated the unacceptable, whatever is left, however improbable, must be the truthiness" - Holmes
As someone who's been on antidepressants for nearly 20 years, had talk therapy for about as long, I thought I could leave the stuff behind. I was in a good place in my life - things were going very well, both personally and professionally.
About two years ago, I asked my Doctor if I could try going off my antidepressants. I wanted to stop taking them. I thought that 20 years of therapy had helped, and that I'd be able to cope, because my life was so much better than when I started antidepressant use.
I tapered down, and eventually off of my antidepressant (venlafaxine, one of the hardest to discontinue) around the end of July. I celebrated the day I took my last dose.
Things seemed good at first - tapering off and discontinuing the drug wasn't awful - I felt like I had a mild illness for week or two. Things continued to go well in my personal and professional life. I felt great.
Towards the end of August, I started worrying about stupid things; I didn't really notice my thoughts had changed for several weeks.
September was challenging - there weren't any major changes in my personal or professional life, but I was struggling, and I figured I just needed to work on coping better. I saw therapists, talked things out, and so on. I kept thinking "I just need to make it a few more weeks, and things will be back to normal."
The nightmare began about halfway into October, and it just kept getting worse. None of the things I enjoyed brought me pleasure anymore. Nothing. I dreaded going to work, dreaded going home, dreaded every experience. I would have panic attacks for no reason at all. Most of the time, I had chest pain - crushing anxiety. It didn't take long before it seemed nothing was right - I couldn't cope anymore.
I finally swallowed my pride the second week of November, and did what everybody else in my life had been pleading for me to do six weeks earlier: Therapists wasn't working, Behavioral therapy wasn't working. I agreed to start taking antidepressants again. Things continued to get worse for about a week. I wanted them to get worse to "prove" it wasn't the antidepressants.
Family & friends saw positive changes before I noticed a difference, but stayed quiet, knowing I'd react badly.
When Christmas rolled around, I finally felt normal again. I noticed it, my family noticed, and my friends noticed... and even my boss noticed, and brought up my "months in hell" during my yearly performance review.
In my case, the difference is literally the difference between life and death.
-- Sometimes you have to turn the lights off in order to see.
I'd feel a lot better if we knew HOW/WHY they worked.
I would too. Here's the thing, though: There are a lot of things we don't know why they work, only that they do.
Let's start with Gravity. Honestly, ask "why" enough times about even simple things and we run into "we don't know why, it just is" pretty quickly.
-- Sometimes you have to turn the lights off in order to see.
I was once prescribed AT for my N24 sleep condition. This did nothing to correct for my huge daily drift (period = 25.4 hour), but it had nearly miraculous effects on my sleep quality.
In the werewolf week of my cycle where I was sleeping primarily during the day, my sleep quality was typically poor (not due to light, temperature, or noise, all of which were controlled). After about four days of reduced quality sleep, my listlessness would skyrocket. One small dose of AT would then cause me to sleep very hard and usually for an extra couple of hours. I would awaken feeling miraculously restored.
Unfortunately, I also awoke feeling muzzy-headed until early "afternoon" (body time). Too muzzy to accomplish much at the keyboard.
One day I was reading the monograph for AT and noticed that NT was a metabolite, so I thought, why don't I give it a shot to see if I can keep the benefits, ditch the side effects?
I went through channels to change my Rx to NT (not using Rick Gates) and sure enough, NT had the same benefits, and far less muzziness the day after.
I've been using NT as needed for close to two decades now. Lately, using NT hardly at all because I finally have a melatonin therapy that fixes my problem 95% of the time (the breakthrough step was switching to a sustained-release formulation).
The miraculous effect of NT depends upon my sleep degrading in a specific way. When I take NT in this state, there are two observable effects at "night".
First, micro-wakings become very short in duration and return to the deeper sleep state is pretty much guaranteed. It actually seems like NT suppresses a circuit that notices the micro-waking and sounds the consciousness church bell. Only a tiny little sliver of consciousness gains traction, then fades away very quickly as if it hadn't ever been there.
Second, there's a change in the amplitude of the sleep cycles toward the end of the sleep period. A normal model is that sleep consists of five sleep cycles, averaging about 1.5 hours each. Each cycle has a slightly different mix of functions. For example, the last cycle is particularly important to sleep spindles, which is particularly important to consolidating explosive skill memory, such as golf or figure skating (the fine motor adjustments cascade so fast, they have to be pre-programmed neurologically). I've never figured out whether NT changes my architecture to 6 times 1.5 hours or 5 times 2 hours, but NT does tend to increase my sleep duration to 10 hours, with the last 2 or 3 hours being extremely deep and powerful. Note that his effect only happens when my sleep is in a bad state prior to taking NT (usually the only reason I take NT).
I did for a while take a custom-compounded dose of 4 mg daily to see whether I could go from a shotgun effect to a blanket effect, but it was causing too much intestinal distress (probably irritating another condition of recent origin which the gloriously cost-effective Canadian medical system is taking its sweet time to diagnose—bear in mind while calibrating your irony kneejerk that I am a card-carrying member of the medical-delivery-is-par-thirteen club, and I grade accordingly). The blanket experiment ended up non-conclusive because it was causing me to awaken frequently with bowel and back pain ("just how tight do your bowels need to be to induce back pain?" was my main cognitive content during these waking episodes).
The reason my original doctor put me on AT was that he had a long history of mitigating the sleep impairment component of fibromyalgia by the same strategy, and some of my complaints struck him as similar. There's a fair amount of lore in the FM community about AT (mostly) and NT as effective analgesics.
So now I see that I lied: there's actually a third noticeable effect of taking NT. It doesn't reduce pain so much, and make you more indifferent to the
I thought that. I had been seeing psychiatrists for nearly twenty years, combined with antidepressant therapy. Life was awesome.
I thought I could stop taking antidepressants. I was ready for some struggling while I adjusted.
I wasn't prepared for the nightmare that followed. Discontinuing the drug was easy. I never stopped therapy the entire time (I've been referred to different therapists/psychologists, trying to find something that would work).
In spite of my own (and multiple mental health professional's) best efforts, I couldn't cope. I accepted my psychiatrist's advice to resume antidepressant treatment.
It turns out that many people aren't treatable without antidepressants. My doctor told me it's not that different from diabetics: there are different levels of organ malfunction. Some diabetics just need diet and lifestyle changes. Others, however, must receive shots of insulin.
-- Sometimes you have to turn the lights off in order to see.
In the [UK] The Guardian today https://www.theguardian.com/sc... several letters cast expert light on this highly exaggerated report. For example, blind trials are difficult as anti-depressants have side effects which allow participants to guess whether they are getting the placebo or not. That the tablets considered(!) most effective happen to be those with the greatest side effects also casts doubt - why should that be?
Paul Beardsell