Enoch Choi, MD
Enoch Choi, MD
Male, 43
Palo Alto - CA
Specialties: Family Medicine
Interests: sinusitis, migraine, low back pain, cellulitis, abscess, skin infection, neck pain, allergies, ear infections
Male, 43
Palo Alto - CA
Specialties: Family Medicine
Interests: sinusitis, migraine, low back pain, cellulitis, abscess, skin infection, neck pain, allergies, ear infections
Antidepressants may not be much better than placebo
Feb 26, 2008 03:07PM
- 44 comments
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A fascinating research study was published today by Irving Kirsch of the University of Hull, questioning whether or not 4 popular antidepressants are any better than placebo, and found that they weren't any better. Here's the study:
http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0050045&ct=1
Both published and unpublished data on fluoxetine (Prozac), venlafaxine (Effexor), nefazodone (Serzone), and paroxetine (Paxil) were combined in a technique called meta-analysis, which brings together the data from many different research studies to see if they agree.
The researchers concluded that the antidepressants were not any better than placebo for mildly depressed patients. They found that although there was a benefit from antidepressants, it was not significantly better than what a placebo (pill without any medicine in it) did. The placebo treatments had a great deal of benefit, almost 80% improvement in depression symptoms. The antidepressants didn't do any better than placebo.
They further concluded that the benefit that these antidepressants had on severely depressed patients was from these patient's lack of benefit from placebo treatment. That is to say, severely depressed patients didn't get better from a placebo (pill without any medicine in it). Since severely depressed patients got better at about the same rate as the mildly depressed patients, by comparing this benefit to the lower benefit from placebo, overall they showed a benefit. Another way to think of it is that really depressed patients get better from antidepressants at about the same rate as mildly depressed patients get better, but since severely depressed patients don't get better from placebo, by comparing treatment versus placebo, the difference is greater.
It's important that patients on these medicines don't stop taking their medicines because serious side effects can occur, such as worsening of the depressive symptoms that they initially took them for, including thoughts of suicide for some patients.
This is just one study that will be further examined. The great thing is that it's been published in the Public Library of Science online journal. This is a place where the data and paper are publicly available, without any advertising or corporate support.
Reasons to think twice about the results of this study, is that the technique of meta-analysis is only as good as how well the 47 different data sets they've combined match. These data sets have to be combined in a valid way, controlling for different factors in each study. Some researchers disagree with this kind of process, saying that it's very difficult to control for confounding factors in the separate data sets, calling into question the validity of the results. I'm expecting the drug companies to be fighting these studies powerfully, and be curious to see how they try to disprove the results.
http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0050045&ct=1
Both published and unpublished data on fluoxetine (Prozac), venlafaxine (Effexor), nefazodone (Serzone), and paroxetine (Paxil) were combined in a technique called meta-analysis, which brings together the data from many different research studies to see if they agree.
The researchers concluded that the antidepressants were not any better than placebo for mildly depressed patients. They found that although there was a benefit from antidepressants, it was not significantly better than what a placebo (pill without any medicine in it) did. The placebo treatments had a great deal of benefit, almost 80% improvement in depression symptoms. The antidepressants didn't do any better than placebo.
They further concluded that the benefit that these antidepressants had on severely depressed patients was from these patient's lack of benefit from placebo treatment. That is to say, severely depressed patients didn't get better from a placebo (pill without any medicine in it). Since severely depressed patients got better at about the same rate as the mildly depressed patients, by comparing this benefit to the lower benefit from placebo, overall they showed a benefit. Another way to think of it is that really depressed patients get better from antidepressants at about the same rate as mildly depressed patients get better, but since severely depressed patients don't get better from placebo, by comparing treatment versus placebo, the difference is greater.
It's important that patients on these medicines don't stop taking their medicines because serious side effects can occur, such as worsening of the depressive symptoms that they initially took them for, including thoughts of suicide for some patients.
This is just one study that will be further examined. The great thing is that it's been published in the Public Library of Science online journal. This is a place where the data and paper are publicly available, without any advertising or corporate support.
Reasons to think twice about the results of this study, is that the technique of meta-analysis is only as good as how well the 47 different data sets they've combined match. These data sets have to be combined in a valid way, controlling for different factors in each study. Some researchers disagree with this kind of process, saying that it's very difficult to control for confounding factors in the separate data sets, calling into question the validity of the results. I'm expecting the drug companies to be fighting these studies powerfully, and be curious to see how they try to disprove the results.
Some thoughts:
That is an interesting study as are all such studies. Some would say the results of any study are influenced by the anticipated result of the researchers. Quantum mechanics says that just by looking at something you alter it and all possibilities play out eventually.
One perspective:
I personally have been on and off antidepressants for the last 20 years. My family prefers me on them and so do I. I don't like the idea of being dependent on them and have wondered if maybe I really didn't need them. Last year I was off my Zoloft from Feb. through mid Nov. I thought I was doing okay for several months...not everyone in my family agreed. By fall I was feeling really pretty bad and since I've been back on I feel so much better and my family likes being around me again.
That is an interesting study as are all such studies. Some would say the results of any study are influenced by the anticipated result of the researchers. Quantum mechanics says that just by looking at something you alter it and all possibilities play out eventually.
One perspective:
I personally have been on and off antidepressants for the last 20 years. My family prefers me on them and so do I. I don't like the idea of being dependent on them and have wondered if maybe I really didn't need them. Last year I was off my Zoloft from Feb. through mid Nov. I thought I was doing okay for several months...not everyone in my family agreed. By fall I was feeling really pretty bad and since I've been back on I feel so much better and my family likes being around me again.
I find this funny considering that there is a ton of other data and studies (double blind studies) that prove this study as complete nonsence. I refer you to the paragraph in which it says, "were not any better than placebo for mildly depressed patients." This study was conducted using only (mildly Depressed individuals or test subjects.)
It comes as no supprise to me that a mildly depressed individual would not notice the difference between a placebo and the real medication. Reason being is that any experienced Psyciatrist can tell you that generally, only Severely depressed individuals benifit from AD medication.
I say if you trust this report and suffer from severe depression, then go ahead and take the Pepsi challenge.
I guarentee after less than 90 days you will fall back into a deep dark hole. If you don't then you didn't need the meds in the first place.
It comes as no supprise to me that a mildly depressed individual would not notice the difference between a placebo and the real medication. Reason being is that any experienced Psyciatrist can tell you that generally, only Severely depressed individuals benifit from AD medication.
I say if you trust this report and suffer from severe depression, then go ahead and take the Pepsi challenge.
I guarentee after less than 90 days you will fall back into a deep dark hole. If you don't then you didn't need the meds in the first place.
Hensley258, as I said, it's important that patients on these medicines don't stop taking their medicines because serious side effects can occur, such as worsening of the depressive symptoms that they initially took them for, including falling so deep into the dark hole that they act on thoughts of suicide for some patients. Just say no to the Pepsi challenge.
I just get worried when I see studies and reports such as that. Simply because some individuals that are less experienced with their depressive dissorder might use it as a reason to discontinue the very medication that was responsible for saving their life in the first place.
Obviously I was being sarcastic and I HIGHLY advise against anyone discontinuing their medications just to see if this study is correct for them too. Any tapering of AD meds should ONLY be done under a doctors supervision.
I really think it would be safe to conclude that the vast majority of Mental Health professionals, such as Psychiatrist would be able to shoot large enough holes in that study to drive a Hummer thru. I think most of us wise enough to detect changes in our condition, clearly understand what our medication does for us.
Obviously I was being sarcastic and I HIGHLY advise against anyone discontinuing their medications just to see if this study is correct for them too. Any tapering of AD meds should ONLY be done under a doctors supervision.
I really think it would be safe to conclude that the vast majority of Mental Health professionals, such as Psychiatrist would be able to shoot large enough holes in that study to drive a Hummer thru. I think most of us wise enough to detect changes in our condition, clearly understand what our medication does for us.
I've always thought the only effect of SSRIs was a placebo effect. In fact, the placebo effect can exist in family members. My wife thinks I am much better taking Effexor, but when I fake taking it for months, she doesn't notice the difference. I don't notice the difference because I never noticed an improvement. Being a cynic, I'm not a good candidate for placebos.
I personally am very suspicious of antidepressants. Considering how much drug companies peddle them. There are more commercials, billboards, and print ads for antidepressants than seems reasonable. I think those ads and many doctors convince a lot of people who aren't depressed that they are. (Which would cause these people to feel and act more depressed... I think that explains why some antidepressants actually increase suicidal thoughts in some people) The level of depression is a hard thing to quantify. That is why psychology and the study of mood is generally considered a soft science, isn't it?
In my past, I have been on Paxil, Zoloft, Prozac, Wellbutrin, Effexor, Remeron,Cymbalta, Lexapro, Lithium (which technically isn't an antidepressant, I don't think, but I was on it to treat depression nonetheless.) and probably other ones that I don't remember any more. Not one of them helped me with my depression, which I was hospitalized several times for. I saw a number of psychiatrists, who would cart me in once a week, ask for a 5 minute explanation about how I'm doing, and prescribe higher doses or a new antidepressant. I never had an appointment with a psychiatrist that lasted more than 20 minutes. Counseling, on the other hand did a world of good.
While I know depression is in part caused by a chemical imbalance, I do not believe it can be treated with a chemical. Because I don't think that is the root of the problem. From my experience with it, it is caused by series of distorted thoughts that build upon one another until you are tangled inside them. The way you perceive outside stimuli causes you to have certain thoughts about it. The thoughts you have influence your mood, and your mood is the result of the level of certain neurotransmitters in your brain. For example, Joe hears about a fatal car accident caused by drunk driving. (stimuli) His perception of it is negative. He has a thought like this "The world is a horrible place, there is nothing I can do to fix it. Why should I go on living in a world like this?" And then he feels sad. When he feels sad, he is more likely to think negatively about other things too. It is an endless cycle that can't be stopped until he changes the way he is thinking. Not try to forcibly and artificially cause himself to have happy chemicals in his brain.
In my past, I have been on Paxil, Zoloft, Prozac, Wellbutrin, Effexor, Remeron,Cymbalta, Lexapro, Lithium (which technically isn't an antidepressant, I don't think, but I was on it to treat depression nonetheless.) and probably other ones that I don't remember any more. Not one of them helped me with my depression, which I was hospitalized several times for. I saw a number of psychiatrists, who would cart me in once a week, ask for a 5 minute explanation about how I'm doing, and prescribe higher doses or a new antidepressant. I never had an appointment with a psychiatrist that lasted more than 20 minutes. Counseling, on the other hand did a world of good.
While I know depression is in part caused by a chemical imbalance, I do not believe it can be treated with a chemical. Because I don't think that is the root of the problem. From my experience with it, it is caused by series of distorted thoughts that build upon one another until you are tangled inside them. The way you perceive outside stimuli causes you to have certain thoughts about it. The thoughts you have influence your mood, and your mood is the result of the level of certain neurotransmitters in your brain. For example, Joe hears about a fatal car accident caused by drunk driving. (stimuli) His perception of it is negative. He has a thought like this "The world is a horrible place, there is nothing I can do to fix it. Why should I go on living in a world like this?" And then he feels sad. When he feels sad, he is more likely to think negatively about other things too. It is an endless cycle that can't be stopped until he changes the way he is thinking. Not try to forcibly and artificially cause himself to have happy chemicals in his brain.
I was interested when I saw this study in my email so I read more. I caught myself being defensive when I read that taking AD was no better than not taking them. I'm living proof that AD meds work. As I suffer from cruel depression and bipolar disorder, I can tell you that AD along with other meds have saved my family life, my relatinships, my sanity and my mortal life. I've tried stopping my meds and not telling anyone, it didnt work for long. I could tell a difference within days. Others around me as well. If you are aware of yourself, you can tell the thoughts in your head change into anger, saddness, worry, suspision, rage and suicide. Thoughts come into your head that wouldnt if you were on the meds. I think the disorder tells you to stop taking the medication, you'll be fine, you don't need it, you were just angry or in a rut for a while. If and when you fall into that belief you are on a path to distruction and chaos. I hate taking medication everyday, and when I take that handfull and try to swallow them all at once so it will not take much time and I dont have to think about it, I realize I have to do this for the rest of my life beause without them, that rest of my life part, wouldnt be for long. So when I read this study, it upsets me that someone could read this and stop their meds, it scares me to think about someone falling back into that deep dark hole of not leaving the bed for days, let alone the house, thinking about suicide,because of the results of one study. I hope they do read further and see the comments made against stopping meds or not getting help for their depression. I do agree that therapy is a huge help along with medication. You have to change the way you think, and the meds help you realize that you can, and want to. I'm no specialist on depression or AD meds, I'm just a survivor.
I don't think there is any disagreement here, really depressed people benefit from the meds, slightly sad people do not. Sometimes we are entitled to be sad, when it becomes monumentally overwhelming, then it is depression. Antidepressants did help me understand that negative thinking created negative thinking and after I understood what looking at things in a more posiitve light could do, I became considerably better. I am okay with being sad occassionally, sometimes I am happy too! If I find myself stuck back in the dark hole again, bring on those SSRIs!
I agree that psychotherapy and counseling is very helpful to untangle the distorted thoughts that influence mood.
I think that medications can be very helpful for some patients. Especially more depressed patients.
I think that medications can be very helpful for some patients. Especially more depressed patients.
I found the student interesting and felt like I needed to put in my two cents worths about Effexor. I was put on it after I had my daughter. I took it for three years only having to increase the dosage once. I was doing fine until my insurance company changed and the new one didn't want to pay for Effexor. They wanted my dr. to try something else. Since I have been living off of the samples my dr. gave me to slowly taper off. The withdrawals are miserable. I have been Effexor free for five days now and I feel miserable. Has there ever been a study done of the horrible withdrawals and is there someplace that offers solutions instead of just other miserable stories from people suffering from the same thing. So far I'm just treating the symptoms as they happen like nausea and headaches but the worst one is the "brain zaps". I can't find anything to relieve those.
I have found there seems to be a continual need to prove that antidepressants do not work. Often I wonder if it is the stigma of mental health and the need to not be broken..There is much more research from more than drug companies to support the scientific basis of the mechanism of antidepressants. I prescribe these meds and people will go off them after 6-9 months and arrive back in my office within 3-9 anxious depressed and miserable. If people seek treatment after 5 years of untreated or under treated depression the chances of them achieving remission is only 5-6 per cent of the time. Statistics can be skewed to anyway they will prove a point,especially in a meta analysis. If antidepressants are so bad then why have they continued to be used for over 30 years. And where is the university of Hull and who funded the meta analysis?
cora3223... this is a great point. But they never worked for me for postpartum depression. Is th b/c I wasn't that severe?
kramer10...My doc put me on Effexor and I took them for a few months, but then ran out of meds.
I didn't have any withdrawls. Did you find something that works? Just wondering???
Thanks,
Jen
kramer10...My doc put me on Effexor and I took them for a few months, but then ran out of meds.
I didn't have any withdrawls. Did you find something that works? Just wondering???
Thanks,
Jen
I AM A PERFECT EXAMPLE THAT THEY HELP DEPRESSION/ANXIETY,,,,..AFTER HAVING FOUR CHILDREN I HAVE HAD A LOT OF ANXIETY AND NERVOUSNESS OVER THE YEARS AND I HAVE TAKEN PROZAC AND IT MAKES ME FEEL MORE LIKE MYSELF AND NOT LIKE SOME NERVOUS SYCHO-PATH WONDERING IF LIFE IS WORTH LIVING! WITHOUT PROZAC I AM SO NERVOUS AND EVERY LITTLE THING THAT SOMEONE SAYS OR DOES I TAKE IT TO HEART AS IF ITS THE END OF THE WORLD!!! I DON'T KNOW IF ANYONE ELSE AS EXPERIENCED THESE NERVOUS/ANXIETY FEELINGS AFTER HAVING CHILDREN ..BUT I DON'T REMEMBER FEELING LIKE THIS BEFORE I HAD MY FIRST BABY!!! EVEN IF I WATCH THE NEWS ..I FEEL REALLY BAD ALL THAT NIGHT... PROZAC TAKES ABOUT 75% OF THOSE BAD FEELINGS AWAY ...WHICH IS BETTER THAN NOTHING. IT GIVES ME A REASON TO LAUGH AGAIN AND NOT BE THINKING ABOUT ALL THE BAD IN THE WORLD AND LETTING THAT AFFECT ME. THE ONLY DISADVANTAGE IS THAT IT CAUSES REALLY BAD URINE RETENTING AND DISCOMFORT WHICH IS MUCH BETTER THEN HAVING ANXIETY!!
I have been suffering the long-term affects from the West Nile Virus, and one of the symptoms that always popped up was depression. I was a macho guy that always considered depression as the result of someone feeling sorry for themselves. Hey, pick yourself up by the boot straps and get going. Boy, was I wrong. After two solid years of fighting the depression associated with WN, and someone who never believed in taking medicines, I finally accepted the fact that I needed help. So, at age 54 I began taking Lexapro. However, the low dosage resulted in anxiety problems, so I was also prescribed Buspar. It took months to regulate and find a balance between the two. I have to take a high dosage of the Lexapro and a medium dosage of the Buspar. If I miss a couple of dosages, I can definitely tell the difference. If I miss one dosage my wife can tell the difference. For me, these two drugs are a life saver.
Judy 2/27/08
Slightly off the initial issue, but what is known about depression being hereditary? My dad had severe depression (in his 70's!) and both my daughters take meds for it and claim that it is necessary. I have "needed" meds, periodically, in the last few years -- mainly for anxiety and my daughters say that I am much calmer. In my case, I wonder if I just have a hyper personality! :) My daughters become "bitchy" (sorry!) when off of meds. My dad was on Norpromine (sp.?) -- doctors claimed that his body was not producing enough of the chemical needed in the brain, for mental equilibrium (as in serotonin). He was a guinea pig -- it hadn't been gov't-approved, at the time. Maybe, we're just a dysfunctional family and should blame our upbringing?!
Slightly off the initial issue, but what is known about depression being hereditary? My dad had severe depression (in his 70's!) and both my daughters take meds for it and claim that it is necessary. I have "needed" meds, periodically, in the last few years -- mainly for anxiety and my daughters say that I am much calmer. In my case, I wonder if I just have a hyper personality! :) My daughters become "bitchy" (sorry!) when off of meds. My dad was on Norpromine (sp.?) -- doctors claimed that his body was not producing enough of the chemical needed in the brain, for mental equilibrium (as in serotonin). He was a guinea pig -- it hadn't been gov't-approved, at the time. Maybe, we're just a dysfunctional family and should blame our upbringing?!
Judy1942
PS -- I'd like to sneak placebos into my daughters' perscription bottles and see what happens!
PS -- I'd like to sneak placebos into my daughters' perscription bottles and see what happens!
Judy1942: don't do it! don't slip placebo's in, that could end in tragedy
My strong, healthy mountain climbing, marathon running, well educated son has Lyme's Disease. It took a long time to diagnose--even the Mayo Clinic couldn't figure out what was wrong with him! (After 12 days of miserable tests). Finally, the correct blood tests by a neurologist in our hometown were done and discovered he had Lymes. He was put on long-term antibiotics. As a result of his suffering and depression with Lymes and no longer able to participate in many activities--even going for a walk-- or holding a job-- he saw a doctor who put him on Paxil. It has helped him tremendously. He is now starting to enjoy life again thanks to the wise doctor and the help of the anti-depressant. My advice is only go off or change meds with the help of your doctor. Using the correct medications can make a huge difference in your life. Good luck!
Hi,
Any studies on Wellbutrin ?
I took Zoloft and/ or Prosac for several years, was hard to tell if there was any improvement with either of these meds, or much if any difference.. I was quite suprised that when Wellbutrin was added , that I felt major improvement. I had not anticipated any changes with another medication (Welbutrin). I've phased out the Prosac, and enjoyed being relieved of the dry mouth side effects.
Thanks, Peaches
Any studies on Wellbutrin ?
I took Zoloft and/ or Prosac for several years, was hard to tell if there was any improvement with either of these meds, or much if any difference.. I was quite suprised that when Wellbutrin was added , that I felt major improvement. I had not anticipated any changes with another medication (Welbutrin). I've phased out the Prosac, and enjoyed being relieved of the dry mouth side effects.
Thanks, Peaches
Like this study and I'll tell you why. ANY medical professional who takes the time to read his updated PDR(not outdated- which I have seen in too many doctors offices) will know anti depressants are recomended for use in SEVERLY depressed persons who are unable to function in a normal day. In addition they were designed for short term use, maximum of 6 months, to allow the patient time to see a good therapist, etc, to work through their emotional trauma. A good example of a candidate for anti depressants would be a male/female who just lost a spouse or child.
Not example of good candidate: 17 yr old girl who is "bummed out" because she fights all the time with her mom about "stuff". the "stuff" being things like not being allowed to spend the night a her boyfriends house, having a curfew, etc. Since when did teenage angst become a catalist for drug therapy? Believe it or not, I saw this often. Or better yet, teens getting put on birth controll and then Prosac since the birth controll made them moody..ARG!
I whole heartedly agree with the main point of the study- refering to those who are mildly depressed. We all have bad days, some of us have bad runs for a while. But it's no reason for the prescription pad.
I am reminded of my moving to Oregon at the age of 19 for a college program that was only offered in this state at the time. The year I got here, the program was dropped due to lack of enrollment. I could have gone home, but I opted to stay here for a year, learn to be a grown up, stand on my own, etc. It was one of the worst years of my life. I cried a lot, wanted to be anywhere but here. At my first flu bug, I told my newdoctor how I was feeling, he offered an rx for Prosac. I turned him down and got myself some friends instead. My year didn't get better right away but with friends and activity I made it through that tough year. I shudder to think of what could have happend had I opted for the Prosac for my mild depression/ unhappiness.
Not example of good candidate: 17 yr old girl who is "bummed out" because she fights all the time with her mom about "stuff". the "stuff" being things like not being allowed to spend the night a her boyfriends house, having a curfew, etc. Since when did teenage angst become a catalist for drug therapy? Believe it or not, I saw this often. Or better yet, teens getting put on birth controll and then Prosac since the birth controll made them moody..ARG!
I whole heartedly agree with the main point of the study- refering to those who are mildly depressed. We all have bad days, some of us have bad runs for a while. But it's no reason for the prescription pad.
I am reminded of my moving to Oregon at the age of 19 for a college program that was only offered in this state at the time. The year I got here, the program was dropped due to lack of enrollment. I could have gone home, but I opted to stay here for a year, learn to be a grown up, stand on my own, etc. It was one of the worst years of my life. I cried a lot, wanted to be anywhere but here. At my first flu bug, I told my newdoctor how I was feeling, he offered an rx for Prosac. I turned him down and got myself some friends instead. My year didn't get better right away but with friends and activity I made it through that tough year. I shudder to think of what could have happend had I opted for the Prosac for my mild depression/ unhappiness.
I wholeheartedly agree with Pseudopal. I've been writing up a research paper on depression using the latest research and I came to the same finding, that such meds are for those who have a severe depression with reasonable functioning.
Dr's are too quick to prescribe Anti-dep meds for anyone feeling a bit low.
But we should be more concerned about the backlash about to occur. I fear people in their hundreds or more coming off the med too quickly, with no hope for improvement. I think someone should arrange a press release to advise people how to go about coming off their meds if they wish and seeking different forms of help for their depression such as secular and spiritual counselling, exercise, financial advice and so on while highlighting the risks of going off them suddenly.
Dr's are too quick to prescribe Anti-dep meds for anyone feeling a bit low.
But we should be more concerned about the backlash about to occur. I fear people in their hundreds or more coming off the med too quickly, with no hope for improvement. I think someone should arrange a press release to advise people how to go about coming off their meds if they wish and seeking different forms of help for their depression such as secular and spiritual counselling, exercise, financial advice and so on while highlighting the risks of going off them suddenly.
Personally? From my experience of being "drugged" up with so many DIFFERENT damn pills for so many years ( 5) now, i have to say that i have had to do most of the research on my own. And i am thinking that why in the hell do they NOT have patients who are severe in a THERAPIST office laying DOWN on the couch just like the OLD DAYS when you babble on and on and THEY LISTEN to you and TAKE REAL NOTES. Sometimes they even will tape what you say. Then they will gather all that information and compile it into something and be able to come up with a reason of why you are having the anxiety and the depression to begin with.
INstead? You go into the office and you tell the doctor. "doc i am having anxiety and i am not sleeping and i am miserable!!" So they immediately diagnose you as being depressed or bipolar or manic or a variety of other things and then dish out medications. Well guess what? Those medications don't RESOLVE anything. You may as well open up a good bottle of Scotch and sit at a bar. IT is relatively the same thing. You are going in one big slow circle of nowhere. And the damage to your body and MIND are the same. IT was for me. And meantime? I was on the computer and in the library doing extensive research finding out what kind of meds i was on and WHY and what the side effects were. And how much money have i dished out over the years on these medications?? OMG i cannot even tell you!!! For how much i have paid for doctors visits and medications and hospital stays etc..? I coulda had a college degree of my own and been a Psychiatrist by now!!
Why just the other night in Ballet i was talking to a girl about her meds and she asked me, " are you a Pharmacist or something?" HA!
INstead? You go into the office and you tell the doctor. "doc i am having anxiety and i am not sleeping and i am miserable!!" So they immediately diagnose you as being depressed or bipolar or manic or a variety of other things and then dish out medications. Well guess what? Those medications don't RESOLVE anything. You may as well open up a good bottle of Scotch and sit at a bar. IT is relatively the same thing. You are going in one big slow circle of nowhere. And the damage to your body and MIND are the same. IT was for me. And meantime? I was on the computer and in the library doing extensive research finding out what kind of meds i was on and WHY and what the side effects were. And how much money have i dished out over the years on these medications?? OMG i cannot even tell you!!! For how much i have paid for doctors visits and medications and hospital stays etc..? I coulda had a college degree of my own and been a Psychiatrist by now!!
Why just the other night in Ballet i was talking to a girl about her meds and she asked me, " are you a Pharmacist or something?" HA!
Just my thoughts, but I personally can't help but wonder when someone talks about how much their meds 'help' them is it REALLY the meds, or is it possibly because they have grown to BELIEVE the meds help...and when they try to discontinue them on their own and really do feel worse, is it not then possibly withdrawal symptoms that factor into the way they feel?
I am one who does not rule out the power of the mind/body connection. Of course I do not forget that there are those who may really need medication, but I honestly feel many more probably do not.
I appreciate Dr. Choi's opinion and that he took the time to address such a controversial and common issue. I do not fault him in his opinions in any way, he is certainly entitled to them, as we all are.
In regards to defending these medications based on them being around for such a long time, etc, I would be inclined to argue that 'big pharma' making money is likely to be a factor. The power of the big drug companies is not something I would rule out.
The reason this subject especially bothers me is that I have noticed through friends/family a growing trend where medical doctors are prescribing antidepressants to patients they barely know. I don't feel it is right for a general doctor to prescribe these medications, instead I feel a patient should be sent to a therapist for further evaluation. I strongly believe a medical doctor is out of line if they casually prescribe psych. medications without doing a detailed patient assessment through a specialist.
For those who feel they cannot do without their meds and would rather risk the possibility of harmful side effects, I wish you the best. For those who would hope for a better alternative and may be willing to look for help elsewhere, I applaud your efforts and sincerely hope you find relief in a safer, healthier manner.
I am one who does not rule out the power of the mind/body connection. Of course I do not forget that there are those who may really need medication, but I honestly feel many more probably do not.
I appreciate Dr. Choi's opinion and that he took the time to address such a controversial and common issue. I do not fault him in his opinions in any way, he is certainly entitled to them, as we all are.
In regards to defending these medications based on them being around for such a long time, etc, I would be inclined to argue that 'big pharma' making money is likely to be a factor. The power of the big drug companies is not something I would rule out.
The reason this subject especially bothers me is that I have noticed through friends/family a growing trend where medical doctors are prescribing antidepressants to patients they barely know. I don't feel it is right for a general doctor to prescribe these medications, instead I feel a patient should be sent to a therapist for further evaluation. I strongly believe a medical doctor is out of line if they casually prescribe psych. medications without doing a detailed patient assessment through a specialist.
For those who feel they cannot do without their meds and would rather risk the possibility of harmful side effects, I wish you the best. For those who would hope for a better alternative and may be willing to look for help elsewhere, I applaud your efforts and sincerely hope you find relief in a safer, healthier manner.
We need to look at people more than studies. Look at what happened in the last few years:
-FDA put black box warnings on all antidepressants (can cause suicidal thinking in children)
-Use of antidepressants in children plummeted.
-Child & adolescent suicide increased.
Do antidepressants do anything? Ask these kids parents.
-FDA put black box warnings on all antidepressants (can cause suicidal thinking in children)
-Use of antidepressants in children plummeted.
-Child & adolescent suicide increased.
Do antidepressants do anything? Ask these kids parents.
I am a Master's level Counselor and personally a comsumer of metal health services. I have taken an antidepressants steadly for about 15 years. For about 10 years prior to thses 15 years, I played the game of taking meds, feeling better and stopping them, feeling bad and startng them again... I finally decided I did not want to go through having panic attacks and the really dark days of getting stabilized on meds again and decided to quit that game. I recognized depression is like many other diseases - for most cases, you can have a full, "normal" life if you work at managing the condition.
For me, managing depression (with extreme anxiety) means - taking meds, periodic counseling to help me work through life issues, meditation, exercise and eating right. (Initially, I had about a year of cognitive/behavioral therapy to learn how to think more positively, resolve some issues and learn to meditate). About eating "right"...for me, I learned I had to stay away from eating too many carbs (foods with lots of starch and sugar). They really affected my thinking and how I felt. Heavy intake of carbs made me feel like I had a hangover - sluggish, low energy, moody, irritable and easily agitated.
In getting my graduate degrees (2 Master's Degrees), I had to conduct some studies and research for some classes. Doing the research I did does not make me a research expert, but it was enough for me to learn to question the initial findings of research done by comparing data sets of multiple studies (as was done for this particular study). There are too many variables that have to be matched in order for such a study to be valid.
Anyway, bottom line for me is that I believe antidepressants are as important to effectively managing chronic, major depression as certain medications are in effectively managing diabetes, high blood pressure, etc...
For me, managing depression (with extreme anxiety) means - taking meds, periodic counseling to help me work through life issues, meditation, exercise and eating right. (Initially, I had about a year of cognitive/behavioral therapy to learn how to think more positively, resolve some issues and learn to meditate). About eating "right"...for me, I learned I had to stay away from eating too many carbs (foods with lots of starch and sugar). They really affected my thinking and how I felt. Heavy intake of carbs made me feel like I had a hangover - sluggish, low energy, moody, irritable and easily agitated.
In getting my graduate degrees (2 Master's Degrees), I had to conduct some studies and research for some classes. Doing the research I did does not make me a research expert, but it was enough for me to learn to question the initial findings of research done by comparing data sets of multiple studies (as was done for this particular study). There are too many variables that have to be matched in order for such a study to be valid.
Anyway, bottom line for me is that I believe antidepressants are as important to effectively managing chronic, major depression as certain medications are in effectively managing diabetes, high blood pressure, etc...
I told my husband when he approached me about this study that they probably used 'mildly' depressed people--people who can control their depression with diet, exercise, and socialization.
I took Prozac and it was not a good fit. I got sick on the high doses of it; I have Major Depression--have had it for about13 years now.
Anyway, TEN years later, I decided to try Lexapro--after being urged to go on it by a doctor. I was on it for about six months and was about to go off because I was on a low dose and it wasn't working--then one day--it just kicked in--and I don't need the high dose at all.
I think Lexapro is surprisingly effective. I have had trouble sleeping, but that could be because my recent TSH was 0.02. I moved to a new state--again--so my next endocrinology appt. is 26 days away--the soonest I could get in--even after being seen in an emergency room--go figure.
If I were mildly depressed, I would do what I already do for my Major Depression--eat right, try to socialize--even when I really don't want to, and exercise some (can't do that right now--heart is racing from TSH level).
Personally, I wouldn't attack Dr. Choi for posting on this. A lot of people take ADs and don't need it.
I took Prozac and it was not a good fit. I got sick on the high doses of it; I have Major Depression--have had it for about13 years now.
Anyway, TEN years later, I decided to try Lexapro--after being urged to go on it by a doctor. I was on it for about six months and was about to go off because I was on a low dose and it wasn't working--then one day--it just kicked in--and I don't need the high dose at all.
I think Lexapro is surprisingly effective. I have had trouble sleeping, but that could be because my recent TSH was 0.02. I moved to a new state--again--so my next endocrinology appt. is 26 days away--the soonest I could get in--even after being seen in an emergency room--go figure.
If I were mildly depressed, I would do what I already do for my Major Depression--eat right, try to socialize--even when I really don't want to, and exercise some (can't do that right now--heart is racing from TSH level).
Personally, I wouldn't attack Dr. Choi for posting on this. A lot of people take ADs and don't need it.
Someone posted about the black box warning:
I have two family members who have committed suicide.
I have a past attempt--about a decade ago--
When I first began Prozac and Lexapro--I had about three weeks of the suicide dark days...but I was open about it and hung in there--and it went away. I also increased my prayer life during this time; I pray 4 or 5 small prayers a day, and I think that prayer can help anyone who believes in it--for whatever medical, scientific, or religious reasons.
I think suicide feelings happen (on ADs) in more adults than is publicly known, but I still think it is mainly from the Depression rather than the medication itself.
I have two family members who have committed suicide.
I have a past attempt--about a decade ago--
When I first began Prozac and Lexapro--I had about three weeks of the suicide dark days...but I was open about it and hung in there--and it went away. I also increased my prayer life during this time; I pray 4 or 5 small prayers a day, and I think that prayer can help anyone who believes in it--for whatever medical, scientific, or religious reasons.
I think suicide feelings happen (on ADs) in more adults than is publicly known, but I still think it is mainly from the Depression rather than the medication itself.
Has anyone on antidepressants tried getting acupuncture? While not the complete solution, it can certainly help and assist in the healing.
First off, I would like to thank Dr. Choi for his post and interpretation of the data. There are just so many variables in depression - from the most severe to the mildest forms. I think patients are put on antidepressants far too quickly these days for many of the wrong reasons. Unfortunately, it seems that psychiatry now uses drugs as the answer for just about all of their patients and are no longer practicing therapy. Many patients then are just taking drugs that can cause them serious side effects that then compound their depression, as they wonder why these drugs are not treating their depression as their Dr. says they will.
What I worry about is what the long-term usage does on our body's own ability to then regulate its neurotransmitters when the antidepressant is stopped? I have read that long-term usage of an antidepressant can cause a permanent dependance because the neurotransmitters have become dependent upon chemicals to regulate their uptake of the seratonin, dopamine, etc.vs. the body regulating it own its own.
I just don't know the answers.
Also, I am concerned about the huge increase now in the diagnosis of bi-polar disorder. I find it fascinating that if an antidepressant causes 1 manic episode, suddenly you are now bi-polar and should be taking a mood stabilizer for life. The bi-polar disorder diagnosis from a psychiatrist tells the patient that they are now bi-polar for life and must take a mood stabilizer and many times antidepressant for life.
Where can the funding come from to study these issues? Certainly, the pharmaceutical industry will not fund it. With the dramatic cutbacks in funding for our researchers at the various universities, how will we get the answers to what long-term usage of the antidepressants can cause?
What I worry about is what the long-term usage does on our body's own ability to then regulate its neurotransmitters when the antidepressant is stopped? I have read that long-term usage of an antidepressant can cause a permanent dependance because the neurotransmitters have become dependent upon chemicals to regulate their uptake of the seratonin, dopamine, etc.vs. the body regulating it own its own.
I just don't know the answers.
Also, I am concerned about the huge increase now in the diagnosis of bi-polar disorder. I find it fascinating that if an antidepressant causes 1 manic episode, suddenly you are now bi-polar and should be taking a mood stabilizer for life. The bi-polar disorder diagnosis from a psychiatrist tells the patient that they are now bi-polar for life and must take a mood stabilizer and many times antidepressant for life.
Where can the funding come from to study these issues? Certainly, the pharmaceutical industry will not fund it. With the dramatic cutbacks in funding for our researchers at the various universities, how will we get the answers to what long-term usage of the antidepressants can cause?
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