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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 23 of 23. This is the beginning of the thread.
Posted by bulldog2 on October 26, 2009, at 15:16:29
There is another post that lists some links to be read about their long term effects?
These drugs are handed out like candy by primary docs who believe in their safety. So they have become first line ads. Yes possibly short term safety. In reality they may actually function in a similar way as the old traditional psychotic drug functions. That is by disrupting dopamine.It seems as if they cause down regulation of dopamine which can have many negative health consequences.
At this point I will not take an ssri. I will consider maois or tcas or a combination. Wellbutrin and other atypical ads may also be safer than the ssris.
I find it amazing that the scientists that engineered this drug were not able to forsee the consequences of an ssri. That dopamine would be disrupted with many health consequences. When you disrupt dopamine your hormonal system is sent out of whack.
I remember all the hoopla when these drugs emerged. They were better than all the old ones. They were miracle drugs. Were they tested long enough to see what harm they could do?
The tcas and maois may be dirty with bothersome sides but at least don't pinpoint one neurotransmitter which appears to have long term consequences on the other ones.
Doctors (p-docs and others) need to be educated about the ssris and their long term effects. Primary care docs who got into the mental health field with the advent of ssris have to be educated about other alternatives if they wish to continue prescribing ads. Now it is so simple for them. You're depressed and they write out a script for Lexapro.
Posted by seldomseen on October 26, 2009, at 15:48:17
In reply to Should SSRIs Be Taken Off The Market?, posted by bulldog2 on October 26, 2009, at 15:16:29
I don't know, Prozac has been on the market for over 20 years and was/is pretty wide prescribed.
How long term are you talking about for long term effects to show up?
Seldom.
Posted by ricker on October 26, 2009, at 15:59:40
In reply to Should SSRIs Be Taken Off The Market?, posted by bulldog2 on October 26, 2009, at 15:16:29
> You're depressed and they write out a script for Lexapro.
Lexapro is working great for me so to answer your question, No, they should not be taken off the market. Just because "some" don't do well with ssri's should not justify a blanket observation.
Many don't do well with atypicals....take them off the market!!!!!Regards, Rick
Posted by maxime on October 26, 2009, at 16:24:45
In reply to Should SSRIs Be Taken Off The Market?, posted by bulldog2 on October 26, 2009, at 15:16:29
For some people, SSRIs are the answer. Besides, they would never take them off the market.
Posted by bleauberry on October 26, 2009, at 17:34:38
In reply to Should SSRIs Be Taken Off The Market?, posted by bulldog2 on October 26, 2009, at 15:16:29
I do not believe SSRIs should be taken off the market.
I do however believe the following:
1) In the medication category, TCAs and MAOIs should be first line, SSRIs second line. Right now they got it backwards. I feel it's about the money. There isn't any money in the old drugs. But they do have a solid track record even after 50 years. SSRIs don't. I also believe "selective" is not necessarily the great thing it is claimed to be. Dirtier drugs seem to work better.
2) As long as the depression is not suicidal or totally incapaciting, natural probing should be tried before drugs...5htp, tyrosine, dlpa, adrenal cortex extract. Try to find out which circuitry is involved by the response to these substances, which is noted within hours or days, with a 50% chance of finding what works great before the med hunt even begins, or at least honing in on what kinds of meds to consider. Very few studies to go on however. Again, the money thing. Back in the 1980's there were a couple studies on DLPA at rather small doses, with the response rate of a comparable TCA taking the lead in the early weaks, but DLPA catching up and even surpassing it by week 6. I think the whole natural approach to healing has taken a sad backseat, primarily due to lack of study and knowledge, and lack of profit.
3) Follow Germany's expertise on plant chemistry. St Johns Wort is prescribed (it is not OTC) 6 times more often than Prozac. That wouldn't be happening if it wasn't working. Another lesser known one is Rhodiola Rosea.
Whatever the course of action, I believe SSRIs should be last in line, not first.
Posted by bulldog2 on October 26, 2009, at 18:17:26
In reply to Re: Should SSRIs Be Taken Off The Market?, posted by bleauberry on October 26, 2009, at 17:34:38
> I do not believe SSRIs should be taken off the market.
>
> I do however believe the following:
>
> 1) In the medication category, TCAs and MAOIs should be first line, SSRIs second line. Right now they got it backwards. I feel it's about the money. There isn't any money in the old drugs. But they do have a solid track record even after 50 years. SSRIs don't. I also believe "selective" is not necessarily the great thing it is claimed to be. Dirtier drugs seem to work better.
>
> 2) As long as the depression is not suicidal or totally incapaciting, natural probing should be tried before drugs...5htp, tyrosine, dlpa, adrenal cortex extract. Try to find out which circuitry is involved by the response to these substances, which is noted within hours or days, with a 50% chance of finding what works great before the med hunt even begins, or at least honing in on what kinds of meds to consider. Very few studies to go on however. Again, the money thing. Back in the 1980's there were a couple studies on DLPA at rather small doses, with the response rate of a comparable TCA taking the lead in the early weaks, but DLPA catching up and even surpassing it by week 6. I think the whole natural approach to healing has taken a sad backseat, primarily due to lack of study and knowledge, and lack of profit.
>
> 3) Follow Germany's expertise on plant chemistry. St Johns Wort is prescribed (it is not OTC) 6 times more often than Prozac. That wouldn't be happening if it wasn't working. Another lesser known one is Rhodiola Rosea.
>
> Whatever the course of action, I believe SSRIs should be last in line, not first.ST Johns Wort is one herb that has a proven track records and some studies that show efficacy.If you use it use a product with standardized hyperforin in the 3 to 4 percent range.
However be aware there are two potential problems with sjw. There appears to be a connection between sjw and cataracts. Also sjw can alter prescription medication levels in your bloodstream which can alter how they work.
Posted by Phillipa on October 26, 2009, at 20:18:41
In reply to Re: Should SSRIs Be Taken Off The Market? » bleauberry, posted by bulldog2 on October 26, 2009, at 18:17:26
That's true. From what I've read. Phillipa
Posted by cactus on October 26, 2009, at 22:48:29
In reply to Should SSRIs Be Taken Off The Market?, posted by bulldog2 on October 26, 2009, at 15:16:29
I can't take/tolerate them, they are like poison to me but they do help a lot of people. I was all for having them banned, especially after coming off Zoloft and Efexor but they work wonders for 1 of my sisters but not the other, and definitely not for me.
Posted by metafunj on October 27, 2009, at 10:14:56
In reply to Should SSRIs Be Taken Off The Market?, posted by bulldog2 on October 26, 2009, at 15:16:29
All I can say is that when I was taken to the psychiatrist as a child no one asked how my diet was, if i exercised, if i tried meditation etc. Now I ask why? My life would be so much more better if I had never started on prozac.
I think doctors prescribe medications all to quickly and need to start looking at the general wellness of their patients before prescribing medications for things like depression, adhd, and anxiety.
Doctors should have patients keep food journals and see if they are eating things that could be making them feel worse and adding foods that will make them feel more stable. Removing simple sugars and dyes and adding protein can do a lot to stabalize mood. Also some supplements like magnesium and fishoil are helpful with mild anxiety and depression.
Doctors should be able to prescribe exercise and meditation treatments. You could get a receipt from the instructor, trainer, gym after the activity to prove that you've been active.
Just doing and completing some of these tasks like cooking a wholesome meal or exercising can do a lot for someone with mild depression and anxiety.
I think ADs are helpful for some but should be reserved for situations that don't respond to improvements in general health and lifestyle or when a person is so debilitated they can't even take these steps towards a healthier lifestyle.
I do believe the drugs have the ability to damage and restraint in prescribing them is needed. My dopaminergic transmission has been permanently down regulated by Prozac for 6 years after ending treatment.
My views on medications aren't based on the idea that no one should take a pill that makes them feel better. I totally understand that and some people need it. Rather my views are based on my own personal negative experiences and permanent changes due to medication.
Posted by delna on October 27, 2009, at 11:49:44
In reply to Should SSRIs Be Taken Off The Market?, posted by bulldog2 on October 26, 2009, at 15:16:29
Nooooooo!
Definitely not! For people who have had one bout of depression and need antidepressants for a few months, they are a godsend.
Plus the other drugs, TCA's and MAOI's, apart from being really hard to tolerate are not safe at all especially for special classes like the elderly, those with hepatic/ renal impairment etc.
Their only option is an SSRI.But I am very anti-irresponsible drug prescribing.
I think drugs, in general should not just be taken off the market because of some possible long term side effect, rather they should be prescribed responsibly. I think in some countries SSRI's are indeed handed out as sweets and that is where the problem lies.Take for example accutane. This drug, in the long-term has been associated with low bone density (and countless other things) which leads to osteoporosis. . But should it be pulled from the market? No, because IMHO it really does help a lot of people and has a very special place in dermatology that no other drug can fill. However it should be prescribed with great care and prudence by a specialist and in serious cases.
Irresponsible use of a drugs is not a reason to remove them from the market. Eduction is the answer. SSRI's need to prescribed when they are REALLY needed and not to 'cover-up' normal life's problems. Which currently they are being used for.
One general comment.... what I do find quite appalling and which happens all the time in the US (as opposed to UK of even India) is direct-to- consumer marketing of prescription drugs. This is so dangerous.It lulls everyone into believing that these drugs are somehow safe and patients approach their docs demanding them for every little thing. I mean, look at the recent campaign for Abilify as an add-on for depression. That ad really cheesed me off because it made Abilify sound like this magical, harmless med. Did you see all the lovely imagery...it made my blood boil!
Oh sorry I think I just went off topic.....Anyway, I feel eduction is key, of both doctors AND patients. SSRI's are definitely not benign but are a valuable addition in the treatment of psych problems. So no, they should not be pulled from the market. Perhaps limiting who can actually prescribe the drug may help
TC
D
Posted by bulldog2 on October 27, 2009, at 12:08:09
In reply to Re: Should SSRIs Be Taken Off The Market? » bulldog2, posted by delna on October 27, 2009, at 11:49:44
> Nooooooo!
> Definitely not! For people who have had one bout of depression and need antidepressants for a few months, they are a godsend.
>
> Plus the other drugs, TCA's and MAOI's, apart from being really hard to tolerate are not safe at all especially for special classes like the elderly, those with hepatic/ renal impairment etc.
> Their only option is an SSRI.
>
> But I am very anti-irresponsible drug prescribing.
> I think drugs, in general should not just be taken off the market because of some possible long term side effect, rather they should be prescribed responsibly. I think in some countries SSRI's are indeed handed out as sweets and that is where the problem lies.
>
> Take for example accutane. This drug, in the long-term has been associated with low bone density (and countless other things) which leads to osteoporosis. . But should it be pulled from the market? No, because IMHO it really does help a lot of people and has a very special place in dermatology that no other drug can fill. However it should be prescribed with great care and prudence by a specialist and in serious cases.
>
> Irresponsible use of a drugs is not a reason to remove them from the market. Eduction is the answer. SSRI's need to prescribed when they are REALLY needed and not to 'cover-up' normal life's problems. Which currently they are being used for.
>
> One general comment.... what I do find quite appalling and which happens all the time in the US (as opposed to UK of even India) is direct-to- consumer marketing of prescription drugs. This is so dangerous.It lulls everyone into believing that these drugs are somehow safe and patients approach their docs demanding them for every little thing. I mean, look at the recent campaign for Abilify as an add-on for depression. That ad really cheesed me off because it made Abilify sound like this magical, harmless med. Did you see all the lovely imagery...it made my blood boil!
> Oh sorry I think I just went off topic.....
>
> Anyway, I feel eduction is key, of both doctors AND patients. SSRI's are definitely not benign but are a valuable addition in the treatment of psych problems. So no, they should not be pulled from the market. Perhaps limiting who can actually prescribe the drug may help
> TC
> DYes you made some excellent points. The drug TV ads you mentioned do list the side effects and some of them are truely awful. I hope people are listening.
Posted by metafunj on October 27, 2009, at 14:40:24
In reply to Re: Should SSRIs Be Taken Off The Market?, posted by bulldog2 on October 27, 2009, at 12:08:09
I wonder if these ads really work. After all the doctor is still in control of diagnosing diseases and determining the appropriate treatments.
Posted by sukarno on October 27, 2009, at 18:03:58
In reply to Re: Should SSRIs Be Taken Off The Market?, posted by metafunj on October 27, 2009, at 14:40:24
SSRIs seem to eventually poop out in everyone who takes them long enough, don't they?
Usually after 5 to 10 years of being on an SSRI, they seem to stop working for a lot of folks.
Would tricyclic antidepressants work then in the case of SSRI poop-out?
What about PSSD (Post-SSRI Sexual Dysfunction)? It seems to be permanent. They have quite a big Yahoo group now.
Posted by Phillipa on October 27, 2009, at 19:38:33
In reply to Re: Should SSRIs Be Taken Off The Market?, posted by sukarno on October 27, 2009, at 18:03:58
If the studies are done for seems like three months max how do the regulatory boards know what long term side effects are? All meds in my opinion. Phillipa
Posted by manic666 on October 28, 2009, at 13:35:03
In reply to Re: Should SSRIs Be Taken Off The Market?, posted by Phillipa on October 27, 2009, at 19:38:33
ocourse you get side effects that are bad. Thats the trade off we all no that., you dont get anything for nothing.There no where near as bad as the illness your taking the med for. jesus your start up on most meds make you feel worse at the start, thats why so many nuke them. If your really ill you put up with anything sooner than the dog on your back.imagine going in the docs an he said sorry no ssri,today i have just band them ,now go home an bang your head on the wall
Posted by allisonm on October 28, 2009, at 16:36:57
In reply to Should SSRIs Be Taken Off The Market?, posted by bulldog2 on October 26, 2009, at 15:16:29
In a word, no. I agree GPs should not be handing out ADs so readily. Your argument re' SSRIs not being tested enough for long-term effects doesn't work b/c drugs such as Wellbutrin and Remeron were released in the same way. None is given enough time in terms of measuring long-term effects. We are all guinea pigs ... at least those of us who have been taking these drugs for decades.
Posted by uncouth on October 31, 2009, at 23:44:47
In reply to Re: Should SSRIs Be Taken Off The Market? » bulldog2, posted by allisonm on October 28, 2009, at 16:36:57
i wish i had never been put on effexor. i think most likely my depression would have resolved with time and changing life circumstances. instead, i have been medicated for 5 years, through a rollercoaster of meds, the SNRIs likely caused cycle accelleration and advanced my bipolar 2, if not directly caused it.
the SNRI/dopamine dysfunction connection IS VERY REAL FOR MANY PEOPLE. after being medicated, i couldn't concentrate. i stopped caring how i was perceived, how i performed at work...i could always come up with rationalizations, etc. for my poor performance...probably as a result of excess serotonin (?)
only in the most recent weeks have things come around with the addition of zyprexa to my 600mg of bupropion, 600mg lithium, and 50mg of agomelatine. i went from 0 to 1 to now 4 drugs. now unsure if im ever going to get off them. i have become a full-fledged psych patient.
i wish i could go back in time. despite the meds working off and on, i am convinced had i never gone on medication, my life would have been better overall, perhaps significantly. i never had serious suicidal thoughts before medication. i never had a mixed state before medication. i was definitely maladjusted, definitely had low self-esteem, and definitely had social phobia before meds, but u know what, the meds overall and overtime havent' helped those symptoms.
i guess its extra hard when there is no clear cut diagnostic to determine when someone is depressed, or bipolar depressed, or cyclothymic, etc. the drugs work very differently on different conditions.
i wish that damn doctor at stanford's student health services had offered me wellbutrin instead of effexor, thats for sure.
Posted by Sigismund on November 2, 2009, at 13:26:01
In reply to Re: Should SSRIs Be Taken Off The Market?, posted by uncouth on October 31, 2009, at 23:44:47
>i wish i could go back in time. despite the meds working off and on, i am convinced had i never gone on medication, my life would have been better overall, perhaps significantly. i never had serious suicidal thoughts before medication. i never had a mixed state before medication. i was definitely maladjusted, definitely had low self-esteem, and definitely had social phobia before meds, but u know what, the meds overall and overtime havent' helped those symptoms.
Yep, know what you mean, bit of a f*ck up.
Posted by 49er on November 6, 2009, at 5:02:38
In reply to Re: Should SSRIs Be Taken Off The Market? » bulldog2, posted by maxime on October 26, 2009, at 16:24:45
No, they shouldn't be taken off the market because people who need to taper would be put in a cold turkey situation which would be very dangerous.
49er
Posted by West on November 6, 2009, at 15:11:15
In reply to Re: Should SSRIs Be Taken Off The Market?, posted by uncouth on October 31, 2009, at 23:44:47
I doubt if effexor caused all the problems, you might still be depressed.
No argument. SSRIs should absolutely not be taken off the market. Whilst no panacea, they save lives and turn living hell's into much more pleasant places to be.
Is this the anti-happiness thread?
Posted by Phillipa on November 6, 2009, at 18:20:56
In reply to Re: Should SSRIs Be Taken Off The Market?, posted by West on November 6, 2009, at 15:11:15
West that's funny my sister calls her ad ssri her happy pill also takes xanax. How come they don't do that for me? Love Phillipa
Posted by bulldog2 on November 6, 2009, at 18:55:47
In reply to Re: Should SSRIs Be Taken Off The Market?, posted by West on November 6, 2009, at 15:11:15
> I doubt if effexor caused all the problems, you might still be depressed.
>
> No argument. SSRIs should absolutely not be taken off the market. Whilst no panacea, they save lives and turn living hell's into much more pleasant places to be.
>
> Is this the anti-happiness thread?
>I love happiness when I experience it now and than..Even like a bit of good mania now and than
Posted by West on November 11, 2009, at 10:58:32
In reply to Re: Should SSRIs Be Taken Off The Market? » West, posted by Phillipa on November 6, 2009, at 18:20:56
I imagine you're the exception to the rule.
Dear. Misery: man hands it to man, it deepens like a coastal shelf.
This is the end of the thread.
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