Earlier quoted context omitted.
The SSRIs have always been controversial. Some studies claim they're rarely more effective than placebos, but more often than not they're effective enough with a pretty safe profile, this article not withstanding. The safe profile is one of the reasons they're probably over prescribed, along with the high profitability. Many doctors give them out like candy, even though many people probably don't suffer from the phys…
In the UK they don't give them out like candy. Are you talking about US doctors?
Extreme side-effects of antidepressants
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Re: Extreme side-effects of antidepressants
#32Dr. Peter C Gøtzsche: Psychiatry gone astray. https://www.youtube.com/watch?v=DiJcSoo3C4Q
Along these lines (overprescription, overdiagnosis, disease mongering) "Saving Normal" by Frances Allen may be a good read as well.
Re: Extreme side-effects of antidepressants
#33Some 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%…
Is this really relevant considering the extremely rapid rise in prescription and use of ADHD medication?
In my anecdotal experience with friends who take these pills, they very quickly create a reliance on the substance and have significant side effects in the long term. I honestly believe they can be quite harmful to a person's mind.
Now, for ADHD there unfortunately aren't good non-medication treatments. But depression is a completely different matter - making lifestyle changes as simple as going for a hike every weekend can easily be as effective or more effective than any medication.
Re: Extreme side-effects of antidepressants
#341. Serotonin is a very basic, very old transmitter found in all bilateral animals. Humans have two sites of serotonin-production, one in the body, one in the brain. 90% of serotonin resides in the body.
2. Serotonin in general regulates "activity". It affects hunger, gut-movement, sleep, cell-growth, mood, body-temperature, blood-pressure and many other things. Any drugs changing serotonin-levels also affect these areas, that is why there are so many adverse effects.
3. SSRIs help exactly one group of people: those who have too low levels of serotonin. When their serotonin is boosted, circuits in the brain like the connection between thoughts and emotions start to work properly, hence they get more in touch with themselves.
4. People who have too little serotonin can show the exact same symptoms like people whose serotonin levels way too high (!!). Prescribing SSRIs to those people will worsen their state and may even lead to life-threatening conditions.
5. The level of serotonin can be tested properly by exactly one method: laboratory blood/urine sampling, which costs a couple hundred dollars, but is available. These doctors generally also know about amino-acid therapy, which consists of nutritional supplements which help the body in manufacture the missing transmitter. This can lower the need for medication, but needs proper testing first.
6. People can have proper serotonin levels and still be sad/angry/depressed. The question still is which brain-circuit is malfunctioning. If the problem is the connection between emotions and thought, serotonin helps. If the malfunctioning circuitry concerns attention regulation [0], like with people who have a genetic disposition towards ADHD, then dopamine helps.
7. People can have all their neurotransmitters adjusted to proper levels and still not be perfectly well. We are talking about signalling inside mutable structures here. Changes in signalling affect the structure, changing the structure affects the signalling.
Fixing neurotransmitters makes someone able to use all of his brain. He still has to use it properly though, to get better.
Re: Extreme side-effects of antidepressants
#35I'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 repe…
She says as soon as she started taking them, she instantly felt better. No more randomly bursting into tears.
But, she is no longer the wife I had. Her conversation is so slow. She regularly forgets what she was talking about, repeats herself. Basic chores are just forgotten about. She drinks more than ever, has started smoking. Her diet is awful. If she can be bothered to eat it is probably a chocolate bar at lunch time. She has gained about 4 stones in weight.
She never took up the counselling that she felt she needed before starting on the SSRIs.
She tried cutting down on her medication a little while ago, but this made her incredibly paranoid. So instead she has had to increase it.
All I see from it is an ever decreasing spiral into ruin.
Re: Extreme side-effects of antidepressants
#36""" if you suffer a psychotic breakdown, your odds of complete, treatment-free recovery are much, much better if you are treated in a third-world country that cannot afford psychotropic medication """
https://aeon.co/essays/treating-acute-psychosis-with-drugs-c...
Re: Extreme side-effects of antidepressants
#37I'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 repe…
My wife went through a rough patch a little while ago and decided she was depressed. She had no problem getting SSRIs prescribed by the doctor. She says as soon as she started taking them, she instantly felt better. No more randomly bursting into tears. But, she is no longer the wife I had. Her conversation is so slow. She regularly forgets what she was talking about, repeats herself. Basic chores are just forgotten…
One of the (unfortunately common) ways people learn that they have bipolar is by being mis-diagnosed with unipolar depression, being prescribed SSRIs, and suddenly finding themselves experiencing 'dysphoric mania'. Not the "everything's great, let's have sex with random strangers" type, but rather the "let's destroy every piece of furniture in the house" type.
But I don't know your situation other than what you've described, and I'm definitely not qualified to tell you what to do. The best I think you can do is to get a second opinion from a competent psychiatrist.
Re: Extreme side-effects of antidepressants
#38Of course antidepressants can cause side-effects as do all other types of drug treatments. It's inevitable, medication effects are extremely complex and unpredictable as interaction with body systems covers a huge gamut of possibilities. Furthermore, most effects of drugs haven't studied even when they are known and a great deal more is not known than is known.
Also bear in mind that drugs in the form prescribed may not be the the chemical that produces the biggest therapeutic effect. This is the phenomenon of active metabolites which are often the drivers of favorable and unfavorable effects.
So we see how quickly these factors yield immense complexity and the reason behind the fact that drugs often have a huge array of side-effects common and rare.
BTW a side-effect occurring in 1% of recipients is considered a common adverse event. 0.1% is infrequent. Maybe 0.01% is getting rare, but definitely not implausibly drug-related.
The bottom line is that taking several drugs even one at a time for more than a few days means there's a surprisingly high probability of have an uncommon or rare side effect. It's happened to me a handful of times, including a couple of pretty serious reactions.
Interesting when I tell my physicians about these reactions. There's a certain look they get on their faces, like "what are you talking about? You're kidding me, that really didn't happen, did it?" Well, yes doctor, it really did, as though I wouldn't know a bad reaction when it's there or I just made the whole thing up.
This is perfectly consistent with what patients reported to me over the years. A long time ago I'd come to believe that people weren't making stuff up, unusual side-effects are ultimately an everyday reality among patients and all reports of AEs must be taken seriously, exactly my policy I put into practice.
Remember this little rule, it will save everyone a lot of trouble: any drug can cause any side-effect at any time.
Re: Extreme side-effects of antidepressants
#39Earlier quoted context omitted.
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%…
>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. Is this really relevant considering the extremely rapid rise in prescription and use of ADHD medication? In my anecdotal experience with friends who take these pills, they very quickly crea…
Re: Extreme side-effects of antidepressants
#40Earlier quoted context omitted.
> 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.