Anti-depressants: Major study finds they work(bbc.co.uk)
bbc.co.uk
Anti-depressants: Major study finds they work
http://www.bbc.co.uk/news/health-43143889
5 comments
Comments moved to https://news.ycombinator.com/item?id=16434618.
> meta-analysis
I knew a lot of other grad students, myself included, who would throw anything with meta-analysis in the introduction in the trash. You cannot deal with controls across completely different studies in meaningful ways.
I'm also hesitant about anything that tries to claim things definitively without question. Science is about continually questioning your axioms. Without [doubt](https://khanism.org/science/doubt/) there is no progress.
As someone who has been on various anti-depressants, I will say that some of them "worked" .. but the side effects were quite high. Working only lasted the first few weeks with several different SSRIs. Eventually the side effects ended up being worse than the treatment.
I found the most effective thing for me was simply a really good therapist. She did try to recommend drugs to me again after I had quit, but she did respect my wishes to not be on them. I feel that having someone who really showed me my options and truly helped examine negative thinking patterns helped a lot more than the drugs ever did.
That being said, I know people who say they'd be in serious trouble or dead without SSRIs. It's a tough line to talk about. I personally would rather not ever be on them again. Dulling the pain for me also meant dulling life.
There are trade offs and we need to talk about them and have full discussions on the consequences of mind alternating drugs. When things are written into pure absolutes, it is a means of killing real discussion and dialogue.
I knew a lot of other grad students, myself included, who would throw anything with meta-analysis in the introduction in the trash. You cannot deal with controls across completely different studies in meaningful ways.
I'm also hesitant about anything that tries to claim things definitively without question. Science is about continually questioning your axioms. Without [doubt](https://khanism.org/science/doubt/) there is no progress.
As someone who has been on various anti-depressants, I will say that some of them "worked" .. but the side effects were quite high. Working only lasted the first few weeks with several different SSRIs. Eventually the side effects ended up being worse than the treatment.
I found the most effective thing for me was simply a really good therapist. She did try to recommend drugs to me again after I had quit, but she did respect my wishes to not be on them. I feel that having someone who really showed me my options and truly helped examine negative thinking patterns helped a lot more than the drugs ever did.
That being said, I know people who say they'd be in serious trouble or dead without SSRIs. It's a tough line to talk about. I personally would rather not ever be on them again. Dulling the pain for me also meant dulling life.
There are trade offs and we need to talk about them and have full discussions on the consequences of mind alternating drugs. When things are written into pure absolutes, it is a means of killing real discussion and dialogue.
Reposting from the other thread about the study.
>"We excluded quasi-randomised trials and trials that were incomplete or included 20% or more of participants with bipolar disorder, psychotic depression, or treatment-resistant depression."
Wikipedia defines treatment resistant depression as "cases of major depressive disorder that do not respond adequately to appropriate courses of at least two antidepressants."
Maybe I'm unfamiliar with study methodology, but doesn't this undermine the study's conclusion? It's essentially stating that forms of deppresesion that respond well to antidepressants respond well to antidepressants.
>"We excluded quasi-randomised trials and trials that were incomplete or included 20% or more of participants with bipolar disorder, psychotic depression, or treatment-resistant depression."
Wikipedia defines treatment resistant depression as "cases of major depressive disorder that do not respond adequately to appropriate courses of at least two antidepressants."
Maybe I'm unfamiliar with study methodology, but doesn't this undermine the study's conclusion? It's essentially stating that forms of deppresesion that respond well to antidepressants respond well to antidepressants.
Please don't repost across threads. It makes merging them much more of a pain. If there are two discussions going on about the same thing, you're welcome to let us know at [email protected].
For me this paper fires of the typical warning signals for antidepressant studies.
>It should also be noted that some of the adverse effects of antidepressants occur over a prolonged period, meaning that positive results need to be taken with great caution, because the trials in this network meta-analysis were of short duration.
Issue one for me due to the typically long effect of depression. There is little to no assistance to coming off of antidepressants. For me personally even on a moderately ineffective dosage, the withdrawal symptoms are nearly incapacitating.
>The median duration of the acute treatment was 8 weeks (IQR 6–8).
The effects of long term depressive disorders seem to be essentially unstudied. I can't say I'm a valid source, like most people commenting this comes from a place of subjective personal experience, however with a median outcome time of 8 weeks this seems almost pointless to me?
>The great majority of patients had moderate-to-severe major depressive disorder
We're talking about a greater than middle ground level of depressive disorders and the study outcomes are judged at the 8 week mark. While admirable the study to me seems to just exemplify the fire and forget attitude towards depression in most developed countries. The costs are astronomical and these costs are not simply due to 8 weeks of treatment.
>Our primary outcomes were efficacy (response rate measured by the total number of patients who had a reduction of ≥50% of the total score on a standardised observer-rating scale for depression)
Considering it's a greater than 50% reduction, that appears to be a considerable enough reduction to assume the full recovery of the patient? However with all the numbers around costs etc. It seems a 50% reduction in 8 weeks, while great on paper, doesn't amount to much more than a slightly comforting silver lining to a storm cloud. Perhaps you won't be dead but you'll feel like it forever.
I'm writing this from a place of great personal distress in response to my so far completely ineffectual treatment after over a decade of attempted treatment and I simply cannot put faith in these papers and especially not these headlines. So apologies if my comment comes of as arrogant, incorrect or just plain offensive. I'm still in my early 20s and full of angst and regret.
The headlines remind me of the countless comments that tell me things will get better while I watch my life fall to pieces around me as I drain the finances and time of my already struggling family and partner who have to come to terms equally as I do that while 'major study finds they work', myself and my father continue to see little to no improvement in our quality of life.
Personal feelings aside, to summarize, I simply cannot see this paper as anything more than egotistical numbers surrounding psychiatric medication that has been the topic of debate among medical professionals regarding who is right, rather than who it helps.
Thanks for reading.
>It should also be noted that some of the adverse effects of antidepressants occur over a prolonged period, meaning that positive results need to be taken with great caution, because the trials in this network meta-analysis were of short duration.
Issue one for me due to the typically long effect of depression. There is little to no assistance to coming off of antidepressants. For me personally even on a moderately ineffective dosage, the withdrawal symptoms are nearly incapacitating.
>The median duration of the acute treatment was 8 weeks (IQR 6–8).
The effects of long term depressive disorders seem to be essentially unstudied. I can't say I'm a valid source, like most people commenting this comes from a place of subjective personal experience, however with a median outcome time of 8 weeks this seems almost pointless to me?
>The great majority of patients had moderate-to-severe major depressive disorder
We're talking about a greater than middle ground level of depressive disorders and the study outcomes are judged at the 8 week mark. While admirable the study to me seems to just exemplify the fire and forget attitude towards depression in most developed countries. The costs are astronomical and these costs are not simply due to 8 weeks of treatment.
>Our primary outcomes were efficacy (response rate measured by the total number of patients who had a reduction of ≥50% of the total score on a standardised observer-rating scale for depression)
Considering it's a greater than 50% reduction, that appears to be a considerable enough reduction to assume the full recovery of the patient? However with all the numbers around costs etc. It seems a 50% reduction in 8 weeks, while great on paper, doesn't amount to much more than a slightly comforting silver lining to a storm cloud. Perhaps you won't be dead but you'll feel like it forever.
I'm writing this from a place of great personal distress in response to my so far completely ineffectual treatment after over a decade of attempted treatment and I simply cannot put faith in these papers and especially not these headlines. So apologies if my comment comes of as arrogant, incorrect or just plain offensive. I'm still in my early 20s and full of angst and regret.
The headlines remind me of the countless comments that tell me things will get better while I watch my life fall to pieces around me as I drain the finances and time of my already struggling family and partner who have to come to terms equally as I do that while 'major study finds they work', myself and my father continue to see little to no improvement in our quality of life.
Personal feelings aside, to summarize, I simply cannot see this paper as anything more than egotistical numbers surrounding psychiatric medication that has been the topic of debate among medical professionals regarding who is right, rather than who it helps.
Thanks for reading.