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posted by martyb on Friday February 23 2018, @01:55AM   Printer-friendly
from the things-are-looking-up dept.

Anti-depressants: Major study finds they work

Scientists say they have settled one of medicine's biggest debates after a huge study found that anti-depressants work. The study, which analysed data from 522 trials involving 116,477 people, found 21 common anti-depressants were all more effective at reducing symptoms of acute depression than dummy pills. But it also showed big differences in how effective each drug is.

The authors of the report, published in the Lancet [open, DOI: 10.1016/S0140-6736(17)32802-7] [DX], said it showed many more people could benefit from the drugs. There were 64.7 million prescriptions for the drugs in England in 2016 - more than double the 31 million in 2006 - but there has been a debate about how effective they are, with some trial[s] suggesting they are no better than placebos. The Royal College of Psychiatrists said the study "finally puts to bed the controversy on anti-depressants".

The so-called meta-analysis, which involved unpublished data in addition to the information from the 522 clinical trials involving the short-term treatment of acute depression in adults, found the medications were all more effective than placebos. However, the study found they ranged from being a third more effective than a placebo to more than twice as effective.


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  • (Score: 2) by Subsentient on Friday February 23 2018, @02:13AM (5 children)

    by Subsentient (1111) on Friday February 23 2018, @02:13AM (#642158) Homepage Journal
    I mean I knew they weren't super effective, but I also knew they *did* do some good. Now, for OCD, these medications are awesome, SSRIs specifically (like Prozac, Zoloft), but yeah, for depression, they work, just not that well. I generally think tricyclic antidepressants are better for actual depression.
    --
    "It is no measure of health to be well adjusted to a profoundly sick society." -Jiddu Krishnamurti
    • (Score: 2, Disagree) by qzm on Friday February 23 2018, @03:40AM (4 children)

      by qzm (3260) on Friday February 23 2018, @03:40AM (#642192)

      Are you SURE you mean OCD?

      They treat OCD with drugs? that is truly worrying..

      • (Score: 3, Informative) by FatPhil on Friday February 23 2018, @03:48AM (1 child)

        by FatPhil (863) <pc-soylentNO@SPAMasdf.fi> on Friday February 23 2018, @03:48AM (#642195) Homepage
        Whyever not?

        I'd treat it with either alcohol, or dope - just enough to get a "who gives a fuck, whatever, man" buzz.
        --
        Great minds discuss ideas; average minds discuss events; small minds discuss people; the smallest discuss themselves
        • (Score: 3, Insightful) by Dr Spin on Friday February 23 2018, @06:55AM

          by Dr Spin (5239) on Friday February 23 2018, @06:55AM (#642245)

          Exactly: comparison with a placebo, but not with a shot of whiskey? what kind of a study is this?

          Enquiring students want to know^H^H^H^H^HWhiskey

          --
          Warning: Opening your mouth may invalidate your brain!
      • (Score: 1, Insightful) by Anonymous Coward on Friday February 23 2018, @07:04PM

        by Anonymous Coward on Friday February 23 2018, @07:04PM (#642559)

        so wait, what do you suggest fixes it?

        demonic voices in ones head suggesting to do harm unless a religious like ritual is performed repeatedly until perfected is often both depressing and more than what a simple pep talk with a therapist can provide.

      • (Score: 2) by Subsentient on Friday February 23 2018, @08:51PM

        by Subsentient (1111) on Friday February 23 2018, @08:51PM (#642629) Homepage Journal
        Yes, I'm sure I mean OCD. I have very severe OCD, and 80mg of Prozac once daily is the only thing keeping me from killing myself.
        --
        "It is no measure of health to be well adjusted to a profoundly sick society." -Jiddu Krishnamurti
  • (Score: 1, Informative) by Anonymous Coward on Friday February 23 2018, @03:04AM (11 children)

    by Anonymous Coward on Friday February 23 2018, @03:04AM (#642180)

    Nobody with depression should avoid anti-depressants because they believe they "don't work."
    From personal experience, they help. If I said to you they are an 80 to 90 pct cure, would that not be good enough? You have nothing to lose by trying them. An honest try for one month.

    • (Score: 2, Informative) by Anonymous Coward on Friday February 23 2018, @03:35AM (2 children)

      by Anonymous Coward on Friday February 23 2018, @03:35AM (#642190)

      Make sure you understand the side effects of the one you are going to try first. In some cases impotence and anhedonia can be worse than the depression itself, obviously depending on the severity of the depression. These symptoms don't stop in all cases when the medication is discontinued as well. Take care.

      • (Score: 2, Interesting) by Anonymous Coward on Friday February 23 2018, @04:41AM (1 child)

        by Anonymous Coward on Friday February 23 2018, @04:41AM (#642223)

        I was prescribed an SSRI anti-depressant drug when I was having panic attacks. The biggest drawback was they completely blocked my kundalini energy awareness and killed off the benefits of tantric energy practice. This was the ultimate drawback, and I absolutely loathed taking them. I could still have conventional (ejaculatory) orgasms, but even those felt greatly much less pleasurable. I weened myself off, then started some energetic grounding practices that resolved the panic attacks. Regular orgasms came back to full pleasure after a month or two. But, unfortunately it took a couple of years before my kundalini energy returned.

        I can't remember which SSRI it was, but holy shit, that was definitely a case of the cure being worse than the problem.

        Once you've gone down the tantra/kundalini path, ejaculation drains your energy away and stops you getting to the even greater levels of tantric pleasure. It actually made me depressed to think that the SSRI had broken me, and that I might only ever be able to have ejaculatory orgasms from then on. Fortunately, a couple of years later I was back to normal.

        • (Score: 0) by Anonymous Coward on Friday February 23 2018, @07:06PM

          by Anonymous Coward on Friday February 23 2018, @07:06PM (#642561)

          My wife was prescribed a low dose of SSRI for her anxiety and now she no longer has the crippling attacks. She also feels fine otherwise.

    • (Score: 4, Informative) by FatPhil on Friday February 23 2018, @03:46AM

      by FatPhil (863) <pc-soylentNO@SPAMasdf.fi> on Friday February 23 2018, @03:46AM (#642194) Homepage
      The problem I have with such studies is the framing of the results - effectiveness is not linear, scale factors such as "one third more effective" are not absolutely meaningful.

      Consider these two test results:
      1) 100 subjects, placebo: 60 are cured, drug A: 90 are cured.
      2) 100 subjects, placebo: 2 are cured, drug B: 3 are cured.
      Both can be framed as "50% more effective" than placebo, but they're very different results.

      Rewording as "Drug A is useless 10% of the time, placebo is useless 40% of the time" and "Drug B is useless 97% of the time, placebo 98%" leads to a conclusion that A is 4 times less useless, and B is barely less useless, and we can differentiate between the two cases more easily.

      Of course, you can object to measuring uselessness. So let's measure usefulness again, but with a different perspective. You could arrgue that 60 of drug A's 90 would have been cured by placebo effect anyway, so actually it only cured 30 out of the remaining 40. B only cured 1 in 98. So again, we can distinguish between the two.

      To mix things up even further, serious medical research normally doesn't frame the results in any of these three ways!

      The typical measure used in the real world is "number of subjects treated in order to affect one cure", which puts A at 1.11, and B at 33.3. Again, clearly distinguishable.

      So I posit that "N% more effective than" is utterly meaningless, yet it's the thin that is most often claimed in publicity materials for such studies.
      --
      Great minds discuss ideas; average minds discuss events; small minds discuss people; the smallest discuss themselves
    • (Score: 0) by Anonymous Coward on Friday February 23 2018, @10:36AM (6 children)

      by Anonymous Coward on Friday February 23 2018, @10:36AM (#642309)

      You have nothing to lose by trying them.

      The long lists of side-effects would like a word with you.

      • (Score: 0) by Anonymous Coward on Friday February 23 2018, @03:22PM (5 children)

        by Anonymous Coward on Friday February 23 2018, @03:22PM (#642400)

        The side effects of depression are quite debilitating too. Sometimes, it's fatal.

        • (Score: 3, Informative) by JNCF on Friday February 23 2018, @06:04PM (4 children)

          by JNCF (4317) on Friday February 23 2018, @06:04PM (#642503) Journal

          True, but saying "you have nothing to lose by trying them" is wrong. I have boners and bone density, and I'd like to keep both.

          • (Score: 0) by Anonymous Coward on Friday February 23 2018, @07:03PM (3 children)

            by Anonymous Coward on Friday February 23 2018, @07:03PM (#642558)

            You are not going to lose your boners or bone density in a single month.

            This is what I originally posted: try it for one month. See if the medicine "get you over the hump" of your depression. No one is saying you have to take it for the rest of your life. Just getting out of the depths of depression can be the enabling factor that lets you begin to address your depression possibly in other, non-medical ways.

            I think you are letting the perfect be the enemy of the good.

            • (Score: 3, Informative) by JNCF on Friday February 23 2018, @07:45PM (2 children)

              by JNCF (4317) on Friday February 23 2018, @07:45PM (#642589) Journal

              No, I'm being pedantic. Your quoted statement was simply incorrect, find better wording next time. I recognise that the trade-off/gamble is worth it in some cases, but we can't honestly pretend that you have nothing to lose. Loss of bone density is something that happens on a continuum, and I have no reason to believe that it can't happen at some scale in the first month of use. Loss of boners is sometimes permanent. If you have data showing that no negative side-effects have been demonstrated in the first month of use I'll cede the point, but until then I'll keep being a pedant who understands that negative side-effects of SSRIs are well documented.

              • (Score: 0) by Anonymous Coward on Saturday February 24 2018, @12:42AM (1 child)

                by Anonymous Coward on Saturday February 24 2018, @12:42AM (#642773)

                Nobody seems to argue that taking magic mushrooms, just once, might alter one's mind and even be an effective depression treatment for some. This is because of changing the mind, regardless of mechanism. Otherwise nothing would be different after.

                Why then would it be hard to imagine that trying an SSRI *once* might have long-lasting or permanent effects?

                Some people have schizophrenia precipitated by a single cocaine use event.

                Why then should a month's application of strong mental medicine not possibly precipitate an illness?

                GP sounds like the worst of contemporary doctors. "Here, try this, it's got 10% better cure rates on the thing we're discussing than placebo, and we'll see you in two weeks to prescribe drugs for the side-effects."

                • (Score: 0) by Anonymous Coward on Saturday February 24 2018, @01:45PM

                  by Anonymous Coward on Saturday February 24 2018, @01:45PM (#643017)

                  I assume you don't take *any* medicine then because they all *might* have a side effect.
                  Have fun treating yourself with spring water baths and healing crystals.

  • (Score: 3, Insightful) by Anonymous Coward on Friday February 23 2018, @04:54AM (2 children)

    by Anonymous Coward on Friday February 23 2018, @04:54AM (#642227)

    Before taking antidepressants, perhaps check that you are not depressed because you are surrounded by assholes.
    If so, try changing your environment, and perhaps you will feel happier without having to take medicine.

    • (Score: 3, Funny) by Anonymous Coward on Friday February 23 2018, @10:39AM

      by Anonymous Coward on Friday February 23 2018, @10:39AM (#642312)

      Nice try, but I'm not leaving SN that easily!

    • (Score: 3, Insightful) by PiMuNu on Friday February 23 2018, @11:38AM

      by PiMuNu (3823) on Friday February 23 2018, @11:38AM (#642321)

      Yeah, problem is depression makes you think "I can't be bothered". So antidepressants may well be required as a first step in order to fix your circumstances, be it assholes, debt, bad relationship or any of another 100 factors.

  • (Score: 1, Insightful) by Anonymous Coward on Friday February 23 2018, @06:18AM (4 children)

    by Anonymous Coward on Friday February 23 2018, @06:18AM (#642241)

    If accurate, I would see that as pretty much nailing the coffin shut on anti-depressants. While their effectiveness may be up for debate, the very real side effects are not. People are taking on all sorts of critical side effects, which include things like increased suicide rates in younger individuals on top of interacting with damn near every other drug in heinous ways, for something that's UP TO twice as effective as a sugar pill. I can't be the only one seeing how absurdly idiotic that trade is!

    • (Score: 2) by Snotnose on Friday February 23 2018, @02:34PM (3 children)

      by Snotnose (1623) on Friday February 23 2018, @02:34PM (#642375)

      Came here to say this. If it's twice as effective as a placebo, and a placebo has no effect, then isn't 2 * 0 = 0? Especially when the side effects are very real, there's a good reason why lots of people with the pills don't take them.

      --
      Why shouldn't we judge a book by it's cover? It's got the author, title, and a summary of what the book's about.
      • (Score: 2) by JNCF on Friday February 23 2018, @08:11PM (2 children)

        by JNCF (4317) on Friday February 23 2018, @08:11PM (#642600) Journal

        a placebo has no effect

        But a placebo does have an effect, otherwise there would be no reason to use them as benchmarks. Even when people know they're placebos, they have an effect. It's ridiculous that we don't prescribe them for all sorts of ailments, depression included. Note that I've been pointing out negative side-effects of SSRIs in other comments, I'm not disagreeing on that point.

        • (Score: 0) by Anonymous Coward on Friday February 23 2018, @09:55PM (1 child)

          by Anonymous Coward on Friday February 23 2018, @09:55PM (#642660)

          the mental act of receiving treatment is healing unto itself, that where placebo derive their power

          • (Score: 0) by Anonymous Coward on Friday February 23 2018, @10:04PM

            by Anonymous Coward on Friday February 23 2018, @10:04PM (#642663)

            I forgot to ask you to tried that experience: next time you have some piqns, ask someone you trust to give 3 pills, a mix of advil and Tylenol of his choices. next time you have a similar pain do the same thing yourself. chances are that the pills from the trusted person are more effective than the one you choose yourself.

  • (Score: 5, Interesting) by Azuma Hazuki on Friday February 23 2018, @06:31AM (3 children)

    by Azuma Hazuki (5086) on Friday February 23 2018, @06:31AM (#642243) Journal

    Hasn't the serotonin hypothesis been all but debunked?

    I seem to be one of those people who can't handle SSRIs, so no big loss there, but what I did to cure depression was a lot less medical. And I mean major depression, lasting almost my entire life, which became comorbid with PTSD, anxiety disorder, and Cthulhu knows what else over time. Have you ever met a suicidal 8 year old? I was one.

    This might not, indeed probably will not, work for everyone, but for me, this is what did it:

    1) Magnesium, about twice the RDA, as Mg citrate in morning and night doses. This is in the powder form, Natural Calm or similar.
    2) 5-Methylfolate (NOT folic acid!), single dose of 100% RDA in the morning. These come as dissolvable little sublingual tablets.
    3) Dry vitamin-D3, single does of 100% RDA in the morning.
    4) A big morning vitamin C dose, one of the ones with some rutin, hesperidin, etc. included in the pill
    5) Also niacin in the morning. This will give you flushing and burning, but endure it.
    6) Dissolve some turmeric, some black pepper, and some Salt Sense (i.e., potassium salt...) into the evening Mg dose, and chase it with something with a little fat in it.

    I suspect a MTHFR gene mutation, which would explain the effectiveness of the 5-methylfolate. The thing that seemed to have the most effect was the magnesium, followed by the turmeric/pepper regimen, which would also suggest that inflammation was playing a role here. There's been some new research suggesting that depression may either stem from or actually *be* an inflammatory condition. I know I feel much calmer and less achy on this regimen, and seem to have a lot more tolerance for life's constant absurdities.

    Again, this might not and probably will not work for anyone else, but all of these are fairly cheap and seem to have no harmful side effects. I can't really say this is a "cure," as some of the mental scars left by my past simply won't go away, but they're far less painful and obstructive now.

    --
    I am "that girl" your mother warned you about...
    • (Score: 2) by Aiwendil on Friday February 23 2018, @10:10AM (2 children)

      by Aiwendil (531) on Friday February 23 2018, @10:10AM (#642298) Journal

      I seem to be one of those people who can't handle SSRIs

      I'm also one of those that react badly on SSRIs, in my case MAOIs* helped

      Also, have you tried any SSRE**? My shrinks refused to prescribe it for me.

      * (MonoAmine Oxidose Inhibiter) For those that are unaware, that is the generation of antidepressants between tricyclics and SSRIs, if fscks up up in a more pleasant way than SSRI if you suffer from unacceptable sideeffects, it also comes with some interesting dietary restrictions.

      ** Reuptake Enhancer

      (Also - try aloo gohst, the indian dish, you basically just described a lot of indian food but that is my favorite with tumeric in it)

      • (Score: 3, Informative) by Azuma Hazuki on Friday February 23 2018, @09:47PM (1 child)

        by Azuma Hazuki (5086) on Friday February 23 2018, @09:47PM (#642656) Journal

        My body is bizarrely sensitive to medicines of all kinds; things work at lower doses than they should and have slightly longer half-lives. So I try to avoid anything stronger than paracetamol (Tylenol) unless there's absolutely no alternative, and attempt to keep inflammation down through diet, vitamins, and a little biofeedback.

        Restaurant curry isn't something I get to eat often, maybe a couple times a year, but I cook with lots and lots of spices and fresh ingredients. Lunch today was a modified ma po tofu recipe (made with lean ground turkey and sliced onions) over brown rice, and hot enough to clear other peoples' sinuses from across the table :)

        Aside from that, cutting out ALL sodas including diet ones, not drinking milk, limiting fried foods, and avoiding refined sugars and white flour seems to do the trick. That and getting enough sleep, not drinking or smoking or doing drugs, etc. Maybe this sounds boring, but I feel so much better this way than even a year ago it's amazing.

        --
        I am "that girl" your mother warned you about...
        • (Score: 2) by Aiwendil on Friday February 23 2018, @10:42PM

          by Aiwendil (531) on Friday February 23 2018, @10:42PM (#642682) Journal

          I know that feeling - for me I react at insanely low doses (a high dose of paracetamol for me is about 100mg, good thing the liquid kiddie-version has a great taste) combined with a very short halflife [nothing really is quite like having painkillers wear off while they are stiching you up after minor surgery]. Funnily enough I can take close to LD50 doses without much more effect than I had where the dose went to "strong" for me. I guess my basic physique has a lot to do with this (oxygenation and heartrate is what is expected from an athlete, I'm a couch potatoe with bad knees).

          I rarely eat resturant curry as well due to allergies, but my gf loves indian food so I basically just learned to make a couple of dozen indian dishes (personally I favour the japanese and persian regions). My lunch today was gyudon in which I'm currenty experimenting with making "lazy packages" I can keep in my freezer. Yesterday it was a chicken and potatoe coconut curry (reviewing how to stuff as much fat as possible into food without it adversly impacting taste in order to help friends with eating disorders to keep their bodyweight up - so far I'm up to about 75g of butter per portion).
          Oh, and due to some bananas being close to overripe I also made banana sponge-cake.

          Due to a bowel disorder I can't really eat much high fibre food (I miss high fibre bread) and need to stick with white rice.

          Good that you found a way that works :)

  • (Score: 2) by Aiwendil on Friday February 23 2018, @10:15AM (1 child)

    by Aiwendil (531) on Friday February 23 2018, @10:15AM (#642302) Journal

    Ehm, has there every been any discussion about if it helps against _acute_ depression? I mean, that is what the friggin things was develop to combat, the issue is that people end up getting them for chronic depression (which should be dealth with my competent therapy, medication should only be a stop-gap measure for depression)

    • (Score: 2) by Aiwendil on Friday February 23 2018, @10:16AM

      by Aiwendil (531) on Friday February 23 2018, @10:16AM (#642303) Journal

      (Sorry for even worse spelling, concussion, those handles in elevators are a friggin safety hazard)

  • (Score: 0) by Anonymous Coward on Friday February 23 2018, @03:11PM

    by Anonymous Coward on Friday February 23 2018, @03:11PM (#642392)

    522 Trials Find Anti-Depressants have More Side Effects than Placebos, too.

    Do you ever read the list of side effects that comes with medications? Often a long list in very small print starting from flatulence and ending in death.

  • (Score: 0) by Anonymous Coward on Friday February 23 2018, @05:44PM

    by Anonymous Coward on Friday February 23 2018, @05:44PM (#642481)

    "finally puts to bed the controversy on anti-depressants"
    nevermind all those school shooters and suicides, then. good to know.

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