Why are selective serotonin reuptake inhibitors (SSRIs) so popular?

[Duckbruck]

Is it simply easier/safer to prescribe an SSRI than any other type of treatment?
Are most cases of depression caused by a serotonin problem?

When SSRIs came out on the market at the beginning of the 90s, big pharma marketed them as the new wonder pills with almost no side effects, but today we know that they cause substantial sexual side effects, gastrointestinal side effects, dizziness, sleep disturbances (insomnia, sleepiness), headaches, agitation & tremor / shaking...

I don't want to even start on zombification, lack of emotions, apathy and so on...

And what about Citalopram/Escitalopram-induced QTc prolongation? Wasn't that always an anti-TCA argument? "Bad TCAs may cause problems with your heart, but SSRIs don't!"

And for all we know right now, SSRIs don't show greater efficacy than TCAs, TeCAs, MAOIs, Atypicals etc.
I will not deny that there are people out there, who benefit from SSRIs, but that's also true for TCAs, TeCAs, MAOIs, Atypicals...

So what's the big deal with SSRIs?
Why are they randomly prescribed like children's candy?

[Modestaustin811]

You may enjoy these.


https://www.youtube.com/watch?v=eavGcz6bqaw&ab_channel=BustTheBall


https://www.youtube.com/watch?v=UC5RZRG7-QQ&ab_channel=TheRealTruthAboutHealth

[panic_down_under]

So what's the big deal with SSRIs?

Modern doctors don't know anything else. They've been taught SSRIs (and SNRIs) have fewer side-effects than other antidepressants, only partially true, are more effective, which is demonstratively false, and are much safer than the others in overdose, again only partially true as citalopram and escitalopram may not be. The SNRI (really only a SSRI) venlafaxine isn't either. Anyway, safety in overdose is not as big an issue as it's often made out to be. Most intentional overdoses aren't of the patient's antidepressant and accidental ones typically aren't of a high enough dose to cause serious harm.


Why are they randomly prescribed like children's candy?

Because in many places the alternative, the cognitive/behavioural/mindfulness therapies are harder to access, either because of cost, or the lack of therapists.

[AntsyVee]

Hey, I like my Lexapro candy :winks:

[MyNameIsTerry]

Why are the prescribed like candy? Because doctors in the NHS face a stark choice whether to help you or refer you for therapy and let you suffer everyday while you wait months.

Guidelines about antidepressant use are based on blue sky. They work on everything being available and they don't mention lead times. The reality is far different.

Why are they randomly prescribed? Many reasons. Some GP's are more clued up based on experience and head for what has worked in the past. Some just follow the guidelines without knowledge of the differences. GP's aren't trained in these meds but unlike other specialisms the NHS give them something to play with rather than refer to all the psychiatrists that they simply don't have.

How does your country compare?

Go private and the world's your lobster. Celebrities go straight into rehabs and get any med they want, all with a glass of champagne in one hand no doubt.

---------- Post added at 05:16 ---------- Previous post was at 05:03 ----------


You may enjoy these.


https://www.youtube.com/watch?v=eavGcz6bqaw&ab_channel=BustTheBall


https://www.youtube.com/watch?v=UC5RZRG7-QQ&ab_channel=TheRealTruthAboutHealth

Ian has mentioned Kirsch quite a bit so I'm sure he will be able to expand on this.

I noticed Molyneux popped up lower down, that guy is out of his depth should anyone spot him and it would be worth fact checking him because there are sites that have countered his explanations. I remember watching some of that and he was selective In his presentation. The structure is good but not the detail.

[panic_down_under]

Ian has mentioned Kirsch quite a bit so I'm sure he will be able to expand on this.

Sorry, I don't have the time to watch more than a couple of minutes, but as a general comment, Kirsch has made a career out of claiming antidepressants are just expensive placebos and publishing meta-studies to support the claims. While meta-studies can be useful, their value very much depends on how rigorously the studies providing the data are selected. You can get just about any desired result if you design a meta-analysis to do so, the programming phrase, Garbage In = Garbage Out is just as pertinent in meta-analyses, and, imho, Kirsch is a master at doing just that.

I think I can destroy the antidepressants=placebos nonsense with two simple questions:

1) If they are just placebos then why do they seem to work so well in veterinary practice?

2) Are cats, dogs, even birds (http://criticalpsychiatry.blogspot.co.uk/2009/01/telegraph-story-parrot-is-taking-prozac.html) a lot more aware than we believe?

Reconcile (http://www.veterinarypracticenews.com/April-2013/Fluoxetine-Treats-A-Number-Of-Behavioral-Issues-In-Animals/) is a med frequently prescribed by vets. We know it as Prozac (fluoxetine).

As for Stefan Molyneux, I think this thread (http://www.nomorepanic.co.uk/showthread.php?p=1660463) sums him up pretty well.

[Modestaustin811]

How can you gauge if an animal is depressed though?

For a human it takes us to fill out a questionnaire, to answer questions. Yes a dog can be lethargic, and not move around as much, but to call that depression is insane.


Those drugs don't work for dogs or animals lol. And that hardly disproves the placebo theory at all. Even the FDA has said there is a "marginal" difference between drug and placebo.