Why Antidepressants Don't Work for Treating Depression

[KatWrangler]

http://www.huffingtonpost.com/dr-mar..._b_550098.html

The study I'm talking about was published in The New England Journal of Medicine. It found that drug companies selectively publish studies on antidepressants. They have published nearly all the studies that show benefit -- but almost none of the studies that show these drugs are ineffective. (1)

What do you think? Very interesting article.

[mom0810]

I don't know... they worked for me in the throes of PPD. There was a time when I really needed them, or I don't think I would have been able to pull myself out.

[Oubliette8]

The idea that antidepressants don't work was the cover story for the February 8th 2010 issue of Newsweek, you can read that article here- http://www.newsweek.com/id/232781

I do fully believe that the drug companies only publish studies that show their drugs work. Why would they publish studies that show they don't work? I also believe they tweak studies to their benefit. Robert Whittaker touched on this some in his book Mad In America, but he has a new book out, "Anatomy of an Epidemic" which goes into greater depth on the subject of effectiveness of psychiatric drugs and on how studies are used by drug companies. I've just started it and it is so far very good. Peter Breggin has also discussed this in his writings, including his book "Medication Madness". This article discusses some of this briefly- http://www.huffingtonpost.com/dr-pet..._b_107162.html

This article from Rolling Stone in 2008, although about antipsychotics, gives a look into how large drug companies market their psychiatric medications- http://www.ethicaldoctor.org/article...tter_Pill.html

And this article by Evelyn Pringle talks about supression of studies and intentional manipulation of data- http://www.scoop.co.nz/stories/HL0811/S00080.htm

[philomom]

I tried a couple of anti-depressants after my son was stillborn in the early 90's. They honestly made me more sleepy, weepy and tired even after the initial six week "adjustment" period recommended by the docs. So, I went off them.

[*Jade*]

I think there is huge benefit in looking at the causes of depression. For myself, I can pinpoint specific issues and stressors that pushed me over the edge, so dealing with them was a must. However, when you are so low medication can (and did for me) really help to get you to a place where you can start to work on these things.

Something about people who claim everything is related to diet rubs me the wrong, but that could be because most of it's proponents that I've met have been pretty fanatical.

[femalephish]

Although I DO agree that drug companies selectivly publish articles and we need to be wary of their claims (particularly the 'too-good-to-be-true' type) I think it's dangerous to say that anti-depressants don't work. And the author of the article, a doctor, I think it's irresponsable for him to say that.

People die from deppression. Please don't tell us we can't get better. Antidepressents can and DO help people. Just my .02cents

*pardonm my spelling, I'm NAKing*

[nd_deadhead]

Brain chemistry is a very complicated, very poorly understood thing. If only it were as easy as culturing a bacteria and prescribing an antibiotic targeted to that bacteria! But it definitely is NOT that easy.

Antidepressants and antipsychotics affect people diferently. My son has been on Prozac for over a year, and really had a hard time functioning without it. We noticed a significant change when we increased his dosage last fall. At the same time, he has tried two different anti-psychotic meds that he reacted very badly to. One of them gave him wild mood swings and suicidal thoughts. And the AD he was on before Prozac was not nearly as effective for him.

The thing is that no single AD is going to work for everyone. I have a friend that suffered such severe depression she could hardly get out of bed. She and her doctor spent over a year getting her one the right combination that worked for her - and she is functional again.

Medication is also not usually the only solution to depression. My son's therapist says that meds can help bring a person to a place where therapy can actually work.

If you're the parent of a 14-yr-old who is curled up in a ball at the foot of his bed, who won't come out from under his quilt, who can't go to school, or if you're the spouse of a beautiful woman who can't even get up to fix her young sons a bowl of cereal - I challenge you to not do everything you possibly can to help your loved one - including medication. Unless you've looked depression in its ugly face, you can't begin to understand what a lifeline antidepressants can be.

[Learning_Mum]

I think there is a difference between situational depression, where something has happend (death, marriage break up, financial problems etc) and depression where there is a chemical imbalance in the brain.

I think the first is best treated with therapy, behaviour modification skills and time but if your brain is just screwed up I don't think therapy or coping skills alone will help and that is where AD come in.

[Sileree]

Not surprised. Wellbutrin, Lexapro, Celexa and Cymbalta all had absolutely NO effect on me in varying doses and combinations, so I quit them after three years of trying to find one that "worked".

[Sileree]

Originally Posted by femalephish

I think it's dangerous to say that anti-depressants don't work. And the author of the article, a doctor, I think it's irresponsable for him to say that. People die from deppression. Please don't tell us we can't get better.

Who is saying depressed people can't get better? There are other options than medications. I personally think it is a worse disservice to depressed people (and I am one of them) to lie to them. These medications are NOT harmless placebos. They can have serious adverse effects.

[femalephish]

Originally Posted by Sileree

Who is saying depressed people can't get better? There are other options than medications. I personally think it is a worse disservice to depressed people (and I am one of them) to lie to them. These medications are NOT harmless placebos. They can have serious adverse effects.

I think for many depressed people, saying they can get better with vigiourus exersise is the same as saying they can't get better. I couldn't get off the couch and I REALLY didn't want to be around people, there was no way I would have made it to the gym without medicine.


Depression is an illness. People should feel bad for taking medicine to get well. We would take them if we had diabetes or high blood pressure. Even if they had side effects and don't work for everyone. No medicine is perfect.

NAK

[Oubliette8]

Except that medications for diabetes fix a recognizable deficit in the body (a lack of insulin) and work much better than a placebo. Give diabetics placebo instead of insulin, and the results will not be so good. Studies have NOT found a brain chemical imbalance so far, except in medicated brains where the condition is iatrogenic. Indeed, studies of brain chemicals have found those with (un-medicated) depression have almost identical brain chemical levels as normal people. And from the studies, it appears that antidepressants do not work any better than placebo for all but the most severely depressed patients.

There are other treatments for depression beyond exercise and nutrition. Psychotherapy, for instance, can be very effective.

Also, as a mental health patient, I find that those who tell me I need to take pills are the ones who are saying that I can not get better. It implies that there is something permanently wrong with me and I will always need to take medication to make it better. I see this message given to mental health consumers all the time, it leaves little hope of recovery.

And its important to remember that while depression does cause people to talk their own lives, antidepressants have been shown to INCREASE a persons risk of suicide. That's why they carry black box warnings for children, teens and young adults.

Antidepressants are far from benign pills, they carry serious risks and side effects. If the research is showing that they work no better than placebo, then that is something that consumers need to be aware of. Lying to the public, and to mental health patients who are desperately searching for a cure, is irresponsible. The pills are not harmless, people deserve to know what they are getting into.

[KatWrangler]

Originally Posted by Oubliette8

Except that medications for diabetes fix a recognizable deficit in the body (a lack of insulin) and work much better than a placebo. Give diabetics placebo instead of insulin, and the results will not be so good. Studies have NOT found a brain chemical imbalance so far, except in medicated brains where the condition is iatrogenic. Indeed, studies of brain chemicals have found those with (un-medicated) depression have almost identical brain chemical levels as normal people. And from the studies, it appears that antidepressants do not work any better than placebo for all but the most severely depressed patients.

There are other treatments for depression beyond exercise and nutrition. Psychotherapy, for instance, can be very effective.

Also, as a mental health patient, I find that those who tell me I need to take pills are the ones who are saying that I can not get better. It implies that there is something permanently wrong with me and I will always need to take medication to make it better. I see this message given to mental health consumers all the time, it leaves little hope of recovery.

And its important to remember that while depression does cause people to talk their own lives, antidepressants have been shown to INCREASE a persons risk of suicide. That's why they carry black box warnings for children, teens and young adults.

Antidepressants are far from benign pills, they carry serious risks and side effects. If the research is showing that they work no better than placebo, then that is something that consumers need to be aware of. Lying to the public, and to mental health patients who are desperately searching for a cure, is irresponsible. The pills are not harmless, people deserve to know what they are getting into.

I agree and disagree with your reply. Yes the meds can have serious side effects. But twhen the choice is side effects or my husband committing suicide, I think we will take the side effects.

I think one of the things the author of the article is trying to say is, there are other physical reasons why a person can be depressed. For example by fixing lack of vitamin such and such, this will take care of the depression. Rather than jumping on the anti-depression med band wagon.

It's very interesting. I am going to print it out and take it to our next therapy appointment and see what his take is on it.

[Mom2M]

I've read that article and agreed with a lot of it. So I started reading a lot of information on psychiatric drugs and disorders and this is one of the sites I found really, really interesting.
In reference to the "brain changes" and depression, read Chapter 6. If you are interested, go to the home page, there is a ton of stuff to read! I first thought that this might be a quack writing but I can't find evidence of that. (if you do, please let me know!)
http://www.psycheducation.org/mechan...anismIntro.htm

[Sileree]

Originally Posted by femalephish

I think for many depressed people, saying they can get better with vigiourus exersise is the same as saying they can't get better. I couldn't get off the couch and I REALLY didn't want to be around people, there was no way I would have made it to the gym without medicine.

But there are other non-medication therapies for depression than vigorous exercise, that don't take a lot of effort. I have tried a ton of them.

It's funny, because for me the effect of anti-depressants on my will to help myself was the opposite. I was tired much of the time and so not motivated to exercise, so I never did. Now that I've been off of them for six months, even though I still have periods of feeling crappy, I actually have the will to exercise for 3-4 times a week.

[sbgrace]

I've seen anti-depressants make a difference for me. I have been treated with SSRI's for OCD which, when it gets to the point that I need meds has depression associated. I always see a huge improvement in those depressed aspects (hopelessness for example) before I see reduction in the OCD which typically takes longer to respond to SSRI treatment. I've also seen family members respond dramatically to anti-depressants.

I think it's dangerous to make a blanket statement like that because, for a person already feeling desperate and hopeless that type of statement might push them further into the dark. Depression can kill people. And, beyond that, they do statistically work--just not better than placebo. We can't treat patients w/placebo without their consent (as part of study in this case). So where does that leave those who desperately need help?

[crunchy_mommy]

Well based on their numbers it looks like antidepressants DO work for 60% of people (although 2/3 of those would have been helped with a placebo as well).

I guess it's like anything else, each person will react differently.

I have been on nearly every antidepressant out there, high doses & strange combinations, augmented with other psychiatric meds, took 12+ pills a day, and had no relief from depression. They definitely didn't work for me & I would not try them again in the future.

I did find the part about food allergies interesting & I'd definitely like to look into that further!

[Pariah]

Despite suffering from depression, anxiety, and eating disorders since very early childhood (as long as I can remember), I used to be one of the med-bashing, "I just need to exercise and eat right" people. Things got so bad that my boyfriend, out of concern, very strongly encouraged me to see a doctor. I started an AD recently and it is a such a big difference...like this weekend, I dealt with some stressors that would normally give me severe anxiety and have me crying in bed/sleeping as much as humanly possible to escape. And I was okay. The pills aren't magic, I cried twice and had a little anxiety, but it was SO different from how it typically goes for me. I was able to be much more productive than usual, spent more time being calm, patient, etc. Yes, I had side effects for a few days upon starting the AD...felt like morning sickness. It was well worth the difference I experienced the past couple days. I'm still not keen on medication in general (I rarely even take OTC stuff for headaches), and I certainly don't see this as a permanent fix...I am starting therapy as well...but for now it is very nice not to spend most of my time in mental anguish, having episodes of self injury, etc.

[Proxi]

I am in agreement with everyone who has basically said that anti-depressants work differently with everyone, and for some people they will work and for some people they won't. I think they probably have less effect on people with situational depression.

I know for myself that there were antidepressants that did not work for me, such as Wellbutrin and Paxil and a couple of others. On the other hand, Effexor worked great, but only at a very high dose that just wasn't maintainable.

Psychotherapy didn't work at all for me, and I tried different programs with different therapists/psychologists/psychiatrists for different periods of time.

So far I haven't found anything that has worked as well as Effexor did. However, I don't plan on going back on effexor because I depression has lessened to a point where I now can function, and I rarely feel suicidal. So I can't say that antidepressants don't work. I do think there are multiple answers to how to treat depression and I think it really depends on the person, the severity of the depression, and how the illness is affecting one's life.

For example, if I went back to the place where I was for years (not getting out of bed most days, often feeling suicidal, on days where I thought I would be find and would go out in public I would break down crying for no apparent reason) I would definitely go back to some kind of antidepressant. I would also up my exercise routine .


I think people (even people with depression themselves) can be very judgmental about different types of treatment. I find psychotherapy doesn't work for me at all, but I know people who have found that it has basically moved mountains for them. I know people who journal in order to work through their feelings. I find journalling depressing, aggravating and definitely not something that helps me. I know people who have taken Paxil for six months to a year, had it help them get back on track with life and recover from depression. I took it and noticed absolutely no difference whatsoever.

I think at this point depression is so poorly misunderstood that we should be open-minded about all possible cures. Heck, if taking sugar pills but calling them some fancy name worked to help me, I would do it and pay a decent amount of money for it too lol!

[RiverTam]

OP's link really misrepresents that study. The headline is especially inflammatory and misguided.

The study found that SSRIs and tricyclics don't work for people with mild to moderate depression. (It actually found that it was as effective as a placebo for people with mild depression. That basically means that the act of seeking care and being cared for was responsible for the improvements.)

They were effective for people with more severe depression.

The study doesn't address Wellbutrin (which isn't an SSRI) as treatment for mild to moderate depression.

They used a specific depression index to measure symptom severity.

My conclusion was that talk therapy and exercise should be first line treatments for mild to moderate depression, and drugs along with talk therapy and exercise should be first line treatment for moderate to severe depression.