Tuesday, January 12, 2010

Are Antidepressants not any better than the placebo effect?

Interesting article in the New York Times about an antidepressant study which concluded that antidepressants aren't any better than the placebo effect for mild to moderate depression.

Before you Quit Antidepressants

My personal experience with antidepressants has not been that positive, granted I have bipolar disorder and not major depression.

As a teenager I was on Prozac, and looking back I'm not sure that it did any good. At the time I was diagnosed with major depression and an anxiety disorder. Bottom line: I attempted suicide while on Prozac.

Later I was on Paxil and it lead to severe mania with psychosis. Which is no surprise since it is risky to put bipolar patients on antidepressants without a mood stabilizer.

Later I was on Wellbutrin and had a seizure.

I was recently on Zoloft and my depressions got worse not better.

What is your experience with antidepressants?

16 comments:

Anonymous said...

As an adolescent, my doctor put me antidepressants, even after diagnosing me with bipolar disorder. I lapsed into a prolonged manic episode with severe psychotic tendencies, and my brain was on the verge of seizure. I was hospitalized for 2 months and had to be in treatment for another 9 months after that. None of that probably would have been necessary if I hadn't been put on the antidepressant (I haven't had a manic episode since coming off the antidepressants). Needless to say, I'm not a huge fan of them.

Anonymous said...

Zoloft is what created my first serious mania, it was given to me at the same time as depakote when I was first diagnosed bipolar, but either the depakote didn't work or the zoloft was faster. I was deeply depressed so they tried despite it being risky. What ended up getting me stable (after much trial and error) was a combo of lots of lithium and some Welbutrin, which over a few years I stepped down to just lithium. When I tried stepping down the lithium last year I thought going back on Welbutrin might help, but since my lithium dose at the time was less than half what it was when I was first stabilized, in only a few days I could tell the Welbutrin was making me edgy. In general, since the Zoloft-mania was my only big mania and resulted in my hospitalization, I've always found the idea of taking antidepressants again terrifying.
-stbc

postpartummom said...

I recently have been prescribed Trileptal (mood stabilizer for BP) and Zoloft (antidepressant, as you know). Haven't started either yet, but have a question for you. Did your depression get worse with ONLY the Zoloft or did you also take a mood stabilizer? I guess I am looking for info, and don't have any answers either. My psych doc said they prescribe both to have an overall better effect. He told me to first try just the mood stabilizer for one week and if it seems to work already, then hold off on Zoloft. So curious what others have to say...also regarding overall side effects, I never had a seizure or anything too serious, but I did get a horrible skin reaction (hands only)while on Lexapro last month and had to stop. So I guess it's all trial and error...

Rachael said...

postpartummom,

I was on two mood stabilizers (Lamictal & Abilify) and Zoloft. I also was lucky enough to gain 25 in the year that I was on Abilify & Zoloft going from a cute size 4 to a size 8-10. Now I am trying to lose that weight.

I have really never had success with antidepressants I failed to mention when on Paxil I attempted to kill myself, also. Thank God I am not good at suicide.

Anonymous said...

I've known I was bipolar since I was 10 years old, but my doctors refused to believe me and told my parents that I just had "an overactive imagination". This was despite episodes of staying up all night and not seeming tired the next day, extreme irritability during part of the year, periods of horrible depression and horrible, horrible panic attacks during the spring. Oh, and a family history on my dad's side. They wouldn't give me ANYTHING until I turned 18, at which point they gave me Paxil. It worked for exactly half the year. During the spring (which is when I have my depression...I know I'm backward from most people) I was fine. However, during the fall I felt awful, worse than normal. Complete inability to concentrate, partying all night, sex with anyone and everyone, flying into rages and getting into physical altercations. Finally, I moved to a different city and had to go to a new doctor who took one look at me and asked if I had ever been diagnosed with bipolar disorder. I just started crying because I was so relieved that someone believed me. She made an emergency appointment for a psychiatric evaluation where I was officially diagnosed. The lamictal is the main thing that makes me feel normal. During the fall when I feel manic, my doctor drops my Lexapro down to .5 mg. We've found that if I go off of it altogether I end up in a mixed state, but if I stay on 10 mg I end up hypomanic. I have to be on Lexapro in the spring or I get depressed really, really fast, but if I'm under a great deal of stress I still have to supplement with Zyprexa (the only thing that will bring me out of a mixed state, to which it seems that I'm very prone). So I guess I can say that it's better than nothing, although Paxil made me super fat, Zyprexa made me fatter, and as long as I'm on the drugs I'm on I can't seem to lose the weight, even on a sensible, nutritionist approved diet.

Anonymous said...

I posted the previous comment and should note that while on anti-depressants I've never felt suicidal. The only time I've had a suicide plan was when I was 16 and having 6-7 severe panic attacks a day and the doctors wouldn't give me any medication because I was a minor (this was about 15 years ago in the South...I hear things have changed somewhat).

Anonymous said...

Have you started your other website on bipolar motherhood or should I stick to this one? It's so comforting to read about other people going through what I am...AS PERTAINS TO MOTHERHOOD. Bipolar is hard enough, but as a mom...even more challenging.

Rachael said...

I am still working on getting the new site set up. I'll post here when it is ready.

RainGirlLori said...

The first thing my doctor put me on to handle my depression was Zoloft. It made things better for awhile. Then I was starting to act almost 'high' by noonish every day. She then put me on Xanax to try and stabilize that, and later I was also put on Prozac.

Around that time, my partner suggested that I should see a psychiatrist about bipolar, so I did - and was diagnosed. She took me off all that other stuff and started me on Trileptal and Lamictal - now that I'm pregnant, I'm only on Lamictal.

I've been reading more about Zoloft and bipolar disorder, as well as asking around. What I've noticed is that the two really don't mix - sometimes it makes things seem good for awhile, but it triggers manic episodes and aggravates the range of your 'swings.'

kvoltolin said...

Before I was diagnosed bipolar I was prescribed Zoloft for postpartum depression (which I now know was my bipolar "acting up"). It made me much worse, paranoid, aggressive, you name it. Once I was diagnosed bipolar my dr wanted to put me on Lamictal (sp?), low dose Zoloft & Klonopin. She wanted to keep the Zoloft at a low dose of 50 mg to help with the anxiety. I found out five days later I was pregnant & had to stop all meds. I'm due in 3 months & am disappointed at the lack of mood stabilizers that are safe during breastfeeding. Overall from my experience with antidepressants over the last 15 years I'd say they hurt more than they help bipolar patients (I've been suffering since I was 13, am now almost 30 & just diagnosed BP 7 months ag(

Rachael said...

kvoltolin,

I breastfed for a year on Lamictal. Statistically it is safe. My Psychiatrist, OB/GYN & Pediatrician felt the benefits of breastfeeding outweighed any potential risks.

Check out Dr. Hale's Book Medication and Lactation.

Anonymous said...

Thank you so much for creating a blog about disorder. I was diagnosed w/it, and then told I didn't have it, but I know I do. I have the kind of mood swings that can destroy someone's self worth and ruin relationships. It feels like I can't help myself. Lexapro did help me for my depression for awhile, but I was manic hyper and everyone told me I was acting strange. I am also not a big fan of antidepressants. I am pregnant right now, and am taking nothing. It is risky, but I cannot tolerate them while pregnant. I hope you all find solace in knowing you're not alone in this..:)

Anonymous said...

in response to your blog entry "before you quit antidepressants" :)


I have bipolar 2 (bipolar affective disorder), so i have never experienced any mania, only hypomania. so, no psychosis.

In my experience, antidepressants do help me. I don't know how to argue the placebo effect... but i just don't feel that is the reason i improve.

for me -

Prozac helps. i'm not all together perfect or anything. but it takes the edge off. i am more likely to be hypomanic, but i like feeling that way... and my depression is there at times, but not as bad. However, it kills my libido. not what a newly wed (at the time) wanted :(

Celexa. did nothing for my depression. and i gained 25 lbs over the year i was on it. bummer.

Welbutrin. i liked it. i lost 5 lbs and it increased my libido. i know it has a slightly higher risk of seizure. sorry to here that happened to you :( I thought it did help my depression. But the second time i took it I had to stop a month later because it was drying up my breast milk!! warning to those who may be nursing.

Zoloft. horrible. didnt help me. made me incredibly fatigued and just had to keep upping the dosage to get it to help with my depression at all... and the higher the dosage to more side effects i noticed... twitching, jaw clenching.... the list goes on and on.

my recommendation?? the absolute best product in the universe that i have EVER used. and will EVER use again...

EMPowerPlus by a company called TrueHope. it is a God send. there are no words to describe the healing power of this supplement. i have several close relatives and friends who have also come to benefit from it as well. and even my 5 yr old, who was having anxiety attacks, is doing AMAZINGLY on it. Go to truehope.com take 5 capsules three times a day for 6 weeks and it will absolutely change your life. you'll see. My aunt has been off of Lithium for 7 years now. miraculous.

Rachael said...

Thanks Monica. I'm going to check out that website.

Anonymous said...

I attempted suicide on Prozac, tried again on Effexor, again on an older one I can't remember the name of, and again on Effexor. Even with the diagnosis of bipolar these meds seemed to be seen as a solution and not an instigator. Thankfully I know enough about my own health now to say NO when a doctor tries to prescribe more antidepressants.

Laura charlotte Murray said...

Hi,
I've been diagnosed for 21 years with bipolar [manic-depression] and 11 years with shizoaffective [hear voices,that's all]. I had a pretty bad time with the antipsychotics and really recommend that if your voices aren't that bad you don't take them, because they made mine bad. I mean hearing mean, delusional things as opposed to voices of those I know. So, for ten years I went without any meds to have and raise my baby. Which was good, but I could have used an antidepressant towards the end. [I was a single mother and it was tiring and stressful.] But I've taken it since, [Zoloft] and it's given me energy big time, which is nice. I'm pregnant now and it's supposed to be safe in small doses like 25 mgs. during the first and second trimester only.