What do SSRIs 'actually' do? [Archive]

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Diver

12-12-10, 18:12

dabrucru

12-12-10, 19:13

hi diver, i v been on ssri for almost 4 months now, for anxiety. i am taking 10 mg of cipralex. for me one thing is sure, they make me feel a lot better, and at last i am having my life back. that s my point of view, but im sure you ll receive much more detailed replies. for me thats enough:winks:

hugs

david

Geoff2301

12-12-10, 21:05

its a very trickyone..... lots of people swear by them and believe they've been the cure to all their mental troubles. I found fluoxetine helpful and went several years without a bad spell of depression/anxiety. Hit a bad patch and was switched to Paroxetine.... worked for a while but the dose kept being increased till I reached maximum and now returning to the good old fluoxetine! A lot of test results do suggest that most of the benefit gained from taking them is a placebo effect...... and the strange, or perhaps not strange, thing is that the worst the side effects of a drug, the stronger the placebo effect of that drug...... I suppose your brain thinks you've got to get something out of feeling so rough on it!! Anyway, placebo or not, somehow they do seem to help a lot of people though there does seem to be a tendency for gp's to keep increasing the dose and for the medication to apparently lose its effectiveness after a period of time resulting in a change to another AD. I did read a fascinating book, "The Emperors new drugs" by prof Irving Kirch which explored all the details of antidepressants and the trials we never heard of..... must admit that it did make me very sceptical about their effectiveness but I'm still taking them in the hope.....!!

guitarpants

13-12-10, 00:56

No one knows what they really do or how they work.

CE3K

13-12-10, 10:32

I can only speak from personal experience (and those of a couple of people close to me) and my view is as follows:

most drug trial reports I've read over the years show fairly clearly that only 25% to 35% of people 'benefit' (depending on which SSRI)
there appears little statistical difference between the drug and the placebo
it's true that science doesn't know how they work
the pharmaceutical companies form a multi billion pound industry and their marketing techniques leave a lot to be desired
the worst thing of all is that because they clearly don't know how they work, SSRIs have a list of mild to severe side effects
some of these side effects are worse than the existing illness
I had awful experiences with Anafranil (not an SSRI), Seroxat (nearly ended up in hospital, and someone I know became suicidal on it) and Prozac. In every case, the anxiety became much worse and there were a number of physical symptoms as well.
I swore a number of years ago, that I would never ever go down the SSRI route again.
I think the whole thing is a big con, although naturally, I am very happy for those people who appear to benefit from taking them.
I often read/hear people quoting that "the first few weeks are awful (side effects) but things eventually settle down". My question is why would anyone want to experience some of the side effects and put themselves through hell before apparently gaining some relief? Obviously, I can only refer to my own personal experiences and those of my friends/relatives and these have been enough for me to avoid ever again contemplating ADs.
I also think (some) GPs are only too ready to push ADs on to people too soon (my own daughter had one panic attack last year and the GP (not her usual one) suggested Seroxat!!! Needless to say, she did not go down that route.
I recognise that for some people, there may be only this course of action left to follow and I can fully appreciate their decision or need to do this. I also wish everyone well who finds benefit from taking SSRIs and please don't take my views as being anything other than my own.
Before anyone considers going down the SSRI route, I would advise them to consider and follow up in practice, all other options (relaxation techniques, CBT, natural remedies, counselling etc).

JaneC

13-12-10, 10:46

Hi Diver, I'm a long-term user of ADs, for depression and panic, currently on Prozac, which I first started on a long time ago for post-natal depression. When I am depressed, I find it really hard to motivate myself to get up and do anything - ADs have allowed me to get over this and get on with my life, things aren't so much of an effort any more. I also have problems with feeling I don't fit in and that people don't like me, and it helps with that too. Prozac has also completely stopped my panic attacks.

I do think it is also important to try things like CBT or counselling. RMH asks "why would anyone want to experience some of the side effects and put themselves through hell before apparently gaining some relief?". In my case the answer would be because the long-term benefits have far outweighed the short-term side effects ( which I have only had one one of the two occasions I have started taking Prozac/fluoxetine.

Hopes this helps xx

PUGLETMUM

13-12-10, 11:18

:)i have heard quite alot of opinions over the years about meds and ive changed my mind a few times - first they worked for me with no side effects - then they didnt and i became very anti-meds and now im taking them again and i felt almost immediate relief and so im now pro-meds again. i think it all depends on your state of mind at the time and also your own circumstances and expectations. also maybe some ppl arent depressed enough when they take them and thats why they dont help, or ppl are more anxious and a med makes that worse - ive gone on citalopram and it has helped my depression and anxiety, i dont feel the need to be trying to work everything out anymore and im also more confident socially - im sleeping better and my anxious reactions are less trigger happy - thats the actual real life positives for me - hope this helps:winks:

KK77

13-12-10, 11:29

I take sertraline for recurrent depression and I would urge anyone considering taking these drugs to spend time with their GP or psychiatrist discussing the pros and cons first. I do agree that they're handed out too quickly these days when other options like talking therapies and self-help should be explored first.

All drugs come with side effects. If you were to draw up a legal document for your doctor to sign accepting full responsibility for any serious side effects you may suffer, they wouldn't prescribe you a single drug. They all come with potential risk factors and the onus is on the person taking the drug to discuss this with their doctor.

Antidepressant medications are not a cure as some would like to believe. They can help motivate you to getting better though. And as for the placebo effect, well morphine, one of the most powerful painkillers, is also thought to owe a large part of its pain relieving properties to this. The important thing is that these drugs work for people - obviously not everyone though.

No one can decide for you. It's something you need to discuss at length with your doctor. But meds have helped me and continue to do so, and as Jane said, I think the positives outweigh the negatives for me.

heavenly

13-12-10, 13:01

What do SSRIs actually do for people with stress or anxiety?

I'm not talking about the pharmacology - that's easy to find on the web or in a book. What I'm asking is the actual effects of SSRIs in the real world person.

I took Sertraline for a few years and it basically didn't do anything tangible for me in terms of helping my state of mind.

So what do 'YOU' get from taking SSRIs? I ask as I'm considering giving
Citralopram a go to help with what I (and others) now call stress - a mixture of worry, self doubt, anxiety, obsessive thoughts and depression.

I respond okay to Diazepam and find a bit of relief if I take around 10mg if I'm getting myself worked up. So I know that some drugs do help.

So then what does the average person who has difficulty with stress/anxiety/depression etc get from using Citralopram or other SSRIs once they get past the initial unwelcome side effects?

What do they do for you?

Please take the time time to write down your experiences.

Thanks.

I started getting anxiety attacks about 4 months ago, and then the depression started. I was put on Olanzapine (a non-addictive tranquiliser) to help with the anxiety and it did. I was put on 20mg Citalopram 6 weeks ago, the first 2 weeks were tough but I have had minimal anxiety for the past 3 weeks and am now only taking 1 Olanzapine every other day and hopefully can stop them soon. So the Cit has helped with my anxiety, which is great. I am still getting low moods at times, I am seeing my GP tomorrow, she might suggest upping to 30mg but I am not rushing into that. I am reading positivity books, I go to counselling and I am changing my diet, that is a preferred course of action, obviously, to upping the dosage but obviously I will monitor my moods and see how I go. I don't see myself on Cit long term, I am having counselling which will be as long as it needs to be, but I need a bit of help at the mo, which is where Cit comes in.

Diver

13-12-10, 15:51

Interesting replies thanks very much.

From what people are saying I'm not sure that SSRIs will do anymore than the Inositol I currently use.

Cipralex sounded pretty 'attractive' but I'm not so sure now?

debs71

13-12-10, 16:30

It is very hard to explain what SSRI'S do for someone, as everyone's experiences are subjective and personal but for me personally - I am taking Cipralex 10mg o.d. - they completely take that awful, dreading, scared edge off me.

I suffer with panic attacks and anxiety and have suffered from depression in the past. Without meds I feel anxious all day long, like I am going insane and just scared in my own body. SSRI's offer me calm, that is as plain as I can make it. Yes, I still feel the panic rising, perhaps I should be on a higher dose, but I am able to DEAL with that feeling without going to pieces and rationalise much more than I can when I am in the maelstrom of panic without meds.

I don't honestly know how much is me thinking it will help so it does, and how much is the drug, but to be honest I don't give a monkeys. All I know is I feel better on the Cipralex and it offers me hope and some semblance of normality and that is enough for me.

Geoff2301

13-12-10, 17:39

yes, the placebo effect is quite amazing really....... even the "blind" trials carried out by the drug companies have a tendency to be distorted. Although patients are not supposed to realise whether they are on the real drug or a placebo, they frequently do because of the side effects they're experiencing........ this then effects the test results.

ems43

13-12-10, 17:55

I'm not sure of there exact action, however they have been greatly helpful to me in the past. I agree that the side effects can sometimes be quite bad, but when you feel in a dark hole you know you need to try something. Its interesting really that I sometimes think the more you read on the symptoms, side effects etc, the more you experience them. For example, about 10 years ago when i first tried cirt and didn't have access to the internet I just accepted the ups and downs and didn't question them too much. Now, with the internet, I find myself constantly looking into side effects etc. About 2 years ago I had quite a major blip, was put on escitalopram, it honestly worked wonders (and that was despite my skepticism as I have never responded so well in the past), I wasnt involved in any forums etc and just went with the flow and really hoped they would help, and they really did. In other words, I think forums about medication can sometimes be a blessing or a nightmare for those of us with anxiety x

geejaybee

14-12-10, 18:51

I've had GAD for around 8 months and recently was getting a handle on it, but have been getting increasingly depressed because of insomnia. My Psych decided to try me on Duloxetine an SSNRI anti-depressant which has many of the same properties of std SSRIs but which also is supposed to help anxiety. After just one dose I experienced anxiety attacks which were much more severe than usual and typical of my bad previous experiences of SSRIs (prozac and paroxetine) which made me hyper anxious.
I think this is fairly typical of many GAD/Anxiety sufferers with this class of drug.