Live data from Hacker News

Most people on antidepressants don’t need them

economist.com

11–20 of 167 posts

Re: Most people on antidepressants don’t need them

#11

I can tell this thread is going to be a nightmare but whatever I really want to share my experience in case there are people similar to me that need to hear this: I cannot emphasise enough how much Escitalopram (lexapro) has helped me with issues I didn't even know I had until I started taking it. At which point I realised I was living in a constant state of anxiety up to that point, and I probably should have been o…

Me too! I used to be anxious about everything going on in my life. When I started Lexapro and it finally started working, I realized, "Wow, is that what normalcy feels like?" It's been a lifesaver.

Re: Most people on antidepressants don’t need them

#12
It can on one hand be argued antidepressants aren't necessary for anyone. You can argue that and be correct. This is because antidepressants don't actually cure depression, but lessen the symptoms and enable severe depression to be cured through behavioral changes.

It's a line of reasoning that is technically true but really sort of missing the point.

The problem with treating depressed people is to get them to actually do the things that will help them. That can be incredibly difficult without medication.

Re: Most people on antidepressants don’t need them

#13

I can tell this thread is going to be a nightmare but whatever I really want to share my experience in case there are people similar to me that need to hear this: I cannot emphasise enough how much Escitalopram (lexapro) has helped me with issues I didn't even know I had until I started taking it. At which point I realised I was living in a constant state of anxiety up to that point, and I probably should have been o…

Same here! I was like “wow, this is what it’s like to not be so cynical and defensive and anxious all the time!”

I lived like that for 15 years :(

Re: Most people on antidepressants don’t need them

#14
Pretty short article, this quote sums it up: "When the results of all trials submitted to America’s medicines regulator between 1979 and 2016 were scrutinised by independent scientists, it turned out that antidepressants had a substantial benefit beyond a placebo effect in only 15% of patients."

It's unclear what paper they refer to, as it is not linked. This article (https://www.ncbi.nlm.nih.gov/books/NBK361016/) has many citations to papers that cover this stuff. I think the important take away is in "Antidepressant drug effects and depression severity: a patient-level meta-analysis" (https://pubmed.ncbi.nlm.nih.gov/20051569/):

"Results: Medication vs placebo differences varied substantially as a function of baseline severity. Among patients with HDRS scores below 23, Cohen d effect sizes for the difference between medication and placebo were estimated to be less than 0.20 (a standard definition of a small effect). Estimates of the magnitude of the superiority of medication over placebo increased with increases in baseline depression severity and crossed the threshold defined by the National Institute for Clinical Excellence for a clinically significant difference at a baseline HDRS score of 25.

Conclusions: The magnitude of benefit of antidepressant medication compared with placebo increases with severity of depression symptoms and may be minimal or nonexistent, on average, in patients with mild or moderate symptoms. For patients with very severe depression, the benefit of medications over placebo is substantial. "

Short version: if your depression is mild, antidepressants may not work better than a placebo (though placebos are not exactly nothing). If it's severe, there is more of a chance it'll really help,

From my personal experience, I can definitely attest to them helping, though they are not by any means a magic bullet.

Re: Most people on antidepressants don’t need them

#15

I can tell this thread is going to be a nightmare but whatever I really want to share my experience in case there are people similar to me that need to hear this: I cannot emphasise enough how much Escitalopram (lexapro) has helped me with issues I didn't even know I had until I started taking it. At which point I realised I was living in a constant state of anxiety up to that point, and I probably should have been o…

Agree. I have watched a family member suffer mental health, anxiety issues. When she turned 18 she was finally able to get the doctor to prescribe meds. It was a life-changer for her.

So chalk that up as another Lexapro win (that was not forced by some drug company on the patient).

Re: Most people on antidepressants don’t need them

#16

I can tell this thread is going to be a nightmare but whatever I really want to share my experience in case there are people similar to me that need to hear this: I cannot emphasise enough how much Escitalopram (lexapro) has helped me with issues I didn't even know I had until I started taking it. At which point I realised I was living in a constant state of anxiety up to that point, and I probably should have been o…

That's exactly what happened to me. I began to take it when the pandemic hit and latter decided to stop. But it was transformative in the sense that it made me aware of how handicapping my anxiety was. My doctor didn't want me to stop tho. I clearly match the criteria to stop (stable for an year), while he still recommended that I continued. He didn't veto my stopping either, but it was my decision.

Re: Most people on antidepressants don’t need them

#17

I can tell this thread is going to be a nightmare but whatever I really want to share my experience in case there are people similar to me that need to hear this: I cannot emphasise enough how much Escitalopram (lexapro) has helped me with issues I didn't even know I had until I started taking it. At which point I realised I was living in a constant state of anxiety up to that point, and I probably should have been o…

Adding to the anecdata, on the other hand, when I took it, I just felt the same :(.

Re: Most people on antidepressants don’t need them

#18
post #9

I'm a bit nervous about these articles clearly centred on the USA which seems to have an epidemic of private drug companies pushing all kinds of stuff via doctors who may or may not be getting backhanders to push certian drugs. I'm not saying this isn't partially true in Europe but the USA definitely comes across as choosing drugs as the first resort for many things that you wouldn't in Europe. Also, as many have fou…

Sadly, while this is more rampant in the US, it happens in other places too.

Re: Most people on antidepressants don’t need them

#20
I was about to write that there clearly are huge differences betwween the US and the rest of the world, but it seems some European countries have caught up with the US, especially Iceland, with more than 140 daily doses per 1000 adults [1]. Interestingly Iceland frequently has one of the top positions in the world happiness report [2].

[1] https://en.wikipedia.org/wiki/List_of_countries_by_antidepre...

[2] https://en.wikipedia.org/wiki/World_Happiness_Report#2022_Wo...

Post reply on HN