Anti-depressants "of little use"

[morningpaper]

Anti-depressants 'of little use'

"New generation anti-depressants have little clinical benefit for most patients, research suggests. A University of Hull team concluded the drugs actively help only a small group of the most severely depressed."

I'm not surprised by these findings - I took antidepressants and various other drugs when I had a severe depressive episode over 10 years ago.

I know that people (incl. GPs) want to 'fix' depression but I strongly feel that drugs don't do it. Prozac especially was hailed as the 'wonder drug' at that time but it had no effect whatsoever.

Coming off the drugs was a massive boost to my ego (being dependent on antidepressants etc. I'm sure reminds you that you are 'mad' every morning and evening that you are popping them).

I was 'rescued' by 2 years of psychotherapy. I know it is expensive but when I see friends taking antidepressants I feel really frustrated that they don't spend money on therapy or counselling instead. People think it is 'too expensive' but then they are happy to get signed off work for months. Argh. When I rule the world I will make cheap therapy available to everyone.

Anyway that's my rant of the day

I think every person's experience of depression is different, as is their reaction to medication. SSRIs worked for me, in fact, I'm not sure I would have survived the PND after dd2 without them. My depression was triggered by hormonal / chemical factors, though. I can imagine that in the case of a severe life trauma that then goes on to influence behaviour in later life, therapy would be much more effective and appropriate.
I think the real issue is that as a society we are getting used to the idea that there is a cure-all pill for everything. I'm also sure that as mental health resources are so stretched, it is much easier and less costly for GPs to prescribe medication than to refer a person on for therapy.

It makes me angry too. I was precribed anti depressants when i was struggling with university and my mum was getting ill. didn't help in the slightest, but had side effects. So many have awful side effects but are given so quickly by gps because they are so much cheaper than psychotherapy. I'm not sure about counselling either, if not done by a psychotherapist, it can vary hugely in quality. But anti depressants can have severe side effects [the rise in suicide amongst young people who take some of them] and are handed out like sweeties, IMO.

That's great that it worked for you Yeahbut - I know there are some cases where it is a solution, like you say.

I had one severe episode of depression and prozac did seem to help. But the study is pointing out that a placebo might have been just as good. I wonder if finally accepting that there was something wrong and the ritual of taking the pills together with reading a CBT book and using hypnosis cds were my cure.

They don't know how these pills work and they do have side effects - maybe acupuncture and homeopathy should be used in the first instance together with CBT? With the clinical effectiveness of CBT I find it shocking that more funding cannot be made available for it.

I think that some things work for some people that dont for others.

Ad's have been a lifeline to me, but I am also receiving CBT and other help in order to change me too.

Without the help of the anti D's I would not have been strong enough to do the CBT or here long enough for it to have any effect.

I know that I was lucky in that I had really supportive GP's who got me the treatment I needed in a very timeley manner and I did not have to wait to see a theapist or consultant, but not everyone is as lucky.

Also we could not have afforded to pay for a counceller without taking out a loan, which my DH was prepared to do. But even then private care was not avalable in a timely manner.

For those of us taking Anti'D's please dont just stop taking them, discuss the findings with your GP

Dh takes ads and without them I doubt we would be still together or that he would even still be on this mortal coil, so profound was the effect of his depression.

It was a last resort for him; he was always very against them in the past. But I think his depression is a chemical imbalance, not circumstantial - at the moment his life is just as perfect as it could be, yet if he stops taking ADs then he will go downhill again.

Counselling is so totally out of our reach its laughable. Dh just started working again yesterday after not having a job to speak of in seven years.

Reports like this depress me because it will tar everyone who takes ADs with the same brush . You are right - it's not a "happy pill", and we do live in a "fixit" society, but it's not quite as straightforward as that.

Not all depression is triggered by life events or the way someone is brought up, so in those cases therapy wouldn't be more helpful than ad's.

And when I was severely depressed the ad's lifted my mood enough for me to actually cope with getting out the door to my counselling sessions. They cleared the fog enough for me to see that things could and would improve. My mood wouldn't have lifted without them, I had struggled on for quite long enough to know that.

I wasn't "mad" at that time. I was depressed. And even now when I "pop" my pill every evening I think ... just trying to think what I think! ..... actually I don't think anything. If, occasionally, I think back to the time when I was most ill I shudder and think "thank heavens I have medication that ensures that that never happens again. If I were diabetic I'd take insulin, I don't see this as any different.

IMO there's a place for ad's and therapies, on their own or jointly. It's not a one size fits all - each person and their circumstances are different and should be treated as such.

Surfermum - I agree with that and found the traditional-style counselling sessions organised through my workplace less than useless. The counsellor seemed obsessed with my upbringing and traumatic life events.

CBT does not do that. It focuses on correcting errors in thinking and while I am not sure it really "cured" me. I do think that it made me less likely to have another episode.

agree with surfermum and miaou. for me counselling was inappropriate, and in a way made matters slightly worse, as it stopped my GP from referring me to a psychiatrist in a timely mannner.

in severe cases the Drugs* work

even this research says that for many people.

AD's saved my Dh's life I am certain, and if anyone is considereing coming of fthe meds as a result of this reseacrh I would stronly suggest a chat with their GP first. It's important to do it properly for a start, and also someone with depression is often the alst to decide that theior case is is mild or severe or wahtever.

Therapy wouldn't have helped Dh, it wouldn't have made an ounce of difference as his depression was (is- but the Prozac he ahs take for the last few months has made him well) is caused by chemical imbalances, not trauma.
The prozac has enabled him to keep his family together (no mean feat- we're a demanding lot for someone even without an illness, 2 disabled DC's), hold down a job (2 in fact) unlike last time he ahd a bout, and be well.

Each erson must make their own decisions, but PLEASE speak to your medical professionals before stopping prescribed medications!

good point Peachy.

Oh and not all GP's prescribe them like sweeties- mine refused me AD's when I ws so depressed after DS1's diagnosis of ASD. He referred me to counselling which was probably right except that counselling doesn't come with childcare atatched so i couldn't do it.

I've had Ad's and counselling. Both useful - counselling brilliant, but I found the AD's good too. I feel they keep me leveled out and I defo noticed a different when I came off them. This is just one study remember?

And agree with peachy - depends what kind of depression you have etc. Mine was partly reactive but also to do with my dodgy brain chemistry, and I think that prozac and seroxat really helped, especially when I was really severe, I couldn't have got out of bed to get to see therapist without them.

Attitudes to prescribing and other treatments for depression vary wildly between areas. A comprehensive assessment should be able to help determine whther someones repression is reactive and/or intrinsic and whther they do in fact have boilogical depression or are sressed and unhappy or struggling with emotional regulation.

I see many young people who've taken overdoses but they're not in fact always depressed as in ill with depression. They're more often disaafected, impulsive and unhappy without the skills to manage their emotions. However biological depression can be assessed by looking at someones sleep, appetite, memory, motivation, concentration etc. It often seems almost like a physical illness, people can be drained of energy or extremely agitated. In these cases I do beleive ads have their place and can make someone "ready" for CBT. It's hard to access cognitions and emotions when people are so flat and withdrwan but with e bio-chemical "lift" you can start drawing out negative thinking styles and working on self-destructive behaviours.

I also agree with posters who say "conuselling" not specifically psychotherapy or CBT can be ineffective or even detrmental especially when carried out by poorly trained, poorly supervised people who believe that constant venting and "getting it off you chest" is helpful.

Having seen both sides (been depressed and now a therapist for depression) I would urge anyone on treatment to stay on it and speak to their GP before doing anything. Also if referred for psychological support check that the therapist is using an evidence based approach and is properly supervised by an experieneced professional.

This was being debated on 5 live this morning as I was on the way to my Consultant appointment and he was concerned that people might just stop the medication due to a report that was not even published in one of the professional jounrnals and was also not based on enough informaion in his opinion.

I am going to come off my medication, but graually over the next year with his and my DH's help. I have had 6 months of weekly CBT, which was arranged at home during my two DS's nap time. So I am a happy bunny at the moment

Prozac caused my DB to become paranoid and he said when he took it he started having recurrent self-harming thoughts when he'd never had them before.

It also caused one young mum I know who was suffering with PND to have a full scale psychotic episode. Her DH had to physically restrain her from literally running naked through the streets in a frenzy.

These are the worst cases I've heard about. I also know lots of people who have been severely ill with depression, and the only "help" they were given were anti-depressants which did bugger all, and they were left alone to worsen and worsen.

This research does NOT come as a surprise to me.

That's dizietsma as there are other ad's that could have been tried. It sounds like the issue wasn't the ad's themselves but the lack of support/follow up for the people involved.

When I was perscribed prozac there was no follow-up whatsoever. If it wasn't for my truly amazing DH I can't imagine how I would have come through the depression.

i have been reading loads about this over the past few weeks,as i have been on ad's for 3 years,and although prozac helped when i was very,very bad,i was staring to wonder if it could be causing my anxiety and paranoia to get worse.my gp had sent me away with beta-blockers to help with the anxiety,plus i was having to take laxatives all the time to deal with the constipation,which my gp told me was due to my diet and nothing to do with the prozac(as was the weight gain,which wasnt shifting despite eating less than my 2 year old and excersising like a madwoman).

so 2 weeks ago i thought 'fuck it' and went cold turkey.lo and behold,my digestive system starts functioning again,i have lost some of the weight,and i am nowhere near as anxious.

these findings that have been reported today are not new.the drug companies have known about them all along,many of the clinical trials were pretty much fixed anyway.

the chemical imbalance thing has not been scientifically proven in the same way insulin deficiancy has.it's not possible to test the brain serotonin levels of a living person.the lack of serotonin idea is only a theory,and drug manufactuers have always said that they dont actually know how these drugs(ssri's)work,they just say how they are thought to work.

but nobody should stop taking ad's without dicussing it with their doctor.often the withdrawal sypmtoms(or the slightly fluffier 'discontinuation effects' as they are called in the patient info leaflets)can be far worse than the original illness.

Wow Divastrop that's amazing

I sometimes wonder what WOULD happen if there was some sort of law passed that banned all pschopharmaceuticals for a month or two...

I know people who have been on drugs like these for decades... and others who are constantly having their 'medication altered' to try and improve things

I also have some friends who swear by them but I have other friends who take them because they feel shit and then feel shit because they take them - and then spend years 'trying out' different drugs ("Give it 3 months... give it 6 months...") - it's all horrible.

If only GP's would let people 'try out' different / holistic approaches - exercise, therapy, counselling etc. with the keenness they have for trying out drugs. (Of course they can't - I understand that.)

TheMadHouse glad to hear you are feeling positive and have A Plan - good luck.

I don't think people should stop taking a/ds but if you are thinking that they are making you worse and you don't WANT to be taking them then you need to get support around you (a good GP/therapist/family) to create a plan to get you well again.

There is a difference between someone who has a supportive environment and quite 'sane' coming off medication and someone who is living in a hostel with no support tossing their anti-psychotics down the loo.

People can become too terrified to stop taking the drugs in case things explode in their head. That's why you need SUPPORT (whether personal / therapeutic or a different/lesser/more short-term drug). It's a BIG step and not to be taken lightly.

Actually Surfer the friends I'm talking about who were abandoned in their despair with nothing but pills to keep them company were cycled through many different drug combinations. NONE of them seemed to do more than produce hideous side effects. One of these friends was in psychiatric hospital as an in-patient for 2 years and was offered no other help than drugs, drugs and more drugs.

Haven't read the whole thread as I've got to put a load of washing on before bed otherwise DS has now clean undies for the morning!

So this may have been mentioned already but I was at a bit of a do this morning with the Health Secretary Alan Johnson. The Government is funding training for at least 3,000 more cognitive behavioural therapists with a view to providing talking therapies more widely in primary healthcare (ie. on the NHS and available via your GP). I was there as a patient and had the opportunity to talk to him about my therapy.

In the reception beforehand, I was chatting to my therapist and others who work in her Department about whether or not it was just a coincidence that the findings re. antidepressants was broadcast on the same day as the announcement about this big new thing in Mental Healthcare! Everyone there saw it as a very big deal.

I heard some really very interesting stories about how talking therapies have helped people with many different issues (OCD, social phobia, PTSD, other phobias) some of whom had been on antidepressants for 20+ years.

I have no experience of antidepressants so don't feel in a place to comment, really, other than to just flag up that alternatives might be more readily available on the NHS quite soon.

only skim-read this but heard it on the radio earlier today.

Just wanted to say I understand this research is very much in the public interest but it really does make me feel a bit heavy inside when I hear the covereage the research gets in the media.

A piece of research is often completely misrepresented by the media and this is where things go wrong. There must be a hell of a lot of people out there living with the general hell of depression that cling onto the hope that ADs will help in some way. Some never get offered therapy (which is appalling) others have a long time to wait and ADs can be their only hope in the meantime. When the media start to rant about how ADs don't work - without actually giving the full story - what help is that for all those have have only them to rely on?

btw Citalopram helped me after 13 years of depression without ADs.