Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Antidepressants Work Better Than Sugar Pills Only 15 Percent of the Time (2022)

newsweek.com

Post reply on HN
Print view View original

21–30 of 35 posts

Re: Antidepressants Work Better Than Sugar Pills Only 15 Percent of the Time (2022)

#21

Post by tcj_phx »

My friend eventually figured out for herself that she has the genetic condition of not being able to methylate the provitamin folic acid into Vitamin B9 (important for dna synthesis). She told me how adding L-methylfolate to her routine was like flipping a switch from ‘depressed’ to ‘not-depressed’. #MTHFR: https://twitter.com/jamesknochel/status/1595562181692907520?...

MAOIs are reasonably effective at lifting people’s moods, and start to work right away - helpful for breaking 'depressions' negative feedback loop.

SSRIs were promoted because they were profitable, not because they’re especially effective. Now that the patents have expired the harms of these drugs are getting more attention.

Re: Antidepressants Work Better Than Sugar Pills Only 15 Percent of the Time (2022)

#22

Post by NoZebra120vClip »

eulgro wrote: post #7
jgerrish wrote: post #4

There have been several posts on Hacker News about this the past few days. I know myself. I'm a hacker, right? I can reprogram my body to accomplish anything. But sometimes people do need help, and that's not bad. I love this site, and the people on it. I hope these recent posts don't create a culture that rejects all depression management methods. It's a very fine line. The previous post mentioned that the "placebo…

> I know myself. I'm a hacker, right? I can reprogram my body to accomplish anything. Is there a name to that way of thinking? That's how I've been thinking lately but I can't help but think it's wrong.

Positive visualization + Self-actualization?

Older: self-mastery

Re: Antidepressants Work Better Than Sugar Pills Only 15 Percent of the Time (2022)

#23

Post by NoZebra120vClip »

hoagsobject wrote: post #14

Article claims that SSRI are overpresribed, and that only 15% derive any benefit. To me it seems that people who don't need it and were over-prescribed the drug do not derive any benefit. But it does not mean that drug efficiency is 15%. It's like giving aspirin to people without headache, and claim that aspirin does not work.

No statistics are actually cited for the "mounting evidence" but the 15% is cited to a "single study" -- so is 85% overprescribed by definition, if they're not helping?

FYI, psychiatrists don't (can't) really check to see whether the drugs are "helping". As long as you're staying out of the hospital, not going fucking nuts in their face, and you're not screaming about ten side effects, they'll keep you on all the ineffective drugs you can afford. (n.b. be careful about mentioning side effects; that's a good way to get bonus drugs.)

Your aspirin analogy is perspicacious. I often struggle with use of pain relievers, because how can I know that they've relieved any pain, or my pain just subsided somewhat coincidentally? I was in ER for kidney stones, for example, and the pain was excruciating and I vomited and writhed around, so they gave me an IV dose of "NSAIDs on CRACK!" as the nurse so aptly and professionally described it. Within 10 minutes my pain was receding rapidly. I had no lingering complaints, long after it would've worn off. So, correlation or causation?

Conversely, I've never perceived even the slightest relief from OTC pain meds, and I've run the gamut. Experimenting with Bali Red Kratom this year.

Re: Antidepressants Work Better Than Sugar Pills Only 15 Percent of the Time (2022)

#24

Post by funnym0nk3y »

SkyPuncher wrote: post #12
nxm wrote: post #5

I keep seeing all these placebo studies regarding anti-depressants, and yet I know for a fact that SSRIs were able to get me out of 2 episodes of months long depression in life within a few days of taking them. Everybody reacts different is my only explanation

My wife is a psychiatrist. She told me I the past that anti-depressants are a bit like roulette - you have to keep trying until the right one lands. Unfortunately, that can take years as most antidepressants take 4 to 8 weeks to take full effect. Everybody’s body is just slightly differently so it can take a while to find a drug that pairs well with your body. Further, there’s a lot of indication that antidepressants…

It's very possible that the combination of antidepressants and CBT is superior. Antidepressants enable you to relearn faster und CBT teaches you what to learn.

Re: Antidepressants Work Better Than Sugar Pills Only 15 Percent of the Time (2022)

#25

Post by funnym0nk3y »

tcj_phx wrote: post #21

My friend eventually figured out for herself that she has the genetic condition of not being able to methylate the provitamin folic acid into Vitamin B9 (important for dna synthesis). She told me how adding L-methylfolate to her routine was like flipping a switch from ‘depressed’ to ‘not-depressed’. #MTHFR: https://twitter.com/jamesknochel/status/1595562181692907520?... MAOIs are reasonably effective at lifting peopl…

SSRI are way better tolerated than irreversible MAOIs.

Re: Antidepressants Work Better Than Sugar Pills Only 15 Percent of the Time (2022)

#26

Post by whoknew1122 »

barrysteve wrote: post #19

Antidepressants are also increasingly related to lower libido and reduced sex drive. They have way more side effects than is publicly talked about. People know more about the side effects of smoking, than they do, doctor prescribed medication. Something is wrong with that picture.

Some forms of antidepressants can be related to lower libido. If your prescribing doctor doesn't talk about this, get a new one.

My psychiatrist was very open about this and we tried different medications to see which impacted this the least. But, you know what else is related to lower libido? Depression. So let's not act as if the antidepressants are only to blame.

I'm not sure who the 'people' you reference are, but if your prescribing doctor doesn't talk to you about side effects, get a different one.

Re: Antidepressants Work Better Than Sugar Pills Only 15 Percent of the Time (2022)

#27

Post by barrysteve »

whoknew1122 wrote: post #26
barrysteve wrote: post #19

Antidepressants are also increasingly related to lower libido and reduced sex drive. They have way more side effects than is publicly talked about. People know more about the side effects of smoking, than they do, doctor prescribed medication. Something is wrong with that picture.

Some forms of antidepressants can be related to lower libido. If your prescribing doctor doesn't talk about this, get a new one. My psychiatrist was very open about this and we tried different medications to see which impacted this the least. But, you know what else is related to lower libido? Depression. So let's not act as if the antidepressants are only to blame. I'm not sure who the 'people' you reference are, bu…

Yes I do in fact know that depression lowers libido.

Here's a HARVARD website [0] that lists sexual side effects to common antidepressants, including anorgasmia (inability to experience orgasms).

I have experienced both (colloquially known as blue balls) anorgasmia and lower libido from depression..

How cruel is that irony! Can't get it up from depression, can't seal the deal from SSRI induced anorgasmia!

There is no act or blame here, only science, observation and lived experience.

[0] https://www.health.harvard.edu/womens-health/when-an-ssri-me....

Doctors I speak to go like this. You want antidepressants? They'll solve XYZ problem. They're good, but they don't always work. Do they clash with any medication or health problems.. no. Anything else? Take these ones with food, here's your script/referral/whatever.

Then I take it and it sucks. Literally the government puts up ads saying smoking is going to kill me, but chemical castration (tiny bit exaggeration!!) from SSRIs is A-Okay!

Better article:

In a 2003 survey, approximately 41.7% of men and 15.4% of women discontinued psychiatric medications due to perceived sexual side effects.4 Given that SSRIs may cause sexual dysfunction in 40% to 65% of individuals, these side effects may exacerbate depression and create a barrier to medication adherence.5,6

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6007725/#:~:tex....

Re: Antidepressants Work Better Than Sugar Pills Only 15 Percent of the Time (2022)

#28

Post by mrguyorama »

NoZebra120vClip wrote: post #3

My First SSRI at 19. I'd been referred to a psychologist and so I started attending appointments in his office, at the Children's Hospital with the playsets in the waiting room. He was a kind man, and our sessions were trustful and frank. He spoke to me with candor and not unlike Mr. Rogers on my TV, only he was there for me alone. Shortly he handed me off to his accomplice who pushed drugs. I got fluoxetine HCl. Tha…

>I got fluoxetine HCl. That's mostly fluoride in case you're not a chemist.

That's a staggering lack of understanding of how basic chemistry works.

Hydrogen is 66% of water and yet water is not flammable.

Re: Antidepressants Work Better Than Sugar Pills Only 15 Percent of the Time (2022)

#29

Post by nuancebydefault »

krzat wrote: post #6

My takeaway is that placebo pills are surprisingly effective for mental issues. I'm not quite sure how this could be utilised in psychiatry though.

Indeed. The placebo effect is a real and known effect, a kind of psychological artifact. If it didn't exist, testing medication effectiveness would be much easier, as there would be no need for tests to be double blind.

I compare placebo to noise, as in, signal to noise.

I think we shouldn't fall into the trap of thinking that taking/doing a placebo would most often be an effective enough treatment, because tests show that the placebo effect happened. That would be like saying, just use full noise instead of the signal, since tests show they are close, rms wise.

Re: Antidepressants Work Better Than Sugar Pills Only 15 Percent of the Time (2022)

#30

Post by nuancebydefault »

barrysteve wrote: post #27
whoknew1122 wrote: post #26

Earlier quoted context omitted.

Some forms of antidepressants can be related to lower libido. If your prescribing doctor doesn't talk about this, get a new one. My psychiatrist was very open about this and we tried different medications to see which impacted this the least. But, you know what else is related to lower libido? Depression. So let's not act as if the antidepressants are only to blame. I'm not sure who the 'people' you reference are, bu…

Yes I do in fact know that depression lowers libido. Here's a HARVARD website [0] that lists sexual side effects to common antidepressants, including anorgasmia (inability to experience orgasms). I have experienced both (colloquially known as blue balls) anorgasmia and lower libido from depression.. How cruel is that irony! Can't get it up from depression, can't seal the deal from SSRI induced anorgasmia! There is no…

I feel you are painting the picture too black. Do one wants to be depressed or can they live with not always being able to 'seal the deal'?
Post reply on HN