Gript-A source of misinformation. **Read OP before posting**

My difficulty is that for 50 years the serotonin hypothesis has been used to promote ssris and other drugs, when it was only ever a hypothesis.

I'm not cherry picking at all. Trials for approval of antidepressants tend to last approx 8 weeks, so long term use is not well understood by many people. The only long term study, known as star D, claimed a 67 % success rate. It was reviewed in the past couple of years, and there were many problems with the methodology. When the raw data was processed using proper methods, short - term success was 37%, and remission was only 3% after one year, not great given the range of well documented adverse effects. There is a campaign to get the journal who published the original study to retract it, but no luck so far.

I have worked in the medical device area, and benefited from surgical procedures and short term use of drugs. I don't have any agenda against medicine. You asked about cardiac stuff earlier - I commend the improvements in outcomes particularly after heart attack, and the modern approach of getting people moving rather than curbing activity. However, I have seen a convincing argument that prescription drugs are the no. 4 cause of death, and half of those deaths are in cases where the drugs are used as described. That's concerning, as is the rise in disability for mental health reasons in the US which has paralleled the increase in prescribing of anti- depressants. (I realise correlation is not causation, but surely worth further investigation).

I find your attempt to put words into my mouth " just suck it up" a personal affront. It's easier to throw pills at someone rather than ask the big question " what is it about modern society that causes so many people to suffer so much distress?" Lest there be any doubt, while I am sceptical about some mental health diagnoses (DSM V defines grief as an illness if it lasts more than 2 weeks), I am absolutely convinced that distress is real, and often underestimated in fact.

I can assure you that I'm the furthest thing you can imagine from a Catholic, Irish or otherwise. I think you might have flung the "right" thing at me too - that's a miss as well.

Can you provide a peer reviewed study that compares the efficacy of antidepressants with doing nothing, as distinct from a placebo?

I can't believe that there's been just ONE study on long term use of SSRIs in medical science all over the world. But honestly, I'm not going to go there with you. We've dragged the thread off-topic far enough at this stage.

I do genuinely share your concerns about over reliance on medication, but you seem to be making huge leaps away from mainstream medical science. Good luck with that cherry picking, as they say.

I'd respectfully suggest that the value of non-expert debates on stuff like this is close to zero. You're welcome to your opinions of course, but let's not pretend that your opinions or my opinions on the merits of SSRIs have even negligible value, any more than our opinions on cardiac surgery techniques or motorway bridge design techniques or petrol engine spark plug design methods. There's reasons why people build careers and expertise in these areas. Perhaps the growth in mental health conditions is in part relating to the culture of 'everyone's opinion counts equally'?

@AndrewJRenko

I really don't want to spam/troll you or the thread, so I'll just state this and then leave it at that unless anyone has questions. The NHS would be considered pretty mainstream, I think. I have seen copies of their checklists for diagnosing depression and General Anxiety Disorder. They had a Pfizer logo on them. That scares me. ( I can't link as I'm travelling).

Voluntary snip. Too much of this off topic crap already.

Riiight.

Someone sent me an article from the Guardian that prompted me to have another look at this thread. I re-read the links you provided, and they actually support the arguments I made on here, almost word for word. They down play the suicide risk though. As for Jack Turban (the twitter post seems to be gone), I'd have to file that under "never ask a barber if you need a haircut".

You mentioned my distance from the mainstream - well, is a combination of the Guardian, The British Royal family, and the UK legal system mainstream enough for you? I think the embedded info is enough to avoid accusations of link-dumping.

That's a pretty callous attitude towards people who commit suicide, and those bereaved. Are you aware of the Ely Lilley study on healthy volunteers ?( it was looking at SSRI's as treatment for incontinence). One of the healthy subjects killed herself in the lab.

You really want to drag in vaccines? Most of them have a pretty good risk / benefit profile - polio and smallpox were pretty much eliminated. The benefits of SSRIs is either small or not statistically significant, depending on which studies you read, and the long list of harms is very much downplayed. Exercise is more effective for mild depression.

I think it might actually be 1 in 6 people in the UK who are on SSRI's. How likely do you think it is that one sixth of people have developed a disease that requires long- term medication? ( have you heard of iatrogenic harm?)

As for your RFK reference, again with the mudslinging, but you need a better aim, or some better amunition. I will concede though that you have come a fair way since defaming Joanna Moncrief - RFK does seem a bit unhinged. Have a look at David Healy's website - he's been researching SSRis for over 40 years, has consulted for the pharma industry and appeared as an expert witness for plaintiffs in lawsuits. The Aurora cinema shooter had recently started on SSRIs - his diary is scary but informative reading.

I agree with you that the US have a weird relationship with guns - Bowling for Columbine highlighted the contrast with Canada, where they have a few guns too.

Do you have anything to offer the discussion other than more mudslinging? Given your penchant for demanding supporting evidence from others, is it really too much to ask that you might engage with the substance of my arguments, rather than seeking to defame those I cite, and to associate me with US politicians that I have no connection and little in common with.

I wouldn't want to share any kind of hole with you 😀 and I have no interest in conspiracy theories, other than as a further insight into how crazy people can be. Do you think the Oxycontin scandal was a conspiracy theory?

Far from being in a rabbit hole, everything I've said is based on drug company studies and internal documents. There's even a chain of documents discussing what they could do about David Healy, suggesting sueing him in the UK ( they couldn't as he could back up his claims using their documents). Healy and Moncrieff both say that some drugs can be helpful in acute situations and their arguments for this make sense.

I was genuinely hoping you'd be able to provide evidence that everything I've said is wrong. I know people who have been harmed by SSRIs, and I know of others who have suffered or are continuing to suffer drug withdrawal effects. Some people take years to withdraw completely, many are unable to fully do so. There's lots of documented evidence from mainstream sources on this - the Maudsley Deprescribing guidelines for example, which has been favourably reviewed by the British Journal of General Practice.

I'm very glad the drugs worked for those close to you - long may it continue.

Before I answer your (possibly rhetorical) question, I need to state something clearly. I'm not offering medical advice, however for anyone reading, if you or someone you know is taking SSRI's, do not in any circumstances stop taking them without consulting a medical professional. Experts believe that the phases of starting, changing dose, or stopping drugs altogether are the most dangerous.

To your question: none. The only thing I don't understand is why you persist in characterising mainstream medicine and the wider pharma industry as rabbit holes, but each to their own. Rest assured Andrew, if there was any danger of having to occupy any hole with you I'd be reaching for the SSRI's, and probably opioids😀!

Your obsession with rabbit holes brings to mind the axiom "for a man with a hammer, every problem looks like a nail". It's interesting though that you refer to RFK - I don't know a whole lot about him apart from his family history, but he does seem to throw out wild accusations without any supporting evidence. Does that remind you of anyone?

Yes, I could refer you to strange websites - like WHO, or NICE, or

https://www.drugsandalcohol.ie/26814/1/Patient%20Health%20Questionnaire.pdf

The webpage linked above is PHQ-9, a checklist used for evaluating severity of depression, also used by that crazed hotbed of conspiracy theorists, the NHS. Their version also has the Pfizer copyright on it. Do you see a problem here? My earlier reference to asking a barber if you need a haircut may inform - or perhaps not if you're determined not to hear anything that conflicts with your worldview. Again, I'm fervently hoping to find reliable evidence that proves that everything I've said is a steaming pile of bullsh1t, but based on my experience to date I'm not optimistic.

One more assertion that I can support with evidence: I don't know if you would regard the UK MHRA as a bunch of conspiracy theorists, or any links to them as a rabbit hole, but they recently decided to adopt a MedDRA code introduced in 2021 for PSSD (10086208 in case you need to confirm). These things are not done lightly, so there must be good reason for it.

Absolutely. I don't want to criticise individual GPs - it's a systemic problem due to limited time. But doctors are often ignorant or blasé about side effects, and not all doctors will tell you anything about stopping. People suffering mental / emotional distress are often not in a good position to advocate for themselves. It's easy to find reports of patients where drugs were chopped and changed almost on a whim, and where a second (or third or fourth) drug is prescribed to counteract a side effect of the first. Google the Lindsay Clancy case for one that was widely reported. I was shocked to find that 50-80% of people taking SSRI's experience sexual dysfunction, which is not always reversible on cessation. Drug companies are required to report adverse effects noted during trials, but the trials are often designed not to capture the most commonly experienced side effects. Also, lead-ins are common, where they eliminate those reporting side effects and then start the trial proper. I've worked for a couple of medical device companies, and while testing relies on similar statistical methods, our internal procedures didn't allow any shenanigans like those.

Apart from side effects, drug withdrawal effects are also downplayed. These drugs are not addictive in the sense that they don't give users a hit, or high, like opioids do, however the body adjusts to them, and can take a disproportionately long time to adjust back after even a relatively short time taking them. As stated above, in some cases the adverse effects are permanent.

The problem with falling down the rabbit hole is that you don't realise that you've fallen down the rabbit hole.

Thanks for the detailed response - it's a lot more helpful than mudslinging. The chart is interesting too - I'll have a browse on that website in the coming days. It doesn't tally with the totality of what I've read, so I'll try to see what's behind that.

Another statement I feel it's important to make: I've nothing against prescribed drugs per se. I've tried many, and had excellent results with some, mediocre with others, and some I stopped as there was no discernible benefit and I had some ethical problems (asthma medication which was permitted under Athletics competition rules - I stopped just in case there was any performance benefit, and in fact I recorded faster times at all distances after cessation). I'm sceptical though that 10-15% of any population might need to be on any medication long term.

I don't doubt your story about your two friends who have benefited from Sertraline - many others have had good results with this and other drugs, I'm aware of many. It's also easy to find stories of people committing suicide after going on Sertraline. Healy and Moncrieff have described how, rather than curing an abnormality in the brain, the drugs cause an abnormal brain state which may be helpful in acute situations - I think this is called a serenic effect. Emotional blunting is very common, again this may be helpful in the short term, but is no help at all if depression is a perfectly normal reaction to life circumstances that need to be dealt with somehow. The narrative tends to be that all bad things are down to the illness, and all good things are down to the drugs. I'm only aware of one case in Ireland where the coroner has recorded a verdict blaming drugs - I won't link but google Shane Clancy Sebastian Creane for the very distressing details, not least how respected members of the psychiatric profession behaved to try to protect their guild interests.

While reduced libido is a common feature of depression, David Healy has said that there's no presentation of depression where sexual dysfunction is a feature. I was referring in my earlier posts to dysfunction that only appears after starting to take drugs. Healy describes a patient who experienced genital numbness on SSRI's, and who, several months after cessation, could rub a stiff bristle brush against her genitals with no sensation whatsoever. There are documented cases of people who have committed suicide due to sexual dysfunction. But you're absolutely right - if the benefit you experience outweighs any side effects experienced and possible risks, then it makes sense to fire away. I'd like to see a more formal protocol though rather than just sending someone away with a month's prescription - there should be some form of active follow-up.

I agree with you on suicidal ideation, but the data shows a doubled risk of suicide compared to no drugs.

Just as a matter of interest, what do the doctors you interact with tell their patients about how the drugs work?

Exactly. I thanked @o1s1n 's post as he had responded to mine. I have a policy of thanking anyone who quotes one of my posts, unless I think they're being a complete d1ck.

As above - it's nice to be polite. I even thanked your post quoting a post of mine, which you snipped before I could read what you quoted or what your response was. As you have waited since 9th Sept to have a go, implying that my argument has been torn apart (based on the post you've thanked), I'll pay you the courtesy of replying, despite the fact that I'll probably never figure out why people comment on debates when they either haven't read or understood the arguments on both sides.

I told o1s1n that I'd have a look at the site his table came from. I did, and here are a few quotes relating to the table taken from that site:

Keep in mind that a number '4' in the chart doesn't equal guaranteed side effects in a particular individual from a certain drug, nor does a '0' exclude the possibility that a patient may experience the corresponding side effect.

Additionally, the whole topic surrounding side effects is complex and there is room for interpretation. For example, Escitalopram is listed as a '0' for drowsiness, however, one of the more commonly reported side effects is fatigue and somnolence. 

Clear communication between the prescribing healthcare provider and patient about potential side effects is the most important component in building rapport and increasing treatment adherence, as up to 33% of all patients chose to discontinue their prescribed antidepressant due to intolerable side effects.

These statements seem to broadly support the points I was making, as do the links previously supplied by AndrewJRenko. One of those points was that SSRI's have a wide range of side effects - the table posted helpfully demonstrates just that. They're not my arguments btw, just my summaries of other people's arguments. The rabbit hole that @AndrewJRenko keeps accusing me of falling down must be pretty big, as it needs to contain WHO, NICE, and the entirety of the pharma industry, as the arguments I'm presenting are based on their studies and guidelines. Here's a few more links:

This one is based on published trials i.e. those submitted to the FDA. (There are other studies that include unpublished trials, which show no clinically significant benefit, but I can't find the link just now).

I'm not a medical expert but an NNT (number needed to treat) of about 7 is very scary for such widely prescribed medicines - it means 7 people have to exposed to harm (almost everyone experiences some side effects) in order for one person to benefit.

This link is to a study by John Read, Professor of Clinical Psychology, and is based on a survey of patients - it describes the adverse effects they have experienced:

These links are taken from Robert Whitaker's Mad in America website — he wrote the book Anatomy of an Epidemic which first sparked my interest in this stuff.

I could also talk about a WHO study examining the success rates of treating schizophrenia in Europe, South America and Africa. They found that the two societies with better social supports and less reliance on psychiatric drugs (i.e. not Europe) had dramatically better results. They were so shocked that they decided to repeat the study, and they got the same results.

Or the NICE guidelines, which refer to overprescribing and suggest watchful waiting as the best first response.

I'd be a lot happier if my argument had been torn to shreds, as it would mean the world would be a better place for those suffering from mental health problems, and the medical industry wouldn't be in quite the mess it seems to be in from the POV of informed consent.

I look forward to the day Gript are reporting on other news outlets being taken to court for all their misinformation they've printed over the years.