Blogger's Endorsement/Encouragement of AD Use

[alexjuice]

I came across an article intended to convince depressed individuals harboring reservations about antidepressants to take the plunge.

 

The article is quite terrifying to me, but one nugget caught my attention. IN response to concerns that "Antidepressants Don't Work," the author/blogger writes:

 

There seems to be two fears among people who are considering antidepressants: antidepressants don’t do anything or antidepressants do too much. I understand both fears.

 

First of all, yes, antidepressants do work to treat depression, particularly moderate-to-severe depression. While many people will not be successfully treated by their first antidepressant the vast majority of people will be helped by a following antidepressant. So if the first one doesn’t work, don’t give up hope.

 

And as far as efficacy goes, there was a recent meta-analysis that indicates that antidepressants are about as effective as other medication used for internal medicine.

 

Regarding the bolded part, have we discussed this much already? It does appear true that many people do not "get better" on the first antidepressant. They are told they haven't found the right one for their specific chemistry or "picksomenonsense". I, for instance, tried four or five antidepressants sequentially when I first started psychiatric treatment.

 

I wonder if a large percentage of the apparent success rate resulting from a 2nd, 3rd, 4th, or 5th AD is largely explainable as alleviation from an acute withdrawal effect caused by introduction and removal of the previous ADs? Is there a good reason that Zoloft should be the one that works for a person first tried on Paxil, Prozac, Lexapro. When for another Lexapro be the 'wonder drug' after Zoloft et al have failed.

 

It seems the simplest explanation is that an AD will eventually work to the extent that it provides some stability following the created instability of series of trials.

 

Anyway, here are some other bits of from that article.

 

 

Are you afraid an Antidepressant will harm you?

I can understand this fear. Many people speak of psychiatric medication in very negative terms but it doesn’t have to be this way. In fact, most people use psychiatric medication for a time, and then get off of it and never say a thing about it because they don’t want anyone to know. That is the common experience – nothing of great interest to report.

 

Because properly used, antidepressants can be effective with minimal side effects. Yes, some people are harder to treat than others and those patients who are harder to treat may require more medication and that ups the side effects, but most aren’t in that group. Many people can take one medication, in a normal dosage range, and get better.

 

And, to the best of my knowledge, there is no side effect of antidepressants that continues after you stop taking the drug. In other words, if a side effect develops with which you can’t live, you can always reduce the dose or get off the drug entirely.

 

[update: one reader reminded me that there are additional risks, including mania, associated with treating people with bipolar disorder with antidepressants. Not all doctors agree on this but I have written about the controversy here. See about the dangers of misdiagnosis here.]

 

And on Taking a Leap

Taking a Leap

 

All that being said, it still takes a leap of faith to try something new, especially something scary like putting a medication into your body, so it’s all about the pros and cons. Are the possible pros of taking the medication work the possible cons? How sick are you today? Have you tried other treatments? Are you in therapy? Have you attempted suicide? What will happen if you choose not to get treatment?

 

http://www.healthyplace.com/blogs/breakingbipolar/2012/06/help-im-depressed-but-im-scared-to-take-antidepressants/

[Jemima]

I wish I knew how to crash a website.

[Altostrata]

You go, grrrl.

 

It is the widely discredited STAR*D study that claims successive antidepressant trials are beneficial.

 

We have quite a few people here who were switched from one drug to another to another on this assumption.

[bubbles]

Hi

 

I don't know enough about the Star D to comment on that, but...

 

I used think antidepressants were only placebo, but I no longer believe that. I am coming to the conclusion that for *some* people, antidepressants are important. I spent many hours and dollars in therapy, but did not remit until I started an antidepressant. I then stayed remitted as long as I was on my full dose (I had recurrent episodes prior to meds).

 

Several years of being, essentially, very well on ADs put rose colored glasses on my memory with regard to "before", I think! I'd forgotten how bad it was and therefore the side effects took on a incorrectly greater importance in the ratio. This recent episode has jogged my memory and I now have to say that for me the risk/benefit ratio came out in favor of the ADs.

 

Now, I was a bit upset at first about that realization, but I have decided to find it empowering, instead. I've got *somewhere* to go in my treatment, if I need it. Knowing that that is out there is really, really helpful.

 

Please don't hate me for this opinion!

Best wishes

B

[alexjuice]

Of course I won't hate you! I'm pretty sure no one here will hate you, bubbles. :-)

 

Your experience is so far from my own, it sounds fantastical to me. But I respect your ability to know when in life you felt your best.

 

I'd also just remind that the grass does tend to look greener... And that even if side effects seem less unpleasant in retrospect that is largely, I suspect, influenced by which ones affected you. I suspect you did not develop diabetes, for example. Though diabetes presents a larger risk to people taking ADs.

 

best,

Alex

[bubbles]

Hi Alex

 

Funny you mention diabetes, as it has been on my mind lately. My BMI was over 27 (now okay) and i figure I was well on the way. Thankfully so far so good, but it is something I will have to watch.

 

I know I was lucky with my AD experience. I am grateful for that.

 

B

[inmediares]

Posted a comment. Will see if it survives moderation.

 

Regarding STAR*D, I thought this was interesting:

 

http://www.karger.com/Article/FullText/318293

[Altostrata]

Very interesting. Also see http://survivingantidepressants.org/index.php?/topic/333-piggott-critiques-of-the-stard-study/