do ssri really work?

[Final Escape]

Drug companies are indeed terrible.

https://www.pharmaceutical-technology.com/features/biggest-pharmaceutical-lawsuits/

But so are a lot of large companies, as the dominant ethos is one of profit, not people, environment, or even a social conscience for the very communities that are the source of those very profits.

Anyway, they have also spun the chemical imbalance hypothesis to be presented like it is a fact. When it isn't. That more came out of marketing and misrepresenting findings on serotonin and the convenience of downplaying stigma. Also, everyone likes a quick fix to complicated problems.

https://pdfs.semanticscholar.org/f670/37b3c2ae7e17f211d399a18349fd6ae70a2b.pdf

If you don't have the energy to read much of that. It comes down this. If you are depressed and I give you chocolate and you report your mood is lifted. That is not proof that your depression is caused by a lack of chocolate or even cured by chocolate. Only that chocolate seemed to lift your mood.

SSRI's work on the same principle. Since depression is not at all understood in an objective manner like a disease may well be. Then the focus is on the reduction of symptomatology. This is not a great deal different to physical illness which is objectively understood but has no current cure. So the focus is on the reduction of symptomology to provide a better quality of life and functionality until a cure is discovered one day...

Sticking with the chocolate example. If you consistently eat chocolate at some point there are going to be ramifications. Maybe significant weight gain, even onset diabetes further down the line.

SSRI's are the same and the ramifications can be far more serious. Does that make them bad though? Well, only you can decide if rolling the dice on if a reduction in symptomology in the now vs potentially lasting consequences is worth it? Since biologically we are all different and comorbid conditions create even more variability. There is no certainty it will work for you, even if it works for someone else. Medicine is reliant on you being a guinea pig and simply seeing what happens. Then dealing with the outcome.

Where I have significant contention. Is to make an informed decision is to be informed of risks. To be provided truthful information even if that information is, "We don't know how or why it works for some but this is its efficacy versus placebo. This is the worst known potential outcome. Are you wanting to take that risk?" if even the physician is being lied to by not having all the data then how can anyone make an informed decision? Professional or otherwise?

What usually happens is you present with depression. They sip from their branded Zoloft mug aware they have a heavy caseload, and write you a prescription for Zoloft and tell you to come back in two weeks. Not even bothering to rule out physical issues. This behaviour increasingly seems to be becoming more common due to time constraints. Which is of major concern if you have a developing thyroid issue, onset diabetes or a tumour in the brain that is growing with every day wasted. Or a myriad of other potential issues that produce depressive symptoms as one of the first warning signs. This may well then get lost amidst the side effects now altering brain chemistry.

My other contention is that applying a purely biological reductionist approach to everyone as a first response. Is pretty dismissive of environmental factors that may be ruining your life. Taking an SSRI is not going to help you if you are still being molested by your uncle, or live in a toxic environment that is constantly tearing down your self-esteem. Or being bullied at school. Or job stress makes you want to stab your own eyes out on a regular basis. Or a host of other things that are logically damaging to well being.

Another contention is that leaving people to languish on things because if you are a zombie, you are not technically in distress or making a nuisance of yourself; even if your life is slipping you by one year at a time. Is both wrong and not a meaningful quality of life outcome at that point.

I think the problem is we are dealing with broken systems content to make us collateral if it serves the bottom line. That bottom line is best served by keeping people uninformed in the first place.

This was pretty deep, I like this post.

 

[RememberWhatUCameFor]

This was pretty deep, I like this post.

yes good post

 

[Deleted member 1465]

Drug companies are indeed terrible.

https://www.pharmaceutical-technology.com/features/biggest-pharmaceutical-lawsuits/

But so are a lot of large companies, as the dominant ethos is one of profit, not people, environment, or even a social conscience for the very communities that are the source of those very profits.

Anyway, they have also spun the chemical imbalance hypothesis to be presented like it is a fact. When it isn't. That more came out of marketing and misrepresenting findings on serotonin and the convenience of downplaying stigma. Also, everyone likes a quick fix to complicated problems.

https://pdfs.semanticscholar.org/f670/37b3c2ae7e17f211d399a18349fd6ae70a2b.pdf

If you don't have the energy to read much of that. It comes down this. If you are depressed and I give you chocolate and you report your mood is lifted. That is not proof that your depression is caused by a lack of chocolate or even cured by chocolate. Only that chocolate seemed to lift your mood.

SSRI's work on the same principle. Since depression is not at all understood in an objective manner like a disease may well be. Then the focus is on the reduction of symptomatology. This is not a great deal different to physical illness which is objectively understood but has no current cure. So the focus is on the reduction of symptomology to provide a better quality of life and functionality until a cure is discovered one day...

Sticking with the chocolate example. If you consistently eat chocolate at some point there are going to be ramifications. Maybe significant weight gain, even onset diabetes further down the line.

SSRI's are the same and the ramifications can be far more serious. Does that make them bad though? Well, only you can decide if rolling the dice on if a reduction in symptomology in the now vs potentially lasting consequences is worth it? Since biologically we are all different and comorbid conditions create even more variability. There is no certainty it will work for you, even if it works for someone else. Medicine is reliant on you being a guinea pig and simply seeing what happens. Then dealing with the outcome.

Where I have significant contention. Is to make an informed decision is to be informed of risks. To be provided truthful information even if that information is, "We don't know how or why it works for some but this is its efficacy versus placebo. This is the worst known potential outcome. Are you wanting to take that risk?" if even the physician is being lied to by not having all the data then how can anyone make an informed decision? Professional or otherwise?

What usually happens is you present with depression. They sip from their branded Zoloft mug aware they have a heavy caseload, and write you a prescription for Zoloft and tell you to come back in two weeks. Not even bothering to rule out physical issues. This behaviour increasingly seems to be becoming more common due to time constraints. Which is of major concern if you have a developing thyroid issue, onset diabetes or a tumour in the brain that is growing with every day wasted. Or a myriad of other potential issues that produce depressive symptoms as one of the first warning signs. This may well then get lost amidst the side effects now altering brain chemistry.

My other contention is that applying a purely biological reductionist approach to everyone as a first response. Is pretty dismissive of environmental factors that may be ruining your life. Taking an SSRI is not going to help you if you are still being molested by your uncle, or live in a toxic environment that is constantly tearing down your self-esteem. Or being bullied at school. Or job stress makes you want to stab your own eyes out on a regular basis. Or a host of other things that are logically damaging to well being.

Another contention is that leaving people to languish on things because if you are a zombie, you are not technically in distress or making a nuisance of yourself; even if your life is slipping you by one year at a time. Is both wrong and not a meaningful quality of life outcome at that point.

I think the problem is we are dealing with broken systems content to make us collateral if it serves the bottom line. That bottom line is best served by keeping people uninformed in the first place.

I'd actually like to include this as a link in my bookmarked for future response ssri post, if I may?

 

[Lost.]

SSRI are pure posion as other antidepressants. It is chemical weapon. It delete your emotions, your sexual function, your ability to think, your personality! Just google PSSD. Be aware that evry kind of antidepressants and antipsychotics can cause this, not only SSRI and SNRI antidepressants. Just google article "PSSD burried alive", read that and 111 coments. It is realy important. It is worthy.
You can take antidepressants for moths and don't get PSSD. You can take few pills and get PSSD, especialy if you took antidepressants in your past. Russian roulete. Stay away from that posion.

 

[Simba]

I actually find that they do more harm than good ... I'm on Viepax which is Venlafaxine i think and im on the max dose which is 300mg a day ... 150X2 and i don't like it... 1 thing i can say for sure is that it made me twich in my sleep and the only reason i know of that is cause my mammy had videod me in my sleep ! My parents had thought that maybe i had epilepsy but nope ,it's them drugs doin ,and the worse part of all this - i showed my psychiatrist and he was like "what do you want me to do with this ?" WOW !! JUST GREAT !!!!

 

[Backwood_tilt]

I actually find that they do more harm than good ... I'm on Viepax which is Venlafaxine i think and im on the max dose which is 300mg a day ... 150X2 and i don't like it... 1 thing i can say for sure is that it made me twich in my sleep and the only reason i know of that is cause my mammy had videod me in my sleep ! My parents had thought that maybe i had epilepsy but nope ,it's them drugs doin ,and the worse part of all this - i showed my psychiatrist and he was like "what do you want me to do with this ?" WOW !! JUST GREAT !!!!

that's awful. Is this a common side effect? does it affect your sleep quality at all?

 

[Simba]

that's awful. Is this a common side effect? does it affect your sleep quality at all?

Not really sure. I can still sleep tho. I don't really remember how i was before them ... But i can definitely say that my thoughts of suicide and my depressed moods hasn't gone away.. i keep telling my psychiatrist that everything in my case is situational. SITUATIONAL !!! But he doesn't seem to budge not even for a split second. He even said to me one time that maybe my Depression is part of me ,as in part of my personality. It sucks :/

 

[Susannah]

SSRI are pure posion as other antidepressants. It is chemical weapon. It delete your emotions, your sexual function, your ability to think, your personality! Just google PSSD. Be aware that evry kind of antidepressants and antipsychotics can cause this, not only SSRI and SNRI antidepressants. Just google article "PSSD burried alive", read that and 111 coments. It is realy important. It is worthy.
You can take antidepressants for moths and don't get PSSD. You can take few pills and get PSSD, especialy if you took antidepressants in your past. Russian roulete. Stay away from that posion.

This was new research to me, though not surprising. Thanks for sharing.

 

[neetschizo]

Nothing works. All meds are a scam. I weaned myself off my antipsychotic and antidepressants recently. Now I've just given in to the voices, I'm supposed to hear and listen to them. They are right.

 

[Close_to_freedom]

Anhedonia will make you beg for death.

 

[Samsara]

As frustrating as this answer is, the short and long-term effectiveness of SSRIs (and antidepressants more generally) really do vary person to person, and some antidepressants are better at dealing with certain symptoms than others (e.g., lack of pleasure versus sleep problems in depression).

In general, the best results for depression and many other psychiatric disorders are seen when an antidepressant is combined with psychotherapy. For me personally, I had to try out 3-4 different types of antidepressants (giving the effects at least 2 weeks to appear for each med) before I found one (Zoloft) that significantly helped me for about a year. I do give it a lot of credit for significantly decreasing the intensity of my depression and returning some color to my life.

Nevertheless, it's positive effects on my mood have seemed to subside after about 2 years and antidepressants can definitely be difficult to get off of for some people.

 

[DeadButDreaming]

They made my life bearable. I don't know why they don't work for everyone, but they certainly work for me.

 

[itsallover]

They don't work. Only the heavy hitters the shrinks dole out which completely numb out the world work.

 

[Hhhhhh]

they definitely work for people with normal depression and anxiety (they did for me) now im not sure because im way worse. Im trying them again willingly to see if they go anywhere but i think theres a point they stop working or you need to get heavy duty with antipsychotic shit which are the ones that mess you up the most. stuff like prozac tho seems harmless in my experience

 

[RememberWhatUCameFor]

Anhedonia will make you beg for death.

what is anhedonia

 

[Lost.]

Anhedoia is loss ability of enjoyment. People damaged by psych drugs often use that word instead of the word emotional numbness.

 

[Sapphodivine]

Nothing has worked for me, which makes it worse, because you know drugs work for some, so what the hell is wrong with me.

 

[Lost.]

You can be happy it didnt damage you bad. People do suicide because of psych drugs brain damaged their brain.

 

[Spiral]

If they worked (placebo or not), there wouldn't be so many people here I think... I wonder sometimes if they simply prescribed caffeine pills, it would help more. It would at least energize those who feel too tired to do anything and that itself could lead to even a tiny bit more motivation to do something that may lead to feeling a tiny bit better...

I wonder also if caffeine would work for some people for anxiety. Sometimes my anxiety stems from one minor thing (ie being too tired to do something) and then escalates fast to wanting to CTB. Not necessarily that caffeine is the answer but it doesn't make sense to me that pills than sedate you should make you feel better. Its like your psych hospitalizing someone without good reason so they don't need to worry...

Speaking from personal experience caffeine makes my anxiety worse because it just exacerbates the racing heart beat / palpitations / hot and cold sweats. Definitely feel better with something calming.
For lack if energy my GP once prescribed me some super strong vitamin D tablets and those 100% changed my life for the better with no negative side effects but they don't allow continued use of them so after my vitamin D tablets ran out my life just plummeted back to my normal depressed state and I wasn't allowed any more :( it's ridiculous because the risks of taking vitamin D long term are less than the risk from SSRIs

 

[GenesAndEnvironment]

No

 

[Cherry Crumpet]

They've helped me, to a small degree. It's very hard to notice if you try to compare day to day. But I keep a mood journal and I see an improvement from the years I was off SSRIs. I've been on and off of them for over a decade.

One thing to look out for is the damn brain zaps if you try to get off them though. Those are a fcking horrible bitch.

I take generic cymbalta and while it doesn't make me 'happy' it bumps my baseline up about 1-2.5 points, which is pretty huge for me.

 

[rs929]

I wonder if you wouldn't get a biased response on a suicide forum. Obviously SSRI's and antidepressants overall aren't working well for most of us or we wouldn't be here.

 

[RememberWhatUCameFor]

bump

 

[ket]

hello, i am a scientist.

ssris work to a degree, meta-analyses show they relieve symptoms for 40-60% of individuals. unfortunately, the whole thing is a coin flip. if they work for you, great! if not, dang! the science on why they don't work for everyone isn't very well understood, and i don't think those various cytochrome genetic assays have helped refine treatment much. unfortunately, two people can experience similar depressive symptoms and have entirely different things wrong synaptically.

you can try a drug of another class (ssri->ndri), or augment with lithium or something. if you've tried a few regular antidepressants and they don't work, you're technically classified as treatment resistant and should look into ketamine, tms or ect or something.

 

[ven]

Do SSRI work? Yes, but not for everyone. SSRIs work for people who legitimately have serotonin chemical imblances. For those of us who do not have a serotonin imblanace and are still depressed, SSRIs will probably not work.

 

[ket]

Do SSRI work? Yes, but not for everyone. SSRIs work for people who legitimately have serotonin chemical imblances. For those of us who do not have a serotonin imblanace and are still depressed, SSRIs will probably not work.

it's kind of complicated unfortunately, concentrations of serotonin in cerebrospinal fluid or brain tissue from postmortem individuals with depression usually don't directly correlate with mood. it's a lot more than less serotonin=more sad. serotonin plays some role, but it's not the whole story.

the etiology of depression is not well understood unfortunately. individuals who don't respond to ssris may still respond to serotonergic psychedelics which presumably are hitting the same receptors, for example.

 

[Sherri]

I've tried most, by most since the first ones discovered till the new generation which I am now taking. The new one I take it's been working well along with my mood stabilisers

 

[Dragon's Heart]

My experience with SSRIs: It seems that although different ones may work a little differently, they all go to the same destination which is to numb out emotions. For me, I'm still depressed as hell, just don't care that I'm depressed. They do seem to help temper my emotional reactions to stress though.

 

[LingeringUnreal]

My SSRI experience was very very negative because psychiatrists decided to test out various meds and methods on me from the time I was 10 until 17. I was on up to 5 different (including experimental) drugs at a time including SSRIs. They really zombied me out at best and increased my suicidal thoughts + lack of impulse control at worst. If you have them, definitely just try to avoid situations that are like "med to counteract the side effect of other med" until you're on like 6 different things. It's okay to shop around for medications instead of locking yourself into something that sucks.

That being said, I do have friends who are on an SSRI only and seem to do okay, aside from stuff like having a harder time with libido.

 

[Hirokami]

They sort of work for me, though more so for my anxiety than my depression. I can cope with being depressed easier, so I guess it's a win. They can't improve my situation, though.