Modern depression treatments are fucking bullshit.

The Something Awful Forums > Discussion > Debate & Discussion > Modern depression treatments are fucking bullshit.

AARO: Mar 9, 2005; by Lowtax

I've been reading about some studies and meta-analysis on anti depressant medications. There have been many studies over the years that prove that modern anti-depressant medications preform no better than placebo with mild to moderate depression and only slightly better than placebo with severe depression. Yet they give these drugs out like candy to anyone who comes to them feeling sad about life, despite all the harmful side effects. It has been proven time and time again that SSRI's can cause suicidal idealization in patients, along with a host of other more common unpleasant side effects. And even the patients taking the placebo can experience unpleasant side effects called the "nocebo effect" (although this is rare and largely misunderstood.) The people who are receiving relief from SSRI or other drugs are largely just psychosomatically "curing themselves." This is not science. It needs to change.

It seems to me that we should stop proscribing these anti-depressant drugs, except for maybe in the most extreme cases. I feel that psychiatry is in its infancy and many of the treatments of today will be looked upon as absolute quackery by future generations.

# ¿ Jun 4, 2016 19:29

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# ¿ May 14, 2024 01:48

AARO: Mar 9, 2005; by Lowtax

Brainiac Five posted:

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

Antidepressants are supposed to work by fixing a chemical imbalance, specifically, a lack of serotonin in the brain. Indeed, their supposed effectiveness is the primary evidence for the chemical imbalance theory. But analyses of the published data and the unpublished data that were hidden by drug companies reveals that most (if not all) of the benefits are due to the placebo effect. Some antidepressants increase serotonin levels, some decrease it, and some have no effect at all on serotonin. Nevertheless, they all show the same therapeutic benefit. Even the small statistical difference between antidepressants and placebos may be an enhanced placebo effect, due to the fact that most patients and doctors in clinical trials successfully break blind. The serotonin theory is as close as any theory in the history of science to having been proved wrong. Instead of curing depression, popular antidepressants may induce a biological vulnerability making people more likely to become depressed in the future.

# ¿ Jun 4, 2016 19:41

AARO: Mar 9, 2005; by Lowtax

You lazy research vampires can go ahead and find the studies I'm talking about yourselves that prove these contentions. What I'm saying seems to be totally non-controversial. It's only the application of the studies which are not presently being taking into account.

(USER WAS PUT ON PROBATION FOR THIS POST)

# ¿ Jun 4, 2016 19:46

AARO: Mar 9, 2005; by Lowtax

Brainiac Five posted:

However,

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4804177/

I admitted in the OP that the actual drugs do work better than placebo in severe depression. But severe depression accounts for a very small number of the patients prescribed these drugs.

# ¿ Jun 4, 2016 19:49

AARO: Mar 9, 2005; by Lowtax

Angepain posted:

are you telling me i've got to do more than find an abstract that I agree with in order to determine the truth of an assertion? this is bogus i'm going back to hardline religious doctrine to solve my problems

I've read more than the abstract of these studies. Nowadays, all studies are easily available on the internet.

# ¿ Jun 4, 2016 19:56

AARO: Mar 9, 2005; by Lowtax

Brainiac Five posted:

This doesn't refer to severe depression, it refers to analyzing studies conducted of first-generation SSRIs and using reported changes in depressive mood as the yardstick instead of the 57-point scale. It includes patients with moderate and severe depression. Essentially, the conclusion as found in the study is that SSRI antidepressants do have a statistically significant effect when it comes to improving depressive mood over placebo, which in turn suggests that the 57-point scale may be ineffective. Neither is actually conclusive and final when it comes to determining the effectiveness of the treatments, though the meta-analysis does perforate the serotonin reuptake model of depression.

So what to make of the meta-analysises which prove the opposite?

# ¿ Jun 4, 2016 19:58

AARO: Mar 9, 2005; by Lowtax

Mister Adequate posted:

I used to want to kill myself and now I don't thanks SSRIs

Gald you're feeling ok today but it's proven that they may eventually increase your desire to kill yourself at some later point.

# ¿ Jun 4, 2016 20:02

AARO: Mar 9, 2005; by Lowtax

quote:

http://jama.jamanetwork.com/article.aspx?articleid=185157

Antidepressant medications represent the best established treatment for major depressive disorder, but there is little evidence that they have a specific pharmacological effect relative to pill placebo for patients with less severe depression.

Objective To estimate the relative benefit of medication vs placebo across a wide range of initial symptom severity in patients diagnosed with depression.

Data Sources PubMed, PsycINFO, and the Cochrane Library databases were searched from January 1980 through March 2009, along with references from meta-analyses and reviews.

Study Selection Randomized placebo-controlled trials of antidepressants approved by the Food and Drug Administration in the treatment of major or minor depressive disorder were selected. Studies were included if their authors provided the requisite original data, they comprised adult outpatients, they included a medication vs placebo comparison for at least 6 weeks, they did not exclude patients on the basis of a placebo washout period, and they used the Hamilton Depression Rating Scale (HDRS). Data from 6 studies (718 patients) were included.

Data Extraction Individual patient-level data were obtained from study authors.

Results Medication vs placebo differences varied substantially as a function of baseline severity. Among patients with HDRS scores below 23, Cohen d effect sizes for the difference between medication and placebo were estimated to be less than 0.20 (a standard definition of a small effect). Estimates of the magnitude of the superiority of medication over placebo increased with increases in baseline depression severity and crossed the threshold defined by the National Institute for Clinical Excellence for a clinically significant difference at a baseline HDRS score of 25.

Conclusions The magnitude of benefit of antidepressant medication compared with placebo increases with severity of depression symptoms and may be minimal or nonexistent, on average, in patients with mild or moderate symptoms. For patients with very severe depression, the benefit of medications over placebo is substantial.

# ¿ Jun 4, 2016 20:18

AARO: Mar 9, 2005; by Lowtax

foot posted:

Have you tried cocaine or ecstacy?

You know the problem with rec drugs is they eventually gently caress up your life and cause psychosis. Otherwise this would be the ultimate cure all.

# ¿ Jun 4, 2016 20:38

AARO: Mar 9, 2005; by Lowtax

OwlFancier posted:

To an extent, so does breathing.

If you snort coke everyday for 4 months, you're gonna start having some psychiatric problems. The same cannot be said for breathing.

# ¿ Jun 4, 2016 20:45

AARO: Mar 9, 2005; by Lowtax

Peven Stan posted:

More like $$RIs.

I don't care if you're being serious or not. If they actually did what they're purported to do they'd be worth every penny.

# ¿ Jun 4, 2016 21:01

AARO: Mar 9, 2005; by Lowtax

Sergg posted:

The vast majority of recreational drugs do not do this.

The good ones do.

# ¿ Jun 4, 2016 21:26

AARO: Mar 9, 2005; by Lowtax

The Aardvark posted:

Then what do you propose to make psychiatric science better?

How the hell should I know? I'm just some random idiot goon.

# ¿ Jun 4, 2016 21:36

AARO: Mar 9, 2005; by Lowtax

T8R posted:

Somethingawful was magnitudes more effective at curing my depression than anti-depressants. It might have even caused less side effects as well!

AARO fucked around with this message at 21:55 on Jun 4, 2016

# ¿ Jun 4, 2016 21:49

AARO: Mar 9, 2005; by Lowtax

Where did I criticize antipsychotics?

Some people need antipsychotic drugs. But they are probably given out too often as well. These drugs actually shrink the size of the patients brain so they shouldn't be given out willy nilly.

I think a better approach would be to talk to the schizophrenic about the hidden microphones. Why do these microphones matter? Even if they are real how can it hurt them that someone is listening to what they are saying. If they are trying to hide some criminal details of their lives then that is what should be addressed. Whether or not the hidden microphones exist isn't the real issue. It's about trying to get them to live in their reality without the feeling of distress.

Like if they say "The water is poisoned and only I know about it". Don't say "No it isn't poisoned!" Say "Ok, we'll get you some bottled water so that you can avoid this." That is true therapy. Helping people cope with their own reality.

AARO fucked around with this message at 23:12 on Jun 4, 2016

# ¿ Jun 4, 2016 22:57

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# ¿ May 14, 2024 01:48

AARO: Mar 9, 2005; by Lowtax

Sergg posted:

Schizophrenia shrinks the size of a patient's brain, in addition to messing up their dopamine regulation. I have heard no evidence that psych meds cause brain shrinkage but I have read plenty of scientific papers on how schizophrenia does it.

quote:

Taken together, these studies suggest that antipsychotics may contribute to early gray matter loss and, later in the course of treatment, to white matter loss. These effects may be dose-related and probably are not prevented by the use of second-generation agents. This argues for minimizing antipsychotic exposure both acutely and long-term. However, we are left with the additional dilemma that a longer duration of untreated psychosis (DUP) may also be neurotoxic. Longer DUP has been associated with poorer symptomatic and functional outcomes7 as well as brain volume loss.8 Studies of DUP have their own methodological limitations and controversies, but they should serve to warn us that the rapid control of psychosis may also be important. - See more at: http://www.psychiatrictimes.com/articles/antipsychotics-and-shrinking-brain#sthash.bokwHK1F.dpuf

# ¿ Jun 5, 2016 05:53

The Something Awful Forums > Discussion > Debate & Discussion > Modern depression treatments are fucking bullshit.