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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 29. This is the beginning of the thread.
Posted by Abby Cunningham on January 6, 2010, at 19:09:08
What do you all think of the latest findings as published in the JAMA regarding ineffectiveness of antidepressants except for the severely depressed? I take bupropion 150 XL and find it does help but not that much.
Here is a blog I follow from a doctor; very interesting and a link to the JAMA article:
Posted by mtdewcmu on January 6, 2010, at 21:37:47
In reply to Antidepressants only for severely depressed--, posted by Abby Cunningham on January 6, 2010, at 19:09:08
Thanks for posting that blog. I liked this bit about Abilify: "Bristol-Myers Squibb, manufacturer of Abilify, has been running a disinformation campaign in medical journals to tout its drug as an antidepressant. Their attempts to paint a positive picture of Abilify's antidepressant properties and its allegedly fantastic safety/tolerability profile have been simultaneously tragic and amusing." I let my previous psychiatrist put me on Abilify for depression, but I have stopped taking it due to it having apparently no benefit on my mood. I wish I hadn't wasted money on it. It only makes sense that the drug companies would want to steer depressives to expensive atypical antipsychotics now that most antidepressants are off-patent.
Posted by Phillipa on January 6, 2010, at 21:41:19
In reply to Antidepressants only for severely depressed--, posted by Abby Cunningham on January 6, 2010, at 19:09:08
Abby they have never helped me. I've not seen them help patients took care of either. But benzos did. Phillipa
Posted by mtdewcmu on January 6, 2010, at 21:49:10
In reply to Antidepressants only for severely depressed--, posted by Abby Cunningham on January 6, 2010, at 19:09:08
By the way, here is a news article based on the JAMA article from the New York Times: http://www.nytimes.com/2010/01/06/health/views/06depress.html?hpw
Posted by Phillipa on January 6, 2010, at 21:55:58
In reply to Re: Antidepressants only for severely depressed--, posted by mtdewcmu on January 6, 2010, at 21:49:10
Sounds like what I learned about osteoporosis meds today will post later on health thread. I think big pharm is in trouble. Phillipa
Posted by rjlockhart04-08 on January 6, 2010, at 22:02:06
In reply to Re: Antidepressants only for severely depressed--, posted by mtdewcmu on January 6, 2010, at 21:49:10
Wow...thanks! I can say really I do have s-e-v-e-r-e depression at times but it comes and goes, usally antidepressant's are not effective. Stimulants stop it from going down into the pitts
Thanks Abby!
Well here, who has seen the abilify commercial's?
Posted by SLS on January 6, 2010, at 22:28:10
In reply to Antidepressants only for severely depressed--, posted by Abby Cunningham on January 6, 2010, at 19:09:08
It is only with the more severely depressed that you are guaranteed to have the real thing.
- Scott
Posted by topcatclr on January 6, 2010, at 22:37:11
In reply to Re: Antidepressants only for severely depressed--, posted by SLS on January 6, 2010, at 22:28:10
Always had fairly severe depression/anxiety and could not live without them. I am not sure some people know how bad it can be!
Posted by polarbear206 on January 6, 2010, at 23:29:17
In reply to Re: Antidepressants only for severely depressed--, posted by topcatclr on January 6, 2010, at 22:37:11
> Always had fairly severe depression/anxiety and could not live without them. I am not sure some people know how bad it can be!
So true. Mine is so severe that without drugs, I go into a vegetative state. It's quite horrifying. This is what happened to my great grandmother. She didn't have the luxury of medication and she died in a mental institution.
Posted by topcatclr on January 7, 2010, at 0:16:40
In reply to Re: Antidepressants only for severely depressed--, posted by polarbear206 on January 6, 2010, at 23:29:17
Had a Great Aunt who had old school ECT. In and out of mental institutions. Same place i would be without meds! Cracks me up when people say they don't work. Probably means they just didn't need them. In my case it feels like severe anxiety causing depression. Who knows what came first, the chicken or the egg! Graduated to Cymbalta after being on imipramine, serzone, ssri, etc. Feeling pretty good on it. After being on SSRIs to long, you get to numb.
Posted by emmanuel98 on January 7, 2010, at 0:51:10
In reply to Re: Antidepressants only for severely depressed--, posted by topcatclr on January 7, 2010, at 0:16:40
Well I had severe depression and a combination of lexapro and abilify was like magic. Got me from the living dead to completely normal. Also made me gain weight like crazy. I ended up on an MAOI. I bet if they included MAOIs in this study they'd also find that they work primarily for severe depression. I think a lot of depressive symptoms are not biologically based and require therapy rather than drugs.
But severe, nearly catatonic, depressions are mostly biological and require meds.
Posted by jedi on January 7, 2010, at 3:26:12
In reply to Re: Antidepressants only for severely depressed--, posted by emmanuel98 on January 7, 2010, at 0:51:10
> Well I had severe depression and a combination of lexapro and abilify was like magic. Got me from the living dead to completely normal. Also made me gain weight like crazy. I ended up on an MAOI. I bet if they included MAOIs in this study they'd also find that they work primarily for severe depression. I think a lot of depressive symptoms are not biologically based and require therapy rather than drugs.
>
> But severe, nearly catatonic, depressions are mostly biological and require meds.Yes, even though my depression is atypical and thus supposedly not as bad as melancholic depression; without phenelzine I would not be here writing this today. I have been off the medication about one half dozen times in the past 12 years; every time the major depression has returned within a few months. I agree that people who just have the blues are hurting themselves using these powerful medications. But phenelzine was like flipping a switch when it kicked in. One day I was hopeless and dying, the next day everything was clear and the solutions to my problems were obvious. There are a lot of people on this board who have written about similar effects with the MAOIs. Many of the people who post on this board are treatment resistant. There may be a few that can survive without medication. But serious depression requires serious medication. Nardil has been around for over 50 years and is the only medication that works for me. For me talk therapy is a bad joke. I am not disagreeing with what everybody has written in this post. But, for the seriously, biologically depressed; the medications are the only thing that works.
Thanks,
Jedi
Posted by jedi on January 7, 2010, at 3:27:04
In reply to Re: Antidepressants only for severely depressed--, posted by emmanuel98 on January 7, 2010, at 0:51:10
> Well I had severe depression and a combination of lexapro and abilify was like magic. Got me from the living dead to completely normal. Also made me gain weight like crazy. I ended up on an MAOI. I bet if they included MAOIs in this study they'd also find that they work primarily for severe depression. I think a lot of depressive symptoms are not biologically based and require therapy rather than drugs.
>
> But severe, nearly catatonic, depressions are mostly biological and require meds.Yes, even though my depression is atypical and thus supposedly not as bad as melancholic depression; without phenelzine I would not be here writing this today. I have been off the medication about one half dozen times in the past 12 years; every time the major depression has returned within a few months. I agree that people who just have the blues are hurting themselves using these powerful medications. But phenelzine was like flipping a switch when it kicked in. One day I was hopeless and dying, the next day everything was clear and the solutions to my problems were obvious. There are a lot of people on this board who have written about similar effects with the MAOIs. Many of the people who post on this board are treatment resistant. There may be a few that can survive without medication. But serious depression requires serious medication. Nardil has been around for over 50 years and is the only medication that works for me. For me talk therapy is a bad joke. I am not disagreeing with what everybody has written in this post. But, for the seriously, biologically depressed; the medications are the only thing that works.
Thanks,
Jedi
Posted by jedi on January 7, 2010, at 3:28:47
In reply to Re: Antidepressants only for severely depressed--, posted by jedi on January 7, 2010, at 3:27:04
Posted by inanimate peanut on January 7, 2010, at 11:31:14
In reply to Antidepressants only for severely depressed--, posted by Abby Cunningham on January 6, 2010, at 19:09:08
So what does that mean if you have severe depression but a med works partially and so your depression is not so severe anymore? Would these drugs not work for the now not-so-severe depression? Would they not be expected to take you the rest of the way to normal? I will not give up on feeling normal. I will not just lay down with what's left of my depression and take it.
Posted by topcatclr on January 7, 2010, at 12:42:33
In reply to Re: Antidepressants only for severely depressed--, posted by inanimate peanut on January 7, 2010, at 11:31:14
Well I had severe depression and a combination of lexapro and abilify was like magic. Got me from the living dead to completely normal. Also made me gain weight like crazy. I ended up on an MAOI. I bet if they included MAOIs in this study they'd also find that they work primarily for severe depression. I think a lot of depressive symptoms are not biologically based and require therapy rather than drugs.
But severe, nearly catatonic, depressions are mostly biological and require meds.
Exactly,
I could not have said it better myself! The made make me a functional, productive, normal person. They DO NOT make me happy. For that people need to evaluate their lives more closely. These meds merely give people the tools to find peace and contentment, not happiness. In my case, they strip me of debilitating panic attacks, and dysthymia, as well as terrible anxiety. Absolutely could not live without them!
Posted by SLS on January 7, 2010, at 13:24:46
In reply to Re: Antidepressants only for severely depressed--, posted by inanimate peanut on January 7, 2010, at 11:31:14
> So what does that mean if you have severe depression but a med works partially and so your depression is not so severe anymore? Would these drugs not work for the now not-so-severe depression?
That's a good question.
I don't think it is a matter of how severe the depression is so much as it is whether or not you are treating the right condition with the chosen remedy.
I think a higher percentage of people describing mild depression are experiencing psychogenic rather than biogenic depression when compared to the percentage of those describing more severe depressions. If drugs are of little value when there is no biological anomaly, then it would appear that a smaller percentage of mild depressives will respond to a drug in a clinical trial. The rate of response would be little better than that of placebo. If, instead, you allow only those with severe depression to enter a trial, the drug will separate itself from placebo more robustly simply because the chosen subjects will be more likely to have the illness being investigated.
I know that things are not so black and white. However, I think the trend is for more severe depressions to have a greater biological component to them, and that they are more likely to respond to biological interventions than are psychogenic depressions. If, then, someone with a biological depression were to respond only partially to a given treatment regime, they might yet respond more robustly when the treatment is refined. It is possible, of course, that there also be psychological issues to be addressed. Any depression resulting from the persistence of such issues might appear as being residual to the biological disorder, and thus be wrongly assumed to be the result of an incomplete biological response. Psychotherapy might then be indicated.
Too many words, I know. The bottom line is that you do not have to settle for a partial response..
- Scott
Posted by SLS on January 7, 2010, at 13:38:05
In reply to Re: Antidepressants only for severely depressed--, posted by topcatclr on January 7, 2010, at 12:42:33
> They DO NOT make me happy. For that people need to evaluate their lives more closely. These meds merely give people the tools to find peace and contentment, not happiness.
I think one can have the tools with which to sculpt a happy life, but not have a workable piece of clay to sculpt with those tools. A depressed, malfunctioning brain is all but unworkable.
- Scott
Posted by Justherself54 on January 7, 2010, at 16:06:50
In reply to Re: Antidepressants only for severely depressed--, posted by SLS on January 7, 2010, at 13:38:05
Well said. I know there are things I could be doing that would probably make me feel better, but I just can't do them. I remember asking my pdoc if there was something I was doing wrong and should I be seeing a therapist and he said no, you have a chemical imbalance in your brain. The kicker for me is that we can't seem to find the right cocktail to get things firing properly. Sucks..sigh..
Posted by Phillipa on January 7, 2010, at 19:39:20
In reply to Re: Antidepressants only for severely depressed-- » SLS, posted by Justherself54 on January 7, 2010, at 16:06:50
So let's say your're from an era where barbituates were just starting to go out of vougue but still used and you had anxiety. At that time miltown and valium completely healed me from anxiety panic attacks. In that case since gave up the miltown with no withdrawal functioned exceptinally well achieved a lot that I never and don't have true biological depression. Basically since no ad's till thyroid that any symptoms are really to be treated with theraphy and the tiny doses of benzos still on? Lowering cause don't work daily. So I should stop the 50mg of luvox also and see what happens? I'm curious. Thanks Phillipa
Posted by Abby Cunningham on January 8, 2010, at 13:35:57
In reply to Re: Antidepressants only for severely depressed--, posted by Phillipa on January 7, 2010, at 19:39:20
Good question Phillipa. I know I have severe lack of motivation with anxiety/depression both but SSRI's no good. Wellbutrin helps a tiny bit but not great. My pdoc wanted me to try Effexor but I hesitate due to the fact that many people claim the withdrawal is horrible and just stay on it forever. I don't feel motivation to do much of anything especially in the winter :( I wonder then if I am not severely depressed if nothing will help me. Sometimes I want to ask for Vicodin because as you said once, when I broke my ankle and injured my elbow needing surgery it did make me feel less depressed??? Now I am getting more and more depressed just thinking about these drugs not helping so what do I do?
Posted by Phillipa on January 8, 2010, at 20:35:18
In reply to Re: Antidepressants only for severely depressed-- » Phillipa, posted by Abby Cunningham on January 8, 2010, at 13:35:57
I know and the weather isn't helping this year. I do believe there are opiod responders. I wonder a lot about this stablon and Ldn? Whatcha up to? Love Phillipa
Posted by floatingbridge on January 8, 2010, at 23:05:57
In reply to Re: Antidepressants only for severely depressed-- » Phillipa, posted by Abby Cunningham on January 8, 2010, at 13:35:57
Hi Abby,
Thanks for starting this thread. I, too feel better when I take a bit of Vicodin. However I (really) avoid opiates because of tolerance issues, and because eventual withdrawal would leave me worse off.
I wonder if your positive response can be seen as a clue to others here for potential treatment options?
fb
Posted by floatingbridge on January 8, 2010, at 23:12:24
In reply to Re: Antidepressants only for severely depressed--, posted by inanimate peanut on January 7, 2010, at 11:31:14
>I will not give up on feeling normal. I will not just lay down with what's left of my depression and take it.
Good for you, peanut! I'm think it's in your advantages that you can identify a normal baseline.
fb.
Posted by floatingbridge on January 8, 2010, at 23:26:27
In reply to Re: Antidepressants only for severely depressed--, posted by polarbear206 on January 6, 2010, at 23:29:17
I'm. sorry, PB. Sounds like you have your meds working....
My great aunt, too, was repeatedly hospitalized in one of the worst on the East Coast. She was a real sweetie, too. I was too young to know until years after her death.
My own condition is so long-standing, I'll never be med-free. Any therapeutic window that might have made that possible is years past. However, I remain hopeful that I can undo some maladaptive habits and find a workable med.
fb
> So true. Mine is so severe that without drugs, I go into a vegetative state. It's quite horrifying. This is what happened to my great grandmother. She didn't have the luxury of medication and she died in a mental institution.
>
>
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