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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by Nootril on September 23, 2012, at 17:10:23
Here's a very thorough citation study on the effects of various types of antidepressants on cognition, Neurogenesis and Other bodily systems that could be adversely affected by antidepressants usage.Damn is there any other way, as it seems that your damned if you do and damned if you don't !
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3334530/pdf/fpsyg-03-00117.pdf
Posted by linkadge on September 24, 2012, at 18:52:31
In reply to Do antidepressants do more Harm than good ?, posted by Nootril on September 23, 2012, at 17:10:23
The article is a decent summary of some of the contrarian views of antidepressant treatment safety / efficacy.
Antidepressants do have side effects, and I don't think researchers have fully quantified these.
I am not a fan of SSRIs, mainly because they never did me much good. However, they do (apparently) work for some people.
I have no problem with the concept of an antideprssant. That is, I have no problem with taking a drug for depression, or even that a drug can help depression.
The case is certainly muddled when the drugs don't work, or when they only partially work as seems to be the case for a number of people.
My mental checklist is as follows:
- is it really depression?
- have I exhausted all other treatment options?
- is there an actually a pharmacudical option
that works? (don't worry about side effects if
the drug doesn't work - don't take it!!)
- if I do need medication, are there no alternatives, and have I found a medication that works? - if so, take the medication at the least effective dose **in conjunction with** all other alternative / complimentary treatments that can augment treatment.
- Only feel guilty about this if I am using the medication as an idol - that is, I am desiring that the medication 'do it all' and letting go of supports. I think this is the mindset that promotes relapse. Don't put all your eggs in one basket.Note, some people make money their idol, some people make religion their idol for others its psychiatry and / or prozac. I think its imporant to recognize what antidepressants can and cannot do (just like reconizing what money can and cannot do).
The safety issue goes over in my head repeately. I would assume that the safety is dose dependant, time dependant and dependant on a host of other mitigating factors.
Keep the dose low. Don't get to 375mg of effexor only to realize that it isn't working! If you are in the midst of a severe depression and 375mg of effexor does work (and is needed)...then take it, but as soon as remission occurs (if it dose), I would personally look to lower the dose whilest substituteing other tools in its place. For instance zinc apparenly augments TCAs and lowers the effective dose needed. SAMe might help some and lower the effective dose needed.
I don't have a problem with antidepressants, but I don't like the idea of indefinate treatment with them especially if you're on massive doses.
Also, I think this is a shift in the way that doctors treat depression. It used to be that you took amitriptyline (or whatever) until the depression got better and then you were well. Now, the trendy thing to do is keep patients on ADs forever. If you convince patients that they are permantly sick (because they have some bad gene) then they will live up to it. If you convice people that they can get better and that treatment is only temporary, I think it produces a different mindset for the patient. It may not be as palatable for the patient, however.
I peronally think that patients can get better, IE 'well' - if they are given treatments that promote recovery. I don't think that SSRIs really promote recovery.
Even if patients have bad genes, I think we underestimate recovery. We are now learning that certain genes can be turned on and off with stress.
In summary, I think where antidepressants do the most harm is when they don't adequatly help (or worse yet..hinder) ones ability / amition to engage in other healing measures.
Linkadge
Posted by jono_in_adelaide on September 24, 2012, at 19:41:46
In reply to Re: Do antidepressants do more Harm than good ?, posted by linkadge on September 24, 2012, at 18:52:31
I think there are a few rules/guidelines that might help the more rational use of antidepressants as well
1. Is the illness severe enough to warrent drug therapy (is it a deep depression, or it is just "the blues"
2. Is it the type of depression where drugs will work. If the patient is depressed because their marriage is on the rocks, they hate their job and they are up to their neck in debt, a script for Zoloft is unlikely to help them.
3. Is it a reactive depression or an endrogenous depression? One symptom cluster tends to respond to drugs that hit seretonin, the other to drugs that hit noradrenalin. if the depression is especialy deep or resistant to treatment, a combination of 2 drugs might be required to hit both neurotransmitters.
4. Take the drug for the right length of time..... 50% of people stop taking the drug within 4 weeks 9which suggests they shouldnt have been prescribed AD's in the first place. For a first depressive episode, six months is reasonable, for a second episode, 1-2 years is reasonable, for a third episode, you might consider life long treatment provided side effects arnt problematic.
5. Are drugs all the patient needs, CBT and other types of psychotherapy are extremely important in helping the patient learn coping skills, especialy in the reactive/neurotic type depressions
This is the end of the thread.
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