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Question
Posted by: truth | 2010/10/14

What the doctors dont tell you about Anti Depressants

I have been on Mirtazapine for exactly one month now with no noticable improvement on my Major Depressive disorder (or so the ''clever'' doctors call it). In fact, I have become more irritable, my thought patterns are irrational, I feel aggressive, I started having panic attacks (which were not part of the original diagnosis) and worst of all I have caught myself thinking of suicide the past few days.
There is NO conclusive scientific evidence that AD''s actually work and I challenge any doctor to prove to me otherwise. At best they are placebos and at worst they are mind altering drugs with dire side effects.
Just google ''truth about anti deppressants'' and see what you come up with or check out cchr-dot-org.
Humankind survived for ages without all this crap, so why is it that all of a sudden everyone has some disabling disorder?

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Our expert says:
Expert ImageCyberShrink

When you google such a broad subject with such a VERy ooaded phrase, you'll selectively find a load of very highly biased, inexpert and exclusively critical stuff. Evidence on the valuee of such drugs will not be picked up as "the truth about..." Search with biased terms, and you will find biased material, from people with personal axes to grind.
To deny that there is such thing as Depression is simply naive and stupid - it has existed throughout human history, and in every culture known on earth.
Now, I certainly don't believe that the evidence for specific ADs is overwhelming or conclusive, but it is true that a significant proportion of depressed people find benefit from such drugs. I don't think, though, that more than 70 % at most, find significant benefits from any one drug, so there are fairly good odds that the first one tried might not suit your highly individual brain chemistry and prove helpful.
I despair of doctors ( you don't mention whether you're being treated by a specialist psychiatrist or only a GP ) who prescribe ANY drug to ANYONE at ANY time, without a full explanation of the diagnosis, the drug, what it may or may not do, possible benefits, side-effects, and so on. They should ALWAYS review your progress or lack of it on any new drug within the first month, and if you have not reacted favourably to an AD within a month, its is perfectly clear that this is not the right treatment for you, and a different plan should have been made.
Perhaps you should consider a non-drug method, such as CBT, Cognitive-Behaviour Therapy, where there is good research showing lasting benefits.
I would not use Mirtazpine as a first choice for a new depression, and there are other varities of AD which might both be more helpful for you and without these particular side-effects.
You're right to ask for good scientific proof - if we waited for totally conclusive proof in most useful medical interventions, a great many people would suffer for far longer without the help they deserve.
Do, by all means, ask for a discussion of relevant research, but don't just accept the negative conclusions of people with a strong bias who are often selling a different or rival approach.
Criticising ADs as "mind-altering" is a bit odd - DEPRESSIon is, beyond question, horribly and dangerously mind-altering, and something that will alter the mind in a more useful way is worth considering seriously.
"no better than placebos" is also a dodgy argument. In most of the research, such drugs are tested comparatively against either placebos ( which certainly do have some benefits ) and against existing, standard drugs. It'd be hard to get them licensed for sale without reasonable proof of benefits beyond those of placebo.
The utter give-away of the source of your bias is when you quote the enormousl biased website of the CCHR - which is considered a front for Scientology, an organization which in some countries has been banned and in other has been refused the status it asked for, as a religion. They carefully collect all the negative material they can, about psychiatriy in general and psych treatments - because they are proposing and selling a competitive approach, that of Scientology, for which there is not any good evidence of effectiveness and safety - but of course they don't really discuss that in such websites.

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Our users say:
Posted by: roger | 2010/10/18

CCHR is not linked to scientology - it was merely founded by the same person, not really the same thing?. Scientology is about the subect of scientology, cchr is the citizens commission on human rights, an organisation which investigates and exposes psychiatric violations of human rights (child drugging, electric shock treatment, involuntary incarceration, misdiagnosis, etc etc - stuff that is going on in SA and globally) - the subject in itself being nothing at all to do with scientology. Get your facts right Doc. Funny that Scientology have NEVER lost a court battle yet???



Reply to roger
Posted by: truth | 2010/10/17

OK doc. Thanks for a very insightful and elaborate answer. I never knew that CCHR is linked to Scientology and that places things in a complete new perspective.
I will contact my prescribing pscyhiatrist first thing in the morning and get him to review my medicine. I still believe that medicine only play a part in the recovery process albeit a more substantial role than I initially thought.

Reply to truth
Posted by: truth | 2010/10/17

OK doc. Thanks for a very insightful and elaborate answer. I never knew that CCHR is linked to Scientology and that places things in a complete new perspective.
I will contact my prescribing pscyhiatrist first thing in the morning and get him to review my medicine. I still believe that medicine only play part in the recovery process albeit a more substantial role than I initially thought.

Reply to truth
Posted by: truth | 2010/10/17

OK doc. Thanks for a very insightful and elaborate answer. I never knew that CCHR is linked to Scientology and that places things in a complete new perspective.
I will contact my prescribing pscyhiatrist first thing in the morning and get him to review my medicine. I still believe that medicine only play part in the recovery process albeit a more substantial role than I initially thought.

Reply to truth
Posted by: cybershrink | 2010/10/16

When you google such a broad subject with such a VERy ooaded phrase, you'll selectively find a load of very highly biased, inexpert and exclusively critical stuff. Evidence on the valuee of such drugs will not be picked up as "the truth about..." Search with biased terms, and you will find biased material, from people with personal axes to grind.
To deny that there is such thing as Depression is simply naive and stupid - it has existed throughout human history, and in every culture known on earth.
Now, I certainly don't believe that the evidence for specific ADs is overwhelming or conclusive, but it is true that a significant proportion of depressed people find benefit from such drugs. I don't think, though, that more than 70 % at most, find significant benefits from any one drug, so there are fairly good odds that the first one tried might not suit your highly individual brain chemistry and prove helpful.
I despair of doctors ( you don't mention whether you're being treated by a specialist psychiatrist or only a GP ) who prescribe ANY drug to ANYONE at ANY time, without a full explanation of the diagnosis, the drug, what it may or may not do, possible benefits, side-effects, and so on. They should ALWAYS review your progress or lack of it on any new drug within the first month, and if you have not reacted favourably to an AD within a month, its is perfectly clear that this is not the right treatment for you, and a different plan should have been made.
Perhaps you should consider a non-drug method, such as CBT, Cognitive-Behaviour Therapy, where there is good research showing lasting benefits.
I would not use Mirtazpine as a first choice for a new depression, and there are other varities of AD which might both be more helpful for you and without these particular side-effects.
You're right to ask for good scientific proof - if we waited for totally conclusive proof in most useful medical interventions, a great many people would suffer for far longer without the help they deserve.
Do, by all means, ask for a discussion of relevant research, but don't just accept the negative conclusions of people with a strong bias who are often selling a different or rival approach.
Criticising ADs as "mind-altering" is a bit odd - DEPRESSIon is, beyond question, horribly and dangerously mind-altering, and something that will alter the mind in a more useful way is worth considering seriously.
"no better than placebos" is also a dodgy argument. In most of the research, such drugs are tested comparatively against either placebos ( which certainly do have some benefits ) and against existing, standard drugs. It'd be hard to get them licensed for sale without reasonable proof of benefits beyond those of placebo.
The utter give-away of the source of your bias is when you quote the enormousl biased website of the CCHR - which is considered a front for Scientology, an organization which in some countries has been banned and in other has been refused the status it asked for, as a religion. They carefully collect all the negative material they can, about psychiatriy in general and psych treatments - because they are proposing and selling a competitive approach, that of Scientology, for which there is not any good evidence of effectiveness and safety - but of course they don't really discuss that in such websites.

Reply to cybershrink
Posted by: psychbuster | 2010/10/15

ja its also known as ''the marketing of madness'' - the more people who are sane and well, the less money for them. so the more mental disorders they can invent, the more drugs they can sell! According to one psych, " there''s just no money in normal"  !!!

Reply to psychbuster
Posted by: flower | 2010/10/15

thanks Lize, I also wake up many times at night

Reply to flower
Posted by: truth | 2010/10/15

Liza, I never used to be a fan of CBT but have recently changed my mind about it. (Excuse the irony).
It takes a lot of discipline to gain control over a mental illness, both physically and mentally. The good thing is that once you are in control of your thinking habits you can extend this discipline to all spheres of your life and become a better, healthier person. I am currently reading Scott Peck''s " the Road less travelled"  again and find some of his ideas quite remarkable.
The idea that people with mental problems just sit around and wait for the meds to kick in and do all the work for them is very simplistic and misleading.

Reply to truth
Posted by: Liza | 2010/10/15

First off - this takes practice - lots and LOTS of practice.

Usually when a person has a panic attack, they don''t recognize the early signs and when the panic attack goes full-blown it is MUCH harder to stop. CBT counseling has taught me how to recognize the very early signs. When I do start with the early signs, I do various things to take my mind off anxiety completely. Like listen to music really loudly and actually sing along (not always aloud cause I work in an open-plan office - earbud earphones prevent other people from having to suffer from my loud music  ) Sometimes I just take a break and go outside for a smoke. Smoking helps me to control my breathing - so that I breathe in deeper and breathe more slowly. When I breathe slower, I feel less anxious - and the less anxious I feel, the quicker the panic attack goes away again.

It also helps to learn what your panic attack triggers are and not to avoid them. One of my triggers are standing in a queue at a till-point in a busy shop. When I just started using the CBT techniques, I took my mp3 player along when I went shopping and did the loud music thing. It didn''t always work, but I persevered and now I don''t even need the mp3 player anymore. You just need to break the circle where the anxiety itself causes more anxiety.

Insomnia is still a problem for me. I''ve taught myself how to fall asleep quicker by using either meditation or progressive relaxation, but my main problem is waking up a lot during the night - not falling asleep.

Reply to Liza
Posted by: flower | 2010/10/15

and what can one do, with the racing thoughts when its time to sleep at night, this goes on and on for hours I hate it, thats why I drink alcohol every night otherwise I will never sleep, should I just pop sleeping pills

Reply to flower
Posted by: flower | 2010/10/15

exactly, I felt peace and calmness for the first time in my whole life when i had a few drags of green, how do you get through the panic attacks Liza, I instictively can feel sometimes when I am having a bad panic attack I MUST NOT TOUCH the green stuff it just sends the panic attack into overdrive I'' have even blacked out now and again , in my case it was the mental illness that made me turn to the green

Reply to flower
Posted by: Liza | 2010/10/15

If you have been on the medication for a month and it hasn''t worked - why are you still taking it? Why haven''t you gone back to your prescribing psychiatrist to try something else?

I''ve been on various anti-depressants over the past couple of years and I can tell you that they''ve saved my life more than once! Then there are also the ones that make you feel like something the cat dragged in - in this case you have to go back to the prescribing psychiatrist to discuss other options. I do not trust GP''s who prescribe AD''s because they only want to prescribe a pill - not listen to what you have to say. In my view CBT style counseling is essential in conjunction with medication.

I''ve read what Dr D Kaiser has to say on psychiatry and it''s amazing how he just focuses on depression and completely ignores disorders like bipolar and schizophrenia in his discourse. He also advocates psychoanalysis - something that I''ve come to be VERY sceptical about. CBT style counseling has scientifically been proven as more effective than psychoanalysis. I still remember enduring hours and hours of psychoanalysis - without benefit. Just a couple of CBT counseling sessions and some practice in the techniques - Viola! I can even handle a panic attack without medication!

There will always be opposing views in psychiatry where scientific studies either try to prove or disprove accepted practices. The problem is that there are so many different variables, that many of them are ignored in particular studies - and then compared to a study that focused on a completely different subset of variables. As an example I take a recent study done on marijuana use. In it their ''results'' showed that marijuana users are more prone to suffer from mental illness. Great - the only problem is that the results could mean something completely different - i.e. that people who suffer from mental illness, are more prone to using marijuana. It''s the chicken and the egg all over again. Is it the marijuana that causes mental illness? Or is it the mental illness that makes sufferers turn to marijuana?

Just my view.
Liza

Reply to Liza
Posted by: Flower | 2010/10/15

ja those panic attacks are really dreadful, I HATE having them, i''ve had them since I was five years old, I used to go to my mother and tell her I could feel the devil was in my bedroom, which she thought was a lot of hogswash, but I did''nt know what was a panic attack at 5, I also had chronic insomania as a child and used to sit wide awake in the pitch dark, i knew something was wrong with me when I was a kid but I did''nt know what and my parents did''nt know about any of these kind of things, it was only years and years later that i realised i am most probably bi-polar going by my own calculations of being very up and then very down, I''ve read as much as I can over the years or suffer from manic depression and what not, life had been damn hard with all this stuff going down, I have''nt ever been for councelling, because of the cash involved and lack of trust in general
otherwise i''m actually more cheerful and nicer, gentler and kinder than most people LOL its a crazy world...

Reply to Flower
Posted by: Flower | 2010/10/15

actually you''ve just given me a brilliant idea, I have a gym at work
so I must join and I think I must start on Monday I can go in my lunch hour, they have showers and so on, so it will be fine, I am unfit and have''nt exercised for ages, and i know this will be very very good for me, I HAVE to cut out the alcohol more than I am as i know for a fact it can actually bite me on the backside, because the next day a person can feel all down again and it IS because of the alcohol I know this, sort of a vicious circle, thanks for inspiring me, one can hardly discuss this sort of thing with just anyone as you well know, its kinda like my secret that i hide from people

Reply to Flower
Posted by: truth | 2010/10/15

I hear you, Flower. One person''s medicine is another''s poison. I must say that from all the different therapies I have engaged in stenuous anearobic excercise have worked best. After my previous Major Depressive episode I excercised like crazy (I did serious martial arts training) and I felt so good I went off the AD''s completely. After I moved to another town I stopped the martial arts, became unfit again and went into another Major Depressive episode. Now I am back on track again with another Martial arts school and I must say that this training is the only thing that focusses my body and mind and make me forget about this terrible ilness.
There is scientific evidence that prove that excercise actually work better than AD''s although the symptom relieve might take a bit longer. IMO it is because excercise adress the root of the depression where as meds only disguise the symptoms.
I dont know about marijuana though. It now has an adverse effect on me but then again I sererely abused the drug when I was a teenager. If it works for you, cool. Taking all things in consideration marijuana is anyway a much more benign drug than the benzodiasipines (Xanor, Alzam, Urbanol etc..)

Reply to truth
Posted by: Flowers | 2010/10/15

oh yes, tranqilizers the Alzam or Xnor 0.25mg does help me I take them on and off, they do go a long way, I also pray a lot and meditate

Reply to Flowers
Posted by: flowers | 2010/10/15

I heard on tv the other day, that the new way of thinking these days for depression and so on is they want to start using mood stabelizing drugs that they use for people that get epilectic fits, because lots and lots of people actually commit suicide when they are on the anti depressants, I was suicidal and the doctor put me on abti depressants, what a bloody nightmare, first I became outrageaously aggresive and actually hit someone on the head with my handbag and on another occasion smacked someone through the face and another occasion threw bottles violently at someone else and these were all peopl I knew, next thing I felt soulness as if I was a ghost, I had no feelings whatsoever, THAT was scarey, sometimes I could''nt feel the ground I was standing on, so i threw them in the toilet and swore never again, I self medicate with smoking small amounts of dagga and having a glass of wine or two or three, and God knows its not okay to self medicate, I still get terrible sadness and still cry and still get suicidal now and again, but I will NEVER take anti depressants again

Reply to flowers
Posted by: truth | 2010/10/15

Oh and in case you wondered, I have done everything by the book. I have done extensive psychotherapy, I drink my meds religiously, I eat healthy, I excercise 6 time a week, I give meticulous attention to my spiritual life and I have completly given up alchohol. Still no noticable improvements.

Reply to truth

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