Effexor and other anti-depressants

[Dion]

Originally Posted by Momo

I think you may be mistaken here, as Remeron has never been pulled off the market.

I stand corrected, it was Serzone.

http://www.antidepressantsfacts.com/...off-market.htm

18 Deaths Linked to drug - Serzone Removed from European market, not US

http://www.ahrp.org/infomail/0103/17a.php

]Drug manufacturers absolutely do do long term studies on drugs. All drugs must go through phase I, II, and III trials (done on increasingly larger numbers of people) before being allowed on the market. Most side effects are found during phase I and II trials. The problem is that these trials are done on a limited number of people. The target population, for example, the population of depressed patients, will always be more than the number of volunteers/patients for each clinical trial. It's a matter of statistics that the rarer side effects often don't show up until phase IV trials (post-market). It's unfortunate, but it is reality. Also, life-threatening side effects can and do occur with some drugs during clinical trials before they make it to market. Usually, this means the drug never makes it to market.

The Food and Drug Administration (FDA) today issued a Public Health Advisory announcing a multi-pronged strategy to warn the public about the increased risk of suicidal thoughts and behavior ("suicidality") in children and adolescents being treated with antidepressant medications.

"Today's actions represent FDA's conclusions about the increased risk of suicidal thoughts and the necessary actions for physicians prescribing these antidepressant drugs and for the children and adolescents taking them.

They reflect what we heard from our advisory committee last month, as well as what many members of the public have told us," said Dr. Lester M. Crawford, Acting FDA Commissioner.

http://www.antidepressantsfacts.com/...Is-suicide.htm

Shouldn't the drug companies and their testing catch this before it reaches the market?

It's actions like the above that has me leery of their testing methods.

[Hack&Lube]

Originally Posted by Dion

I stand corrected, it was Serzone.

http://www.antidepressantsfacts.com/...off-market.htm

18 Deaths Linked to drug - Serzone Removed from European market, not US

http://www.ahrp.org/infomail/0103/17a.php




The Food and Drug Administration (FDA) today issued a Public Health Advisory announcing a multi-pronged strategy to warn the public about the increased risk of suicidal thoughts and behavior ("suicidality") in children and adolescents being treated with antidepressant medications.

"Today's actions represent FDA's conclusions about the increased risk of suicidal thoughts and the necessary actions for physicians prescribing these antidepressant drugs and for the children and adolescents taking them.

They reflect what we heard from our advisory committee last month, as well as what many members of the public have told us," said Dr. Lester M. Crawford, Acting FDA Commissioner.

http://www.antidepressantsfacts.com/...Is-suicide.htm

Shouldn't the drug companies and their testing catch this before it reaches the market?

It's actions like the above that has me leery of their testing methods.

The FDA has some questional practices...they are not however, Health Canada.

[Momo]

Originally Posted by Dion

I stand corrected, it was Serzone.

http://www.antidepressantsfacts.com/...off-market.htm

18 Deaths Linked to drug - Serzone Removed from European market, not US

http://www.ahrp.org/infomail/0103/17a.php




The Food and Drug Administration (FDA) today issued a Public Health Advisory announcing a multi-pronged strategy to warn the public about the increased risk of suicidal thoughts and behavior ("suicidality") in children and adolescents being treated with antidepressant medications.

"Today's actions represent FDA's conclusions about the increased risk of suicidal thoughts and the necessary actions for physicians prescribing these antidepressant drugs and for the children and adolescents taking them.

They reflect what we heard from our advisory committee last month, as well as what many members of the public have told us," said Dr. Lester M. Crawford, Acting FDA Commissioner.

http://www.antidepressantsfacts.com/...Is-suicide.htm

Shouldn't the drug companies and their testing catch this before it reaches the market?

It's actions like the above that has me leery of their testing methods.

Alright, in order then...

1. Nefazodone was pulled from the market before I entered pharmacy school, so you'll have to forgive me as I don't know much about it. I just did some reading, and it appears liver toxicity was the problem. As per the Health Canada advisory, the risk was very low.

"This risk, while very remote, poses a greater risk than other similar antidepressants currently available in Canada."

As I mentioned before, the rarity of these side effects make it difficult to find in phase I, II, or III trials. I couldn't really find any good evidence, but this article, while admittedly not being the best source in the world, says there were 55 cases of liver failure, resulting in 20 deaths in nefazodone's 9 years on the market. They also say there were 2.8million prescriptions written for nefazodone in 2002 alone in the US. Drug companies will never be able to get that many people in a clinical trial to test for these kind of side effects. In reality, all medications can cause adverse side effects. You can't really avoid it.

2. Clinical trials are typically not done on children. This is a problem, and it is being looked at. However, parents are not really willing to sign up their children for clinical trials.

In terms of that adverse effect, pharmacists and doctors are aware of it. Typically, antidepressants tend to increase one's energy levels before their mood gets better. It's not completely understood, but the problem appears to come from more severely depressed people getting this increased energy first without the elevated mood, and therefore having the energy to attempt suicide. As a health professional, you have to try to get the family involved in a more severely depressed patient's care and make sure they are vigilant. Until the mood elevating effects kick in, the patient is definitely at risk.


As I said, these drugs can and do help some people. Can you honestly say they have no benefit? All drugs have their risks, but you need to weigh the potential benefit against the potential risk. For most people, the benefits greatly outweigh the risks.

As an aside, I am not defending drug companies or the over-prescribing of medication. Any vigilant pharmacist will try to prevent this from happening, although it's not always possible.

[Dion]

Originally Posted by Hack&Lube

The FDA has some questional practices...they are not however, Health Canada.

So do the drug companies. Seeing drug manufacturers advertising their anti depressants on TV with hopes that people will rush to their GP to get them to prescribe them. Something wrong with that picture if you ask me.

[Dion]

Originally Posted by Momo

As I said, these drugs can and do help some people. Can you honestly say they have no benefit? All drugs have their risks, but you need to weigh the potential benefit against the potential risk. For most people, the benefits greatly outweigh the risks.

I would argue no. I spent 3 years talking just about every anti depressant on the market. Luckily i found a GP with enough smarts to get me some talk therapy, which i might add cured my depression - not the drugs. Unless you are suffering from some permanent disorder like bi polar or schizophrenia, i don't think these drugs are necessary. GP's over prescribe them because it's the easier soultion.

[Ayrahb]

I was given Effexor, but it didn't do much for me aside from making me last longer, which was nice. The problem is, what good is stamina if you only feel like doing it once a month.

My doctor finally combined treating my ADD and depression with Wellbutrin and Adderall and that reduced the depression symptoms. BTW, Wellbutrin = horny for men, too. I heard it is a good medication to help you quit smoking, but I never smoked.

[Dion]

Selective publication of trial results.

A recent federal study of 315 published clinical trials of 29 antidepressant drugs noted that every one which identified a sponsor came from a drug company. While the FDA requires companies to submit failed trials, reports of drugs with no effect seldom make it to the medical journals.

For example, one published trial of Serzone with a marginal result matches the FDA records. But an identical trial with no measurable drug effect did not get published, according to the federal study. How many drug companies are going to publish a study that makes their drug look bad?

http://thomasjmoore.com/pages/prozpop.html

[daveyboy]

Originally Posted by Dion

I would argue no. I spent 3 years talking just about every anti depressant on the market. Luckily i found a GP with enough smarts to get me some talk therapy, which i might add cured my depression - not the drugs. Unless you are suffering from some permanent disorder like bi polar or schizophrenia, i don't think these drugs are necessary. GP's over prescribe them because it's the easier soultion.

Depression can be a life-long and recurrent disorder that is just as troubling as a biploar disorder or schizophrenia. I do agree that prescirbing medications shouldn't be a first resort and they are over-prescribed, but they save lives.

I'm on Effexor 225mg and Depakote 750mg right now and I don't feel perfect by any means, but I can get through the day now, which is more then I ever could before.

The side effects are a bit rough to deal with, I have very noticeable tremors in my hands, everything feels a bit blunted. If I miss a dose or am late taking a dose I can definitely tell as I get brain shivers and just generally feel like crap.

Effexor generally has more side-effects because it works on both your serotonin and norepinephrine transmitters as opposed to just prozac, paxil etc... which just work on your serotonin reuptake.

Good luck man, there is the right combination or therapy out there for all of us that have the curse of mental illness. It's just a matter of finding it.

[Kybosh]

Originally Posted by Dion

Selective publication of trial results.

A recent federal study of 315 published clinical trials of 29 antidepressant drugs noted that every one which identified a sponsor came from a drug company. While the FDA requires companies to submit failed trials, reports of drugs with no effect seldom make it to the medical journals.

For example, one published trial of Serzone with a marginal result matches the FDA records. But an identical trial with no measurable drug effect did not get published, according to the federal study. How many drug companies are going to publish a study that makes their drug look bad?

http://thomasjmoore.com/pages/prozpop.html

This same stuff can be said about any peer reviewed journals for any science. There is no such thing as the journal of unpublished results. You don't publish stuff that didn't work, period.

[Locke]

Wow, this anti-depressant sounds really, well....depressing.

[Dion]

Unsubstantiated Chemical Imbalance Theory Of Depression Perpetuated By Media

"The chemical imbalance theory, which was formulated in the 1960s, was based on the observation that mood could be artificially altered with drugs, rather than direct observation of any chemical imbalances," Leo said. "Since then there has been no direct evidence to confirm the theory and a significant number of findings cast doubt on the theory."

The researchers said the popularity of the theory is in large part based on the presumed efficacy of the SSRIs, but they say that several large studies now cast doubt on this efficacy. A review of a full set of trial data published in the journal PLoS (Public Library of Science) Medicine last month concluded that much of the perceived efficacy of several of the most common SSRIs was due to the placebo effect. Other studies indicate that for every 10 people who take an SSRI, only one to two people are truly receiving benefit from the medication, according to Lacasse and Leo.

Still, the National Center for Health Statistics found that antidepressants are the most prescribed drugs in the United States, with doctors writing more than 31 million prescriptions in 2005. Both Lacasse and Leo emphasized the importance of patients being given factual information so they can make informed decisions about medications and the role of other potentially useful interventions, such as psychotherapy, exercise or self-help strategies.

"Patients might make different choices about the use of medications and possibly use alternative approaches to their distress if they were fully informed," Lacasse said. "We believe the media can play a positive role by ensuring that their mental health reporting is congruent with scientific literature."

http://www.medicalnewstoday.com/articles/99356.php

[Dion]

Originally Posted by Kybosh

This same stuff can be said about any peer reviewed journals for any science. There is no such thing as the journal of unpublished results. You don't publish stuff that didn't work, period.

As a former user of anti-depressants i found that disturbing. I'd like to know all the facts behind the drug i'm taking in reagrds to it's effectiveness. Hiding the true facts in an effort to prop up the drug you are trying to sell makes me wonder what else these drug companies are trying to hide.

[Dion]

Originally Posted by daveyboy

Depression can be a life-long and recurrent disorder that is just as troubling as a biploar disorder or schizophrenia. I do agree that prescirbing medications shouldn't be a first resort and they are over-prescribed, but they save lives.

I'm on Effexor 225mg and Depakote 750mg right now and I don't feel perfect by any means, but I can get through the day now, which is more then I ever could before.

The side effects are a bit rough to deal with, I have very noticeable tremors in my hands, everything feels a bit blunted. If I miss a dose or am late taking a dose I can definitely tell as I get brain shivers and just generally feel like crap.

Effexor generally has more side-effects because it works on both your serotonin and norepinephrine transmitters as opposed to just prozac, paxil etc... which just work on your serotonin reuptake.

Good luck man, there is the right combination or therapy out there for all of us that have the curse of mental illness. It's just a matter of finding it.

Yes, it can be a life-long and recurrent illness. It's something i've been battling with since i was a teen and will probably battle for the rest of my life.

I've also been down the road you're traveling. I know all too well the nasty side effects these anti-depressants can have. It got to a point where i didn't know who i was as a person. I felt drugged up all the time and came to the conclusion i didn't want to live in that drug induced haze anymore. Even my friends noticed a change for the worse and urged me to get off the drugs.

For me i found exercise was a good replacement for the drugs i was taking. It elevates my mood much the same way as those drugs. It's now become an addiction for me. I crave those endorphine highs.

For sure there's no right combination.

Best of luck to you in your fight against depression.

[Momo]

Originally Posted by Dion

Unsubstantiated Chemical Imbalance Theory Of Depression Perpetuated By Media
*snip*

Well, unless there is someone out there who would like to volunteer to have their brains dissected and analyzed while they are on antidepressants... There is no way of measuring increases in neurotransmitters. But if they can see that the drug is having an effect on their moods, why is that a bad thing?

Bottom line... just because they didn't work for you, doesn't mean they don't work. It is theorized that some depressions are biological (ie. caused by imbalances in neutrotransmitters) and some are not. It could also be that the depression eventually changes the chemistry in the brain and causes lower levels of neurotransmitters. There is no way to know for sure.

Many people will benefit from non-pharmacological therapy (eg. seeing a therapist or psychologist), but it is expensive. It should be recommended to everyone if they can afford it, and if it wasn't... there's the problem. Depending on the severity of the depression, getting cognitive therapy may not be enough. There is a need for antidepressants, but it is not needed for everyone.

[Dion]

Originally Posted by Momo

Well, unless there is someone out there who would like to volunteer to have their brains dissected and analyzed while they are on antidepressants... There is no way of measuring increases in neurotransmitters. But if they can see that the drug is having an effect on their moods, why is that a bad thing?

Bottom line... just because they didn't work for you, doesn't mean they don't work. It is theorized that some depressions are biological (ie. caused by imbalances in neutrotransmitters) and some are not. It could also be that the depression eventually changes the chemistry in the brain and causes lower levels of neurotransmitters. There is no way to know for sure.

Many people will benefit from non-pharmacological therapy (eg. seeing a therapist or psychologist), but it is expensive. It should be recommended to everyone if they can afford it, and if it wasn't... there's the problem. Depending on the severity of the depression, getting cognitive therapy may not be enough. There is a need for antidepressants, but it is not needed for everyone.

The Placebo effect during trials seems to have the same effect.

Theorys are all that the medical community has right now. It's the latest best guess as to what causes the so called chemical imbalance. When the medical community comes up with solid proof that they work, then i'll believe them.

It's not always expensive. There are places like the Calgary Counselling Centre that operate on a sliding fee scale where people pay what they can afford. I've used their services in the past and it didn't hurt me finacialy.

[Momo]

Originally Posted by Dion

The Placebo effect during trials seems to have the same effect.

Theorys are all that the medical community has right now. It's the latest best guess as to what causes the so called chemical imbalance. When the medical community comes up with solid proof that they work, then i'll believe them.

It's not always expensive. There are places like the Calgary Counselling Services that operate on a sliding fee scale where people pay what they can afford.

You'll see a placebo effect in every trial. Trials must prove that the drug has an effect greater than the placebo effect.

Theories are a part of science. It's not just antidepressants... you may be surprised at the number of drugs out there that we don't know exactly how they work, but they do.

Counseling services are different from cognitive therapy. If counseling works for you, then great. Cognitive therapy is much more involved and much more expensive.

I'm happy that you've found something that works for you to deal with your depression. If that doesn't involve medications, then that's even better. A good pharmacist doesn't want you on more drugs than you need.

[Dion]

Originally Posted by Momo

You'll see a placebo effect in every trial. Trials must prove that the drug has an effect greater than the placebo effect.

When placebos are giving the same results as those given anti-depressants, it makes me wonder if these drugs are really effective at all

Counseling services are different from cognitive therapy. If counseling works for you, then great. Cognitive therapy is much more involved and much more expensive.

I had cognative therapy from that place. They offer services that are tailor made to the clients needs.

[Locke]

To inject some humour into an otherwise depressing thread....










We now return you to your serious, not funny in any way, discussion.

[Dion]

^^^ Hahahahaha! Good job Locke!

I can always trust on you to give me my laugh of the day

[dissentowner]

Great cartoons! You have to be able to laugh at the crappy things in life or you just end up on more stupid pills,lol.