SSRIs-Worth the Risks?

[Nocd39]

I’ve just been listening to this podcast about SSRIs with Dr Rangan Chatterjee and Joanna Moncrieff:

https://podcasts.apple.com/gb/podcast/feel-better-live-more-with-dr-rangan-chatterjee/id1333552422?i=1000712300093

It’s a really interesting listen and they discuss research on how SSRIs work (basically we don’t know), whether they are effective, and side effects.

I think it’s pretty worrying that we still don’t understand how the drugs work when there can be serious and ongoing side effects. I wish there was more research into alternatives. And more non-medicinal support for people who are struggling.

AIBU?

I’m sorry you also have problems with the medication. Lots of people don’t find SSRIs work for them or they can’t take them for various reasons so it would be great if there were alternatives available

But alternatives are just as likely to bring side effects. Drugs that have an effect on the brain are almost certain to have other impacts as well.

You mention psychedelics, they are showing promise at helping with several forms of MH issues that are unresponsive to current treatments but they will have side effects too.

Over the 12-week study period adverse effects, including headache, nausea and dizziness, occurred in 84 per cent of participants in the 25 mg group, 75 per cent in the 10 mg group and 72 per cent in the 1 mg group. Suicidal ideation and intentional self-injury were seen in all dose groups, as is common in treatment-resistant depression studies.

Largest trial to date shows that psilocybin reduces depression symptoms | King's College London

I adore my SSRI (sertraline). It restores my chemistry to the point where I can just about function normally.

Thanks for sharing.

Agreed, I assume most, if not all, medications have side effects. I’m not particularly pro psychedelics, just had heard that there are trials

I would like to see more support for non drug alternatives e.g. quicker access to therapies and not just short-course CBT. There are also non invasive procedures like TMS which might help but I don’t think have been widely researched and generally aren’t available on the NHS (as far as I know).

Fluoxetine 30 years ago both changed and saved my life after major PND
30 years later I'm diagnosed bipolar and take Duloxetine which is an SNRI( works on norepinephrine as well) Again saved my life and is the key to my quality of life
In my case my depression was predicted due to hypoxia at birth
Try them for a month and see how you feel
Personally, I'd trust a psychiatrist over a random content creator

I’m really glad it works for you. The evidence that MH issues are caused by chemical imbalance is not very strong though. It’s one theory but lots of inconclusive studies as far as I know. I don’t actually think the idea of a chemical imbalance is very empowering as it suggests that taking a medication is the only fix.

Fluoxetine had some unpleasant side effects for me and caused me to gain a lot of weight around my abdomen and I swear caused my face to go all puffy. But they saved my life and have also been life changing in that for the first time in my life I wasn't anxious and was able to work on feeling that way all the time. I don't care how they worked, without them I'd still be a depressed anxious wreck or dead.

I don’t really understand your point about trying the drug you’ve taken? I’ve been taking advice from my psychiatrist and unfortunately there aren’t good alternatives to treat OCD, at least ones that have been well researched at this point

Another issue I was advised by my Drs is that SSRIs can take weeks to work. Meantime, there often isn’t support for people who may be actively suicidal. Obviously really pleased to hear from PPs where they have had positive experiences with SSRIs. They do seem to work well for some people

I would like to see more support for non drug alternatives e.g. quicker access to therapies and not just short-course CBT.

Most alternatives like therapy only work alongside medication, though.

There are many alternatives available but the first lines are cheaper!
see a private psych and your options are endless
I'm certain interested in TMS which I gather works similar to the seldom used ECT but is obviously safer
There must be something in it because many anticonvulsants are used as mood stabilisers.I take Lamotrigine

Well they’ve saved my life twice,

Only someone who has never been extremely unwell would follow that sort of stuff.

I think weight gain would be really upsetting for some people. When I was referring to serious side effects I was more thinking about becoming suicidal or developing long-term sexual dysfunction that persists once off the medication, just because those are 2 of the very serious side effects I’m aware of. Im not saying these are common-I don’t think there’s any research into how common they are

Sorry I keep thinking of other points
CBT does help but antidepressants boost mood to enable the best results
in the depths of depression nothing whatsoever can change your thought processes
I'm either catatonic or psychotic without medication

Not any well researched options for OCD. I’m interested in TMS too but not available on the NHS. I think it’s around £8k?

@Nocd39Apologies I missed you were referring to OCD
i know it can be helpful in OCD and also is used in eating disorders

I disagree. I think it’s important and interesting to follow (well-respected) professionals on this topic. They are both medics. I have had severe OCD and have been actively suicidal from it. I can also enter into a debate and consider the pros and cons of medical approaches. I think this is vital when we’re talking about the health at people when they are at super vulnerable times in their lives.

Sorry should have been clearer. I don’t disagree with you when you say they saved your life. But I disagree about your second point.

Yes I understand. I was so ill with OCD I couldn’t engage in therapy without an SSRI. Unfortunately I can’t take these anymore and it would be good to have alternatives on the NHS

Did you need the crisis team? That’s what l class as severely unwell. Were you walking round the house looking for things to kill your self with whilst your Dh was trying to stop you?

I had terrible side effects after taking only two fluoxetines, severe nausea and vomiting that went on for around a month and caused a hiatus hernia.

I took it for anxiety and in hindsight it should not have been prescribed as therapy/cbt would have been more effective and not left me with a life long condition like fluoxetine has.

There wasn’t a crisis team in my area so
I wasn’t offered support, but yes. Scouting out buildings to jump off, making plans to buy poison etc. I think that counts as severe mental illness?!

I couldn't orgasm while on them and it took a while to return. They weight gain was also 4 stone in a very short amount of time that took me from just to the edge of underweight to just into an obese bmi.

When someone is already at a point where they are planning to take their own life, talking therapies or CBT isn't going to cut it. It would be like having your leg shattered in a car accident and declining the morphine because you are going to do some breathing exercises. Suicidal thoughts are listed on the side effects to watch out for and GPs only prescribe a few weeks at a time so you have to have regular reviews.

Yes I agree at the moment in severe cases medication is the only real option we have. Although I have to say with OCD starting therapy asap I think makes a big difference-getting a diagnosis and knowing what’s happening can stop people spiralling even further.

Therapy does nothing for me. Nothing at all. I’ve tried loads.

The only thing that had any effect was EMDR

Why is it when someone has a dangerously adverse reaction to an antidepressant that caused serious harm peopld always want to jump on and invalidate the experience.

i had an adverse reaction that is documented as being a risk. Health professionals ignored me iver and over. It literally ruined my life.

Please do not diminish that.