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One sleepless night can rapidly reverse depression for several days in mice

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Re: One sleepless night can rapidly reverse depression for several days in mice

#241

Post by yosame »

biohacker85 wrote: post #233
thowaway91234 wrote: post #93

Earlier quoted context omitted.

I recently was forced off of SSRIs after nearly ten years because I lost my psychiatrist and couldn't get a new one because the waitlists were ridiculous. After 10 years on them, the next 6 months were absolute hell (i legit thought at one point I might go full Joaquin Phoenix in Joker) but I made it through, no small part thanks to my wonderful amazing wife. Rebound depression have been an issue - though in general…

Sometimes I wish I wasn't so cynical, but I've suspected that SSRIs are a preferred treatment because it is almost impossible to get off of them. They say "It can take up to a month for it to work" is just a way to make sure dependency is strong enough by that point to make withdrawal unbearable. Many people don't fully understand the concept of withdrawal or chemical dependency, and will think the "medicine" works b…

Well no, SSRIs (essentially) work by becoming tolerant to their effects, which takes 3 weeks to 3 months. It's not a conspiracy, it's just how they work.

They're a preferred treatment because they're usually effective and they're far safer than other medication classes for depression.

Re: One sleepless night can rapidly reverse depression for several days in mice

#242

Post by [deleted] »

biohacker85 wrote: post #233
thowaway91234 wrote: post #93

Earlier quoted context omitted.

I recently was forced off of SSRIs after nearly ten years because I lost my psychiatrist and couldn't get a new one because the waitlists were ridiculous. After 10 years on them, the next 6 months were absolute hell (i legit thought at one point I might go full Joaquin Phoenix in Joker) but I made it through, no small part thanks to my wonderful amazing wife. Rebound depression have been an issue - though in general…

Sometimes I wish I wasn't so cynical, but I've suspected that SSRIs are a preferred treatment because it is almost impossible to get off of them. They say "It can take up to a month for it to work" is just a way to make sure dependency is strong enough by that point to make withdrawal unbearable. Many people don't fully understand the concept of withdrawal or chemical dependency, and will think the "medicine" works b…

[deleted]

Re: One sleepless night can rapidly reverse depression for several days in mice

#244

Post by doktrin »

erikpukinskis wrote: post #114
thowaway91234 wrote: post #93

Earlier quoted context omitted.

I recently was forced off of SSRIs after nearly ten years because I lost my psychiatrist and couldn't get a new one because the waitlists were ridiculous. After 10 years on them, the next 6 months were absolute hell (i legit thought at one point I might go full Joaquin Phoenix in Joker) but I made it through, no small part thanks to my wonderful amazing wife. Rebound depression have been an issue - though in general…

Just a side note for anyone reading: you can get an SSRI prescription from your GP (general practitioner i.e. normal doctor) you don’t need to go through a psychiatrist. This is especially true if you are at risk for withdrawal, they will want to prevent that.

Indeed, and this easy availability is potentially a double edged sword.

Re: One sleepless night can rapidly reverse depression for several days in mice

#245

Post by arcticbull »

yosame wrote: post #241
biohacker85 wrote: post #233

Earlier quoted context omitted.

Sometimes I wish I wasn't so cynical, but I've suspected that SSRIs are a preferred treatment because it is almost impossible to get off of them. They say "It can take up to a month for it to work" is just a way to make sure dependency is strong enough by that point to make withdrawal unbearable. Many people don't fully understand the concept of withdrawal or chemical dependency, and will think the "medicine" works b…

Well no, SSRIs (essentially) work by becoming tolerant to their effects, which takes 3 weeks to 3 months. It's not a conspiracy, it's just how they work. They're a preferred treatment because they're usually effective and they're far safer than other medication classes for depression.

Interestingly enough, SSRIs are only slightly but statistically significantly better than active placebos. While early trials showed a big difference between antidepressants and placebos, more recent studies have significantly narrowed that gap. FDA data shows a reduction of symptoms of about 30% in placebo vs 40% in antidepressants. [1]

[edit] Doctors note that the difference between antidepressants and placebo isn't clinically significant. They do something, but not much which is why the revival and breakthrough drug designation of psychedelics in the treatment of - especially major - depression is so exciting.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4592645/

Re: One sleepless night can rapidly reverse depression for several days in mice

#246

Post by chupapimunyenyo »

tomcam wrote: post #194
chupapimunyenyo wrote: post #150

Earlier quoted context omitted.

You know, you are right. I agree, but it still drives me nuts seeing this, maybe it's just ignorance? I expect a higher standard from a .edu website

If this helps any, Siri NEVER seems to get this right, always preferring the contraction over the possessive. As a syntax/grammar fanaticist who is also old I rely on Siri for dictation and she has sunk embarrassingly low these last few years. I have to spend a long time correcting any message of reasonable length for this reason. It has made me much more sympathetic to errors like this, but I cannot begin to tell yo…

This is tragic, how many people will doubt Siri? It definitely contributes to the problem

Re: One sleepless night can rapidly reverse depression for several days in mice

#247

Post by Aurornis »

pedalpete wrote: post #168

The impact of sleep restriction on depression has been known for decades (though most of the research I'm seeing is from late 2010s on [1], this link says "from the beginning of the last century [2]) However, sleep deprivation as a treatment needs to be balanced with the health impact of sleep deprivation itself. A single night of lost sleep can have significantly detrimental impact on long-term health. Insulin respo…

Yes, and we've also known for a long time that the effects are temporary and unsustainable. It also doesn't work for everyone and can induce or worsen depression in others.

It is interesting, though. There have been some attempts to use sleep deprivation to kick off antidepressant treatment.

There have also been attempts to extend the effect by using a single night of sleep deprivation followed by a slightly altered sleep schedule.

Many people can even benefit from simpler alterations of going to bed earlier and getting up earlier. A lot of people discover that if they adjust their sleep schedule to go to bed earlier and get early (enough to be awake by sunrise) they feel substantially better. Convincing people to actually do this and maintain it is often difficult.

Certain medications with depression-altering properties might act through alterations of circadian rhythm. Lithium inhibits GSK-3, which has significant effects on circadian rhythm. Agomelatine, a newer antidepressant, has significant interactions with the Melatonin receptor. It should go without saying that medications like these are infinitely more sustainable than sleep deprivation.

Re: One sleepless night can rapidly reverse depression for several days in mice

#248

Post by jdietrich »

biohacker85 wrote: post #233
thowaway91234 wrote: post #93

Earlier quoted context omitted.

I recently was forced off of SSRIs after nearly ten years because I lost my psychiatrist and couldn't get a new one because the waitlists were ridiculous. After 10 years on them, the next 6 months were absolute hell (i legit thought at one point I might go full Joaquin Phoenix in Joker) but I made it through, no small part thanks to my wonderful amazing wife. Rebound depression have been an issue - though in general…

Sometimes I wish I wasn't so cynical, but I've suspected that SSRIs are a preferred treatment because it is almost impossible to get off of them. They say "It can take up to a month for it to work" is just a way to make sure dependency is strong enough by that point to make withdrawal unbearable. Many people don't fully understand the concept of withdrawal or chemical dependency, and will think the "medicine" works b…

SSRIs replaced older-generation antidepressants because they're similarly effective and much safer - that's not to say that they don't have side-effects, but they probably won't kill you. TCAs are extremely toxic in overdose (an obvious and serious shortcoming in patients with elevated suicide risk) and MAOIs come with a really difficult set of drug-drug interactions and dietary restrictions.

We know from the data that SSRIs work about as well as psychotherapy. We also know that SSRIs and psychotherapy work considerably better than either treatment alone. SSRIs don't work nearly as well as we'd like, they can cause significant side-effects, but they do deliver very important benefits for many patients and they're an important tool in the psychiatric arsenal with no adequate substitute yet. We need more and better treatment options, but we shouldn't unfairly denigrate the treatment options we have right now.

I don't mean to diminish anyone's lived experience, but I've always been slightly sceptical of claims about withdrawal effects of antidepressants. I suffer from TRD and have withdrawn cold turkey from maximum doses of several antidepressants with no ill-effects, but I didn't get any significant benefits when I was taking those drugs. If you stop taking a drug that was effectively reducing your depressive symptoms and you feel terrible, there's a fairly obvious explanation.

Re: One sleepless night can rapidly reverse depression for several days in mice

#249

Post by Aurornis »

biohacker85 wrote: post #233
thowaway91234 wrote: post #93

Earlier quoted context omitted.

I recently was forced off of SSRIs after nearly ten years because I lost my psychiatrist and couldn't get a new one because the waitlists were ridiculous. After 10 years on them, the next 6 months were absolute hell (i legit thought at one point I might go full Joaquin Phoenix in Joker) but I made it through, no small part thanks to my wonderful amazing wife. Rebound depression have been an issue - though in general…

Sometimes I wish I wasn't so cynical, but I've suspected that SSRIs are a preferred treatment because it is almost impossible to get off of them. They say "It can take up to a month for it to work" is just a way to make sure dependency is strong enough by that point to make withdrawal unbearable. Many people don't fully understand the concept of withdrawal or chemical dependency, and will think the "medicine" works b…

> Sometimes I wish I wasn't so cynical, but I've suspected that SSRIs are a preferred treatment because it is almost impossible to get off of them.

That is indeed very cynical! However, it's not correct. SSRIs are actually much easier to quit than our previous generation antidepressants. The first "S" in SSRI stands for "Selective", meaning they more or less selectively work on the serotonin transporter. Older medications were less selective and worked on a lot of different systems, which often meant withdrawal was even more difficult as multiple different systems were in rebound all at once.

The older medications can be more effective for resistant cases, but due to the higher side effect profile and more difficult withdrawal they are second line treatment.

> They say "It can take up to a month for it to work" is just a way to make sure dependency is strong enough by that point to make withdrawal unbearable.

Quite the conspiracy theory.

But again, it's unfounded. SSRIs are known to take up to a month to work because the antidepressant effect is the result of a sequence of changes that happens over time. The brain has to arrive at a new equilibrium with medication, and the various systems and feedback loops don't immediately recalibrate.

The biggest flaw in the theory that “they” prescribe SSRIs to get people addicted is that most SSRIs are cheap. $4/month at Walmart cheap, or $10 every 3 months. The common ones are long off patent.

I hope nobody takes the parent comment too seriously. If you're suffering from major depression, don't let HN conspiracy theory comments scare you away from trying treatments that work well for many people (though not everyone, but you don't know if you don't try)

Re: One sleepless night can rapidly reverse depression for several days in mice

#250

Post by Aurornis »

arcticbull wrote: post #245
yosame wrote: post #241

Earlier quoted context omitted.

Well no, SSRIs (essentially) work by becoming tolerant to their effects, which takes 3 weeks to 3 months. It's not a conspiracy, it's just how they work. They're a preferred treatment because they're usually effective and they're far safer than other medication classes for depression.

Interestingly enough, SSRIs are only slightly but statistically significantly better than active placebos. While early trials showed a big difference between antidepressants and placebos, more recent studies have significantly narrowed that gap. FDA data shows a reduction of symptoms of about 30% in placebo vs 40% in antidepressants. [1] [edit] Doctors note that the difference between antidepressants and placebo isn'…

Contrarians and cynics have been trying the "barely better than placebo" angle for decades, but antidepressants are indeed superior to placebo.

You can find articles and reviews that play games with statistics, cherry pick studies, and use various thresholds for effect size to try to downplay it, but they do work for a lot of people.

> While early trials showed a big difference between antidepressants and placebos, more recent studies have significantly narrowed that gap.

The part you're leaving out is that the placebo effect is quite strong in studies for depression and even pain. It's misleading to say "barely better than placebo" without explaining that placebo works quite well in those studies.

Placebo effect is also getting stronger over time: https://bigthink.com/health/placebo-effect-worse/

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