Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Extreme side-effects of antidepressants

bbc.co.uk

Post reply on HN
Print view View original

21–30 of 99 posts

Re: Extreme side-effects of antidepressants

#21

Post by pmoriarty »

qrybam wrote: post #6

Some thoughts from someone who's been prescribed anti depressants in adolescence but never took them because I believed the doctor misdiagnosed: * Do these drugs genuinely help or is it just a strong placebo response? * If the anecdotal evidence increases the odds from 1 in 100 to 1 in 4, would this be considered normal in medicine? Of course the symptoms could be attributed to the wrong thing here but they sound pre…

People react quite differently to these mind-altering drugs -- and there are a lot of them, with different effects on different people.

They "worked" for someone I know when they were in a very dark place, but the price was a permanent dulling of their emotions, even after they stopped taking them.

Someone else I know underwent extreme personality changes on a different antidepressant, becoming more aggressive and basically an asshole, and I had to beg them to stop taking it.

Your mileage may vary. They are very serious things.

Re: Extreme side-effects of antidepressants

#22

Post by rtpg »

qrybam wrote: post #6

Some thoughts from someone who's been prescribed anti depressants in adolescence but never took them because I believed the doctor misdiagnosed: * Do these drugs genuinely help or is it just a strong placebo response? * If the anecdotal evidence increases the odds from 1 in 100 to 1 in 4, would this be considered normal in medicine? Of course the symptoms could be attributed to the wrong thing here but they sound pre…

I can't comment on anti-depressants, but for a similar case (ADHD meds), where societies attitudes regarding meds are similar.

ADHD has by far the most successful medical treatment of any mental illness. Something like 90% of cases get positive response out of medication, with 35-40% of people having all their symptoms handled.

My understanding is that for treatment of clinical depression, medication helps around 75% of cases, but that most people continue to have symptoms even when under medication due to the nature of the illness.

In both cases, though, treatment is understood to be a continuous process. You cannot be cured of these illnesses, you can only cope with the side effects.

The treatments are like a prosthetic leg: No matter how much you use it, removing it will bring you back to square one.

There's a lot of research showing the positive effects of medication (and in ADHD's case, the futility of non-medication-based treatments), but there's still a major fight for acknowledging the validity of this form of treatment. Major parts of the population do not think these illnesses are even real!

But it's all pretty dangerous. We have some understanding of how brains work around these illnesses thanks to the research gone into it, but there's a lot of complex interactions going on. Not that physical medicine is much different.

Re: Extreme side-effects of antidepressants

#23

Post by marincounty »

threeseed wrote: post #18
qrybam wrote: post #6

Some thoughts from someone who's been prescribed anti depressants in adolescence but never took them because I believed the doctor misdiagnosed: * Do these drugs genuinely help or is it just a strong placebo response? * If the anecdotal evidence increases the odds from 1 in 100 to 1 in 4, would this be considered normal in medicine? Of course the symptoms could be attributed to the wrong thing here but they sound pre…

Antidepressants in general work. However they have a range of side effects and efficacy profiles depending on the person. Then have saved far more lives they they have killed. So no I don't think we will be negatively looking back at this era.

I have taken seven different anti-depressants. I started with Prozac. I really believed they would help. All I got was side effects.

"That's just antidotal evidence!" Yes--it is, but wouldn't you think, just one time, I would have gotten a bit of a Placebo Effect? I really thought every new drug would help. Their was no doubt on my mind they wouldn't work.

It wasen't until years later I looked into the studies. I looked into the 62% improvement over Placebo claims. I noticed the small studies. I noticed the way they determined improvement, like determining success by slight improvement(three questions answered differently) in standard, dubious psychological tests.

I came away hoping all western medicine isn't evaluated like this--a lot of drugs are studied terribly.

Anyways, a Psychologist did some interesting research on the efficacy of the wonder drugs a few years ago. I have a weird feeling his conclusions were the truth. I wish they weren't.

https://www.psychologytoday.com/blog/looking-in-the-cultural...

Re: Extreme side-effects of antidepressants

#24

Post by tcj_phx »

threeseed wrote: post #19
tcj_phx wrote: post #5

SSRI drugs (sold as 'anti-depressants') have always been known to cause suicide ideation... While they do seem to help some people, it is now known that this is because of the drugs' effects on the neurosteroids [1], NOT because of 'increased serotonin'. Anti-serotonin drugs (LSD, various MAOIs, etc) are much more effective anti-depressants. [1] https://en.wikipedia.org/wiki/Neuroactive_steroid#Role_in_an... There ar…

Making blanket generalisations when it comes to mental health is extremely reckless and misinformed. There are lots of SSRIs and their interactions will manifest differently in each person. Doctors aren't in the business to kill people. SSRI do save lives. We just know they kill a tonne of people as well.

> Making blanket generalisations when it comes to mental health is extremely reckless and misinformed.

The SSRIs are modern snake oil. I gave a reason why they seem to work for some people. Other people think that they're helped, but really their SSRI has only helped them "not care" about circumstances in their life that they're not happy about. I've posted this link in earlier comments.

> Doctors aren't in the business to kill people.

Pharmaceutical companies are in business to pay dividends to their shareholders. Their researchers are employed to make new patent drugs, not to figure out fundamental causes of disease. For these businesses, killing people is par-for-the-course: not the ideal outcome, not unexpected. Doctors' credibility is just collateral damage.

> SSRI do save lives. We just know they kill a tonne of people as well.

Robert Whitaker disagrees with you - he's found that, over the long term, most psychiatric medications are very harmful. Look at his website [1], read his books, and get back to me with specific reasons why he's wrong.

[1] https://www.madinamerica.com/

Re: Extreme side-effects of antidepressants

#25

Post by impossiblegame »

tcj_phx wrote: post #5

SSRI drugs (sold as 'anti-depressants') have always been known to cause suicide ideation... While they do seem to help some people, it is now known that this is because of the drugs' effects on the neurosteroids [1], NOT because of 'increased serotonin'. Anti-serotonin drugs (LSD, various MAOIs, etc) are much more effective anti-depressants. [1] https://en.wikipedia.org/wiki/Neuroactive_steroid#Role_in_an... There ar…

If you think that SSRIs don't affect serotonin, you should halt your amateur medical career now. I send my best wishes for you and your girlfriend and I hope she feels better soon, on her terms and not via a formula. However, SSRIs are highly specific to serotonin receptor bindings. LSD is specific to a relatively sparse type of serotonin receptor, and MAOIs will bind with anything in your brain which is why they are so dangerous and require a strict diet to minimize tyrosine.

Honestly, her coke habit is the lede here, not the scare story that might turn other people off to treatments that work for them.

Re: Extreme side-effects of antidepressants

#26

Post by westvaflamer »

threeseed wrote: post #19
tcj_phx wrote: post #5

SSRI drugs (sold as 'anti-depressants') have always been known to cause suicide ideation... While they do seem to help some people, it is now known that this is because of the drugs' effects on the neurosteroids [1], NOT because of 'increased serotonin'. Anti-serotonin drugs (LSD, various MAOIs, etc) are much more effective anti-depressants. [1] https://en.wikipedia.org/wiki/Neuroactive_steroid#Role_in_an... There ar…

Making blanket generalisations when it comes to mental health is extremely reckless and misinformed. There are lots of SSRIs and their interactions will manifest differently in each person. Doctors aren't in the business to kill people. SSRI do save lives. We just know they kill a tonne of people as well.

>blanket generalizations

Re: Extreme side-effects of antidepressants

#27

Post by tcj_phx »

hiram112 wrote: post #17
tcj_phx wrote: post #5

SSRI drugs (sold as 'anti-depressants') have always been known to cause suicide ideation... While they do seem to help some people, it is now known that this is because of the drugs' effects on the neurosteroids [1], NOT because of 'increased serotonin'. Anti-serotonin drugs (LSD, various MAOIs, etc) are much more effective anti-depressants. [1] https://en.wikipedia.org/wiki/Neuroactive_steroid#Role_in_an... There ar…

There's no doubt that antidepressants are more of an art than a science, and that they are not the silver bullet the pharmaceutical companies claim. But trying to say they're all bad because they didn't work on your girlfriend, whom appears to have had some serious issues long before using an SSRIs, is disingenuous. There are millions of people who are helped with SSRIs, and even some who'd long ago have been dead we…

> But trying to say they're all bad because they didn't work on your girlfriend, whom appears to have had some serious issues long before using an SSRIs, is disingenuous.

I started the comment with generalities, offered supporting references and links, then mentioned my girlfriend as a case-study. I have other case studies too.

> There are millions of people who are helped with SSRIs, and even some who'd long ago have been dead were it not for the use of MAOIs and others that work when absolutely nothing else will.

MAOIs are generally safe enough to use temporarily, to get someone out of an intense depressive funk. SSRIs are modern snake oil: they are addictive palliative drugs that do not address fundamental problems. Sometimes they seem to help, but not for the reasons given.

Getting excess serotonin under control is much more beneficial than increasing serotonin levels.

Re: Extreme side-effects of antidepressants

#28

Post by spangry »

I've been prescribed multiple SSRIs over the last decade. 5, by my count. I've also researched them pretty extensively for about the same time. They are a crap-shoot at best.

The best that a knowledgeable and well intentioned doctor can do is prescribe them in a trial and error fashion, maybe with a tiny bit of guidance from prominence of patient symptoms. But it's largely just prescribe, wait 6 weeks, rinse and repeat. I happen to be one of the 'treatment resistant' types, in that SSRIs don't do jack-squat for me (well, except for when there's a drug-drug interaction, and that's definitely not the 'good kind' of effect).

The medical literature suggests SSRIs are only just barely more effective at treating depression than placebo. There's also an interesting (and in my view, plausible) explanation behind why SSRIs might cause an initial increased suicide risk. A common symptom of depression is 'psychomotor retardation': "a slowing-down of thought and a reduction of physical movements in an individual" (https://en.wikipedia.org/wiki/Psychomotor_retardation). If SSRIs have any positive effect, they occur gradually.

So the hypothesis goes: a patient might be suffering from suicidal depression, but the psychomotor symptoms prevent suicide. When they are prescribed SSRIs, and those SSRIs start having a positive effect, they lift the psychomotor retardation just enough that the patient is finally able to kill themself. It probably sounds a bit strange, but I can attest to how debilitating 'psychomotor retardation' can be.

Re: Extreme side-effects of antidepressants

#29

Post by tcj_phx »

impossiblegame wrote: post #25
tcj_phx wrote: post #5

SSRI drugs (sold as 'anti-depressants') have always been known to cause suicide ideation... While they do seem to help some people, it is now known that this is because of the drugs' effects on the neurosteroids [1], NOT because of 'increased serotonin'. Anti-serotonin drugs (LSD, various MAOIs, etc) are much more effective anti-depressants. [1] https://en.wikipedia.org/wiki/Neuroactive_steroid#Role_in_an... There ar…

If you think that SSRIs don't affect serotonin, you should halt your amateur medical career now. I send my best wishes for you and your girlfriend and I hope she feels better soon, on her terms and not via a formula. However, SSRIs are highly specific to serotonin receptor bindings. LSD is specific to a relatively sparse type of serotonin receptor, and MAOIs will bind with anything in your brain which is why they are…

> If you think that SSRIs don't affect serotonin

I didn't say that, I said that "increasing serotonin" is not why these drugs sometimes help people feel better.

> Honestly, her coke habit is the lede here,

Yes. In the long term, cocaine use wrecks the mitochondia, which contributes to exhaustion. The proper therapy in this case is to restore the mitochondria density. Etiology (" a branch of medical science concerned with the causes and origins of diseases") is thrown out the window when a patient is prescribed an SSRI.

> not the scare story that might turn other people off to treatments that work for them.

The BBC story that this submission links is about how SSRI treatments sometimes wreck people's lives. You should read it. My comment was that adverse effects of these defective drugs (SSRIs) have been known from the very beginning, and I said a few words about alternatives that work better.

Re: Extreme side-effects of antidepressants

#30

Post by cel1ne »

tcj_phx wrote: post #29
impossiblegame wrote: post #25

Earlier quoted context omitted.

If you think that SSRIs don't affect serotonin, you should halt your amateur medical career now. I send my best wishes for you and your girlfriend and I hope she feels better soon, on her terms and not via a formula. However, SSRIs are highly specific to serotonin receptor bindings. LSD is specific to a relatively sparse type of serotonin receptor, and MAOIs will bind with anything in your brain which is why they are…

> If you think that SSRIs don't affect serotonin I didn't say that, I said that "increasing serotonin" is not why these drugs sometimes help people feel better. > Honestly, her coke habit is the lede here, Yes. In the long term, cocaine use wrecks the mitochondia, which contributes to exhaustion. The proper therapy in this case is to restore the mitochondria density. Etiology (" a branch of medical science concerned…

> I didn't say that, I said that "increasing serotonin" is not why these drugs sometimes help people feel better.

Yes it is. Only some people don't have too little serotonine.

Post reply on HN