I have talked about my continual battle with depression on this blog before, and today, I saw something that I felt compelled to discuss. First of all, I should mention, in case it isn’t “known”, that I take a SSRI for my depression. I have for a long time, and often times, I wonder if it even works, because I still find that I go through bouts of moderate to severe depression. Well, after reading this, I can’t help but wonder if the medication is actually “treating” the depression.
In the article, they discuss a study that was done to compare the “clinical effectiveness” of several SSRIs (mine is listed), in order to see if the benefit of the drug was more than a simple placebo. What’s interesting, is that they found that across the board for those drugs that they looked it, it wasn’t (except in cases of extreme depression). This makes me wonder about the drug that I take every morning to “prevent” my depression; especially since, as I mentioned, it hasn’t actually gone away at any time during the course of my “treatment”.
I am not saying that I don’t believe the drugs have any benefit. Even the placebo effect is proven to have a benefit, and that may account for some of these findings. However, I do think that it is easy to wonder, that if you take drugs to help with a problem, and the problem doesn’t seem to want to go away, then perhaps those drugs aren’t working for you. The article also mentioned that trying therapy first would probably be a new recommendation; but I did that, and still ended up taking medication, a medication that I am now even more curious about.
I know that the medication must have some benefits. I don’t have anxiety as intense as I did before I took (at least I don’t think that I do). I also know (through the magic of therapy), that my depression is more likely than not, tied to my anxiety. So, if the medication is working on the anxiety, but it doesn’t have an effect on the depression, what does that mean? Should I be taking a different class of medication to deal with the depression as well? Or, am I “better” than I was before, and I just don’t know it? Maybe the drugs are working, and I just don’t know the difference because I have been taking them so long? I find myself riddled with questions right now.
This is something that I think might be worth exploring further. I may make a doctor’s appointment to find out more about what may or may not be a better option for me.
One issues I do have, is that the article goes so far as to say that the medications “don’t work”, citing it is below clinical significance. That is to say, that just because it wasn’t statistically significant, they have proven that it doesn’t work; which really doesn’t make sense, if it did work on the minority of those “not-statistically-significant-so-forget-them” patients. This is where the cynic about clinical research in me steps in, because I always question its reliance on numbers, and a lack of perspective on the individual that may benefit… In the case of a drug that MAY benefit some that has very few side effects (for adults), why would they declare that it simply doesn’t work, just because it doesn’t work more often than not? Additionally, if it doesn’t work most of the time, why have they waited until now to tell people that are taking it?
What’s your take on this? If you take one of these medications, is this going to effect your future treatment? Does it concern you that your medication may not be doing what you need it to? What do you think?
I don’t know anything specific I can share, but my overall advice is to be careful and get 2nd opinions.
Sometimes it seems like everyone is in lockstep on things–doctors, pharmacists, etc, and it seems like a cookie-cutter diagnosis. For instance, my experience with doctors is they over-prescribe anti-biotics for almost every kind of cold/flu like symptom.
My recommendation is for you to do your own research: buy books, google, etc, and find out if there are alternatives. You might be getting doped up for nothing.
I’ll check in my alternative medicine books and see if I can find anything.
Ok, in “Spontaneous Healing” by Andrew Weil, he says for depression:
-at least 30 minutes of aerobic exercise a day (5 days a week)
-avoidance of alcohol, sedatives, etc.
-less protein and fat; more starches, fruit, and veggies
-DLPA, B6, C, fruit or juice.
-don’t eat breakfast for at least an hour
Look into his books to get the specifics, and ask your doctor what he thinks if you were to try these things. Maybe your doc will say it would do no harm to go off your meds.
My only experience with SSRI is when one of my pain specialists prescribed sertraline after I told him I was in so much pain all the time that I was thinking of killing myself. I was also under a large amount of stress at the time with the move overseas. Eventually after doing more research it looked like amitryptaline was a more appropriate choice for pain management (I think one of the reasons he went with sertraline is that it has less side effects and he knew I wouldn’t be around for him to monitor). While at the time I wasn’t convinced the sertraline was doing all that much for pain, when I stopped taking it to clear my system before the ami - I realized that it had been doing a lot. However the ami does more, and now I don’t regret switching.
While I’ve read that you struggle with depression, I don’t remember seeing any complaints for pain. They often go hand in hand since depression and intensify any pain you might feel and being in pain all the time can certainly be depressing. The medication you’re on may not work against what is triggering your depression. If you don’t think it is, then be sure to talk to your doctor about how to safely stop taking it and what might be a better approach.
The anxiety I’ve had mostly went away when I started taking endep for blood pressure. After being treated for Lyme’s *again*, my blood pressure problem went away, but I still take a smaller amount of endep to keep my heart rate down to a normal level (before antibiotics I was 170/110 with a 135 bpm pulse, after antibiotics my bp came down to 120/70 but my pulse was still high, a little endep brings it down to a much more comfortable 70 bpm). I don’t think most people think of endep as an anti-anxiety drug, but it works for me. Good luck, and I agree that it doesn’t hurt to get 2 docs opinions.
Nice of you to write such a candid post. I had a good experience with Paxil -it helped me with anxiety (which is my “thing”). I would guess these things take revisiting every so often, though docs can be pricey. I have found that as I age, life keeps tossing shit at me and it really helps to approach this kind of stuff as a “management” issue. It is hard to erase problems, but they can be managed well if you are open to trying different options. I TRY to be optimistic and approach mental health in a very practical way.
I also recently read that the 40’s are the heighth of discontent and I am a year from 40! Great.
I am careful with health research on the web - message boards are often filled with hysteria!
Hi Duane,
Thanks for the post. I think you raise some interesting issues about mental health medications and medication research in general. I have drug resistant (in that most medications don’t work) type II bipolar disorder and have over the years taken pretty much all the anti-depressants and mood stabilizers you can think of. It has been a frustrating experience and one where I needed to work incredibly closely with my psychiatrist to get through.
For me I think there are two important points that I always urge others to consider. Firstly mental health medications should be managed by a mental health professional and should be assessed, reassessed and possibly changed as needed. I don’t think anyone should be taking a medication they feel is ineffective for any extended period of time. My second point is that although in my case I believe my illness is largely chemical in its origin I also accept that medication and talk therapy have a tremendously higher success rate when combined together. I believe that despite the invaluable contribution of medication it is talk therapy that has enabled me to write this post, wherein I admit I actually have an illness.
Research and medication is a really tough and complex area, and yes I admit I have a bias as it is the area I work in. I agree with Duane that numbers and statistics can definitely be highlighted to show what manufacturers want to show but I also believe that this happens in relatively rare instances and is not the general norm. I too have suffered the frustration of having a medication that worked very well for me become unobtainable simply because not enough people were able to tolerate the drug and have the same low side effects. But I have to remain optimistic that these losses ultimately lead to better research and development, that will consistently help a broader population….one that hopefully includes myself.