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

Re: Many People Taking Antidepressants Discover They Cannot Quit

#101

Post by ada1981 » Sat, Apr 07, 2018, 10:11 PM UTC

nashashmi wrote: post #25

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.

What diseases are there on the field of psychiatry that can be "cured"? It seems to me that all of those diseases are only mitigated enough to help the person recover on their own.

MDMA is in phase 3 clinical trials for PTSD and something like 65-85% of participants don't show any signs of having it 12 months after treatment.

Maps.org

Re: Many People Taking Antidepressants Discover They Cannot Quit

#102

Post by ada1981 » Sat, Apr 07, 2018, 10:12 PM UTC

stordoff wrote: post #83

aviv wrote: post #16

Earlier quoted context omitted.

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.

Yes, the attempt to reduce symptoms is admirable when a cure is not available.

Fortunately Psychedelic medicines are coming online that can allow for actual healing of the underlying patterns. They saved my life for certain.

Re: Many People Taking Antidepressants Discover They Cannot Quit

#103

Post by intralizee » Sat, Apr 07, 2018, 10:12 PM UTC

make3 wrote: post #54

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…

There is no doubt that antidepressant therapy needs to be combined with psychotherapy, sports, meditation and just reducing the unhealthy parts of your life. The cost of taking antidepressants is really low however. Most of the time, they have almost no side effects, and are proven to help https://www.bmj.com/content/360/bmj.k847 Where I live, they are pretty cheap. I find that there is undue bias against antidepress…

How exactly is the cost really low?

The study you linked doesn't scientifically prove antidepressants help.

Exactly, what undue bias against antidepressants have you found?

Re: Many People Taking Antidepressants Discover They Cannot Quit

#104

Post by DanBC » Sat, Apr 07, 2018, 10:17 PM UTC

vanderZwan wrote: post #7

thatsamonad wrote: post #5

Earlier quoted context omitted.

I take Wellbutrin and Lamictal (a mood stabilizer) every single day for PTSD and I wouldn’t really be able to function without them. I really wouldn’t call myself or the psychiatrist who prescribed them irresponsible. I’d say it’s equally irresponsible to make a blanket statement about something that does actually help people in certain circumstances. That being said, there are a number of GPs out there who prescribe…

I think the "irresponsibility" was aimed at the medical field, not at the patients. At least that was how I decided to read it. EDIT: Also, I think that even for the patients where the cause of the depression is not "chemical" in origin, that does not reduce the severity of the illness in the slightest. It just means that the causes may lie elsewhere (for example externally). I have been depressed as an indirect resu…

SSRIs help even if the causes are psycho-social. Obviosuly the person also needs the other stuff too in those cases - fixing the situation; some talking therapy - but meds aren't useless.

No-one credible talks about a chemical imbalance anymore.

Re: Many People Taking Antidepressants Discover They Cannot Quit

#105

Post by fogzen » Sat, Apr 07, 2018, 10:17 PM UTC

Fnoord wrote: post #82

fogzen wrote: post #69

Earlier quoted context omitted.

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…

> SSRIs are not psychoactive, and better studied.

The whole point of taking SSRI's is to affect the mind, so they are literally psychoactive.

They are better studied, but the risks you mentioned are associated with SSRI's as well as LSD.

Do you have evidence/study that shows LSD is more dangerous than SSRIs? LSD not being studied as much doesn't mean it's more dangerous...

Re: Many People Taking Antidepressants Discover They Cannot Quit

#106

Post by dredmorbius » Sat, Apr 07, 2018, 10:19 PM UTC

cassowary37 wrote: post #79

aviv wrote: post #6

This shouldn't come as a surprise to anyone. Modern medicine is not in the business of curing diseases. It's all about disease and symptom management.

yep, all those cancer cures somehow slipped out despite our best efforts to keep them secret. c'mon, let's be real. The folks who try to develop new treatments are people with family members and friends who get sick too. The reason we struggle for cures is that it's hard!!!

Cancer cures are decidedly spotty. First, "cancer" isn't one single disease, it's a symptom complex with numerous etiologies. Some of those are now well-managed -- tunerculin baccilli for yreatment of bladder cancer, say.

Others have seen no progress in 50+ years and continue to have exceptionally poor prognosis.

The biggest advances in medical outcomes are virtually all based on public health, preventive measures, and improved access to fundamental care.

Re: Many People Taking Antidepressants Discover They Cannot Quit

#107

Post by gabept » Sat, Apr 07, 2018, 10:19 PM UTC

make3 wrote: post #50

gabept wrote: post #35

The "Chemical Imbalence Theory", although heavely popular and promoted, is largely unfounded on science: https://joannamoncrieff.com/2014/05/01/the-chemical-imbalanc...

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

Even if that was true, it doesn't invalidate the fact there is no scientific reasoning behind the theory of chemical imbalance.

Re: Many People Taking Antidepressants Discover They Cannot Quit

#108

Post by cassowary37 » Sat, Apr 07, 2018, 10:19 PM UTC

electricEmu wrote: post #94

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…

1) So do placibos 2) They're common while tapering too. 3) Agreed 4) Possibly true. What's unpolite about mentioning this? 5) Wrong analogy; depression only increases would be analogous to increased cholesterol. What are statin drug side effects when quitting, from the drug. 6) The mechanism of action isn't even fully understand. You're absolutely wrong to claim "we would have seen them (long-term side effects)". Isn…

well said... in order, then...

1. Read the reference before responding; the study looked (in part) at antidepressant-placebo differences. Also - I can't prescribe placebo.

2. Got anything to back that up?

3. OK

4. Because it implies that some of the 'withdrawal' symptoms are actually recurrent depressive/anxious symptoms (which can include somatic symptoms). Which is different than arguing that all of these symptoms are a consequence of relapse/recurrence.

5. Well, one of the critiques of antidepressants is that, after someone is on them for years, depression can recur... but fair point, not a perfect analogy.

6. Fully understood? It's not even a little understood. What does that have to do with detecting long-term consequences? We have 25 year follow-up data with antidepressants now. Despite lots of effort to find otherwise, show me some solid literature supporting risk.

7. Yup. We should. And we should keep looking.

We also agree that there's substantial harm associated with people confidently posting misinformation - so while I mostly lurk here on HN, I feel that 20+ years of treating mood disorders and 20+ years of pharmacovigilance research gives me the right to push back. Lived experience is critically important, but it does not trump data.

Re: Many People Taking Antidepressants Discover They Cannot Quit

#109

Post by dimal » Sat, Apr 07, 2018, 10:24 PM UTC

DanBC wrote: post #98

dimal wrote: post #90

Earlier quoted context omitted.

> 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…

Discontinuation effects are listed on the patient information leaflet for venlafaxine. Patients, at least in the UK, are always given this leaflet with every packet of medication. https://www.medicines.org.uk/emc/product/4487/pil > If you stop taking venlafaxine suddenly you may get withdrawal reactions (see section 3) [...] > Do not stop taking your treatment or reduce the dose without the advice of your doctor even…

And of course, all patients read the long pamphlets extensively /s. We depend on our doctors to explain risks like this. And at the time I was discontinuing (not abruptly) the concept of “brain zaps” was met with great skepticism. I am fairly certain that some of the side effects you list (electric shock sensations) were added more recently. It took years of patients being ignored for the idea to be taken seriously.

Re: Many People Taking Antidepressants Discover They Cannot Quit

#110

Post by ada1981 » Sat, Apr 07, 2018, 10:28 PM UTC

Fnoord wrote: post #58

ada1981 wrote: post #51

Keep in mind that SSRIs appear to do little more than active placebo in the vast majority of cases with the downsides of withdrawals and all the other symptoms including deceased emotions in general. There are many alternatives that have been shown to be as or more effective. Writing and then reading 14 Gratitude Letters to people. Spending an afternoon a week outside. Practicing telling the 100% truth in your relati…

> 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…

Interesting. I'm quite passionate about this topic as I recovered from suicidal depression, bipolar and schizophrenia without pharma.

Gratitude practices have been tested and shown to be significant in reducing depression, many studies on this.

https://pdfs.semanticscholar.org/a7bb/972b39435b0c5481aef88b...

Time in nature is also shown to fight depression, as found by some Stanford Researchers:

https://www.theatlantic.com/health/archive/2015/06/how-walki...

I wouldn't recommend trying psychedelics on your own, rather used in a specific therapeutic setting with a trained sitter / guide.

There are all sorts of studies on the effectiveness of psychedleic mushrooms on depression or MDMA for PTSD, etc.

Maps.org has ample info.

For me, I'm lucky that I didn't trust the mainstream Doctors who wanted to put me on antipsychotics or whatever else.

And I was blessed to find my way through medical research to find a path that worked. In no small part due to helping Peter Theil launch a startup in the private medical research space -- that experience showed my how very inefficient our medical system is at getting up to date information and practices to folks.