Anti-depressants thought to be placebo?

[Jacob Morres]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172306/

This researcher claims -

manipulation of which studies are published

misrepresenting evidence found 

Most, if not all studies actually indicate placebo effect 

This is ground breaking.. but also old news?? Where is the uproar? 

[Leo Gura]

If only that were true. Anti-depressants are much worse than placebo due to the very real negative side-effects.

[Matt23]

You might be interested in Robert Whitaker's work.  He's a journalist who's studied the pharmaceutical industry for something like 30 or 40 years.  He wrote a book called Mad In America 

Here's a summation:

• The history told in Mad in America will surprise many readers. In its review of the scientific literature, the book reveals that long-term outcome studies  of antipsychotics regularly showed that the drugs increased the likelihood that people diagnosed with schizophrenia would become chronically ill. The book also investigates the marketing of the new atypical antipsychotic medications in the 1990s, and uncovers the scientific fraud at the heart of that enterprise.

He's got a website too where he's got articles, studies, and summaries of various mental conditions and treatments, along with their effectiveness.

https://www.madinamerica.com/author/rwhitaker/

[Leo Gura]

@Matt23 Nice share!

[Matt23]

Here's a documentary relating to the topic as well.  Centered on the recent Jordan Peterson psychiatric (benzodiazepine) breakdown.  Robert's work is featured here as well.

 

[Lyubov]

It's really a much broader topic than a single sentence. It depends on a lot of things and also each person's perspective and how they experience emotions. It's hard to really exactly define each emotion every person feels and condense them into a research paper. I think a large amount of people taking them aren't really having much altered and they are just thinking more positive thoughts now that they popped a pill they think is going to alter all sorts of stuff and thus their bodies are relaxing and they are feeling better. Other people and other medications however I think can manage sensational bodily reactions so they aren't as intense and are more pleasant and thus allow for clearer thinking. I've taken then before and while I haven't noticed too much typical "depressive" experiences being affected by them as much I've noticed they greatly reduce fear reactions and allow for calmer thinking instead of being thrown into fight/flight all the time with disorganized/delusional thinking. I also need to mention side effects like a reduced sexual drive (most common). Makes sexual stimulation not as intense/enjoyable.  

Edited September 15, 2020 by Lyubov

[lmfao]

SSRI's for me blunted emotion. Common description for this is that you "feel like a zombie". So that got me to want to stop. I've been tapering off very slowly, but even then it's been a bumpy ride. 

The withdrawal of these drugs can be rough, in addition to the side effects whilst taking them. I'm almost paranoid that I've "damaged my brain" but I don't allow myself to be that pessimistic about it in the long term. 

Withdrawal for me involves muscle weakness, severe dizziness ( https://pubmed.ncbi.nlm.nih.gov/20144124/#:~:text=Dizziness is the most commonly,to be vestibular in) and agitation. 

Edited September 15, 2020 by lmfao

[Michael569]

The following acount of treatment of Charles II of England is a case point: 

First, he was bled of a pint of blood. Then his shoulder was cut and eight ounces more of blood was extracted by cupping. Then followed an emetic, a purgative and another purgative. Next, an enema in which they used antimony, sacred bitters, rock salt, mallow leaves, violet, beet root, camomile flowers, fennel seed, linseed, cinnamon, cardamom seed, saffron, cochineal and aloes. This enema was repeated. In two hours, another purgative was given.

The King's scalp was then shaved, and a blister raised on it. They gave him next sneezing powder of hellebore root; they sought to strengthen his brain by giving him powder of cowslip flowers. Purgatives were frequently repeated. He was given drinks of barley water, licorice, sweet almonds, white wine, absinthe, anise seed, extracts of thistles, rue, mint and angelica. When these did not cure him, they gave him a poultice of burgundy pitch and pigeon dung, to be applied to his feet. More bleeding, more purging; they added melon seeds, manna, slippery elm, black cherry water, extracts of flower of lime, lily of the valley, peony, lavender and dissolved pearls. When these did not do the trick, they went at it with gentian root, nutmeg, quinine and cloves. When this failed, he was given forty drops of extract of human skull. Then they forced down his throat a rallying dose of herbs and animal extracts. Then some powdered bezoar stone.

Alas, after an ill fated night His Serene Majesty was so exhausted that all the physicians became despondent. And so, more active cordials, and finally pearl julep [a heart tonic] and ammonia, were forced down the royal patient's throat. Then he died.

This is a current psychiatry medicine

[Enlightenment]

10 hours ago, Leo Gura said:

If only that were true. Anti-depressants are much worse than placebo due to the very real negative side-effects.

How can you be so ignorant

WTF is this then

And acceptability (dropout rate)

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32802-7/fulltext

I can understand the tap water/Fluoride conspiracy theory to some small extend 

But how can you say that antidepressants are worse than placebo when they have been proven to be statistically significantly effective in many studies? Guess what also have side effects - psychedelics and every other drug

Every drug have some side effects, it's always a matter of risk/reward ratio and in this case, it's worth it for many people

As you said in one of your blog videos, unless you've had a particular illness you don't really know what's like. You don't really know what's like to be severely depressed to the point where irritability and anxiety makes you suicidal and paralyzed in bed

And BTW I by no means claim that antidepressant cure depression (only time can truly cure MDE), they simply are a tool to cope with it so at least you don't suffer as much and can wait until it resolves and then slowly withdraw from them

 

 

Edited September 15, 2020 by Enlightenment

[Enlightenment]

@neutralempty Yes, some studies are industry-funded but not all of them.

I have experience with many antidepressants myself and they do help but I don't claim they cure depression

Nothing we know now can truly cure major depressive episode - only time can and while you're waiting for it to resolve you may as well take some antidepressants and at least not suffer as much

[Enlightenment]

@neutralempty I've skimmed through, yes but will read it later

I've taken 5-MeO-DMT when I was really depressed and it didn't help for more than a day. I'm well aware of psychedelic research and of course, psychedelics help but I don't think they can cure MDD neither ketamine nor antidepressants can

7 minutes ago, neutralempty said:

if you're attached to the idea that SSRIs help because YOU have taken them or take them and YOU don't want to realize that something like that could happen to YOU, that's not a good bases to examine it properly.

Antidepressant's efficiency is proven in many studies, that was just my little anecdotal evidence. I'm very familiar with a withdrawal prosses of probably the hardest antidepressant to come off of (Venlafaxine) and I tested on myself already that if I go slow enough over a few months, it's not troublesome at all

[Leo Gura]

1 hour ago, Enlightenment said:

But how can you say that antidepressants are worse than placebo when they have been proven to be statistically significantly effective in many studies?

1) My claim that they were worse than placebo had more to do with their negative side-effects, not their lack of positive effects. My point was that in the NET they are not worth it. I do think they produce some positive side-effects that you will not get with mere placebo since they alter brain chemistry similar to a psychedelic.

2) There are many conflicting studies because this is a complex issue. Some studies show that stuff like exercise and other basic practices are as effective if not more effective than anti-depressants. But also, people react to anti-depressants very differently, so it is a great mistake to speak of these drugs in the aggregate, The only thing that ultimately matters is how they affect you personally. For some people it will be helpful and for others it will not. The problem is that these studies do not look at individuals but aggregate data.

Overall, I don't think anti-depressants will solve any fundamental problem. The vast majority of people who take anti-depressants do so because they are clueless of their true effects and because they have no idea that their depression is caused by other root factors which anti-depressants will not correct, only making things worse. And doctors mainly prescribe them because they have no idea of how human psychology or consciousness works and they are corrupted by Big Pharma money. The whole thing is a fucking disaster and a tragedy of ignorance.

Also take into account that many of these studies are corrupted by Big Pharma money and agendas, so they cannot be taken at face value. And they do not properly account for negative side-effects or alternative holistic treatments.

[Michael569]

@Enlightenment most studies on antidepressants take maximum of 8 weeks. Where we know that it takes 4 weeks for stuff like fluoxetine to even start working. There are no systematic long-term studies. You need data that follow people on antidepressants for 10 or 15 years. We simply do not have that sort of data and short-term studies are pretty much pointless because lot of people fall straight back into it once they stop using. 

No pharma company will bother to design long-term study because it costs millions of dollars but also because FDA will accept it as long as they can prove that the drug is at least comparable to the most effective drug already on the market. 

[Enlightenment]

2 hours ago, Leo Gura said:

Some studies show that stuff like exercise and other basic practices are as effective if not more effective than anti-depressants. But also, people react to anti-depressants very differently

Yes, it's well known that a person may have to try a few antidepressants until he/she finds the one that is working and doesn't have unbearable side effects.

2 hours ago, Leo Gura said:

so it is a great mistake to speak of these drugs in the aggregate, The only thing that ultimately matters is how they affect you personally. For some people it will be helpful and for others it will not. The problem is that these studies do not look at individuals but aggregate data.

But how they can do it otherwise? It's not a bug it's a feature. The point is to find things that are effective in the general population and then find ways to match them to individuals.

2 hours ago, Leo Gura said:

Overall, I don't think anti-depressants will solve any fundamental problem.

I think the same. Like I said they are not meant to cure depression but to ease the symptoms.

2 hours ago, Leo Gura said:

The vast majority of people who take anti-depressants do so because they are clueless of their true effects and because they have no idea that their depression is caused by other root factors which anti-depressants will not correct, only making things worse. And doctors mainly prescribe them because they have no idea of how human psychology or consciousness works and they are corrupted by Big Pharma money. The whole thing is a fucking disaster and a tragedy of ignorance.

To be honest, I don't know much about the frequency of doctors prescribing them, perhaps they are over-prescribed

As for root factors that caused their depression, it's important to state that I'm not talking about Dysthymia AKA light depression (people misuse this word a lot) that last for many years or whole life, and yes there is a BIG difference between Dysthymia and a major depressive episode. I firmly believe that all or almost all cases of Dysthymia are a problem of root factors like some conflicts in the mind or lack of purpose in life etc. 

MDE on the other hand is caused by a combination of individual genetic susceptibility to depression combined with a stressful event/period which then triggers it. MDE usually lasts about 6 months and almost never exceeds over 3 years. It's much much more severe than Dysthymia. Stress is unavoidable in life and some people simply will get severely depressed. If someone says to you that he or she is 'depressed' for 5 years or longer, you can just assume it's not MDE. Even if you remove all stressful factors from your life and don't have any internal causes like in Dysthymia examples, MDE once triggered will have to run its course for whatever the time period will be. 

Quote

If left untreated, a typical major depressive episode may last for about six months. About 20% of these episodes can last two years or more. About half of depressive episodes end spontaneously

One of the most BS statements of Big Pharma is that depression is caused by a lack of serotonin in the brain, which has been disproven already. Inflammation has much more to do with it than serotonin but it's still much more complicated

1 hour ago, Michael569 said:

Where we know that it takes 4 weeks for stuff like fluoxetine to even start working

2 weeks my doctor said but fluoxetine for me worked immediately so I guess it depends on a person.

1 hour ago, Michael569 said:

There are no systematic long-term studies. You need data that follow people on antidepressants for 10 or 15 years. We simply do not have that sort of data and short-term studies are pretty much pointless because lot of people fall straight back into it once they stop using. 

Who the fuck uses antidepressants for 10 or 15 years straight? Such people are clearly an example of misuse as MDD never lasts 10 or 15 years. I'm against use of antidepressants in Dysthymia as I think it can be cured very effectively by psychotherapy/meditation/psychedelics

Edited September 15, 2020 by Enlightenment

[Michael569]

4 minutes ago, Enlightenment said:

MDD never lasts 10 or 15 years.

MDD is special case. People don't tend to be suicidal for so long but you have mild depresive disorder which is extremely common and these people would have been on SSRIs for a decade or more very often. Not uncommon to be on same drug for few decades. Think about statins. Most people who get prescribed in late 50s pretty much remain on them till they die. 

[The0Self]

They aren’t just placebo. They do actually work, but the way they work is not how it appears on the surface. You know how they take 4-6 weeks to “kick in?” That’s because the way they actually work is not through serotonin, but through BDNF (brain-derived neurotrophic factor) and NGF (nerve growth factor). They primarily increase BDNF but they also increase slow wave sleep, thereby decreasing REM sleep, which is why they can be used for narcolepsy and the withdrawal from them can cause nightmares and paralysis. But mainly it’s the BDNF — when BDNF builds up, the hippocampus actually increases in size, the main benefit of which is allowing one to escape the pull of intrusive thoughts. Guess what? This process takes 4-6 weeks.
 

The serotonergic effects are actually deleterious [EDIT: over the long term] and the AD effect would be much greater without it, therefore research other ways to increase BDNF if you want to try antidepressants. One of the best ways is light but challenging and lengthy (30-60+ minutes) steady state cardio — a very low impact version of this would be walking on a treadmill slowly with the incline on max setting.

Edited September 15, 2020 by The0Self

[The0Self]

21 minutes ago, neutralempty said:

@The0Self Does it increase BDNF and NGF because the brain cells are looking for new pathways through that inhibition ?

Why only the hippocampus?

Couldn't NGF increase also increase risk for brain tumor?

Not sure about that. I think it also increases cortical expression of BDNF, but the hippocampal increase has been shown to be correlated with antidepressant response, and this response is prominently bolstered by other means of increasing BDNF, such as exercise.

[Matt23]

I just finished reading a book on trauma called "The Body Keeps the Score", but Bessel van der Kolk (a psychiatrist who's been working with trauma victims for ages, though he now uses many alternative techniques and isn't so keen on pharmaceuticals anymore and bashes that industry a bit).

In the book, one claim he makes from his personal experience is that much, if not most, mental health issues results from trauma (of one kind or another; from shock traumas to developmental traumas, etc.), and that medications tend to work best for people with mental health issues who have a history of early childhood trauma and abuse (physical and mental/emotional abuse/neglect) rather than traumas that took place later on in life. 

He also talks about how talk therapy tends to not really work for people with early childhood trauma compared to people who've been traumatized later in life ("later" could mean even early teen years or later childhood years...can't exactly remember, but I'm pretty sure) since they don't have any initial or fundamental feelings of security, safety, and warmth in which they can re-create and remember.  This is where he tends to think giving these patients medications may be helpful (though not necessary).  He gives several alternatives to medications that can really help people with earlier childhood traumas (EMDR, Neurofeedback, Yoga, Pesso-Boyden psychomotor therapy, and more [I think]).

He definitely doesn't advocate strongly for pharmaceuticals, but says in some instances it can help smooth things over.  

[docs20]

Lool whoever criticizes psychopharmaceuticals has no idea of what they're saying most of the time. Yes they're not miracolous, and yes they should be just a small part of the way to heal a patient, yes there is some placebo effect to it, and yes they can cause side effects, but still the alternative is way worse. They should be part of the healing process of some people, along with alternative medicine, meditation, etc, etc. But they shouldn't be demonized either.

Just ask an old psychiatrist who when was young had very few treatments for psychotic patients and with people with all sorts of psychiatric issues (not just depression, but OCD for example) and tell them how they're work and how their patients improved their functioning in the world in most cases with conventional drugs.
Do they fully heal to the cause? No. But still the alternative is far worse. People with schizophrenia completely change if they respond to the antipsychotic drug, and you can verify by yourself or by asking a relative of a patient with this condition. There are obviously side effects, even messy and troubling ones, but still the alternative is usually not some schizophrenic who is peaceful psychic and healer, but usually people who also might seem possessed by the devil of that they really suffer a lot or are often even dangerous to other human being (during my rounds in med school I happened to see a person who completely changed after medication, while before he was just seeing insects and being depressed and hearing voice of "God" saying that he should kill all the people with blue-eyes who were according to him the devil that made the world a shitty place) and are dreaming the worst in their reality, so of course that compared to that situation the drug improves their life so much even if they get side effects it's still valid.

Same things goes with panic attacks and depressions, sometimes drugs are the gateaway to normalize a bit the neurochemistry of the patient so that you can actually counsel him properly and all do the necessary deep healing, which can be quite impossible if the patient is having one massive panick attack a day or he's so depressed that can't get out of bed and can't even come to your psychoteraphy session....

Are they overused? Very true, but still they're one of the tools that you have in your arsenal to give a better life to human being who is in deep suffering, and it's troubling to see how many people demonize them so much, and don't just say that they don't need to be overused or that they don't need to be the only way of dealing with things. Basically they can't be thrown in the trash.

[Enlightenment]

On 9/15/2020 at 3:40 PM, Michael569 said:

MDD is special case. People don't tend to be suicidal for so long but you have mild depresive disorder which is extremely common and these people would have been on SSRIs for a decade or more very often. Not uncommon to be on same drug for few decades.

Well, it that case I agree they're overused

@neutralempty I read the whole article. Example

Quote

IMH-funded investigators tracked the outcomes of medicated and unmedicated depressed people over a period of six years; those who were “treated” for the illness were three times more likely than the untreated group to suffer a “cessation” of their “principal social role” and nearly seven times more likely to become “incapacitated.” The NIMH researchers wrote: “The untreated individuals described here had milder and shorter-lived illness (than those who were treated), and, despite the absence of treatment, did not show significant changes in socioeconomic status in the long term.

 

Correlation doesn't mean causation. Many studies may be incorrectly interpreted assuming correlation is causation examples are the studies listed mentioning peoples worse outcomes in X years if they were medicated vs not, but this doesn't take into consideration that it's the most depressed people that are more likely to try antidepressants since in the first place so the group of medicated people is biased in the direction of the most genetically predisposed to severe, long depressions.

Another example is this

 

It's very possible that as mental health awareness increases and shaming around this topic decreases, more and more people are reaching out for help so of course there will be more mentally Ill patients diagnosed

Antidepressants are also much more effective in severe cases of depression (so actual serious MDE like I mentioned before) so yes if it is the case that people that just kind of not feeling ok, goto a doctor, and they are immediately put on SSRI's, that's a problem in my opinion.

Quote

Two-thirds of all unipolar depressed patients either do not respond to initial treatment with an antidepressant or only partially respond

The thing is - everybody with depression only partially responds. I mean, are they expect depression to completely disappear from antidepressants? That doesn't happen. Again, antidepressants are a tool in a toolbox to cope with depression not to cure it.

@Leo Gura

My father was anti-antidepressants too and eventually, he got severely depressed, refused to take them, and committed suicide. My whole family is genetically vulnerable to depression/anxiety. My aunt just took antidepressants when she got severely depressed and now years later she's doing ok even after withdrawal. I myself might not be writing this post if not antidepressants because I would commit suicide when my depression/anxiety spiked, I even had mild mild psychosis just from depression.

Quote

Lool whoever criticizes psychopharmaceuticals has no idea of what they're saying most of the time. Yes they're not miracolous, and yes they should be just a small part of the way to heal a patient, yes there is some placebo effect to it, and yes they can cause side effects, but still the alternative is way worse. They should be part of the healing process of some people, along with alternative medicine, meditation, etc, etc. But they shouldn't be demonized either.

I think a lot of the people that criticize antidepressants (as much as they suck) fail to see that alternative is simply even worse in many cases. It's similar to how some people criticize chemotherapy, you know it destroys your body literally but the alternative of not doing chemo is even worse, I know it sucks life is hard.

Edited September 17, 2020 by Enlightenment