Many People Taking Antidepressants Discover They Cannot Quit • Hacker News Board

Re: Many People Taking Antidepressants Discover They Cannot Quit

#81

Post by etiam » Sat, Apr 07, 2018, 9:49 PM UTC

yodsanklai wrote: post #48

intralizee wrote: post #15

I've seen enough people in my life become addicted to antidepressants because of a traumatizing event in their life for me to have a dark outlook on it. Instead of therapy or taking real course of action to resolve the trauma/inner problem, a doctor will just label a person suffering depression. The greatest use of an umbrella-word "Depression" to get people on prescription medication and typically the problem never…

Antidepressants have drawbacks, but what matters is that the benefits outweigh the cost. That is something that doctors discuss with their patients when considering such a treatment.

whether the benefits outweigh the cost, and that is something doctors should discuss objectively with their patients when considering such a treatment.

These substances are yet another instance in the history of psychopharmacology where the touted benefits have been exaggerated and the harmful side effects denied. They have their place, but in the bodies of a sizable fraction of the current patients is not it.

Re: Many People Taking Antidepressants Discover They Cannot Quit

#82

Post by Fnoord » Sat, Apr 07, 2018, 9:51 PM UTC

fogzen wrote: post #69

Fnoord wrote: post #58

Earlier quoted context omitted.

> Writing and then reading 14 Gratitude Letters to people. > Spending an afternoon a week outside. > Practicing telling the 100% truth in your relationships. > And of course, Psychedelics. Heh, a decent psychologist would suggest #3 during e.g. CBT sessions. Suggesting #4 is downright dangerous, you don't know who reads your post. Readers, please seek professional help -based on conventional science- instead. I tried…

How is suggesting psychedelics more dangerous than suggesting the use of antidepressants? Data shows both can cause panic attacks and psychotic episodes... Both drugs have mechanisms of action we don’t fully yet understand, and both may cause serious side effects.

> Both drugs have mechanisms of action we don’t fully yet [sic] understand, and both may cause serious side effects.

This is an extremely narrow and arbitrary ruleset you are applying...

If not merely because of the word "fully". That's a given in science.

> How is suggesting psychedelics more dangerous than suggesting the use of antidepressants?

Because psychedelics are not approved, you don't know the source/purity, and there's a lack of professional guidance.

Yes, you can get a panic attack on SSRIs. I had that when I started Fluoxetine because I almost fainted because my blood pressure was low whilst I was in a grocery store and had barely eaten. It happened a few times, though less severe (it is just low blood pressure), and went away after I got used to the drugs, which took longer than average.

SSRIs are not psychoactive, and better studied.

Finally, SSRIs are used under guidance by a professional. Recreational drugs, in contrast, are not.

Re: Many People Taking Antidepressants Discover They Cannot Quit

#83

Post by stordoff » Sat, Apr 07, 2018, 9:52 PM UTC

aviv wrote: post #16

azernik wrote: post #11

Earlier quoted context omitted.

This is psychiatry . We don't know how to cure the underlying diseases, because we don't entirely understand them. When the field can actually cure them, like for PTSD and certain anxiety disorders, it's very happy to.

It doesn't cure any of these disorders. All they can do is reduce the symptoms just enough between each pill you pop.

How is that a bad thing? Sure, a cure would be _significantly_ better, but reducing symptoms can result in a vastly better quality of life.

Re: Many People Taking Antidepressants Discover They Cannot Quit

#84

Post by SAI_Peregrinus » Sat, Apr 07, 2018, 9:52 PM UTC

aaronharder wrote: post #30

kzrdude wrote: post #21

Earlier quoted context omitted.

That's just human nature. We can say the same about programmers. They just want to fix the apparent problems, not write a better program. Yes, if you read Hacker News you probably object. Not everyone does that. But making the problem just go away is the prevailing, widely spread, most commonly used mode of working.

I would assume the best intentions for the vast majority of individuals working in the health system. But the economy of that system is one that favors treatment over cure/prevention. I'd like to believe that is a mistake of circumstance and not a design of human greed.

Not entirely. Whichever company comes up with a cure first will gain nearly 100% of the market, and can charge a TON to insurance companies for it. It cuts off long term profits, but investors reward quarterly growth primarily.

Re: Many People Taking Antidepressants Discover They Cannot Quit

#85

Post by DanBC » Sat, Apr 07, 2018, 9:53 PM UTC

wbkang wrote: post #64

Is there a reason why people are trying to stop taking it? If it helps your life, why not keep using it? For example, I have been taking antihistamine daily for the last 18 years for skin allergy. My QoL is significantly better with it, and unless there is some magical cure, I don't see why I should stop just because it's a "drug", "chemical" or "unnatural". For example, from the article, > "A year and a half after s…

Because depression isn't a lifelong thing, it should be at worst episodic.

Because SSRIs have side effects, and you tolerate those if it's preventing depression, but you might not tolerate them if you're now taking a medication for life.

Re: Many People Taking Antidepressants Discover They Cannot Quit

#86

Post by opportune » Sat, Apr 07, 2018, 9:55 PM UTC

fogzen wrote: post #69

Fnoord wrote: post #58

Earlier quoted context omitted.

> Writing and then reading 14 Gratitude Letters to people. > Spending an afternoon a week outside. > Practicing telling the 100% truth in your relationships. > And of course, Psychedelics. Heh, a decent psychologist would suggest #3 during e.g. CBT sessions. Suggesting #4 is downright dangerous, you don't know who reads your post. Readers, please seek professional help -based on conventional science- instead. I tried…

How is suggesting psychedelics more dangerous than suggesting the use of antidepressants? Data shows both can cause panic attacks and psychotic episodes... Both drugs have mechanisms of action we don’t fully yet understand, and both may cause serious side effects.

Panic attacks from psychedelics (bad trips) are much different from regular panic attacks

Re: Many People Taking Antidepressants Discover They Cannot Quit

#87

Post by jdietrich » Sat, Apr 07, 2018, 9:58 PM UTC

ada1981 wrote: post #59

make3 wrote: post #50

Earlier quoted context omitted.

Meta studies still show that antidepressants help more than the placebo https://www.bmj.com/content/360/bmj.k847

Hmm... I question a meta study that says it has finally solved the issue and put it to rest, when there are plenty of other studies saying the exact opposite. Here's one: https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12... "SSRIs might have statistically significant effects on depressive symptoms, but all trials were at high risk of bias and the clinical significance seems questionable. SSRIs significantl…

All the major meta-analyses come to roughly the same conclusion, which is that anti-depressants have modest positive effects. The paper you linked to finds exactly this, but argues that the effect size they found is insignificant because of the high risk of bias. Other studies have gone to extraordinary lengths to control for potential biases and come up with a very similar effect size. Reasoning about the data is quite challenging, because we're talking about relatively small shifts in a relatively broad statistical distribution.

"Number needed to treat" is a useful epidemiological concept in this case. A perfect drug that cures every single patient has an NNT of one - for each patient you treat, one patient is successfully treated. When you translate the results of SSRI meta-analyses, you get an NNT of about seven - for every seven patients who take SSRIs, one more patient will recover than if those patients were given a placebo.

It's hard to know what to do with that information. Is it worth prescribing antidepressants to 1,000,000 people to treat 142,000 of them? On a pure cost-benefit analysis, the answer is a resounding yes. Antidepressants are relatively cheap and safe. Are you willing to take a pill every day to get a one-in-seven chance of an effective treatment? Maybe. If you're in the throes of a deep depression, you might be willing to give anything a try. If you're just feeling a bit blue, maybe not. By the same token, if you're taking antidepressants and you don't think that they're helping, you're probably right.

Re: Many People Taking Antidepressants Discover They Cannot Quit

#88

Post by Fnoord » Sat, Apr 07, 2018, 10:00 PM UTC

rincebrain wrote: post #8

CocaKoala wrote: post #3

My heart and sympathy goes out to anybody who's on antidepressants and is trying to get off. From what I've seen and heard, it is just an incredibly painful and unpleasant experience, compounded by the fact that you need to be constantly negotiating with your insurance to cover the changing prescriptions as your dosage lowers. The withdrawal symptoms can be incredibly oppressive and disruptive. I wish there was more…

It varies wildly by person, even moreso possibly than antidepressant efficacy. I've been...fortunate, if you can call it that, that while I've taken a great many antidepressants and other psychiatric medications, the worst side effects I've ever faced from stopping have been screwed up sleep/wake cycles, irritability, and a few days of headache. I've had friends and family members who have had much worse, and I've ha…

> the worst side effects I've ever faced from stopping have been screwed up sleep/wake cycles, irritability, and a few days of headache

I wonder if that's worse than a newborn.

Re: Many People Taking Antidepressants Discover They Cannot Quit

#89

Post by mirimir » Sat, Apr 07, 2018, 10:01 PM UTC

Fnoord wrote: post #65

mirimir wrote: post #23

That brings back horrible memories. I took an SSRI for several years, initially prescribed by a GP. But the problem was that I wasn't "depressed". I am bipolar, and sometimes got stuck in down mode. The SSRI did make me more functional. But what it mostly did was make me affectless. That is, I could be sad or happy or angry or whatever, and I felt pretty much nothing. However, I still did whatever someone who was sad…

> Also, I lost interest in sex, and it took forever to reach orgasm. This is a common side effect of SSRIs. I have the same, but I very much enjoy that side effect. Saves time, and already got a child anyway. I still love pleasuring my significant other just as much as before, btw. People who have bi-polar usually get mood stabilisers such as lithium prescribed. Perhaps anti-psychotics? SSRIs are known to be problema…

Lithium sucks, or so I've heard.

Modafinil (antinarcoleptic, originally) plus lamotrigine (anticonvulsant, originally) works well for me. It's easy to tweak the ratio as circumstances warrant.

Edit: About sex. My wife at the time did like that I took longer to reach orgasm. However, after we separated, I discovered that wearing a condom made orgasm unreachable. And that did become a problem. Albeit an amusing one, in retrospect.

Re: Many People Taking Antidepressants Discover They Cannot Quit

#90

Post by dimal » Sat, Apr 07, 2018, 10:01 PM UTC

cassowary37 wrote: post #71

Ah, another Benedict Carey antidepressant hatchet job. Anecdotes about withdrawal symptoms + alarmist statistics about number of Americans on antidepressants + vague questions about lack of data suggesting that we know little about antidepressant long-term safety. A few important points: 1. Antidepressants can truly change people's lives. Not everyone's, and they're not the only treatment that works. Somehow this rep…

> If there were substantial long-term risks associated with antidepressants, we would have seen them

Drug makers have no incentive to see them. I can say from experience that I have seen them. I spent two months out of work when I had to discontinue Effexor. Other people complained about “brain zaps” and were largely ignored. My doctor never warned me. The evidence is there but there if you look, but there is no one with an economic incentive to pay attention. Just because there are few studies documenting these symptoms doesn’t mean they’re not. This is a wake up call that more studies need to be done.