Anti-depressants

Posted by: Earwicker on 31 August 2005

Anyone ever been on anti-depressants and found one that works? Been on fluoxetine (Prozac) which did bugger all, Venlafaxine and that shit nearly killed me, and now Mirtazapine and it's great!! (My idea...!)

Any thoughts??

EW
Posted on: 31 August 2005 by Deane F
How long a trial did you give each medication? I think most antidepressants need at least a month before mood is starting to lift.
Posted on: 31 August 2005 by Earwicker
quote:
Originally posted by Deane F:
How long a trial did you give each medication? I think most antidepressants need at least a month before mood is starting to lift.

One month for fluoxetine and one for Venlafaxine. I've been taking Mirtazapine for a week now and already there are significant improvements. Impressive stuff.

EW
Posted on: 31 August 2005 by Mick P
Chaps

This has the makings of a depressing thread.

Regards

Mick
Posted on: 31 August 2005 by Nime
Then take an anti-depressant Sir. Cool
Posted on: 31 August 2005 by Stephen B
I hate Marzipan.
Posted on: 31 August 2005 by Deane F
quote:
Originally posted by Earwicker:
quote:
Originally posted by Deane F:
How long a trial did you give each medication? I think most antidepressants need at least a month before mood is starting to lift.

One month for fluoxetine and one for Venlafaxine. I've been taking Mirtazapine for a week now and already there are significant improvements. Impressive stuff.

EW


This is quite a personal question EW, but then you started it Smile, but why did you give Fluoxetine only one month? I'm not aware that it is shown to be enourmously better than other classes of anti-depressant but in the real world it is more successful because compliance is better due, I would think, to a different and possibly less offensive set of side effects. Were the side effects intolerable to you?
Posted on: 01 September 2005 by Earwicker
quote:
Originally posted by Deane F:
quote:
Originally posted by Earwicker:
quote:
Originally posted by Deane F:
How long a trial did you give each medication? I think most antidepressants need at least a month before mood is starting to lift.

One month for fluoxetine and one for Venlafaxine. I've been taking Mirtazapine for a week now and already there are significant improvements. Impressive stuff.

EW


This is quite a personal question EW, but then you started it Smile, but why did you give Fluoxetine only one month? I'm not aware that it is shown to be enourmously better than other classes of anti-depressant but in the real world it is more successful because compliance is better due, I would think, to a different and possibly less offensive set of side effects. Were the side effects intolerable to you?

Fluoxetine (an SSRI) had no side effects whatsoever; it simply did nothing. Statistically it only "works" in about a third of cases, and only partial remission is seen in two thirds of those cases.

Venlafaxine (an SNRI) rapidly kicked the shit out of me, worsening my depression and insomnia by orders of magnitude, and providing a whole host of nasty side effcts too - including "brain-zaps", amnesia, muscle spasms, the sweats... etc etc. My memory still hasn't recovered.

After a few hours research on the net, however, I decided the atypical anti-depressant Mirtazapine (a NaSSA) might be worth a try. And it was!!

EW
Posted on: 01 September 2005 by DIL
May seem like a strange suggestion, but why not try and sort out why you need anti-depressants. Suerly better to tackle the problem rather than the symptoms.

/dl
Posted on: 01 September 2005 by Nick_S
Anti-depressants can be useful as a short term strategy to get through a difficult period, but longer term gains may be obtained with one of the cognitive-behavioural therapies (having been found to be useful treatments when evaluated in randomized trials).

Nick
Posted on: 01 September 2005 by Bruce Woodhouse
quote:
May seem like a strange suggestion, but why not try and sort out why you need anti-depressants. Suerly better to tackle the problem rather than the symptoms.


Whilst I understand the intention of this post I would suggest that depression is not always 'solved' by finding a 'cause'. This risks perpetuating the idea that depression is always because of external events, or internal frailties. Whilst it may be true for some it should be still be considered as an illness, some people are prone to get it as others may be prone to diabetes or backache. Depression itself may be the problem, not just the symptoms if you see what I mean.

Contented and well adjusted people can have depressive illnesses.

Bruce
Posted on: 01 September 2005 by Nick_S
Any such 'causes' are likely to be multiple, difficult to identify, and to interact with the depressive disposition itself (depression usually involves both motivational and learning deficits, in addition to the emotional affect). However, solely taking medication does not begin to get at this complexity in dealing with the condition.

Nick
Posted on: 01 September 2005 by Bruce Woodhouse
I think we are in agreement Nick. I was just challenging the idea that depression is the same as 'feeling depressed', in other words that it is purely a symptom rather than a disease entity. Subtle concepts that I write about poorly!

Incidentally anti-depressant (and associated meds) should not be ignored in terms of long term relapse prvention either. I sound like a pill-pusher here; I'm not but I guess am responding to a growing and often ill-informed negativity in the popular media about the value of Ad's.

Bruce

PS That will be emotional effect I think. Vaguely freudian slip!
Posted on: 01 September 2005 by DIL
Bruce et al,
It was not my intention to nonchalise depression nor the problems it most certainly causes. However, the 'tone' of the initial post (As I read it.) was somewhat concerning...

quote:
Anyone ever been on anti-depressants and found one that works? Been on fluoxetine (Prozac) which did bugger all, Venlafaxine and that shit nearly killed me, and now Mirtazapine and it's great!! (My idea...!)
Any thoughts??
EW


Surely, the doctor prescribing these drugs is in the best position to:
a.) understand the wider picture eg "Other factors" of a short or long term nature.,
b.) understand how the drugs work eg. I'm assuming here that it is important to get dosage right depending on body mass or whatever.,
c.) work with the patient towards some long term strategy.

I would respectfully suggest that a further conversation with the GP is a better course of action than a 'what has worked for you' post on a general forum. We're almost in 'what MP3 player' territory.

/dl
Posted on: 01 September 2005 by Nick_S
Bruce,

I agree that there is likely to be a compromise position regarding medication, depending on how a client responds to other forms of treatment.

Actually, I did mean 'affect' --- psychological speak for the feeling aspect of an emotional state!

Nick
Posted on: 01 September 2005 by Bruce Woodhouse
David-Sorry if I over-interpreted your post.

I'm deliberately not commenting on the rx choices of earwicker for precisely the reasons you give. I thought my post and others might stimulate a wider discussion of more general interest.

Bruce

Nick. Emotional affect is a tautology no? Effect on affect maybe!
Posted on: 01 September 2005 by Stuart M
You might like to look at SAMe it's unavailable in Europe but you can import it from the USA legaly.

More info here:-

http://www.medscape.com/viewarticle/443009

It's not cheap (around £60 a month for 800mg per day) but it kicks in around a week.

Don't take if your bipolar.
Posted on: 01 September 2005 by Nick_S
David,

As with Bruce, my intention was to broaden the debate since I don't think it appropriate for me to comment on individual circumstances. I think that your initial post played a useful role in moving the thread away from a narrower discussion of medications.

Nick
Posted on: 01 September 2005 by Nick_S
Bruce, no tautology. We could have fun with definitions here, but I think we understand each other's respective positions. Emotional states in the sense I was discussing are dispositions that include associative (learning), motivational and affective (feeling) components. Affect does not directly label the disposition of not being able to get out of bed in the morning for instance, or reduced levels of eye-contact during conversation.

Nick
Posted on: 01 September 2005 by Mick P
Chaps

The best thing to do with these drugs is to flush them down the loo.

They must surely affect you brain and the long term implications are horrendous.

Regards

Mick
Posted on: 01 September 2005 by bjorne
Mick, are you a physician?
Posted on: 01 September 2005 by Mick P
bjorne

Most people who are "depressed" are suffering from an attitude of mind more than anything else.

How many pills did we have during the last war, answer hardly any but people got stuck and did what they had to do. There was cause to be depressed with you got bombed out and in this day and age we have it made, so depression is mainly in the mind (no pun intended)

I object to spending my taxes on financing the issuing of pills of a dubious nature to a bunch of self pitying whingers.

The money could better be diverted into more deserving areas such as cancer research or whatever.

Regards

Mick
Posted on: 01 September 2005 by bjorne
Mick. There's a disease named clinical depression. This is widely accepted by most physicians. These drugs do help a lot of people even if the sideeffects, as you say, can be severe.
Posted on: 01 September 2005 by Willy
OK Dr Mick next time I see my brother in law I'll tell hime to flush his insulin down the loo since the cost of it offends you.

Willy.
Posted on: 01 September 2005 by mykel
Mick

Until you have lived the life; you know not of which you speak. So until you spend a few years in undiaganosed mental hell then go thru a few more years of another type of hell until the correct drug regimen is found, along the way spend a bit of time in various forms of therapy... I would kindly ask that you shut the fuck up.

regards, as always

michael
Posted on: 01 September 2005 by Mick P
Mykel

No I will not shut up neither will I go into a depression because you told me to shut up.

That is what stops me taking bloody pills.

Regards

Mick