Effexor and other anti-depressants

[Dion]

[Momo]

Originally Posted by Dion

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



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

Same results? Probably not to the same degree... at least not in published trials. I can't say anything about unpublished trials as well, I can't read them. You'll see placebo effects everywhere, even in trials for blood pressure and diabetes medications... and for most of these drugs, we do know how they work. Can you say for sure that they aren't effective?

And if they do offer cognitive therapy at that facility, then that's great.

[Dion]

Originally Posted by Momo

Same results? Probably not to the same degree... at least not in published trials. I can't say anything about unpublished trials as well, I can't read them. You'll see placebo effects everywhere, even in trials for blood pressure and diabetes medications... and for most of these drugs, we do know how they work. Can you say for sure that they aren't effective?

My focus was on anti-depressant medications and the placebo effect only. It's like you said, unless there is someone out there who would like to volunteer to have their brains dissected and analyzed while they are on antidepressants we'll never know if they are working.

Blood pressure and diabetes are different as we have a way to measure how effective those medications work.

[Momo]

Originally Posted by Dion

My focus was on anti-depressant medications and the placebo effect only. It's like you said, unless there is someone out there who would like to volunteer to have their brains dissected and analyzed while they are on antidepressants we'll never know if they are working.

Blood pressure and diabetes are different as we have a way to measure how effective those medications work.

Ok, that's fine then. It's up to you whether or not you believe they work. It really doesn't change the fact that antidepressants do help some people. There are a lot of people out there that could not function without taking antidepressants. The degree to which it helps is entirely subjective, as you've mentioned. There's nothing we can do about it at this point.

As I've mentioned before, I'm not defending the over-prescribing of drugs. I know some people are placed on antidepressants when they shouldn't be. If I find a case I do what I can to help, but sometimes the doctor and/or patient just isn't willing to change. When it comes to a patient's health, it's the patient's wants that really matters. If the doctor recommends an antidepressant and they don't want to take it, they don't have to (unless they're in a psych ward/hospital or whatever).

[Dion]

Originally Posted by Momo

Ok, that's fine then. It's up to you whether or not you believe they work. It really doesn't change the fact that antidepressants do help some people. There are a lot of people out there that could not function without taking antidepressants. The degree to which it helps is entirely subjective, as you've mentioned. There's nothing we can do about it at this point.

My apologies - i probably came across as quite arrogant and all.

For sure there are people out there who can't function without these meds. My bad for not saying so, it's just that i view these meds as a bandaid and not a solution. If it helps them get through some tough times until they can find the solution to their problems, who am i to argue. My only wish is that GP's didn't hand out these perscriptions like they were candy. Other methods do work but it seems to me that writing out that perscription is the easiest way to deal with the problem.

As I've mentioned before, I'm not defending the over-prescribing of drugs. I know some people are placed on antidepressants when they shouldn't be. If I find a case I do what I can to help, but sometimes the doctor and/or patient just isn't willing to change. When it comes to a patient's health, it's the patient's wants that really matters. If the doctor recommends an antidepressant and they don't want to take it, they don't have to (unless they're in a psych ward/hospital or whatever).

Good on you for looking out for the patients best interests

[Momo]

Originally Posted by Dion

My apologies - i probably came across as quite arrogant and all.

For sure there are people out there who can't function without these meds. My bad for not saying so, it's just that i view these meds as a bandaid and not a solution. If it helps them get through some tough times until they can find the solution to their problems, who am i to argue. My only wish is that GP's didn't hand out these perscriptions like they were candy. Other methods do work but it seems to me that writing out that perscription is the easiest way to deal with the problem.

No need to apologize.

I agree that often antidepressants are a kind of "band-aid". It's really unfortunate that GPs seem to just prescribe the meds without even considering or talking about the non-pharmacological alternatives. They should be trained to assess the situation and know if a prescription is needed or not. Maybe it's an issue with the time they have to talk with the patient... I'm not sure.

Good on you for looking out for the patients best interests

Thank you. I do what I can.

[Dion]

Originally Posted by Momo

No need to apologize.

I agree that often antidepressants are a kind of "band-aid". It's really unfortunate that GPs seem to just prescribe the meds without even considering or talking about the non-pharmacological alternatives. They should be trained to assess the situation and know if a prescription is needed or not. Maybe it's an issue with the time they have to talk with the patient... I'm not sure.

I've run into GP's who are quite ignorant when it comes to mental illness.

One wrote out a perscription and said i'd be cured in 30 days.

Another one looked down at his hands the whole time while he was picking at his fingernails. He didn't bother to look up when i was talking. Just handed me a sample of Paxil and said come back in a week.

[Momo]

Originally Posted by Dion

I've run into GP's who are quite ignorant when it comes to mental illness.

One wrote out a perscription and said i'd be cured in 30 days.

Another one looked down at his hands the whole time while he was picking at his fingernails. He didn't bother to look up when i was talking. Just handed me a sample of Paxil and said come back in a week.

Wow, that is pretty bad. I don't even know what to say about that.

By the way, I'm sorry if I sounded defensive about the issue. I didn't mean to.

[Igottago]

Originally Posted by Dion

I've run into GP's who are quite ignorant when it comes to mental illness.

One wrote out a perscription and said i'd be cured in 30 days.

Another one looked down at his hands the whole time while he was picking at his fingernails. He didn't bother to look up when i was talking. Just handed me a sample of Paxil and said come back in a week.

Yeah I've seen the same thing...many of them quickly turn to the prescription without offering their patients any information about other alternatives. Depression is more complex than simply being able to cure it with a pill..in some cases that might work but in some cases it might take some cognitive therapy, or a combination of the two. Every case is different.

[joe_mullen]

being a medical professional myself, i'd like to add a couple of thoughts.

first of all, it is quite easy to measure the effects of anti-depressants in studies as there are a number of verified questionairres/methods to do this. by the same token, one could argue that you cannot prove that analgesics work as well as you can't "measure" pain.

furthermore, any physician that tells someone that anti-depressants will cure them in 30 days is lying. all the literature suggests keeping people on them for at least 6 months.

last, i find it very annoying when people suggest that people with depression should get over it. like every disease in medicine depression has a genetic/biological component and an environmental component. just like hypertension will be affected by a genetic component, poor lifestyle will affect your blood pressure as well. same with depression, there is always a genetic predisposition, but some environmental factors such as stress can affect this as well.

[Berger_4_]

Originally Posted by joe_mullen

being a medical professional myself

Well there Mr. Doctor, I've got a really off topic question for you...how long does it take somebody's PSA count to rise? My grandpa just got rediagnosed with cancer (he had prostate cancer probably...5 years ago now, and has been rediagnosed with bone cancer...). Anyways, his PSA count was only supposed to be at 10, and when he asked the doctors to check him for it (he goes in every month or whatever it is to make sure his cancer was still in remission) So they checked it and it was over 110. So does that mean that the doctors were fataing idiots and didn't bother to check to see if his PSA was still where it should have been? Or could it have just risen recently? So I guess I'm basically asking if they could have caught this new bout a lot sooner than they actually did...

[Momo]

Originally Posted by Berger_4_

Well there Mr. Doctor, I've got a really off topic question for you...how long does it take somebody's PSA count to rise? My grandpa just got rediagnosed with cancer (he had prostate cancer probably...5 years ago now, and has been rediagnosed with bone cancer...). Anyways, his PSA count was only supposed to be at 10, and when he asked the doctors to check him for it (he goes in every month or whatever it is to make sure his cancer was still in remission) So they checked it and it was over 110. So does that mean that the doctors were fataing idiots and didn't bother to check to see if his PSA was still where it should have been? Or could it have just risen recently? So I guess I'm basically asking if they could have caught this new bout a lot sooner than they actually did...

I know you asked joe_mullen, but I'd like to know a few things.

1. Was it a new diagnosis of bone cancer? Or is it metastasis of the prostate cancer?

2. You say his PSA was 110. When was the last time it was checked before that?

3. Has he ever taken drugs such as Proscar , Propecia, or Avodart?

4. Has he recently been catheterized?

[Wookie]

Interesting conversation.

I have one comment regarding the antidepressants being linked to suicidal thoughts/suicide.

Depression can have a lot of symptoms. One of them is not being able to do anything. Like as in you're so depressed you don't want to get out of bed, you don't want to do ANYTHING. Some of these people don't have the motivation to kill themselves. Seriously, killing yourself isn't all that easy. You need to be pretty determined to do it.

So, when some people start taking antidepressants as they have an affect people can begin to come out of this completely depressed state. They're still totally depressed, just a bit less so they can begin to function. It's at this point that someone will suddenly have the energy to go about killing themselves. The thoughts were there before, they're just all of a sidden a lot more able to act on them. Often this is when they do. They're starting to feel a bit better and they kill themselves.

It's kind of screwed up.

[Dion]

Originally Posted by Wookie

Interesting conversation.

I have one comment regarding the antidepressants being linked to suicidal thoughts/suicide.

Depression can have a lot of symptoms. One of them is not being able to do anything. Like as in you're so depressed you don't want to get out of bed, you don't want to do ANYTHING. Some of these people don't have the motivation to kill themselves. Seriously, killing yourself isn't all that easy. You need to be pretty determined to do it.

So, when some people start taking antidepressants as they have an affect people can begin to come out of this completely depressed state. They're still totally depressed, just a bit less so they can begin to function. It's at this point that someone will suddenly have the energy to go about killing themselves. The thoughts were there before, they're just all of a sidden a lot more able to act on them. Often this is when they do. They're starting to feel a bit better and they kill themselves.

It's kind of screwed up.

In July, 2001, a federal jury in Cheyenne, Wyoming ordered GlaxoSmithKline to pay $6.4 million to Donald Schell's relatives. In that case, the relatives found internal GlaxoSmithKline documents showing the company was aware that a small number of people could become agitated or violent from Paxil. Despite this knowledge, Paxil packaging does not include a warning about suicide, violence or aggression.

The actions against the drug companies claim that the companies knew--but failed to warn physicians and patients--that a small number of patients will experience a condition called akathisia, an overwhelming physical and mental restlessness, shortly after they begin taking these drugs. Other patients may, after beginning one of these medications, find themselves sufficiently energized to harm themselves, but not yet helped enough by the drug to control their destructive thoughts.

http://www.kgscounsel.com/case/case.asp?lngCaseId=1087

[Wookie]

Originally Posted by Dion

In July, 2001, a federal jury in Cheyenne, Wyoming ordered GlaxoSmithKline to pay $6.4 million to Donald Schell's relatives. In that case, the relatives found internal GlaxoSmithKline documents showing the company was aware that a small number of people could become agitated or violent from Paxil. Despite this knowledge, Paxil packaging does not include a warning about suicide, violence or aggression.

The actions against the drug companies claim that the companies knew--but failed to warn physicians and patients--that a small number of patients will experience a condition called akathisia, an overwhelming physical and mental restlessness, shortly after they begin taking these drugs. Other patients may, after beginning one of these medications, find themselves sufficiently energized to harm themselves, but not yet helped enough by the drug to control their destructive thoughts.

http://www.kgscounsel.com/case/case.asp?lngCaseId=1087

And?

isn't this part

Other patients may, after beginning one of these medications, find themselves sufficiently energized to harm themselves, but not yet helped enough by the drug to control their destructive thoughts.

stating exactly waht I said?

[Dion]

Originally Posted by Wookie

And?

What else do you want to know?

[Wookie]

look up again.

[Dion]

Originally Posted by Wookie

look up again.

Ahhhh ok

What i was doing was giving you a medical explanation (akathisia) for why that was happening. Wasn't disagreeing with you. Sorry.

[Wookie]

Originally Posted by Dion

Ahhhh ok

What i was doing was giving you a medical explanation for why that was happening.

But I wasn't looking for an explanation. I provided one. The drugs are working. Unfortunately there's a point where someone is depressed enough still to kill themselves and also have the energy and motivation to do it now. Whereas before they didn't.


edit: grrr... stop being sorry I'm not angry nor need an apology lol.

[Wookie]

- Lilly's own figures, in reports made available to the Globe, indicate that 1 in 100 previously nonsuicidal patients who took the drug in early clinical trials developed a severe form of anxiety and agitation called akathisia, causing them to attempt or commit suicide during the studies.

Which is what you're talking about.

I'm talking about depressed suicidal people.