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Dr. Bob is Robert Hsiung, MD,
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Posted by seldomseen on October 25, 2009, at 13:54:48
In reply to Re: Why antidepressants don't work for so many » bulldog2, posted by floatingbridge on October 25, 2009, at 13:38:35
IMO, one should never apologize for being honest. I imagine a lot of people might be upset or confused by this study.
It's okay. We don't even know if any of this will withstand the rigors of peer review, or if these result will translate to humans at all.
Again, it's too early to say anything. Like many studies of this type, I suspect not much will come of it, but that's just my opinion.
Take care.
Seldom
Posted by Fred23 on October 25, 2009, at 14:23:28
In reply to Why antidepressants don't work for so many, posted by jrbecker76 on October 25, 2009, at 9:44:54
> Antidepressants Treat Stress Not Depression
This may explain why I've had success with Lexapro and Klonopin being effective in relieving my general anxiety levels and preventing panic attacks.
Posted by bulldog2 on October 25, 2009, at 14:26:00
In reply to Why antidepressants don't work for so many, posted by jrbecker76 on October 25, 2009, at 9:44:54
You post this as if it is a proven theory. You have to prove this using people. You say rat brains are similar to human brains. That still does not prove anything.
The great majority of these animal studies never end up correlating in humans.
Posted by linkadge on October 25, 2009, at 15:03:57
In reply to Re: Why antidepressants don't work for so many » jrbecker76, posted by bulldog2 on October 25, 2009, at 13:25:03
>6. I still believe that depression is not a >disease but a symptom of possibly many diseases.
I think depression is a disease.
>The flaw in the research that looks for drugs >for this disease is that rearch in reality is >looking for a drug that will control this >symptom so you end up with drugs that help about >somewhat over 60% of people.
I think that number is still overinflated. I also think that if you want to help a person get *well* you need to uncover the mechanism of the disease.
Posted by linkadge on October 25, 2009, at 15:13:50
In reply to Re: This is a rat study!, posted by bulldog2 on October 25, 2009, at 14:26:00
I think this is good research because it is at least attempting to look for alternatives to monoamine based approaches.
I think it is also good because it casts the depressive illness in a better light.
With the stress induced depression theory, depressed patietns are just pathetic wimps who cannot control the stresses of everyday life very well.
At least this study says no, there is something more fundamentally wrong with depressed patients than just people succumming to the stresses of everyday life.
I'm sure stress, like pain can induce depression.
But, I still think there is something more fundamentally wrong.I don't know if the finding of increased adrenal weight has been confirmed in other studies.
I just know with me, the anxiety and depression are for the most part two separate entities.
Linkadge
Posted by bulldog2 on October 25, 2009, at 15:44:29
In reply to Re: This is a rat study!, posted by linkadge on October 25, 2009, at 15:13:50
> I think this is good research because it is at least attempting to look for alternatives to monoamine based approaches.
>
> I think it is also good because it casts the depressive illness in a better light.
>
> With the stress induced depression theory, depressed patietns are just pathetic wimps who cannot control the stresses of everyday life very well.
>
> At least this study says no, there is something more fundamentally wrong with depressed patients than just people succumming to the stresses of everyday life.
>
> I'm sure stress, like pain can induce depression.
> But, I still think there is something more fundamentally wrong.
>
> I don't know if the finding of increased adrenal weight has been confirmed in other studies.
>
> I just know with me, the anxiety and depression are for the most part two separate entities.
>
> LinkadgeRegardless of what you think of the study it is still a rat study. Until the results are duplicated in people that is all it is.
As far as to wether it is a disease or a group of symptoms this was my point. Cancer is a called a disease also. But it is turning out to be a cluster of diseases. At this point it doesn't look like there will be a silver bullet that cures all cancers but each cancer may require a separate approach. Depression may turn out to be a cluster of diseases also and many approaches may be required.Some evidence of this is the fact that you said that anxiety has no part in your depression. For me anxiety had a big part and for many it does.
Maybe we agree on one thing. The cause or causes are needed before we find better cures. I don't mean hypothesis I mean proven facts.
That means studies done on people. Rat studies in the majority of cases will not be found true in people wether you like the study or not. Let this scientist now duplicate this study with people and it becomes credible.
I'm not interested in a long debate with you on this. As of today this is a hypothesis done with a group of rodents.You can love this hypothesis all you like but like most rat studies will burn and fizzle away like a broken rocket.
Posted by SLS on October 25, 2009, at 15:53:26
In reply to Re: Why antidepressants don't work for so many, posted by linkadge on October 25, 2009, at 15:03:57
Absolute crap.
- Scott
Posted by linkadge on October 25, 2009, at 17:11:04
In reply to Re: This is a rat study!, posted by bulldog2 on October 25, 2009, at 15:44:29
>Regardless of what you think of the study it is >still a rat study. Until the results are >duplicated in people that is all it is.
It won't be replicated in human studies as it would be unethical to expose humans to experimental stress sufficiant to alter gene expression.
>As far as to wether it is a disease or a group >of symptoms this was my point. Cancer is a >called a disease also. But it is turning out to >be a cluster of diseases.
Well, its the same end result regardless of the exact etiology. All I am saying is that I think there are a subgroup depressed patients for whom everyday stress is not the *cause*.
>Depression may turn out to be a cluster of >diseases also and many approaches may be >required.Some evidence of this is the fact that >you said that anxiety has no part in your >depression. For me anxiety had a big part and >for many it does.
BIG Note** this study does not say that anxiety is not associated with depression. All it says is that exposing rats to stress alone is insufficiant to create the same altered gene experession that exists in a disease model of depression.
It does not say that the disease model was not experiencing anxiety.
I think this is a very important study because it aims to verify the validity of a disease model of depression in animals. I.e. there is something different about the depressive line of rats than simply taking normal rats and exposing them to stress. The flinders sensitive line is appears to have similar neurobiological underpinnigs to human depression. They exhibit abormalities in sleep, feeding and neuroendocrine function in the absence of stress. They are also responsive to standard antidepressant treatments.
This is a key problem with the posted study. It does not indicate whether or not the disease model of depressive rats used responded to standard antdiepressant treatments. If they did, then (while it does not contradict the findings of the study) it does contradict the conclusions - ie. the reason why standard antidepressant treament is inneffective for many depressed patients.
For many patients with severe, chronic depression
there are evidently no identifyable environmental causes. Patients with bipolar disorder can be up when the world is down and down when the world is up. There is something out of sync. There brain is not responding properly to the environment.My siblings and I grew up in the same house, went to the same school, ate the same food. Yet one of us has sufferent chronic depression since adolecence. I was not subjected to any more stress them. How is my depression caused by stress?
>I'm not interested in a long debate with you on >this. As of today this is a hypothesis done with >a group of rodents.You can love this hypothesis >all you like but like most rat studies will burn >and fizzle away like a broken rocket.
Everything in psychiatry a hypothesis, what exactly are you getting at? Don't stomp on everything that is new and different just because it may not lead to immediate clinical application. I applaud people for thinking outside the box yet some babblers don't give a rats *ss (no punn indented).
Linkadge
Posted by linkadge on October 25, 2009, at 17:30:55
In reply to Re: Why antidepressants don't work for so many, posted by SLS on October 25, 2009, at 15:53:26
It is you of all people SLS that I would expect to produce such a narrowminded responce.
You have always held that there are true neurobiological underppinings to severe chronic depression that many people experience.
You know something about the biological and structural abnormalities that are evident in depression. You, on many occasions, have expressed uncertainty as to whether these are a cause of or response to depression/anxiety.
To call this study absolute crap is to basically say the contrapositive. That is, that all depression is caused by stress. In other words SLS, there is nothing fundamentally wrong with you. The only reason you are depressed is because you are unable to deal with stress effectively.
Yes, that is what you are concluding by saying this study is crap.
Look folks, this isn't rocket science. All this study really concluded is that a group of mice (that have a gene profile that results in tendencies towards depression) is still fundamentally different than a group of mice which have simply been exposed to stress. It actually helps to verify the notion that there is something fundamentally different about depressed people.
Sure, if you want to go on believing that the reason you're depressed is becuase you have a stressful life then be my guest. It really doesn't help plead your case to the lay person (who already things depressed people are just a bunch of people too weak to handle the pressures of everyday life).
Note**, this study does also *not* suggest that stress can't be the straw that breaks the camels back so to speak. Its not unreasonable to suggest that the mice with both the "disease model" gene profile and "stress induced" induced gene profile didn't feel worse than either alone.
All it is suggesting is that the mice who had the depression like behavior before the stress had something different about them.
Think back to your life. So, if it was stress that made you depressed, how was your life before that? Would you have considered yourself perfectly well up until the point that stress caused clinical depression??
Research in humans does seem to suggest that even in people who do have depression that was triggered by stress, there were subtle behavioral differences before the onset of the first episode.
Did people even read the study. Do people even realize what it found??? - or do they just read the headline and disagree with that???
Linakdge
Posted by Cecilia on October 25, 2009, at 18:10:00
In reply to Why antidepressants don't work for so many, posted by jrbecker76 on October 25, 2009, at 9:44:54
I don't get it. How do you even know if a rat is depressed? They certainly don't get depressed the way people do. They may have a few of the same physical symptoms that some humans get, but the worst symptoms, the feelings, the self hate and shame and hopelessness and despair and constant terrifying panic and loneliness and guilt-doubt rats get any of these, animals live in the moment, not in the past which equals depression or the future which equals anxiety. I suppose it's possible they do get some of these feelings but how would the researchers know. Cecilia
Posted by Phillipa on October 25, 2009, at 19:02:30
In reply to Re: Why antidepressants don't work for so many, posted by Cecilia on October 25, 2009, at 18:10:00
I know for me anxiety has always been my problem. Have to be on the go or involved in something. Is that depression? I don't cry. I fear the future. Phillipa
Posted by Sigismund on October 25, 2009, at 19:06:18
In reply to Re: Why antidepressants don't work for so many, posted by Cecilia on October 25, 2009, at 18:10:00
>I don't get it. How do you even know if a rat is depressed?
Exactly
>They certainly don't get depressed the way people do.How do you know?
>They may have a few of the same physical symptoms that some humans get, but the worst symptoms, the feelings, the self hate and shame and hopelessness and despair and constant terrifying panic and loneliness and guilt-doubt rats get any of these, animals live in the moment, not in the past which equals depression or the future which equals anxiety. I suppose it's possible they do get some of these feelings but how would the researchers know.I think it's as possible as it is impossible, which is to say I have no idea.
I feel sure that humans have had strange ideas about what animals do or do not feel.
Posted by TenMan on October 25, 2009, at 19:24:19
In reply to Re: Why antidepressants don't work for so many, posted by Sigismund on October 25, 2009, at 19:06:18
The monoamine hypothesis is a joke. I'm glad this study was conducted and I share linkadge's sentiments. Finally research is starting to look in other directions besides the stressed rat. Looking back, this could be groundbreaking.
Posted by psych chat on October 25, 2009, at 21:25:14
In reply to Why antidepressants don't work for so many, posted by jrbecker76 on October 25, 2009, at 9:44:54
Maybe the rats are observed to be depressed because they don't eat, they sleep all day, don't interact socially, don't mate, etc.
?
Posted by Sigismund on October 25, 2009, at 22:37:11
In reply to Re: Why antidepressants don't work for so many, posted by psych chat on October 25, 2009, at 21:25:14
They must mate, or maybe it was done by AI?
Posted by SLS on October 26, 2009, at 4:32:40
In reply to Re: Why antidepressants don't work for so many » SLS, posted by linkadge on October 25, 2009, at 18:30:55
Ok. You are right. You convinced me.
:-)
I was hasty in condemning the whole paper.
I guess the part that elicited a strong reaction in me was that in which the author of the paper proposed that antidepressants treat stress rather than depression. I interpreted it out of context. However, the rationale that there are few genes that overlap between stress and depression does little to refute the idea that one can trigger the other. Other than that, the paper offers some new perspectives that might require a change in rat study paradigms.
Poor, poor depressed rats. :-(
- Scott
Posted by Netch on October 26, 2009, at 7:40:08
In reply to Re: Why antidepressants don't work for so many » linkadge, posted by SLS on October 26, 2009, at 4:32:40
Looking for the etiology of depression is always a good thing. I'm fed up with all the money and time spent on trying to show the effectiveness of SSRI.
Posted by linkadge on October 26, 2009, at 8:09:40
In reply to Re: Why antidepressants don't work for so many, posted by Sigismund on October 25, 2009, at 20:06:18
They can tell a lot more than you might think about how the rat is feeling.
Like humans, depressed rats:
- Show sleep abnormalities such as early entry into rem sleep.
- Show hypersensitivity to cholinergic agents
- Show exaggerated fear reactions to new or other mice (humans)
- Show reduced tendencies to explore novel environments
- Elevated corticosterone and altered HPA axis function
- Show anhednonic tendencies such as reduced interest in sex, and reduced behavioral responces to drugs like cocaine
- Show diminished neuroendocrine responces to serotonerigc agents
- Show altered levels of cerebral monoamines and neuropeptides.
- Exhibit learning difficulties
- Suffer from elevated noradrenaline release in responce to stress and are often hypertensive.
- Many of these behavioral and neuroendocrine effects resolve with the administration of antidepressant agents and ECT, but not non antidepressant compounds
Ok so sure, so perhaps they can't tell what the rat is *feeling*, but don't suggest that they cannot make grounded inferences based on good research.
Animal models exist for many diseases and are often valid predictors of the sucess of drugs in humans.
Sure, perhaps only one in 8 drugs sucessful in rats ever proves to be useful in humans, but there are plenty of reasons for this. A compound may be an effective antidepressant yet clinically unuseful due to side effects. Its not as if all 7 out of 8 of those drugs do not have antidepressant effects in humans.
Linkadge
Posted by bulldog2 on October 26, 2009, at 9:57:37
In reply to Re: Why antidepressants don't work for so many » linkadge, posted by SLS on October 26, 2009, at 4:32:40
> Ok. You are right. You convinced me.
>
> :-)
>
> I was hasty in condemning the whole paper.
>
> I guess the part that elicited a strong reaction in me was that in which the author of the paper proposed that antidepressants treat stress rather than depression. I interpreted it out of context. However, the rationale that there are few genes that overlap between stress and depression does little to refute the idea that one can trigger the other. Other than that, the paper offers some new perspectives that might require a change in rat study paradigms.
>
> Poor, poor depressed rats. :-(
>
>
> - Scott
>1. Scott makes an important point about the overlap of genes really does not refute the idea that stress can trigger depression.
2. It would not be immoral to do this study in people. Just take soldiers in Iraq or afgahanistan and test them.
3. I remember seeing articles about the high rate of suicide and depression among soldiers in Iraq. That was during the high combat days. You don't think that might have anything to do with stress.
4. My p-doc told me of a study where rats were in a cage where everytime they tried to cross an electronic barrier they were shocked. Eventually they became stressed.
5. It's very common that people under heavy stress often become depressed.
6. So we know stress can trigger depression.
7. Apprently some people can become depressed without depression.as you said you are.
8. You might make a case that the ssris address depression by modulating stress. However that would not be the case with tcas.
9. The reality is real world studies are more important than a rat gene study. Stress is a trigger for some. Maybe you need to have a depression gene to make this connection. But you still have to prove this in people.
10. I have seen studies that show how inaccurate animal studies are. And Link they are immoral. These animals have rights and these rights include not to be abused tortured for studies that rarely pan out. I saw a study that showed a ridulously low percentage that yield useful data.However great for grants and funding.
11. If studies on people which would be the most accurate since we are treating people are immoral. I've read that computer modeling of people might be the way to go.
12. I am not stepping on the study. But I'm not sure she has even made her point with rats. But it is worth exploring.
13. At this point i'm not sure what this scientist has given us to develope new ads.
14. I agree with you that we need better drugs. We also need bette diagnostics that would lead to better use of the drugs we have
Posted by bleauberry on October 26, 2009, at 17:54:21
In reply to Why antidepressants don't work for so many, posted by jrbecker76 on October 25, 2009, at 10:44:54
As with all scientific studies, this one has some merits and some flaws, but overall...like all others...is much too narrow and limited in scope.
For example...
Is a neurotransmitter deficiency involved in SOME depressions? Yes. We know this because SOME people feel immediate relief within hours of taking 5htp and it continues for months, until they realize they now have too much serotonin, at which time they get remission back by lowering the dose or adding tyrosine to it. Those people had low serotonin.
Is stress involved with SOME depressions? Yes. We know this because stress will cause things like hypoadrenalism, where people's depressions disappear with adrenal extract supplements, adaptogen herbs, and improved lifestyles, and in stubborn cases low replacement doses of hydrocortisone.
Are hormones of all kinds involved in SOME depressions? Yes. We know this from women's monthly cycles and menopause. Treat the hormones correctly and the depression disappears. Wait for the few days a month to pass, and the depression disappears.
We also know that because when someone has the symptoms of hypothyroid, yet their lab tests appear ok, but they are given thyroid therapy anyway based on clinical symptoms (smart doctor), their depresesion goes away along with all the other hypothyroid symptoms. (the test was wrong...but that's another story in itself)
Is sunlight involved in SOME depressions? Yes. We know this because some people respond well to bright light therapy.
Are infectious diseases involved in SOME depressions? Yes. We know this because their depression disappears on antibiotics, antivirals, antifungals. This happens A LOT in other forums.
Are heavy metals involved in SOME depressions? Yes. We know this because a lot of people feel a ton better when amalgams are removed and/or they have undergone some rounds of oral chelation.
And well, this list could go on for another couple hours. The causes of depression are not simply either neurotransmitters or stress. It is a bigger picture than that.
With all this in mind, I see this particular study as being like so many others...too narrow.
We do know that the chelation drug DMSA easily crosses the rat's blood brain barrier but it is still of debate whether it crosses the human blood brain barrier...most researchers say it does not, and that the rat BBB is not the same as the human BBB. With just that one tidbit of info, one has to kind of at least be a little bit suspicious when any researcher tries to make implications for the human brain based on what happens in a rat brain. And other than doing certain behavioral tests with rats that we SUPPOSE mimic depression, we can't actually ask the rats how they feel, so we don't even know if the supposed depression they feel is the one we feel.
Interesting study, but not useful.
Posted by zzzz7 on October 26, 2009, at 22:27:40
In reply to Re: Why antidepressants don't work for so many, posted by Cecilia on October 25, 2009, at 19:10:00
Well, you tell via behavior, the same way you tell anyone is depressed. A behavior the look for in rats is a lack of response/diminished response to pain ("learned helplessness").
The headline on this newspaper article is really misleading.
Posted by Cecilia on October 27, 2009, at 1:09:07
In reply to Re: Why antidepressants don't work for so many » Cecilia, posted by zzzz7 on October 26, 2009, at 22:27:40
Well, I don't know about rats, but plenty of humans hide their depression. They get up and go to work every day, smile and say "fine" when people ask how they are, even if they're suicidal inside. It's always seemed strange to me that psych departments are so often called departments of "behavioral health", like all that matters is how you behave on the outside, not how you feel on the inside. Cecilia
Posted by floatingbridge on October 27, 2009, at 10:53:02
In reply to Re: Why antidepressants don't work for so many » zzzz7, posted by Cecilia on October 27, 2009, at 1:09:07
This is turning out to be an interesting thread!
fb
Posted by Phillipa on October 27, 2009, at 19:07:29
In reply to Re: Why antidepressants don't work for so many » zzzz7, posted by Cecilia on October 27, 2009, at 1:09:07
I applaud any of you that feel suicidal and manage to work I could never do that. Phillipa
Posted by psychobot5000 on October 27, 2009, at 21:16:54
In reply to Re: Why antidepressants don't work for so many, posted by bleauberry on October 26, 2009, at 17:54:21
"Interesting study, but not useful."
-If it provides modest evidence that a paradigm that still dominates thinking about the etiology of depression is wrong, that in itself is useful. Without knowing the true cause (i.e. not the problematic and simplistic monoamine hypothesis), we're not likely to find better solutions.
Psychbot
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