The Mystery of When to Stop Antidepressants • Hacker News Board

Re: The Mystery of When to Stop Antidepressants

#21

Post by biturd » Tue, Mar 08, 2016, 6:53 AM UTC

lololomg wrote: post #3

pc2g4d wrote: post #2

There's a disconnect between what the meta-analysed randomized clinical trials are saying about antidepressants (that they are at best minimally effective relative to placebo) and what relapse rates suggest (that people relapse when withdrawn from antidepressants because the antidepressant was effectively treating the underlying depression). This conflict is resolved when antidepressants are acknowledged as addictive…

The annoying thing about (for example) SSRIs is that it's annoying to take accurate doses like that. My escitalopram comes in 5mg, 10mg and 20mg. If I want to slowly taper down from 20mg a day, I have to start chopping off bits from an already tiny pill every day for months on end. I can't just drop down to 15mg a day, it's too abrupt.

Worse, keep in mind that pill, broke perfect in half, will not have equal amounts of the active or inactive ingredients in each side. Further, if it is a generic, it doesn't even have to have the same mg amount of the active ingredient, only within a margin of something like 90%, which is huge when dealing with these types of meds.

Re: The Mystery of When to Stop Antidepressants

#22

Post by biturd » Tue, Mar 08, 2016, 7:01 AM UTC

julie1 wrote: post #12

pc2g4d wrote: post #2

There's a disconnect between what the meta-analysed randomized clinical trials are saying about antidepressants (that they are at best minimally effective relative to placebo) and what relapse rates suggest (that people relapse when withdrawn from antidepressants because the antidepressant was effectively treating the underlying depression). This conflict is resolved when antidepressants are acknowledged as addictive…

Could antidepressant just be a placebo requiring to be addictive then? And could hooking off an addiction be very similar to depression? Would any psychoactive works? If so maybe why not using a less dangerous psychoactive drug if it is a placebo that works good enough to alleviate the pain?

Opiates will cure depression, stop it dead in it's tracks for a large majority of people. Good luck finding a Dr to help you down that road though. There is a reason people have an illicit drug of choice, and that is a good indicator of what anti-d's may work best for you.

Opiates, you are screwed, meth, there is Adderal or Ritalin, ( All these probably have had their names changed by now to something else ), if you like cocaine, then an SNRI may be better for you. Anxiety, ideally they lighten up and give you a benzodiazepine, more than likely you will get a med that was initially a smoking cessation medication.

Psychiatry is a black art, I really almost feel unless you are clinically depressed, schizophrenic, etc, if you are going to be a human medicine dart board, don't, be a human health dartboard. Exercise, diet, etc, but be insanely specific, insanely calculative in what you do if you choose the non-med way, as it is just as much a mystery as are the pills.

Re: The Mystery of When to Stop Antidepressants

#23

Post by biturd » Tue, Mar 08, 2016, 7:01 AM UTC

stevedonovan wrote: post #16

seibelj wrote: post #7

Lexapro (Escitalopram) saved my life. I don't care what any meta-analysis says: years of diet, exercise, and meditation did 5% of what 1 month of Lexapro did for me. I will take it until I die.

Myself likewise. I don't wish to revisit the pit and wallow through the cognitive fog. An interesting aside: why do users of antidepressants feel the need to reduce their dose? It's a benign addiction, like moderate caffeine dependency. One reason is that there _is_ a trade-off; these drugs make us a little dull and less interesting to ourselves.

side effects.

Re: The Mystery of When to Stop Antidepressants

#24

Post by biturd » Tue, Mar 08, 2016, 7:03 AM UTC

roghummal wrote: post #13

jackfrodo wrote: post #11

Anyone know how to get around the paywall?

Google for "The Mystery of When to Stop Antidepressants" and click through there. Didn't work for me in 'incognito mode' but it did when running normally. YMMV.

I was totally unable to bypass it as well.

Re: The Mystery of When to Stop Antidepressants

#25

Post by venomsnake » Tue, Mar 08, 2016, 7:10 AM UTC

roghummal wrote: post #13

jackfrodo wrote: post #11

Anyone know how to get around the paywall?

Google for "The Mystery of When to Stop Antidepressants" and click through there. Didn't work for me in 'incognito mode' but it did when running normally. YMMV.

There seems to be sites that think of private browsing as ad blocker. A watchdog script and firefox with new profile takes 10 seconds ... why do they even bother.

Re: The Mystery of When to Stop Antidepressants

#26

Post by exabrial » Tue, Mar 08, 2016, 7:11 AM UTC

While SSRIs and SNRIs have been around for years and have shown questionable efficacy, opioids have been around for centuries and have shown to provide instant and effective relief to depression. Unfortunately, opioids have a side effect called "ruining your life". Based on this though, there's a new generation of antidepressants that target a completely different part of the brain. Essentially it's the depression blocking effects of opiods without the euphoria, so low to no addiction potential. alks-5461 is the one that will hit the market soon... hoping it's not too expensive. http://mentalhealthdaily.com/2014/08/05/new-antidepressant-a...

Re: The Mystery of When to Stop Antidepressants

#27

Post by exabrial » Tue, Mar 08, 2016, 7:16 AM UTC

exabrial wrote: post #26

While SSRIs and SNRIs have been around for years and have shown questionable efficacy, opioids have been around for centuries and have shown to provide instant and effective relief to depression. Unfortunately, opioids have a side effect called "ruining your life". Based on this though, there's a new generation of antidepressants that target a completely different part of the brain. Essentially it's the depression bl…

And actually... if you have MDD, you might consider signing up: https://clinicaltrials.gov/ct2/show/study/NCT02218008?term=a...

Re: The Mystery of When to Stop Antidepressants

#28

Post by stevedonovan » Tue, Mar 08, 2016, 7:18 AM UTC

biturd wrote: post #23

stevedonovan wrote: post #16

Earlier quoted context omitted.

Myself likewise. I don't wish to revisit the pit and wallow through the cognitive fog. An interesting aside: why do users of antidepressants feel the need to reduce their dose? It's a benign addiction, like moderate caffeine dependency. One reason is that there _is_ a trade-off; these drugs make us a little dull and less interesting to ourselves.

side effects.

Fair enough, I've been lucky. The only side-effect I've noticed over long-term use is a slight dullness. Some people suffer all kinds of weirdness.

Re: The Mystery of When to Stop Antidepressants

#29

Post by exabrial » Tue, Mar 08, 2016, 7:27 AM UTC

biturd wrote: post #23

stevedonovan wrote: post #16

Earlier quoted context omitted.

Myself likewise. I don't wish to revisit the pit and wallow through the cognitive fog. An interesting aside: why do users of antidepressants feel the need to reduce their dose? It's a benign addiction, like moderate caffeine dependency. One reason is that there _is_ a trade-off; these drugs make us a little dull and less interesting to ourselves.

side effects.

May try reducing the dose without going off? Sure things will be a little bit wilder, but there's non-drug therapy (exercise, CBT, etc)

Re: The Mystery of When to Stop Antidepressants

#30

Post by DigitalJack » Tue, Mar 08, 2016, 7:56 AM UTC

biturd wrote: post #18

pc2g4d wrote: post #2

There's a disconnect between what the meta-analysed randomized clinical trials are saying about antidepressants (that they are at best minimally effective relative to placebo) and what relapse rates suggest (that people relapse when withdrawn from antidepressants because the antidepressant was effectively treating the underlying depression). This conflict is resolved when antidepressants are acknowledged as addictive…

I suspect you need not go that slow. I am NOT a Dr., but have talked at length with mine about this. I won't go into specifics or detail as people need to talk to their Dr.s about these methods. All meds have a half life, your taper rate will be based on that and your personal metabolism rate, which can and almost always is altered by the meds themselves. Further confused that a huge percentage of people who suffer d…

effexor, aka venlafaxine, gave me some amazingly horrible vertigo if I missed more than 1 dose in a row. I was off antidepressants for about 2 years, and then I was hit with severe depression. I'm on the generic for paxil now, and it has made a huge difference. The impact was a night and day contrast.