Large study shows SSRIs work for only 15% of patients, huge placebo effect

[Anonymous]

I don't know. I would love to not take them. But every time I quit, I have a relapse in a few months. I don't think this is all placebo effect (for me).

[Anonymous]

So, one problem with SSRI research is that you need to distinguish between mild and severe depression. SSRIs have more support for severe depression, but they are prescribed to everyone.

Also, the linked paper is for depression, not anxiety. I think SSRIs probably work better for anxiety. Lexapro is immediately sedating to me, which makes my anxiety much much better. I also have depression but it didn’t really seem to help for that. What it did was just slowwww down and numb everything. And for someone with serious anxiety that’s a good thing. In fact I feel like I can diagnose anxiety based on the people who say “I love Lexapro, it makes me not feel as much!” vs the people who say “I hate it, it makes me have no emotions.”

When I am on Lexapro I am a better person. Calmer, get along with everyone better, more able to connect, able to encounter new situations without an immediate stress reaction.

But I can’t stand the side effects so I don’t take it.

[Anonymous]

About 10 years ago I attended a conference and there were compelling presentations and studies all about how a walking program was as effective as depression drugs.

I don't knock these drugs for those who need them (apparently 15% of people) but clearly they are overused.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Agree somewhat with OP, but therapy is not a silver bullet. Insurance should cover a range of therapies including EMDR, acupuncture, and others that are effective.

OP here and I agree. For me, CBT and DBT have been most effective of everything I’ve tried at helping me manage my depression and prevent major episodes. But I’ve done them mostly on my own with workbooks I’ve bought— I would have loved to be able to just go to a clinic or take a class on these, but I’ve never found one (and I go did, insurance wouldn’t pay for it!). I also think GPs need more tools to help people than just referring to a psychiatrist or prescribing an SSRI. Depression is so common and is often linked to other issues. People with depression are often given little guidance or support even when they are reaching out for help, which is exactly what you should do. I think the lack of infrastructure is making the problem harder for people.

Which is why, when you get an SSRI, it’s maddening when it doesn’t work or when the side effects are debilitating. It’s incredibly defeating, and unlike other treatments for depression, the drugs offer zero coping mechanisms.

Could you recommend your workbooks? I have tried two therapists that said they did CBT but the sessions were useless. It is too hard to find a good therapist and maybe a workbook would help me, too. Thanks.

[Anonymous]

Anonymous wrote:This is not shocking at all. There is money to be made by Big Pharma and they are certainly not going to promote the fact that these drugs don't work well.

If Big Pharma had a way to treat all depression I assure you they'd be selling it. This is the best science has produced and SSRIs do help many people. Hopefully we can sort out how to determine who they help and who they don't help without resorting to trial and error soon.

[Anonymous]

Would rather be suicidal than deal with the sexual side effects.

[Anonymous]

I haven’t thought about the issue that way before, but I agree 100%.

[Anonymous]

Anonymous wrote:Would rather be suicidal than deal with the sexual side effects.

Yep. And it's amazing how doctors just dismiss that issue.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Agree somewhat with OP, but therapy is not a silver bullet. Insurance should cover a range of therapies including EMDR, acupuncture, and others that are effective.

OP here and I agree. For me, CBT and DBT have been most effective of everything I’ve tried at helping me manage my depression and prevent major episodes. But I’ve done them mostly on my own with workbooks I’ve bought— I would have loved to be able to just go to a clinic or take a class on these, but I’ve never found one (and I go did, insurance wouldn’t pay for it!). I also think GPs need more tools to help people than just referring to a psychiatrist or prescribing an SSRI. Depression is so common and is often linked to other issues. People with depression are often given little guidance or support even when they are reaching out for help, which is exactly what you should do. I think the lack of infrastructure is making the problem harder for people.

Which is why, when you get an SSRI, it’s maddening when it doesn’t work or when the side effects are debilitating. It’s incredibly defeating, and unlike other treatments for depression, the drugs offer zero coping mechanisms.

Could you recommend your workbooks? I have tried two therapists that said they did CBT but the sessions were useless. It is too hard to find a good therapist and maybe a workbook would help me, too. Thanks.

I'm a DP but I did this program about a decade ago through the NHS (in the UK): https://www.beatingtheblues.co.uk/

I saw very quick improvements in some very debilitating anxiety. I should really do it again.

[Anonymous]

SSRIs were lifesavers for me when I was in the depths of postpartum depression and PTSD from a traumatic childbirth. But after awhile, I don't think they helped much and had a lot of bad side effects. Once I was able to make lifestyle changes (like getting more sleep and more help with my kid) plus talk therapy, things got a lot better and I don't attribute that to the pills. I do think they can be crucial in a crisis, but in many situations they don't really solve anything. And the withdrawal coming off of them was really awful. I considered going on them during the depths of the pandemic lockdown, but realized that they weren't going to make covid go away. I had also read a study that exercise everyday is as effective as an SSRI at reducing depression and anxiety, so I resolved to get out and walk--six days a week for an hour. That was a real lifesaver, has no downsides, (and no profits for Big Pharma!).

[Anonymous]

My kid becomes suicidal every time he goes off them so they are doing something. Not enough though.

[Anonymous]

Anonymous wrote:SSRIs were lifesavers for me when I was in the depths of postpartum depression and PTSD from a traumatic childbirth. But after awhile, I don't think they helped much and had a lot of bad side effects. Once I was able to make lifestyle changes (like getting more sleep and more help with my kid) plus talk therapy, things got a lot better and I don't attribute that to the pills. I do think they can be crucial in a crisis, but in many situations they don't really solve anything. And the withdrawal coming off of them was really awful. I considered going on them during the depths of the pandemic lockdown, but realized that they weren't going to make covid go away. I had also read a study that exercise everyday is as effective as an SSRI at reducing depression and anxiety, so I resolved to get out and walk--six days a week for an hour. That was a real lifesaver, has no downsides, (and no profits for Big Pharma!).

+1 As annoying as it is when you are feeling depressed/anxious to have someone tell you to go for a walk, regular exercise, sufficient sleep and limiting caffeine/alcohol allows me to manage my mild depression/anxiety without drugs. Obviously not true for everyone but I think there is a strong bias towards SSRIs because it's a clear and easy step that a Dr can handle themselves

[Anonymous]

SSRI's worked amazingly well for me. That said, I only used them for a relatively short amount of time. Exercise also works well for me.

I think all these things have their place and what works for one person might not work for the next. I needed the SSRI's for a while to get to the point where I could do the work myself.

[Anonymous]

On this very board, I dared to suggest after reading such an article, that without working on the causes and triggers for depression, the side effects to drugs may actually worsen issues, creating a vicious cycle where secondary drugs are needed to "boost" the first drug. And the root causes and problems still haven't been addressed. More than one person called me cruel and wished depression on me.

[Anonymous]

Great. So depression isn't a chemical imbalance and SSRIs don't work. Just buck up! Pull yourself up by your bootstraps!

Research is good. I'm not faulting those who author the studies, but the repercussions of this are concerning to me. It's been a long hard road to convince people that depression isn't just a personal weakness. Now we're back to saying maybe it is?