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Opinions of sertraline

4DQSAR said:
For contrast, citralopam did nothing whatsoever if I took it or if I didn't take it. In that case evergreening HAS taken place as, behold, escitalopram.

I have a feeling that the NHS were able to buy citralopram directly from Lundbeck at a very low price because for a few years it became the first-line medication for unipolar depression in the UK. I suspect GPs soon recognized that it wasn't very good - even some of the human studies showed it to be no better than a placebo.

Just to be clear, the placebo effect is real and why some people swear by altentative medicine - if you BELIEVE a treatment will work, it will work (at least sometimes) and for a mental health condition, I suppose it's easier to think yourself better than, say porphyria, cancer or indeed a broken leg.

I still think if a person is not suicial, tricyclics are more effective. When Prozac arrived I looked at the human studies and noted that they had compared the highest prescribable dose of fluoxetine with the lowest dose of amitriptyline indicated for unipolar depression and the conclusion was that the two medicines were of similar utility. While I can see the theoretical lower risk of intentional overdose most SSRIs offer, we live in a world where medicines can be delivered for a nominal price so a cautious clinician could insist on the tricyclic being dispensed on a weekly basis.

With any medicine, there will always be a risk/benefit ratio and I note SSRIs are associated with INCREASED risk of suicide among some demographics. Yes, taking a whole box of your antidepressant won't kill you but we are surrounded by effective ways to throw a seven.

For those concerned about stopping, the BNF at least DOES advise that SSRIs should be tapered rather than abrupty stopped. Given that all SSRIs have long (or very long) half-lives, how the taper is undertaken can include taking a dose every other day. It does seem complicated and the only good thing I have to fay about fluoxetine is that it's half-life is 4-6 DAYS. I suspect discontinuation syndrome took a while to be accepted because when Prozac was almost a national institution, that extreme duration likely meant discontinuation wasn't as problematic.
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I was prescribed Citalopram first. I took ONE pill....never again. My anxiety - already "severe" was so much worse than it was essentially a panic attack that lasted for like 20 hours.
 
ChemicallyEnhanced said:
Can we get an update? I know it's been 7 years...

Hope it worked out for him!
It literally saved my life. Started it around the same age...been on it for 16 years now (which is weird because I'm only 21) and it still helps.

I actually got a bizzarely RAPID improvement from it and absolutely, positively NOT placebo because it was my second SSRI (Citalopram/Celexa) and the first was a horrible experience, so I did NOT expect much from the Sertraline, plus my doctor gave me the "6 weeks to really help" shpeil. But I felt much better after 3 days...in fact, I was basically high? I'd compare it to a moderate dose of amphetamine sulphate or a hypomanic episode. Anyway, I love it.
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You were put on antidepressants at five years old?!
 
LoginNotSecure said:
All, and I do mean all antidepressants, antipsychotics and their ilk have an increased risk of suicide. I wouldn’t recommend them at all if they can be avoided. Cooking your brain isn’t conducive for longevity.
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Yeah apparently the meds can increase energy or motivation for people to take their own lives, during the earlier stages of starting these meds I believe. After that the risk of suicide lessens?

Has there been any studies correlating the use of these sorts of medications with shortened life expectancy do you know?

Surely this would be very difficult to quantify, because people with mental health issues, could, and probably mostly do, have multiple different but highly significant variables, besides their medications, for not living as long.
 
Bleaney said:
Yeah apparently the meds can increase energy or motivation for people to take their own lives, during the earlier stages of starting these meds I believe. After that the risk of suicide lessens?

Has there been any studies correlating the use of these sorts of medications with shortened life expectancy do you know?

Surely this would be very difficult to quantify, because people with mental health issues, could, and probably mostly do, have multiple different but highly significant variables, besides their medications, for not living as long.
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www.cambridge.org

Antidepressant use and risk of adverse outcomes: population-based cohort study | BJPsych Open | Cambridge Core

Antidepressant use and risk of adverse outcomes: population-based cohort study - Volume 8 Issue 5
www.cambridge.org www.cambridge.org

The key difficulty is that depression itself is linked to increased mortality. Separate UK Biobank research found that a history of depression was associated with roughly a 46% higher risk of all-cause mortality, independent of physical activity levels. That mortality could be from drink, drugs, accidents or just the person press Alt +F4 on themselves. But as I said previously, if they work for you and you have minimal side effects, great. But for the most part them cause more damage than help. In my own opinion, of course. Easy for me to say in my ivory tower and all.
 
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