Antidepressants not so effective?

[Topaz]

This is an interesting story, and it echoes postmarketing data from
Prozac at least. And that is many studies (which were suppressed by the drug companies) show little or no difference in effect compared to placebo:

http://en.epochtimes.com/news/8-2-26/66610.html
Effectiveness of Antidepressant Drugs Questioned
Reuters
Feb 26, 2008

WASHINGTON—Antidepressant medications appear to help only very severely depressed people and work no better than placebos in many patients, British researchers said on Monday.

Researchers led by Irving Kirsch of the University of Hull reviewed a series of studies, both published and unpublished, on four antidepressants, examining the question of whether a person's response to these drugs hinged on how depressed they were before getting treatment.

They were Eli Lilly and Co's Prozac, also known as fluoxetine, Wyeth's Effexor, also called venlafaxine; GlaxoSmithKline's Paxil, also called Seroxat or paroxetine, and Bristol-Myers Squibb Co's drug Serzone, also called nefazodone, which it no longer markets in the United States.

They are all so-called selective serotonin reuptake inhibitors, or SSRIs.

The researchers found that compared with placebo, these new-generation antidepressant medications did not yield clinically significant improvements in depression in patients who initially had moderate or even very severe depression. The study found that significant benefits occurred only in the most severely depressed patients.

The rest of the article is at the link...and they typically don't stay there long.
So if you are interested, look now.

[Details]

They're wrong.

I've been on, and off Prozac. I'm not severely depressed - I just tend to cry easily - at Hallmark card commercials, and even the slightest frustration - and Prozac stops that. Without it - the crying comes back. No way is it a placebo effect.

[Topaz]

I often cry while watching trials on TV. And I have been known to cry at
commercials as well. In fact tear jerkers can be overwhelming for me too.
Watch the movie Simon Birch....and count your Kleenex!

SSRI drugs are very numbing...so if you want to stop expressing real emotion
I guess you have a right to use them.

Real depression means not getting out of bed, not eating, not taking a bath/shower, not
expressing emotions, not being interested in those things that used to interest you.

One person's perception of depression is not what another's may be.

In my opinion, having feelings means you are human. Numbing that only profits drug companies. The fact remains that this article is NOT NEW... search the literature on SSRIs and you find many articles showing SSRIs are not so effective.

One sees articles like this before new drugs hit the market. Wyeth has a new potent antidepressant coming...Pristique. And others are due in late 2008.
Often we see this discounting of previous drugs when the new guys show up on the block.
Hint--- all the drugs mentioned in this article are available generically...hint hint.

[Claudia]

I was on Paxil for 5 years, and it did NOTHING for my depression. In fact, I think I was worse on it. I was completely void of all emotion, it was ridiculous. I am normally a very emotional person, I can totally cry over a commercial, but not on Paxil. After I was off it for several months, the emotions came rushing back. It was like a rush at first, crazy emotions, all over the place, but then it evened out & I am now back to my old emotional self, crying at the dumb commercials, and very thankful that I can.

I have to add - it DID help my panic attacks, but after being off Paxil for about 2 years now, I have only had one bad bout of anxiety in that time. I will deal with that, and keep my other emotions, never again will I go on an SSRI. It almost ruined my life. I am determined now to find a natural way to deal with my anxiety. If I can't, well then, I'll just live with it.

[Details]

I have real emotion. And I have tears happen for nearly no reason. You've got no idea what it's like. We call it the family disease. Without some help from Prozac, I can't get through a normal, even glowing review from my boss at work without crying - not good. I can't so much as tell my husband I love you without crying. I wouldn't have my husband because discussing any normal emotion made me cry, choke up so much I couldn't talk, so I avoided ever saying anything real - had to control my thoughts so I didn't even think about anything real - that's when I was a zombie.

Yeah - sure - I'm just afraid of real emotion.

With it - I'm no zombie, and I still cry at tearjerkers, some commercials, and at appropriate times. But not to the degree I cannot speak, not so far out of control.

[sciencegirl]

I'm alive today because of Antidepressants. I'm just sayin!!!

[NJ_Nurse]

I tried 3 different anti-depressants for treatment of a particular diagnosis, and I reacted by having pretty negative side effects to all.

My opinion is: whatever works for you after consultation with your trusted health care professionals, is the way to go. Keep trying til you achieve optimum results. Sometimes the treatment is medication. Sometimes it is talk therapy. Sometimes it is diet and exercising the mind & body. And sometimes it is a combination of things....Whatever works!

[sciencegirl]

I tried 3 different anti-depressants for treatment of a particular diagnosis, and I reacted by having pretty negative side effects to all.

My opinion is: whatever works for you after consultation with your trusted health care professionals, is the way to go. Keep trying til you achieve optimum results. Sometimes the treatment is medication. Sometimes it is talk therapy. Sometimes it is diet and exercising the mind & body. And sometimes it is a combination of things....Whatever works!

It took me 7 different anti-depressants to find the right one. My doctor was determined at a time I was not. I will never be able to repay him.

[Details]

My mom has the issues with a lack of emotion when she uses them so far. They're still looking for the right solution for her. But when they work - there's no question about it. Although - if they don't work other than for severe depression, and if they eliminate real emotion - does that mean that that is just a placebo effect? Seems like that is what the first two posts by the OP add up to.

[Claudia]

I have real emotion. And I have tears happen for nearly no reason. You've got no idea what it's like. We call it the family disease. Without some help from Prozac, I can't get through a normal, even glowing review from my boss at work without crying - not good. I can't so much as tell my husband I love you without crying. I wouldn't have my husband because discussing any normal emotion made me cry, choke up so much I couldn't talk, so I avoided ever saying anything real - had to control my thoughts so I didn't even think about anything real - that's when I was a zombie.

Yeah - sure - I'm just afraid of real emotion.

With it - I'm no zombie, and I still cry at tearjerkers, some commercials, and at appropriate times. But not to the degree I cannot speak, not so far out of control.

I'm glad they don't do to you what they did to me - I know they don't do the same thing to everyone. I know people on SSRIs that are happy with them. I was just relating my personal experience with the Paxil. For me, it was wrong. For someone else, it could be fine.

I honestly think the doctor that diagnosed me was wrong. I don't think I had depression - the anxiety can cause some depression, I think without the anxiety, I wouldn't have been depressed. In between anxiety attacks, I am my usual happy, sociable, crazy self. That's not a depressed person. I was just in such a state when I went to see her, that I did what she told me without question. Maybe that's why it wasn't so good for me... but I don't know.

I'm not dead-set against them, but I wouldn't recommend them to anyone, either.

[Sumanadevii]

This group of drugs has been a miracle for so many. It has brought some back from the total darkness of deep depression back into life. My personal belief is it belongs in the hand of the physician. For years we had nothing to treat depression and many went untreated...living behind locked doors in their own hell. I think more studies need to be done. And..no...I don't believe this one.

[windovervocalcords]

It took me 7 different anti-depressants to find the right one. My doctor was determined at a time I was not. I will never be able to repay him.

sicnece girrl-- I am so happy you found such an excellent physician. Sometimes it takes awhile to find the right medication.

One of my clients is psychoaffective disorder--meaning symptoms of schizonphrenia and a mood disorder.

It took about eight months to find the right combination of meds for him. He had previously been a street kid in and out of foster homes, a drug addict, and considered unresponsive to treatment. He was in jail when I met him.

Now he has been clean and sober for a year, and is a happy fellow, getting an apartment, taking classes, having friends.

He has a LIFELONG disability--he will never be able to be fully integrated in society in the sense of holding down a job and being totally independent. He will need to see a psychiatrist and be on meds for the rest of his life.

I consider him an overwhelming success. I am proud to have served a small role in helping him be the happy person he is today. He now meditates, does yoga, and is training to be a peer counselor.

[Topaz]

themselves, there is a very good book out there called:

Beyond Prozac:
http://depression.about.com/library/zbookreviewz/bkr_0060391510_3178.htm
by Michael Norden MD

Also there is a good explanation of how neurotransmitters are affected by food:

Food and Mood:
by by Elizabeth Somer (you want the 2nd edition of this)
which explains food cravings, fatigue, carb addictions based on the newest scientific data on neurotransmitter actions. This is a great book too.

I have both of these books, and have found them extreme helpful.

I myself do light therapy during the dark months since I get really immobile during winter. I have a light visor called the FeelBrightLight, and also use B6 and l-tryptophan (not every day) to enhance serotonin synthesis.

http://www.feelbrightlight.com/Feel_Bright_Light.48.0.html
This has turned out to be a wonderful solution for me. :INhouseReading04:

[Topaz]

Just ran their take on this article...Dr. Gupta...

They gave 82% Placebo result. This is very high. I've seen 70% on some drugs.

One common drug you will recognize is Claritin.
There were studies showing Claritin = to placebo for years.
I even had doctors writing for themselves Claritin 2 or 3 times a day because
it "didn't work"...

You know, tricyclics still remain useful. And one wonders why there were not 100's of millions of RXs written for them for depressives?

Suddenly the drug companies started to detail SSRIs to non-psychiatric doctors, and currently more than 1/2 of all those 100 million RXs a year are written by non psychiatric doctors. I attended a seminar several years ago, by Lilly to promote Prozac this way, and the speaker was very revealing.
He said and I paraphrase "if patients come to "you" with an organ recital, they are most likely depressed. And since the SSRIs are very safe in overdose (the TCAs are not), then give the medication with no qualms."

That is what doctors are doing. People come in feeling low, tired, dragged out, "depressed" like Julie Jensen did in that recent trial. Her doctor even testified that her lab work showed increased MCV..which is a clear sign of B12 deficiency...but did this doctor follow up with more tests to clarify that lab result? He testified that increased MCV was not important. (so why test for it?) It IS important! So what did he do? ....he gave her Paxil. People with low B12 feel tired, dragged out have neuro symptoms of depression, etc.
One of the first signs of B12 deficiency is poor sleeping. (Julie complained of that too).

So while antidepressants may work for truly depressed people, who is to say the mild depressive symptoms are even depression in reality, but instead are something else, that is wrong with the person and needs clarification?

The statistic 82% placebo means 18% positive response.
Does 18% justify over 100 million Rxs a year?

So people here with positive response, are most likely part of that 18%.
They should not feel defensive about that.
If you are however, part of the 82%, you might want to seriously consider your choices.

[PatC]

I can't believe I've overlooked this thread this long!

First, regarding Claritin. For years I went through h3ll every spring and fall suffering from allergies. My DH has similar problems (not quite as pronounced as mine). With me, it always seemed to progress to bronchitis before it was over and I'd go to the doctor. I was given Claritin more than once and eventually I'd survive -- probably the pollen count declined and my body began to function properly.

In the meantime, DH "discovered" AlkaSeltzer Plus and when he starts with the runny nose and coughing, doped himself with it. (I had a problem with the fizz-fizz taste part).

Shortly before I retired our local health-food store owner Sami Kennedy (http://www.wholehealthconnection.com/Sami-Kennedy.htm) offered some classes on the use of herbs and I enrolled. Long story made short (I know, I know, it's too late....LOL) the next pollen season came around and hubby became affected first. All morning long I'd heard him snuffing and coughing and blowing his nose... he was out of AlkaSeltzer Plus and when I asked him what he needed as I headed to town for groceries, he told me to get him some. -- I didn't. Instead I went to Sami's store and asked for Nettles & Eyebright. It came as a tincture and when I came home I put the recommended number of drops in a glass of water and took it to DH.

"That's not my AlkaSeltzer Plus", he said. (I never said he wasn't sharp, did I?) I told him, that no, it wasn't but to try it and if it wasn't effective I'd go back to town and get is stuff. I went back to the kitchen and started putting away my groceries. Eventually, I realized I wasn't hearing DH's disgusting sounds anymore. I went back where he was working on something or other and asked if the still needed me to go get the AlkaSeltzer.

"No, I'm fine now." he muttered. "Huh?" I said. "No, I'm fine now." he said slightly louder. "I'm sorry, I can't hear you." I insisted. "All right! It works, OK!"

I left the room smiling smugly.

:girl_haha:

[Grins]

themselves, there is a very good book out there called:

Beyond Prozac:
http://depression.about.com/library/zbookreviewz/bkr_0060391510_3178.htm
by Michael Norden MD

Also there is a good explanation of how neurotransmitters are affected by food:

Food and Mood:
by by Elizabeth Somer (you want the 2nd edition of this)
which explains food cravings, fatigue, carb addictions based on the newest scientific data on neurotransmitter actions. This is a great book too.

I have both of these books, and have found them extreme helpful.

I myself do light therapy during the dark months since I get really immobile during winter. I have a light visor called the FeelBrightLight, and also use B6 and l-tryptophan (not every day) to enhance serotonin synthesis.

http://www.feelbrightlight.com/Feel_Bright_Light.48.0.html
This has turned out to be a wonderful solution for me. :INhouseReading04:
How much exposure time?
Thanks Topaz for all your efforts on our behalf!! :0012:
:love0085:

[Grins]

Nothing worked for me until I tried the oldest, Tranylcypromine [Parnate].
Restores all the neurotransmitters
and
cured my allergies!!

[Topaz]

How much exposure time?
Thanks Topaz for all your efforts on our behalf!! :0012:
:love0085:

I use 30min in the early morning, at the 8000lux (lower) setting.

I started in Oct this year, and did it every day, and the huge down never came.
Last year at that time I was sleeping all the time, and very numb. (the worst ever). I could barely work. I changed my working times to only days, and dropped all the night shifts thinking that would help. By late Jan I was a total wreck. So I bought the visor last Feb. Within 2 weeks, I was at least cogent, and not sleeping so much. I didn't use it at all during the summer, after June.

This season, I haven't needed it every day, in Jan and Feb so far. I am doing about 2 -3 days a week now. I think starting it earlier in the fall was very helpful to me.

My son uses it too, and likes it for afternoon use. He and his roommate have some anxiety ADHD issues, and he says it helps with that too. I don't know how that is... but he says so. I gave him my last year's model, and bought a new one.

I think the only worry in using it would be to watch for mania, or hypomania.
Light therapy can make you change, and if one is an undiagnosed bipolar or has mild bipolar and doesn't know it, too much light is not a good idea.
So I started very low, and stay down there in the mild use category.
If I start getting a bit hyper/loud, I just cut back on it for a day or two.
One can feel it at night trying to sleep. Once I get that late night feeling, I cut back.

Other benefits were:
decreased appetite (less food cravings)
improved pain (I have arthritis)
Improved thinking (no brain fog)

I really like it... no side effects (except for the weird comments from family members ...LOL) The blue-green wavelength is very efficient, but my husband makes fun of how I look wearing them.:22wink:

[nanabillie]

I don't want to think about life without my anti-depressants. Anyone that has never had chronic, severe depression would never really understand. It's like hearing that someone has cancer and you sympathize with them. When you are sitting there in the doctor's office and he says to you, "I'm sorry. It is malignant". No one knows what that feels like.
I do think anyone with chonic depression needs a psychiatrist. I have for years. And I take 300 mg. of Welbutrin in the morning and 40 mg. of Lexapro at night. Along with 20 mg of ambien and 30 requip for RLS.
My problem is trying to get everyone else to take antidepressants. One friend that will cry for days won't take them, and they have been prescribed to her. She doen's want to "get hooked on them". That is what she tells me. I have taken Prozac, Zoloft, Effexor, maybe others over the years. I am satisfied with what I have now.

[nanabillie]

Do you have to have a prescription for the visor? Where do you get them? Flourscent lighting give me migrains, do you think the visor would?

[Topaz]

The link is in my posts above.

The first time I used it, I was a bit stunned! A little nauseous. And it was like 6:30 am besides. I don't get migraines anyway.

After the first time, it didn't bother me that way.

I can't say what it would do for a migraine person, esp one that is light sensitive. But the light from the visor is blue green, not white. Limited wavelength. It is a bit easier on the eyes if the room is light, in the dark it seems brighter (contrast).

I don't want to take antidepressants. I have seen the down side of them since they came out. (that is my job)
Anyway I only suffer in the winter. In the summer I have no problems at all.
As I have aged, the winter blahs became huge...so I am sure I have a SAD issue.

Increasing serotonin in the brain naturally is really the way to go if one can do it. No side effects. In my case the easing of the pain issues was substantial as well.

[nanabillie]

Thanks Topaz, I just read about the light. It said people who have migraines triggered by bright lights should not use the light. I was afraid of that. I try not to wear sunglasses while outside as suggested by my doctor years ago, but since chemo I am so sensitive to light induced headaches I can't always do it. Anything new you learn please pass along.
I, too, have a big pain problem. I have fibromyalgia/chonic fatigue syndrome, digenerative disc, yadayadayada........One big pain.
I don't want to break any rules so don't answer if you don't want to. Are you a doctor, nurse, ???? You sure are knowledgeable.

[Texas53]

I have been on Cymbalta, Wellbutrin (gave me rashes and felt like my tongue was thick) and finally on Effexor XR. I have been diagnosed with Complex PTSD (and its real-won't bore anyone with details). For allergies, down here in Central Texas (Austin and heading south) when the Cedar blows in, its pure hell. I usually use Clariten-D if really needed. Some years I have found are better then others. This year wasn't too bad for me.

[Topaz]

Thanks Topaz, I just read about the light. It said people who have migraines triggered by bright lights should not use the light. I was afraid of that. I try not to wear sunglasses while outside as suggested by my doctor years ago, but since chemo I am so sensitive to light induced headaches I can't always do it. Anything new you learn please pass along.
I, too, have a big pain problem. I have fibromyalgia/chonic fatigue syndrome, digenerative disc, yadayadayada........One big pain.
I don't want to break any rules so don't answer if you don't want to. Are you a doctor, nurse, ???? You sure are knowledgeable.

I'll send you a PM... there is virtually no edit here ( a very short time period),
and I don't want to leave my occupation on here forever.

You can raise your own serotonin by providing the precursors for it.
L-tryptophan works well. (almost as good as Prozac).
Also Vit B6 is needed to convert the tryptophan.

But if you are already using an antidepressant, it is not advisable to take
l-tryptophan. L-tryptophan came back on the market this past summer.
I use NOW brand. I buy at www.iherb.com
They have huge discounts and sell very good ranges of quality supplements,
at 1/2 price or less. Low shipping.
By raising serotonin, you raise your pain tolerance as well.
There are some alternative doctors who feel that long term use of SSRI type antidepressants actually lower serotonin in the body over the long haul. This is why the drugs seem to stop working.
I know that spinal fluid levels fall and that has reported.

Check your PMs.