When you look into the studies for antidepressants, the track record is abysmal. They’re not innocuous, trigger serious side effects, some are hard to quit, but more importantly they only make a difference in people with extremely severe depression. And doctors often downplay or don’t mention side effects honestly because they don’t want patients to not take them. The studies justifying antidepressants as effective t…
Yeah an unregulated and uncontrolled consumption of a poorly dosed hallucinogenic is totally better than a double-blind study of SSRI/SNRI. I swear, I do not reject the possibility that hallucinogenics can cure depression better than existing meds, but the almost religious enthusiasm for such a poorly studied chemical is deeply concerning. And yes, before you accuse me of being a pharma shill, I know that the lack of…
Also, those exact studies you refer to show that SNRIs work very poorly and are very limited.
Usually studies have fewer than 100 participants:
* people are dropped from the study arbitrarily
* they are not double blind
* they are not representative of the population (overwhelmingly participants are white, male, well off or young with no other health complaints and few serious problems)
* studies are usually very short (They then find drugs are less than 15%ppts more effective than placebos. In exchange you get quite extreme side effects for a significant number of users from impotence to suicide...
The lancet picked this up and did. meta-study. Their conclusions:
>We identified 28 552 citations and of these included 522 trials comprising 116 477 participants. In terms of efficacy, all antidepressants were more effective than placebo, with ORs ranging between 2·13 (95% credible interval [CrI] 1·89–2·41) for amitriptyline and 1·37 (1·16–1·63) for reboxetine. For acceptability, only agomelatine (OR 0·84, 95% CrI 0·72–0·97) and fluoxetine (0·88, 0·80–0·96) were associated with fewer dropouts than placebo, whereas clomipramine was worse than placebo (1·30, 1·01–1·68). When all trials were considered, differences in ORs between antidepressants ranged from 1·15 to 1·55 for efficacy and from 0·64 to 0·83 for acceptability, with wide CrIs on most of the comparative analyses. In head-to-head studies, agomelatine, amitriptyline, escitalopram, mirtazapine, paroxetine, venlafaxine, and vortioxetine were more effective than other antidepressants (range of ORs 1·19–1·96), whereas fluoxetine, fluvoxamine, reboxetine, and trazodone were the least efficacious drugs (0·51–0·84). For acceptability, agomelatine, citalopram, escitalopram, fluoxetine, sertraline, and vortioxetine were more tolerable than other antidepressants (range of ORs 0·43–0·77), whereas amitriptyline, clomipramine, duloxetine, fluvoxamine, reboxetine, trazodone, and venlafaxine had the highest dropout rates (1·30–2·32). 46 (9%) of 522 trials were rated as high risk of bias, 380 (73%) trials as moderate, and 96 (18%) as low; and the certainty of evidence was moderate to very low.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
I think even assuming good faith for all those studies, those are poor results when you include the low acceptability. If you don't assume good faith you're left wondering if these drugs work at all.
It should go without saying that NO ONE should stop or change their medication (especially highly addictive ones like these) based on a HN comment. Please speak to your doctors dear readers.