SSRI's (specifically citalopram)

[Allein]

OP I would really try and get referred to a psychiatric doctor for a prescription if possible GPs just tend to work down a list and hope one works. We could argue all day about the effectiveness or otherwise of one type of AD or another but depression can lead to suicidal thoughts and sometime, sadly actions so its important you take action and seek as much medical support as you can.

I have just start CBT (Cognitive behavioral therapy) which is a form of counseling aimed at breaking the mental cycles people develop that can lead to depression but I've found it necessary to go back on an AD due to my persistent thoughts of suicide and fairly acute anxiety.

There are also druga specifically for anxiety, I ws on chlorpromazine for a while when thinsg wrere really bad, it did make me a bit iof a zombie but at least I was wasnt as anxious and it gave me soem breathing space to getmyself together.

Some ADs venlafaxine being one is supposed to help with anxiety as well as depression.

 

[MatthewD]

i find it hard to believe serotonin is the main chemical involved in depression and anxiety. you should look into norepinephrine and epinephrine inhibitors (clonidine)

Definitely agree there! When I'm feeling down, including when I was on my Escitalopram prescription, I found that Serotonin supplements etc. never helped my "depression" as much as even a Coffee, for example. Not that I'd recommend it for long-term use, Amphetamine's seem to do a great job at cheering me up when I need it, and giving me the motivation to FIX whatever it is that is causing me to feel depressed. I imagine the Norepinephrine and Dopamine Reuptake Inhibitors would generally help many people feeling slouchy... Side effects would be a possible increase in anxiety though.

 

[riptaz]

Hi Guys,

I said I would give you all an update after I saw the doc. As my citaolpram was not working he has now put me on Mitazapine took one last night tottally knocked me out lol and made me eat non stop lol. I also take Tramadol ( self prescribed) is there any danger in taking these 2 meds together? as i read on a drug interaction side that i shouldn't take them 2 togeter because it can induce serotonin sysndrome but I also read on another site that Mitazapine can reduce the chances of serotonin syndrome so not sure, any ideas???

Also have anyone got any stories or experineces about Mitazapine they can share?

Thanks guys

 

[Allein]

^^^

With all due respect we all have the internet here, its kind of a given

 

[TheLostBoys]

^^^^^^^^^^^


WTF is up with that..........

 

[laCster]

yah damn dude, no need to quote all of wikipedia. bluelight is not a free encyclopedia

 

[Allein]

thought when I read TLB's posy you were having a pop at me, I did try to be polite buts that massive quote has made the thread difficult to read maybe the poster could edit and just put in the link if he really feel its necessary to provide wikipedia info

 

[Psychedelic Jay]

Overall, I think that's some great advice, jay but do you have any sources to back up that figure?

"In the withheld literature, they had below 50% success. Combined, all studies showed 51% efficacy." This is for ssri's.

The pharmaceutical companies hid or simply did not publish this fact. Selling "dope hope" to the hopeless.

http://en.wikipedia.org/wiki/Antidepressant#cite_note-Turner_EH.2C_Matthews_AM.2C_Linardatos_E.2C_Tell_RA.2C_Rosenthal_R_2008_252.E2.80.9360-0

Scroll down to review studies. This will lead you to other links for further study. Which will also include that newer antidepressants are no better than old ones.

Name brand profit... That is all what it boils down to once again.

Remember... Placebo and lifestyle changes are your friends...

 

[Psychedelic Jay]

By the way people read further than the wikipedia page... Gosh. Don't shun me if you are the idiot that stopped there and didn't look any any source to seek credibility. That's not what wiki is for anyway. It is to bridge sources together to make searching easier.

 

[Allein]

^^^

Having been on a number of ADs I find the whole debate both interesting but confusing, we had a big debate over in EADD which I linked to earlier in the thread, Medicine is not my field of expertise so I claim no real knowledge but some questions jump out at me as part pf the debate:-

1.) Depression is not fully understood - we don't really have a physical way of measuring it like say high blood pressure, those brain scan pictures don't really seem to prove anything IMO.

2.) How do they select the study groups for these trials given we could be dealing with an umbrella type condition

3.) SSRIs definitely change mood and cognition so claims that they are no more effective than a placebo seem difficult to believe

4.) sponsored by pharm companies or not there also seem to be many studies showing the effectiveness of these drugs

I don't seem to tolerate SSRIs well so am currently on an SNRI, its to early to tell if its going to help, I'm also getting CBT and trying to do all the obvious stuff to improve my situation so my reports back on progress wont be pure as I have no control subject that just sits on his backsode and takes the pills!

 

[Psychedelic Jay]

3.) SSRIs definitely change mood and cognition so claims that they are no more effective than a placebo seem difficult to believe.

Yes ssri's are supposed to blunt depression, but suck horribly at it. Placebo convinced people that there were on a actual AD, and those trials did nearly identical.

What would common sense tell us? SSRI's do very little in the way of relieving depression.

The pills simply are not effective.

 

[Allein]

^^^

I don't think I have explained at least some of my point very well:-

Depression is not a condition that is easily measured - you cant do a blood test for it, yes there are various questionnaires like the Hamilton scale (I've filled out more than I care to remember) so we may well be dealing with an umbrella term for a condition that has numerous causes some and their relation to brain chemistry may well vary, this seems likely to a non medical person like me.

Talking to people via this site some do report results from SSRI's you can make statistics and studies say pretty much whatever you want them to but real people do gain some relief from depresion by taking them, I gthink the jury is well and truly still out

Given the above how can a trial of any sort really prove anything, you can't measure the original condition accurately so how can you measure improvement and thats without going into all the other variables that must be in the mix when you are dealing with real people, I'm sure placebo has some effect but without knowing the detail of the group we can't really rely on that. For me it would work in the opposite I've had such a bad time on SSRIs I'd expect them not to work.

 

[Psychedelic Jay]

^^^
Given the above how can a trial of any sort really prove anything, you can't measure the original condition accurately so how can you measure improvement and thats without going into all the other variables that must be in the mix when you are dealing with real people, I'm sure placebo has some effect but without knowing the detail of the group we can't really rely on that. For me it would work in the opposite I've had such a bad time on SSRIs I'd expect them not to work.

There was never any pharmaceutical so-called "antidepressant" without trials. Mood disorders can be measured by severity. It is no mystery how severe a persons depression can be. Antidepressants are meant for all depressed individuals, even for a slightly bummed out person. This is the whole marketing scheme.

The FDA has some really fucked up rules for medications to be approved. And antidepressants were approved because they saw "some" improvement in individuals. This same exact number of individuals responded to every single SSRI antidepressant exactly the same.

It is a waste of money to keep switching antidepressants over and over again... If you been on one SSRI, you have been on them all.


What really happens when you take an "antidepressant" you really are riding life out on placebo. Since you are convinced you are feeling better, you start to become a better version of yourself without even noticing it. You start doing stuff you liked before your episode again. You start socializing with more people. You notice you may be more extroverted than normal.

This is what therapy is for. Some people treat antidepressants like they are therapy in a pill. <This is what the companies who make these thrive off of. Their product giving you hope you already had.

But there is the bad side... You become a terrible moody mess. You fall deeper into your episode, and eventually hit a ward, or you kill yourself. (You use your own imagination here.)

You might even be a bold enough person and sue the shit out of these companies... They very well deserve it.

 

[Allein]

^^^^

I've been "on the ward" and been through numerous SSRIs, the reason They have had to keep changing my meds is the severe reactions I've had to different ones, they can't all be the same. Sertraline I tolerated quite well for a few weeks before it gave me internal bleeding but Citalopram made me hallucinate. Prozac just made me throw up, they may have a similar action on serotonin reuptake but they sure have different side effects so the actions on the body must be different. As I said I'm no doctor juts someone that been through and is till in the mill.

I can't see Placebo working for me as I have a negative view of ADs but when you are faced with thoughts of suicide on an almost hourly basis you've got to do something...I'm sure you would agree.

You say "Mood disorders can be measured by severity" by what means are you talking about, I've done some lengthy questionnaires and sessions with psychiatrists but this is all a little subjective to be called a measure, I'm an engineer so for me those things dint stand up as anything more than a subjective assessment.

My suspicion is that alloy of the people, being given SSRIs don't actually have clinical depression that warrants medication what they need is some CBT or similar. In my case I needed something to stop me from killing myself before I could even start the CBT !

If SSRIs have some positive effects on 51% of the study group (you numbers) and we except that some of the study group either just didn't respond well to SSRIs, (we don't fully understand depression so this could be for a whole host of reasons) I don't see that as being that bad a result, in fact I'm surprised its that high.

I'm not trying to be picky here I'm genuinely interested in the debate...I'm the guinea pig here

 

[RobotRipping]

^ in some studies AD are shown to be just a little bit more effective than placebo. Which means they are about as effective as being tricked into believing you are going to be okay. This is a 2008 study that backs that up: http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0050045

Maybe that just shows the power of positive thinking or that SSRI's are complete bullshit but either way they have too many side effects for me. Unfortunately placebo wears off, especially when people realize they are just taking sugar pills lol. In a psych class I took the prof mentioned that placebo when tested against opiates would work for pain, the first couple of times, then nothing, big surprise there.

IMO 51% is a terrible rate of success especially when you take into account that 25% of these people are more than likely feeling better because they think they are going to feel better. I bet benzos and opiates have a much higher rate of success in treating depression/anxiety lol. Or DXM/MXE/Ketamine.

 

[pally pete]

^^^^

I've been "on the ward" and been through numerous SSRIs, the reason They have had to keep changing my meds is the severe reactions I've had to different ones, they can't all be the same. Sertraline I tolerated quite well for a few weeks before it gave me internal bleeding but Citalopram made me hallucinate. Prozac just made me throw up, they may have a similar action on serotonin reuptake but they sure have different side effects so the actions on the body must be different. As I said I'm no doctor juts someone that been through and is till in the mill.

I can't see Placebo working for me as I have a negative view of ADs but when you are faced with thoughts of suicide on an almost hourly basis you've got to do something...I'm sure you would agree.

You say "Mood disorders can be measured by severity" by what means are you talking about, I've done some lengthy questionnaires and sessions with psychiatrists but this is all a little subjective to be called a measure, I'm an engineer so for me those things dint stand up as anything more than a subjective assessment.

My suspicion is that alloy of the people, being given SSRIs don't actually have clinical depression that warrants medication what they need is some CBT or similar. In my case I needed something to stop me from killing myself before I could even start the CBT !

If SSRIs have some positive effects on 51% of the study group (you numbers) and we except that some of the study group either just didn't respond well to SSRIs, (we don't fully understand depression so this could be for a whole host of reasons) I don't see that as being that bad a result, in fact I'm surprised its that high.

I'm not trying to be picky here I'm genuinely interested in the debate...I'm the guinea pig here

I agree 100% with everthing you have said.

Im currently on 100mg sertraline per day (approx 6 weeks IIRC) and still feel awful, before the sertraline i was on citalopram 20mg per day for around 5 weeks.

I started my course of treatment on 15th June with an open mind so placebo effect will have no effect on my condition asfaik.

 

[Psychedelic Jay]

... Prozac just made me throw up, they may have a similar action on serotonin reuptake but they sure have different side effects so the actions on the body must be different.

You say "Mood disorders can be measured by severity" by what means are you talking about, I've done some lengthy questionnaires and sessions with psychiatrists but this is all a little subjective to be called a measure, I'm an engineer so for me those things dint stand up as anything more than a subjective assessment.

If SSRIs have some positive effects on 51% of the study group (you numbers) and we except that some of the study group either just didn't respond well to SSRIs, (we don't fully understand depression so this could be for a whole host of reasons) I don't see that as being that bad a result, in fact I'm surprised its that high.

The antidepressants are "different" by chemical structures. Some are even metabolites of another one in order to "try" to clean up the side effect profile. But, once you start fucking around with these awful chemicals, people tend to get psychologically attached to them. (addicted) This addiction is nowhere near as bad as any hard drug addiction. It is that "hope" factor... People can physically see their pill bottles running low and can be depressed as if they aren't even on the medication to begin with.

Severity just like you put it in this case. Some people are just not depressed "enough" to have pills shoved at them. Some people are I think too depressed to be on SSRI's. I still think a low dose stimulant is the best way to get a person out of an "over the top, depressive, suicidal episode..."

If you think just under or just over half is a good number, you don't fully understand the concept of medication approval. The reality is that the pharmaceutical companies have been lying to the FDA for a very long time now. These companies claim that their pills treat over 90% of the people tested. This warrant's approval from even the most cautious. But if the FDA really cared about this, ALL AD SHOULD HAVE NEVER BEEN APROVED. In clinical studies, 51% is a big whopping "DUD." They just aren't really having a major impact on society as they have been claimed to have. The general public is always being lied too. Especially in this case.

 

[Psychedelic Jay]

You have been lied to and bamboozled out of hundreds of dollars. It is not hard to assess yourself to see if you are depressed. Just look up the warning signs. And start to watch out for them. Ask yourself if you are depressed. Only you can truly tell if you are depressed. Yeah, other people can observe you and figure it out, but, some just aren't around a big enough chain of support to actually seek help, and deny it in fear of shame.

To me IMHO Society has created depression as a form of oppression. Most know that depression stems from lack of pride in one's self... So amplifying on this point is of no help to people. Why turn it into a disease instead of leaving it as a disorder?

The definition of depression is going to get sicker and sicker...

 

[Allein]

^^^

Thanks Jay you have clarified some of my miss-understandings in this debate, obviously I'm going to make a few comments on your statements.

I think you are correct its fairly easy to test and know you are depressed, although many do not recognise this in themselves or self deny for a long time before seeking treatment, I know I did and ended up in secure care within 2 weeks of my first doctors visit for the issue.

I'm not so convinced they can measure accurately on any scale how depressed you are and this must mean trials have limited accuracy although from what you have explained I guess this variance doesn't invalidate the overall result.

Giving me a stimulant would be a very bad idea since I abused them for the best part of 20 years and as I got more depressed took more and more, my addiction potential is high so the a script would be gone in a day !

Its a bit strong to say "You have been lied to and bamboozled out of hundreds of dollars" / Pounds (I'm from the UK) I haven't been bamboozled at all I'm just someone who is unwell seeking and effective treatment, I'm not naive enough to think I'm going to walk into the doctors office for this and walk out with a script for some pills and all will be good in a couple of weeks, this is a lifetime thing for me, part of the way I am and think. I can see that after some of the counceling I've already had.

I spent 10 years trying to find a cure for an acute skin condition some stuff worked a bit some not at all, in the end I've manged to get to a place where it doesn't impact my life to much and I'm treating the depression / anxiety issue the same way. I really don't have any great expectations of the ADs SSRIs, SNRIs, Tryclclics whatever but I'll give them a go I might be one of the ons for whom they work if not I've lost nothing.

I'll leave the great "are we being ripped off by the pharm companies" for those that get paid for such things and can genuinly judge the studies.

 

[ro4eva]

Having been on a few SSRIs myself over the course of about 30 months, I can say that the one - and most noticeable - effect they all had on me was apathy. I couldn't cry or laugh about anything anymore. My guess is that some mistook/mistake this as an antidepressant effect when in fact imo it's more of a mood stabilizer. While this apathy effect may stop a clinically depressed patient from - for example - crying repeatedly - and yes, I suppose that could be considered an improvement - I for one never felt or noticed any significant short or long term positive changes in mood, motivation, relationships or lifestyle. Some may argue that these changes take time and that they are subtle - I cannot factually prove that they are wrong. I just know I stuck with the high dosages I was receiving for several months and nothing really seemed to improve.