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Extreme side-effects of antidepressants

bbc.co.uk

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Re: Extreme side-effects of antidepressants

#91

Post by mveety »

tcj_phx wrote: post #88
mveety wrote: post #69

Earlier quoted context omitted.

> In the long term, cocaine use wrecks the mitochondia, which contributes to exhaustion. The proper therapy in this case is to restore the mitochondria density. In mice, when given super high doses. The data for humans is much shakier and the effects of this are unknown, or if there are any, or if it even matters. AFAIK, none of the long term studies from reputable sources have shown long term effects on wakefulness…

Going on my observations, cocaine is a much safer drug than meth amphetamine. She recovers quickly from cocaine, but it takes 3-4 days for her to recover from meth amphetamine use.

That doesn't have much to do with safety, more with half-life. Methamphetamine has a longer half-life (averages about 15 hours) than cocaine (about 5 minutes to an hour depending on route of administration). With long term regular use they both have problems. Methamphetamine can be neurotoxic in higher doses without the protection of tolerance and might cause Parkinson's disease later in life. Cocaine has circulatory effects long term, and if smoked causes damage to the lungs. With short term or occasional use they really aren't that bad for you in general (as is true with almost all drugs).

Re: Extreme side-effects of antidepressants

#92

Post by kvb »

khed wrote: post #60
_98fj wrote: post #34

Just a couple of unordered facts here, because discussions about this topic tend to get very confused: 1. Serotonin is a very basic, very old transmitter found in all bilateral animals. Humans have two sites of serotonin-production, one in the body, one in the brain. 90% of serotonin resides in the body. 2. Serotonin in general regulates "activity". It affects hunger, gut-movement, sleep, cell-growth, mood, body-temp…

I am a practicing physician with 2 years of graduate level course work in neuroscience. Point 3 and 4 are wrong. There is no evidence that SSRIs work by fixing a chemical imbalance. There are multiple metananlyses in top tier journals that indicate that SSRIs have an irrelevant clinical effect. SSRIs are almost all placebo with the downside of causing serious side effects. The small effect that isn't due to placebo i…

I like the way Scott Alexander frames the effect size. This is from the conclusion the blog post you link:

  An important point I want to start the conclusion section
  with: no matter what else you believe, antidepressants are 
  not literally ineffective. Even the most critical study – 
  Kirsch 2008 – finds antidepressants to outperform placebo 
  with p
Note that this is the over-placebo benefit, and placebos already have a large benefit in most depression studies.

Re: Extreme side-effects of antidepressants

#93

Post by norea-armozel »

SSRIs made me angry. Like really angry. I remember when I was so angry I wanted to kill anyone making noise. I don't know why it did that for me but when I got off of them I wasn't even nearly as angry or irritable since. So it's why I still refuse get anti-depressants again unless the doctor agrees to steer clear of SSRIs.

Re: Extreme side-effects of antidepressants

#94

Post by jrapdx3 »

vinchuco wrote: post #44
jrapdx3 wrote: post #38

This is a subject I know well, not only as a multi-decade prescriber of antidepressants, and many other classes of medications for health/behavioral problems. I've also been prescribed such medications for my own conditions, so you could say I have a unique perspective, know the issues coming and going. Of course antidepressants can cause side-effects as do all other types of drug treatments. It's inevitable, medicat…

> 1% of recipients is considered a common adverse effect Are these rates determined in the same conditions as the medications are prescribed? Are there methods put in place to continue to gather side effect data after a medication is prescribed?

The FDA accepts reports of "adverse events" for as long as a medication is on the market. That info is incorporated into the stats of drug-associated AEs. AFAIK aftermarket AE stats aren't diagnosis correlated, so would include approved and off-label prescribing.

Re: Extreme side-effects of antidepressants

#95

Post by kqr »

inlined wrote: post #81

As a quick survey, do the people who believe that SSRIs have only a placebo effect also disbelieve any biological source of depression? Since the plural of anecdote is data, I'll share my story. I struggle with depression. I've kept it at bay for a long time now, but I had a big wave this year. It turns out that was ~1wk after a Rx refill and I realized the pharmacist refilled at half the dosage. Fixing the dosage go…

Not saying that is what happened, but perhaps you build a tolerance for the drug? Withdrawal can be a batch even for drugs with no significant positive effects.

Re: Extreme side-effects of antidepressants

#96

Post by kqr »

khed wrote: post #73
_98fj wrote: post #67

Earlier quoted context omitted.

I know these things from a friend who is a doctor and works with these neurotransmitter tests since about 10 years. I asked her how accurate these tests were and she said that, while you can't read everything off a sheet, there are patients, where she can already guess the result of the tests from the bodily symptoms the patient is describing (energy level at which times of the day, feeling of hunger, insomnia etc.).…

There is no evidence for the chemical imbalance hypothesis. Your friend anecdotal evidence is contradicted by a large body of emprical research. For a good overview of the evidence on SSRIs on depression I would recommend the article "antidepressants and the placebo effect". https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172306/?report...

Balls I went deep on this one. Almost makes me want to subscribe to BJPsych or something. So interesting!

Re: Extreme side-effects of antidepressants

#97

Post by mfukar »

Broken_Hippo wrote: post #86
mfukar wrote: post #77

Earlier quoted context omitted.

I think you should both stop here.

I don't. This sort of discussion from people in the field and what their friends see is helpful because it can change how other laypeople see the issue. Furthermore, I like seeing these sorts of discussions because I feel they make me more intelligent through gaining a different perspective.

I'm sorry - no text on Hacker News will convince me the person typing it is an expert in anything. Especially when they present inaccuracies and opinions as facts.

Re: Extreme side-effects of antidepressants

#98

Post by inlined »

kqr wrote: post #95
inlined wrote: post #81

As a quick survey, do the people who believe that SSRIs have only a placebo effect also disbelieve any biological source of depression? Since the plural of anecdote is data, I'll share my story. I struggle with depression. I've kept it at bay for a long time now, but I had a big wave this year. It turns out that was ~1wk after a Rx refill and I realized the pharmacist refilled at half the dosage. Fixing the dosage go…

Not saying that is what happened, but perhaps you build a tolerance for the drug? Withdrawal can be a batch even for drugs with no significant positive effects.

I've had withdrawal effects. They can be severe and tend to be physiological. They're usually fairly easy to point to and help me catch if a change in routine made me forget to take pills (eg after travel). I found this so interesting because a half dose didn't have typical withdrawal symptoms but left me with a very warped view of life.

Re: Extreme side-effects of antidepressants

#99

Post by inlined »

kqr wrote: post #95
inlined wrote: post #81

As a quick survey, do the people who believe that SSRIs have only a placebo effect also disbelieve any biological source of depression? Since the plural of anecdote is data, I'll share my story. I struggle with depression. I've kept it at bay for a long time now, but I had a big wave this year. It turns out that was ~1wk after a Rx refill and I realized the pharmacist refilled at half the dosage. Fixing the dosage go…

Not saying that is what happened, but perhaps you build a tolerance for the drug? Withdrawal can be a batch even for drugs with no significant positive effects.

I've had withdrawal effects. They can be severe and tend to be physiological. They're usually fairly easy to point to and help me catch if a change in routine made me forget to take pills (eg after travel). I found this so interesting because a half dose didn't have typical withdrawal symptoms but left me with a very warped view of life.
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