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Doctors are finally learning to manage antidepressant withdrawal

newscientist.com

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Re: Doctors are finally learning to manage antidepressant withdrawal

#291

Post by [deleted] »

googaar wrote: post #20
D-Machine wrote: post #3

Best way to manage the withdrawal would be to dramatically reduce them being prescribed in the first place. The linked article says they have "small to moderate effectiveness", but this is being far too generous. The correct way to measure drug effectiveness is if the treatment meets the standard of a minimal important difference. I.e. you measure depression on various rating scales, like the 17-point HAM-D, and rese…

I can’t believe we’ve normalized anti depressants as a society. I’m about to get downvoted into oblivion for this take though. I’m not trying to discount mental health, I just think there are better solutions than drugs to fix your state of mind. Also think that some people are dealt a tougher hand than most, and that for a small subset of humans, anti depressants are the most fitting cure.

[deleted]

Re: Doctors are finally learning to manage antidepressant withdrawal

#292

Post by mancerayder »

orangedog wrote: post #260
mancerayder wrote: post #212

Earlier quoted context omitted.

An unfortunate aspect of modern discourse and thinking is how black and white discussions can feel. Several sides of the topic can co-exist together and all be true, so (well, in my experience and reading): - Some people really benefit from and even need SSRIs or other psychoactive drugs to function well in society. - Too many people are prescribed them such that there may be more harm than good. They may have side e…

> In the US you meet with one for 15m, get prescribed a cocktail of drugs, a few months later you report if it worked, and if not they'll up the dose or play around with the cocktail. I don't know how we call that stuff science. Is that not science? It's on a small scale but this is all they have to work on. We don't understand enough, it is all trial and error. I note that not all psychs operate this way, mine would…

Well, it's science if you consider the patient to be the subject of an experiment. But the point I was trying to make is - they don't directly measure serotonin or anything else in the brain. They can't see thoughts through a machine or measure 'chemical balance', whatever that is. They leave it to correlation - give drug, report result given by patient. It's like nutritional science, but even worse, because at least with nutritional science you can measure blood sugar or cholesterol. Psychology involves the outside world - relationships, financial security, social stresses, physical health, etc. Habits of mind. Traumas. So much more.

Re: Doctors are finally learning to manage antidepressant withdrawal

#293

Post by gwbas1c »

ebiester wrote: post #261
gwbas1c wrote: post #230

Earlier quoted context omitted.

Amazon: https://www.amazon.com/s?k=calibrated+milligram+scale --- They're common, cheap, and plenty of (recreational) drug dealers use them.

They're also fantastic for small measures for baking and cooking when it matters.

Curious: What do you make where you need such accurate measurements?

I just eyeball everything when I cook. (For other things that I'm passionate about I'm much more careful.)

Re: Doctors are finally learning to manage antidepressant withdrawal

#294

Post by amluto »

ebiester wrote: post #261
gwbas1c wrote: post #230

Earlier quoted context omitted.

Amazon: https://www.amazon.com/s?k=calibrated+milligram+scale --- They're common, cheap, and plenty of (recreational) drug dealers use them.

They're also fantastic for small measures for baking and cooking when it matters.

Somewhere there’s probably a coffee nerd who wants to measure small fractions of a bean.

Re: Doctors are finally learning to manage antidepressant withdrawal

#295

Post by WhitneyLand »

krupan wrote: post #229
bb123 wrote: post #126

There is a real lack of transparency in communicating some of the long term impacts of SSRIs to new patients. When I was prescribed sertraline not one doctor mentioned the massive (and sometimes permanent!!) sexual side effects, the likelihood of weight gain or how brutal it would be to taper off. Also, I ended up ignoring my doctor's (way too aggressive) tapering schedule and managing my own down-dosing with a pill…

Were you experiencing side effects that made you want to get off? For the vast majority of people there really are none.

So, this is not supported by the data when people are asked.

Sexual effects alone hit about 50–70% people. Then you could face nausea, insomnia, profuse sweating when you’re still, emotional blunting, and weight gain.

I don’t want to discourage anyone, they can save lives. It is a net benefit for some people, but even then most people will experience side effects and wish they didn’t have to take them.

Re: Doctors are finally learning to manage antidepressant withdrawal

#296

Post by orangedog »

WhitneyLand wrote: post #295
krupan wrote: post #229

Earlier quoted context omitted.

Were you experiencing side effects that made you want to get off? For the vast majority of people there really are none.

So, this is not supported by the data when people are asked. Sexual effects alone hit about 50–70% people. Then you could face nausea, insomnia, profuse sweating when you’re still, emotional blunting, and weight gain. I don’t want to discourage anyone, they can save lives. It is a net benefit for some people, but even then most people will experience side effects and wish they didn’t have to take them.

> The most common side effects reported by patients in the study by Hu et al1 of 401 outpatients taking SSRIs were drowsiness (38%), dry mouth (34%), and sexual dysfunction (34%)

> which was conducted in 1999-2000, questioned patients about side effects via phone interviews within 75 to 105 days of starting antidepressant therapy. The side effects deemed most bothersome were sexual dysfunction (17%)

It's no where near those numbers.

https://pmc.ncbi.nlm.nih.gov/articles/PMC3181894/

You notice how the scientific numbers get inflated in anecdotes from 17-34% to 50-70%?

Re: Doctors are finally learning to manage antidepressant withdrawal

#297

Post by roryirvine »

gwbas1c wrote: post #293
ebiester wrote: post #261

Earlier quoted context omitted.

They're also fantastic for small measures for baking and cooking when it matters.

Curious: What do you make where you need such accurate measurements? I just eyeball everything when I cook. (For other things that I'm passionate about I'm much more careful.)

Baking often rewards precision.

I'm also an eyeballer. I'm a decent cook but a truly lousy baker.

Re: Doctors are finally learning to manage antidepressant withdrawal

#298

Post by stoorafa »

erkt wrote: post #238
krupan wrote: post #229

Earlier quoted context omitted.

Were you experiencing side effects that made you want to get off? For the vast majority of people there really are none.

You think the vast majority of people do not experience side effects from anti-depressants? Wild.

FWIW findings about adverse events vary considerably:

> The proportion of patients reporting adverse events ranged from 16% to 98% (median 80%) under SSRI treatment and from 17% to 94% (median 70%) under placebo [1]

So the answer IMO depends on whether we can attribute adverse effects to treatment, which is difficult to disentangle from adverse effects of disease

I’m open to being shown more certainty if available from the literature but meta-analyses are high-strength evidence

[1] https://www.cambridge.org/core/journals/the-british-journal-...

Re: Doctors are finally learning to manage antidepressant withdrawal

#299

Post by wat10000 »

bcjdjsndon wrote: post #160

[flagged]

I'm so sick of this moralistic attitude toward psychiatric drugs. "Happy pills"? Come on. There are ways to work around tolerance. Even if there aren't, what's so terrible about a temporary improvement?

I'd wager most of us use some sort of vision correction. This does nothing to fix the underlying problem or even halt the progression, and most of the treatments leave us with a lifelong dependency on them. And yet nobody goes around derisively referring to "happy lenses" and talking about how stupid optometrists are.

There are legitimate doubts about the effectiveness of some psychiatric drugs. I don't believe ADHD drugs are among them. Regardless, that should be framed as a need for better education and dissemination of the information, better studies to determine effectiveness and better treatment regimens, and new drugs that do a better job. It should not be framed as "happy pills" with this derisive attitude just because the condition I take medication for is a brain condition rather than something like a heart condition.

Re: Doctors are finally learning to manage antidepressant withdrawal

#300

Post by micromacrofoot »

orangedog wrote: post #281
micromacrofoot wrote: post #273

Earlier quoted context omitted.

This is the same myth that women get told about hormonal birth control, it's not an "if" with side-effects of SSRIs, it's a "how much" and "when"

I don't to my knowledge suffer side-effects. Why are you certain about this?

chemistry of complex systems

you don't experience side-effects now, but you will if you need to stop taking it

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