if you have a real mental disorder medicine is a godsend

Not tying to rain on anyone's parade here. But I read tons of science journals, and this subject has been up recently in several of them. Studies are showing, (scientific, clinical studies) that many antidepressants work no better than placebo in the vast majority of people who take them.

That does not mean that they do not work, only that they work because you believe they work. They arent the only class of drugs to show this, many pain meds did as well. They did find some slight benefit in the most severely depressed.

Just wanted to inject a little science into this, I am not saying anyone should or should not do anything different than they already are.

I cant link you to the articles I read, but, I did find several popular media sources for it.

www.guardian.co.uk...

Prozac, the bestselling antidepressant taken by 40 million people worldwide, does not work and nor do similar drugs in the same class, according to a major review released today.

The study examined all available data on the drugs, including results from clinical trials that the manufacturers chose not to publish at the time. The trials compared the effect on patients taking the drugs with those given a placebo or sugar pill.

When all the data was pulled together, it appeared that patients had improved - but those on placebo improved just as much as those on the drugs.

See also,

news.bbc.co.uk...



[edit on 9-1-2009 by Illusionsaregrander]

reply to post by Illusionsaregrander


Determining the effectiveness of antidepressants can be really complicated, since single episodes of depression usually resolve on their own given time anyway. That may even make the placebo effect stronger than typical.

I think it's great that these studies are getting some play – I think it's definitely evidence that antidepressants are overprescribed and access to talk therapy is too limited. But I'm very concerned about a backlash phenomenon affecting the most severely depressed – those that even these studies admit are helped by the new generation antidepressants, even if they're not the promised land they were once sold as.

Have you seen any well-designed studies comparing SSRI/NSRI antidepressants in severely/chronically depressed individuals to placebo treatment, with both groups receiving talk therapy? Ideally, with a third group receiving tricyclics to compare new antidepressants to old?

Originally posted by robdad
for anyone who says medicines are not effective for people with depression / anxiety disorders you probably dont have a true condition ... i hear lots of people say the side effects are horrible ... well i have taken meds for both now for 3 yrs ... there are side effects but i will take these over the symptoms everyday of the week ..

If they didn't work, no one would take them, but aren't you treating a symptom of a deeper problem rather than the cause?

Depression (and many, if not all mental illnesses) are symptoms of something out of balance, either emotionally or physically.

Speaking from personal experience, as one who did not go the pharmaceutical route, talking to a psychologist to find out the root of the problem is very worthwhile. Also making sure you are getting the right nutrients in your diet will help avoid chemical imbalance related problems.

Originally posted by ambushrocks
I am on Paxil and my life is a 100% better than when I'm not on it.

I assume for panic attacks? I used to suffer from severe panic attacks and agoraphobia, but instead of going onto paxil, I did a lot of reading on the subject, and actually found some very interesting things...

1) Suffering from panic attacks could be an indicator that something about your lifestyle is bothering your conscience. Panic Attacks are your subconscious minds way of punishing yourself. Figure out what it is - this will really help, trust me!

2) Because stimulants like caffeine mimic seratonin, drinking copious amounts of coffee (as I used to) can cause your brain to think you have too much seratonin and stop producing any - this will result in severe panic attacks. Lay off the stimulants!

From those two nuggets of info, I haven't had a panic attack in 7 years.

reply to post by americandingbat


I have not seen any studies with people using meds AND talk therapy at the same time.

I honestly do not think you could do a controlled study that way because talk therapy would skew the results. (If you got a crappy psychologist for one study participant for example and a brilliant one for another) And, talk therapy requires effort from the participant. So, the participants as well as the therapists would make the results hard to quantify.

Drugs themselves are much easier to test because x amount of drug in a human is x amount of drug in a human.

As far as Tricyclic antidepressants go, I can link you to a study done on children and adolescents,

www.bmj.com...

Results: From the six studies presenting data which enabled an estimation of effect size the pooled effect size was 0.35 standard deviations (95% confidence interval of -0.16 to 0.86) indicating no significant benefit of treatment. From the five studies presenting data on the number of "responders" in each group, the ratio of the odds of a response in the treated compared with the control subjects was calculated and the pooled odds ratio was 1.08 (95% confidence interval of 0.53 to 2.17); again indicating no significant benefit of treatment. The pooled sample had more than an 80% chance of detecting a treatment effect of 0.5 standard deviations or greater. There was an inverse relation between study quality and estimated treatment effect.
Conclusions: Tricyclic antidepressants appear to be no more effective than placebo in the treatment of depression in children and adolescents.

It is up to you if you want to then take that data and assume it would apply to adults as well. I personally would make that assumption, (until I was presented better evidence) but it would remain an assumption, and those can be and not infrequently are, are wrong.

Originally posted by the siren

2) Because stimulants like caffeine mimic seratonin, drinking copious amounts of coffee (as I used to) can cause your brain to think you have too much seratonin and stop producing any - this will result in severe panic attacks. Lay off the stimulants!

Unscientifically, just on personal observation alone and a few other factoids, agree that stimulants are horrible things for people suffering from mood disorders.

I have a friend with severe depression that cannot afford medical treatment, who I convinced to stop drinking coffee, (he drank HUGE amount of coffee) and he improved significantly. He started up on the coffee again, and he is once again severely depressed.

I dont think coffee or stimulants cause anxiety or depression, nor do I think ceaseing to use them will "cure" the conditions, but they certainly seem to have a significant impact on the severity of the symptoms, and I think anyone who suffers should at least conduct an experiment on their own and eliminate them from their diet. It is a relatively easy, (save for the painful caffeine withdrawal headaches many get for the first couple days) thing to try, and even small benefit to someone suffering is worth it in my opinion.



[edit on 9-1-2009 by Illusionsaregrander]

Originally posted by Illusionsaregrander
I have not seen any studies with people using meds AND talk therapy at the same time.

I honestly do not think you could do a controlled study that way because talk therapy would skew the results. (If you got a crappy psychologist for one study participant for example and a brilliant one for another) And, talk therapy requires effort from the participant. So, the participants as well as the therapists would make the results hard to quantify.

Thanks for the link on tricyclics – I agree that I'd be inclined to think the results could be reproduced with adults.

I agree with you about the difficulty of designing and controlling a study that uses talk therapy, but it seems to me that I've read about studies that have shown that neither SSRIs alone nor talk therapy alone is significantly more successful than placebo treatment, but that when combined there is a significant benefit. Unfortunately I can't turn up a link right now – I'm pretty sure I read that info in Andrew Solomon's Noonday Demon but it was a couple years ago.

The implication though is that any study of treatment effectiveness in depression that doesn't look at combining pharmacalogical treatment with other support is not going to give reliable results.

I've been on disability for around 5 years and it wasn't until around the second year that I felt the desire for medication to sleep nights. After that I was prescribed a medication I wished I never had: Seroquel. Now there are law suits against the maker. I would think most of my problems were more closely related to continual stress factors growing up.

Being in disability without someone else manipulating me has been part of my recovery to think more for myself or die. Many probably can't handle the type of stress our society puts on them and the kids of stressed parents most likely pick up on this. My father apparently hated work, was mostly unhappy when he came home. So, I also learned to hate work and school.

Anyone ever been to the zoo and picked up on the stress of the animals and related to them?

I've heard many people are self medicators and much of which is self destructive or unhealthy behavior. I wonder what the poll is for people who like their work or did when they actually had a job.

Just like my two children with my second wife, I'm on a medication they also use for seizures. The cause is still unknown, but appears to be hereditary and on my side of the family. My cousin has MS.

Originally posted by aleon1018
Many probably can't handle the type of stress our society puts on them and the kids of stressed parents most likely pick up on this.

I tend to lean this way when I consider the incidence of depression and the reason so many self medicate to feel better. (Be that with drugs, alcohol, shopping, sex, whatever) We have a real problem, it isnt the people, it is the social construct itself. We are living in a society that simply does not work in terms of human happiness. We have "stuff" but what we have created does not supply what humans need for psychological happiness. Meaning. The ability to excel at what they are best at. Being recognized as valuable for themselves, their inherent worth, rather than what they can produce for another persons benefit.

Our solution, medicate the people, in my opinion is the wrong one.

The numbers of people who are experiencing mood disorders is incredible, especially considering that so many are medicating themselves they are not even diagnosed. That should be a clue. I would argue that there is little wrong with most, (not all) of these people, but rather that we are living in a society that is not a good fit for us.

It doesnt matter that we are the ones collectively that created it. If I buy a pair of man made shoes that are two sizes too small and shove my feet into them and wear them day in and day out, my feet are going to hurt. And, my feet should hurt. There is nothing wrong with my feet, I am forcing them to live in conditions that are not healthy for them. The solution is not to take painkillers, or cut off my toes, it is to go get a better fitted pair of shoes.

That is what frustrates me. All of these people thinking they are dysfunctional because they are depressed and trying to make themselves "right" when if you look at society objectively, they are perfectly functional to feel depressed by what is going on. I would argue that they are simply the most sensitive to the "wrongness" of how we live, AND, too willing to assume that they are flawed for perceiving it that way.



[edit on 10-1-2009 by Illusionsaregrander]

reply to post by Illusionsaregrander

obviously you do not suffer from any REALdisorder .. i have major depression disorder .. my symptoms have never been my mood .. every one of my symtoms is physical .. know what an anxiety attack is .. ? i had them everyday for 20 yrs .. close your eyes and imagine this ... your heart is beating at 150 bpm .. your chest hurts so bad you can not breathe , only small gulps of air ..most of your fingers are numb .. cant walk cause your legs are rubber.. sound like something that you can wish away ? depression is not about the blues .. its about so much more .. wanting to never move again , literally .. wondering why you exist .. becoming a hypocondriac .. wanting to end it but you dont have enough energy to do it ..

I just dont have time for people who have never suffered with a mental illness and simply say snap out of it

Understand anxiety (my problem) will overcome you. You will be thinking bad things about yourself 24/7. I mainly suffer with hypochondria anxiety and ive had to leave 2 jobs i love because of it (constant bad thoughts about having a medical illness which doesnt exist) MEDS do help, i simply cant see it being a pyschological thing that im taking them, they go someway to repairing the imbalance, which you can literally feel, as you just dont feel normal!

I find myself trying to think of things and how they felt before i developed anxiety, as if clinning to the past. Its a really horrible thing and i wouldnt wish it on anyone. I am thankful for being born in an era where meds are available for this terrible disease. And for all who mock, maybe one day you will experience a chemical imbalance/mental illness, i hope to god you dont though

Medications can help but long-term they just hurt a lot of (not all) people, like me. I have bipolar and paranoid schizophrenia. I was medicated for 4 years and then I took myself off. People say that pharmaceuticals are not addictive which is only half true. An addiction is a basically a dependence. Although you may not want to rake the meds you ARE dependent on them. Just like with narcotics, there is a withdrawal, but it's A LOT LONGER with pharmaceuticals. I went off my meds and went through about 3 months of psychosis but now I'm so much better and I'm so happy I'm not on them. They're drugs, just like coc aine, and ecstasy, but the bad effects aren't very noticable (and I don't mean side effects). If you don't believe me look into Abilify. It has the same base ingredient as ecstasy.

Originally posted by No1NeedsToKnowMyName
Medications can help but long-term they just hurt a lot of (not all) people, like me. I have bipolar and paranoid schizophrenia. I was medicated for 4 years and then I took myself off. People say that pharmaceuticals are not addictive which is only half true. An addiction is a basically a dependence. Although you may not want to rake the meds you ARE dependent on them. Just like with narcotics, there is a withdrawal, but it's A LOT LONGER with pharmaceuticals. I went off my meds and went through about 3 months of psychosis but now I'm so much better and I'm so happy I'm not on them. They're drugs, just like coc aine, and ecstasy, but the bad effects aren't very noticable (and I don't mean side effects). If you don't believe me look into Abilify. It has the same base ingredient as ecstasy.

You are playing with fire!
Sure you may feel good now, but I promise you ARE gonna crash. Bipolars always do.

After years of being on the rollercoaster, you finally learn.

I too am bipolar and for the last several years, my mania manifests as extreme paranoia. It acts and looks like paranoid schizophrenia. Several times I have thought I was cured and no longer needed meds. Only to crash even harder and more psychotic than before. It is a very dangerous game to play. And guess what!
It's a lose/lose situation.

From your post, you sound quite young. Well as you age mental illness gets harder and harder to deal with. The biggest challenge of living with bipolar is most Do NOT TAKE their meds. Please tell someone that you are off your medication an return to your doctor asap. You are truly putting your own life at risk.
With all I said, it is your choice. Your personal responsibility for your behavior and your health. No one can force you to také care of yourself but maybe thinking about your loved ones and what your illness is doing to them will be enough to save your life.

As for antidepressants and mood stabilizers having the same addictive effects as narcotics, this is simply not true. While yes they act on the CNS, they act completely
Different than narcotics.antidepressans/mood stabilizers have different chemical properties than the hard core drugs you named. So this makes no sense.

Abilify like ecstasy? I take abilify and in no way is it like ecstasy. Abilify saved my life. You have been terribly
misinformed.

I wish you the very best, managing your illness

Paxnatus

Originally posted by Illusionsaregrander

We have a real problem, it isnt the people, it is the social construct itself. We are living in a society that simply does not work in terms of human happiness. We have "stuff" but what we have created does not supply what humans need for psychological happiness.

…

That is what frustrates me. All of these people thinking they are dysfunctional because they are depressed and trying to make themselves "right" when if you look at society objectively, they are perfectly functional to feel depressed by what is going on. I would argue that they are simply the most sensitive to the "wrongness" of how we live, AND, too willing to assume that they are flawed for perceiving it that way.

This is an interesting perception, and I'm not sure that I disagree.

But, whether part of my depression is due to how dysfunctional our society is, or not, I need antidepressants to function.

Just because a part of the problem is with society, doesn't mean that I don't deserve the help and support I need to contribute to that society.

Maybe I am more sensitive to wrongness than many people – I think that's probably true. And that that sensitivity is part of what makes it so hard for me to function without retreating into the shell of emptiness I put up around myself during a depression. If I take medication, I can spend a lot more time outside my shell trying to make the world a better place. If I don't take medication, I put myself through emotional and mental agony, and can not contribute anything to anyone.

I'm not buying that that's all there is to depression, especially since I come from a nice long line of depressives going back at least a century. But even if it's true, it in no way changes the need for medication among those of us who are here.

I know this does not apply to all, but at one point in our lives we all (the majority) are young and dumb. We think we are invincible. At age 17, I was taking '___' every day for over two months. I got to the point that I eventually took 12 hits at one time. What a wonderful great experience it was. Now at age 29, my Doc has me trying Effexor XR. No one has yet to find the complete long term effects of '___' use, but current research has shown that '___' blocks your Serotonin Receptors. I have anxiety and depression, nothing interests me, nothing fulfills me. Maybe because I've seen beauty beyond beauty?? Reality is not the same as it was before the '___'. Young and dumb, I now have no desire to live. If it weren't for my son, I think I would have taken my life along time ago. I have no fear of dying other than knowing how badly my son would miss me. I could never let him be hurt because of my selfishness. Three weeks on the effexor (along with the aprazolam which I was previously taking before I got the courage to see a doctor, which he wants me to stay on with the effexor) I'm no longer sleeping 24/7 just to avoid life. I have more energy and enjoy every moment with my little man. There really is beauty left in this world. No one can be perfect, "illness" is everywhere in every form. You have to open your eyes and take a good look at yourself and get help, you just have to find whats right for you.

I wish you all the best in your fight to be alive once again