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Many People Taking Antidepressants Discover They Cannot Quit

nytimes.com

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Re: Many People Taking Antidepressants Discover They Cannot Quit

#221

Post by projektir »

contingencies wrote: post #209
projektir wrote: post #185

Earlier quoted context omitted.

I'm not a huge fan of anti-depressants, but this is just silly. Smiling lots is mostly a cultural difference and Americans seem to be the odd ones out there, not the other way around.

Well, it's a true story. Silly is assuming I'm American. I'm an Aussie/Kiwi/German resident in China, and at the time of the story I had just crossed over from Germany, who aren't exactly known for unbridled displays of west coast US optimism either.

Someone's personal perception of things is not a "true story". Generally, it's not anyone's place to try to assess how happy a person is from what they look like on the outside. Suicidal people may look perfectly happy on the outside, and perfectly happy people can sport very impressive RBFs.

You referenced an American in your story, and they're the only group I've ever really heard complaining about people in other countries not smiling enough, so my assumption is hardly silly. I don't know if Australia shares the same quirk, given that Australia borrows a LOT from the US culturally, are you sure you didn't pick that stuff up from the US?

And I'm not sure why the Germans didn't bother you but the Danes did, that doesn't really add up.

Re: Many People Taking Antidepressants Discover They Cannot Quit

#222

Post by jdietrich »

darkerside wrote: post #215
jdietrich wrote: post #87

Earlier quoted context omitted.

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 qu…

As a layman, I find it surprising that SSRIs were clinically approved for treatment based on a 1 in 7 chance of demonstrating positive effects. Are other medications anywhere near as ineffective? Whether antibiotics, Tylenol, or Viagra, I can't imagine any of those being effective in less than, say, 5 out of 7 cases.

>Are other medications anywhere near as ineffective?

Yes. Reviews suggest that statins have an NNT of between 50 and 200 depending on the patient's underlying risk for cardiovascular disease. Coronary stents are probably useless. Reviews of antibiotics, antivirals and corticosteroids show a wide range of NNTs and often show no positive effect.

The drug approval system has a relatively high bar for safety, but a relatively low bar for efficacy. A drug manufacturer only has to prove that their drug is effective for one particular cohort of patients with a particular disease, but doctors are then free to prescribe the drug to any patient with any disease. Many surgical interventions are never subject to a randomised controlled trial.

http://www.thennt.com/home-nnt/

Re: Many People Taking Antidepressants Discover They Cannot Quit

#223

Post by pasabagi »

verylittlemeat wrote: post #217
pasabagi wrote: post #115

Earlier quoted context omitted.

I've also rarely received accurate advice regarding the likely effects and side-effects of anti-depressants - but I think calling brain zaps a 'risk' is a bit much. Maybe my zaps were nicer than yours, but I don't remember them being particularly painful - except one time I fell in the shower. Anti-depressants, especially something like venlafaxine, are strong meds for a strong condition. It would be surprising if th…

I had brain zaps and they were very distracting. I took 2 SSRIs for about 3 years and went off them close to cold turkey. When I would move my eyes it felt like there was a delay between moving and seeing. This lasted for about a month. In general everything felt very disconnected/fuzzy/unreal. Sometimes it was close to what I imagine people describe as an out of body experience.

I think if you come off any kind of brain med cold turkey, you're gonna have a very bad time.

I still find articles like the above absolutely horrible, and wish people would stop writing them. Meds saved my life. They save the life of millions of people every year - and they make depression hands-down easier to manage and to live with.

That doctors over-proscribe is another problem. Muck-raking and fear-mongering about what are already scary drugs to very scared depressed people has real costs - people probably die because of articles like the above. Many, many people suffer for years without medication because they're afraid to start them.

Re: Many People Taking Antidepressants Discover They Cannot Quit

#224

Post by phkahler »

gabept wrote: post #201
aaron_altamura wrote: post #167

Earlier quoted context omitted.

This is a dangerous opinion and can inspire guilt in folks struggling with mental disorders. Not cool.

Lies and omissions are always more dangerous than the truth.

Tell that to a therapist.

Re: Many People Taking Antidepressants Discover They Cannot Quit

#225

Post by DenisM »

mirimir wrote: post #169
DenisM wrote: post #150

Earlier quoted context omitted.

Don’t discount lithium, it may turn out better than modafinil for you.

I've been using that mix for several years. And I'm not interested in changing. But why do you say "better"?

Midafinil fights effects of poor sleep. Lithium may stabilize the mood swings that disrupt sleep in the first place.

Re: Many People Taking Antidepressants Discover They Cannot Quit

#226

Post by NetOpWibby »

Thanks to the comments here, I was able to figure out why my wife had been experiencing vertigo for the past couple weeks. She ran out of Zoloft and didn’t bother taking any of her refill (we were busy moving).

Thanks for sharing your experiences everyone!

Re: Many People Taking Antidepressants Discover They Cannot Quit

#227

Post by darkerside »

jdietrich wrote: post #222
darkerside wrote: post #215

Earlier quoted context omitted.

As a layman, I find it surprising that SSRIs were clinically approved for treatment based on a 1 in 7 chance of demonstrating positive effects. Are other medications anywhere near as ineffective? Whether antibiotics, Tylenol, or Viagra, I can't imagine any of those being effective in less than, say, 5 out of 7 cases.

>Are other medications anywhere near as ineffective? Yes. Reviews suggest that statins have an NNT of between 50 and 200 depending on the patient's underlying risk for cardiovascular disease. Coronary stents are probably useless. Reviews of antibiotics, antivirals and corticosteroids show a wide range of NNTs and often show no positive effect. The drug approval system has a relatively high bar for safety, but a relat…

Good point. I think stents, and to some extent, statins, are starting to be exposed as often misused tools. Yet, for some reason, it feels politically incorrect to ask the same questions if SSRIs.

Re: Many People Taking Antidepressants Discover They Cannot Quit

#228

Post by imcoconut »

vanderZwan wrote: post #28
finaliteration wrote: post #12

Earlier quoted context omitted.

Ah, that does make sense. I just tend to be a little on the defensive about it because often the response I get is that I’m taking the “easy” way out through medication.

> I just tend to be a little on the defensive about it Completely understandable! Most people seem to have such a frustrating inability to understand that other people can have very different experiences of the world to their own, and that those experiences aren't wrong. I am lucky enough that most of my friends do understand mental illnesses a bit better than the average person out there. Some of them who confided t…

> Call me crazy, but I partially blame the dualist world view of the Western world for that, even if most people aren't even aware that they have been raised with a dualist mindset. This whole mind/matter division makes people think that mental problems have to be solved by thinking.

Not crazy at all. I strongly agree with this.

Re: Many People Taking Antidepressants Discover They Cannot Quit

#229

Post by mirimir »

DenisM wrote: post #225
mirimir wrote: post #169

Earlier quoted context omitted.

I've been using that mix for several years. And I'm not interested in changing. But why do you say "better"?

Midafinil fights effects of poor sleep. Lithium may stabilize the mood swings that disrupt sleep in the first place.

It's lamictal that stabilizes the mood swings. And modafinil adjusts the set point.

Re: Many People Taking Antidepressants Discover They Cannot Quit

#230

Post by ionised »

fredch wrote: post #40

"Cannot stop" is kind of strong. More like "have nasty side effects while tapering off and puss out". Having been on the Zoloft,I can say is got a black box warning for a reason and should only be taken if you're seriously in danger of self harm. Shrinks like it because it keeps people coming back. People like it because they're not willing to confront their real problems and want something to numb themselves out. Ju…

If you are in danger of self-harm, it is already too late for Zoloft.
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