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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 2 to 26 of 26. Go back in thread:
Posted by morganator on June 9, 2010, at 22:19:16
In reply to Do AD's Help Prevent Future Depression?, posted by Phillipa on June 9, 2010, at 21:35:50
Yes!!!!!!!! When they are working o.k. YEEEEEESSSSSS!!!!!
Posted by linkadge on June 10, 2010, at 13:53:09
In reply to Do AD's Help Prevent Future Depression?, posted by Phillipa on June 9, 2010, at 21:35:50
>There's no doubt that antidepressant drugs are >effective in the treatment of depression.
I just stopped reading there.
Linkadge
Posted by stargazer2 on June 10, 2010, at 23:00:47
In reply to Do AD's Help Prevent Future Depression?, posted by Phillipa on June 9, 2010, at 21:35:50
Ha, ha, Ha that was what I was told after my first round of AD's in 1986. Here I am 24 years later and I have never gotten off the depression merry go round. Back then they always took you off meds and I begged my doctor to put me back on the Nardil and she reluctantly acquiesced. I had to convince her that without the med, I immediately felt all of my depression come flooding back. It was like fighting tooth and nails to be put back on it...That was the beginning of my med smorgasboard and it just goes on and on. The majority of the meds I have taken have been totally useless. Only MAO's have ever worked and this proves to me my depression is truly biological. I just hope they don't discontinue Nardil or Marplan again and send me into a crisis of epic proportions when it happened to me in 1993, very bad outcome as no meds were available that worked at all. Years just thrown down the tubes.
Star
Posted by floatingbridge on June 11, 2010, at 0:03:17
In reply to Re: Do AD's Help Prevent Future Depression?NO, posted by stargazer2 on June 10, 2010, at 23:00:47
No nardil in 1993? For real? How long? How did that happen? (Okay, too many questions--.)
Posted by stargazer2 on June 11, 2010, at 0:39:37
In reply to Re: Do AD's Help Prevent Future Depression?NO » stargazer2, posted by floatingbridge on June 11, 2010, at 0:03:17
Actually it was Marplan that was discontinued in 1993 (I decompensated after a long period of stability and lost a really good job). I think Nardil still existed but no longer worked for me. Then Nardil was reformulated, not sure of the year and Marplan come back out and also did not work the way it had worked before, so losing all of those really good original MAO's, that I believe were cleaner and more effective at low doses, messed me up big time.
Posted by linkadge on June 11, 2010, at 13:37:29
In reply to Re: Do AD's Help Prevent Future Depression?NO, posted by stargazer2 on June 10, 2010, at 23:00:47
>Only MAO's have ever worked and this proves to >me my depression is truly biological.
Not necessarily. A bunch of researchers noticed way back, that old MAOI's (initially used for TB) could make mentally normal TB patients abnormally cheerful.Linkadge
Posted by bleauberry on June 11, 2010, at 17:41:55
In reply to Do AD's Help Prevent Future Depression?, posted by Phillipa on June 9, 2010, at 21:35:50
If browsing through the forums where people rate their medications, there is only one med that seems to provide protection from relapse for an indefinite time...10 years, even 20 years, a lifetime. That is parnate. I think I've seen one or two where it was either prozac or zoloft as long as 8 or 10 years. Rare, but it has happened. Parnate though, when people respond to it, seem to stay well indefinitely.
Posted by Phillipa on June 11, 2010, at 21:03:50
In reply to Re: Do AD's Help Prevent Future Depression?, posted by bleauberry on June 11, 2010, at 17:41:55
A poster here currently posting was stable and functioning well on paxil l0mg for either 11 or 13 years. I feel it depends on the person. Phillipa
Posted by Conundrum on June 12, 2010, at 9:55:41
In reply to Re: Do AD's Help Prevent Future Depression?, posted by bleauberry on June 11, 2010, at 17:41:55
Someone in my family took nardil for about 30 years without relapse. In fact when they had surgery they had to stop nardil and ended up in the hospital for a long time. (Kids don't smoke.) When she finally came home 2 months later she was in teh same spirits as before. So it seems like chronic nardil use may have given her the ability to get over her phobias, depression, and anxiety. I'm more likely to believe it was do to psychological changes and insight that the drug allowed her to have over the years than a permanent biological change.
Posted by linkadge on June 12, 2010, at 15:07:09
In reply to Re: Do AD's Help Prevent Future Depression? » bleauberry, posted by Conundrum on June 12, 2010, at 9:55:41
Some patients get better "in spite of" medication rather than "because of" medication.
Linkadge
Posted by bleauberry on June 12, 2010, at 20:06:49
In reply to Re: Do AD's Help Prevent Future Depression? » bleauberry, posted by Phillipa on June 11, 2010, at 21:03:50
> A poster here currently posting was stable and functioning well on paxil l0mg for either 11 or 13 years. I feel it depends on the person. Phillipa
Yeah, that's kind of like the few I saw that went about a decade on either prozac or zoloft. Cool when it happens, but oh so rare. I doubt you'll ever hear of another person going 11 years on paxil. That is so rare.
Of course it depends on the person as you said. But no matter who the person, the odds of that happening are so low as to be almost nonexistent. One in a thousand maybe.
Parnate and nardil, different story. You can find numerous people that have had them work for 10, 20, 30 years. Those stories aren't so rare.
Posted by Phillipa on June 12, 2010, at 21:41:23
In reply to Re: Do AD's Help Prevent Future Depression?, posted by bleauberry on June 12, 2010, at 20:06:49
Many do get better and require no meds. The trials are for weeks not years and info with meds says reevaluate if extending time period over a few months. Phillipa
Posted by SLS on June 13, 2010, at 2:18:35
In reply to Re: Do AD's Help Prevent Future Depression?, posted by bleauberry on June 12, 2010, at 20:06:49
> > A poster here currently posting was stable and functioning well on paxil l0mg for either 11 or 13 years. I feel it depends on the person. Phillipa
>
> Yeah, that's kind of like the few I saw that went about a decade on either prozac or zoloft. Cool when it happens, but oh so rare. I doubt you'll ever hear of another person going 11 years on paxil. That is so rare.
>
> Of course it depends on the person as you said. But no matter who the person, the odds of that happening are so low as to be almost nonexistent. One in a thousand maybe. 0Where do you get your numbers from? From working with doctors over the last 30 years, my impression is that the odds are quite a bit better than that.
> Parnate and nardil, different story. You can find numerous people that have had them work for 10, 20, 30 years. Those stories aren't so rare.The same is true of tricyclics.
- Scott
Posted by linkadge on June 13, 2010, at 7:49:11
In reply to Re: Do AD's Help Prevent Future Depression? » bleauberry, posted by SLS on June 13, 2010, at 2:18:35
Unfortunately, there is no current way to really tell. Sure doctors will have you believe that the meds are what is keeping a patient well, but...
The only way you could tell is by doing a placebo crossover where some patients come off the active drug. The only problem here is that the ones who come off might know on account of discontinuation effects.
Linkadge
Posted by SLS on June 13, 2010, at 10:24:59
In reply to Re: Do AD's Help Prevent Future Depression?, posted by linkadge on June 13, 2010, at 7:49:11
> Unfortunately, there is no current way to really tell. Sure doctors will have you believe that the meds are what is keeping a patient well, but...
>
> The only way you could tell is by doing a placebo crossover where some patients come off the active drug. The only problem here is that the ones who come off might know on account of discontinuation effects.I understand what you are saying. I don't know if any such prospective investigations have been conducted over the course of multiple years. I don't recall coming across any. There are a few that demonstrate the superiority of continuation treatment over shorter periods.
Life-charting can be helpful to establish the pattern of one's illness and determine changes in its course in association with treatment. The NIMH publishes case histories to demonstrate this. Still, this is not a placebo controlled blinded trial. I guess it is really a large collection of anecdotes, but I believe it has clinical value.
- Scott
Posted by morganator on June 13, 2010, at 12:42:57
In reply to Re: Do AD's Help Prevent Future Depression?, posted by bleauberry on June 11, 2010, at 17:41:55
The only reason why Zoloft did not work for me for more than 8 years is because I stopped taking it(and not because it was not working anymore). Otherwise, I may still be on it and doing fairly well. That would have made it a successful 11 years on Zoloft, and possibly many more. I know of 3 people that have been successfully treated on SSRIs for more than 10 years-Prozac for 20, Prozac for 15, Lexapro for 10, and Zoloft for 12. These people are still taking their SSRI and still doing well.
I think we need to start to realize that what we read on Psycho-Babble and elsewhere on the net is not necessarily what is occurring in people's lives that do not frequent the interenet and talk about their antidepressant experiences. Psycho-Babblers are a minute sample of the population that obviously came here because they were in need of help and advice. There are thousands out there that are doing well on their medications that have no reason/motivation to come on the internet and talk about how well they are doing. They just want to take their little pill every morning, forget about it, and live their lives.
Posted by morganator on June 13, 2010, at 12:53:50
In reply to Re: Do AD's Help Prevent Future Depression?, posted by morganator on June 13, 2010, at 12:42:57
One question we have to ask here is, "Are we doing everything in our power to help prevent another depressive episode while having some success on an antidepressant?" Or, "Do we just believe that an antidepressant alone is the only thing that can help us because our illness is purely biologically based."
I guess what I am saying is that I believe we can do many things to set ourselves up and our lives up in a way that we can reduce the likeliness of having a major relapse that we can't seem to pull ourselves out of.
Posted by SLS on June 13, 2010, at 14:18:08
In reply to Re: Do AD's Help Prevent Future Depression?, posted by morganator on June 13, 2010, at 12:53:50
> I guess what I am saying is that I believe we can do many things to set ourselves up and our lives up in a way that we can reduce the likeliness of having a major relapse that we can't seem to pull ourselves out of.
I totally agree with you.
I have been actively working on psychological issues so as to optimize my chances of responding to drug treatment and help prevent future relapses.
- Scott
Posted by morganator on June 13, 2010, at 14:55:47
In reply to Re: Do AD's Help Prevent Future Depression? » morganator, posted by SLS on June 13, 2010, at 14:18:08
That's awesome Scott. I wish you the best of luck.
I only wish I had known many years ago that I was bipolar. I may have stayed on Zoloft, maybe added a little lithium, continued on with group therapy, maintained positive relationships, and protected myself more from physical and emotional trauma. I truly believe if I had done all of these, I would not have had my last major mixed episode 2 years ago and I would be in a much better place now.
Scott I really hope you and I and others here find a way to feel better and enjoy the rest of our lives to the fullest extent possible. Again, best of luck to you brotha.
Morgan
Posted by Phillipa on June 13, 2010, at 19:10:02
In reply to Re: Do AD's Help Prevent Future Depression?, posted by morganator on June 13, 2010, at 12:42:57
You know that's like my sister and her Daughter. Both have been on zoloft for many many years at least 15. And here's good news I know my sister first was on paxil gained weight over the years switched to zoloft and lost weight. So two SSRI"s work for her. That's encouraging. Across street neighbors also 70's been on one wellbutrin and other on forget which one many many years and they feel great. Phillipa
Posted by floatingbridge on June 13, 2010, at 22:09:33
In reply to Re: Do AD's Help Prevent Future Depression?, posted by SLS on June 13, 2010, at 10:24:59
Life charting? I'll google the term. So far I have about two years of charts. First mood, then mood and med, adding activities (beneficial or adverse), pain levels, etc. This is helping me quite a bit. I recommend some form of charting/record keeping to anyone taking medication and/or in therapy. For other illness as well.
Posted by SLS on June 14, 2010, at 5:21:47
In reply to Re: Do AD's Help Prevent Future Depression? » SLS, posted by morganator on June 13, 2010, at 14:55:47
> Scott I really hope you and I and others here find a way to feel better and enjoy the rest of our lives to the fullest extent possible.
That's worth a prayer or two...
- Scott
Posted by chujoe on June 14, 2010, at 6:13:00
In reply to Re: Do AD's Help Prevent Future Depression?, posted by morganator on June 13, 2010, at 12:53:50
> One question we have to ask here is, "Are we doing everything in our power to help prevent another depressive episode while having some success on an antidepressant?" Or, "Do we just believe that an antidepressant alone is the only thing that can help us because our illness is purely biologically based."
>
> I guess what I am saying is that I believe we can do many things to set ourselves up and our lives up in a way that we can reduce the likeliness of having a major relapse that we can't seem to pull ourselves out of.
>This seems like a fundamental insight about the nature of psychoactive drugs. One has to give the drugs a chance -- the molecules don't just interact with our brains, they interact with our minds. O perhaps it's more accurate to say our minds interact with the molecules. This is a place Western science is very reluctant to go, I realize.
This is not the same as the placebo effect, either. It's not the belief that the drug will work that improves a person's illness, but the person's active support of the drug's effects.
Two caveats: 1) There are some mental conditions that are so severe the above does not apply. 2) One has to be careful not to adopt a "blame the patient" attitude, but the person taking psych drugs needs to be encouraged to make the sorts of choices that will work with the drug(s) to change the way he/she experiences the world.
Posted by SLS on June 14, 2010, at 6:40:32
In reply to Re: Do AD's Help Prevent Future Depression?, posted by chujoe on June 14, 2010, at 6:13:00
> > One question we have to ask here is, "Are we doing everything in our power to help prevent another depressive episode while having some success on an antidepressant?" Or, "Do we just believe that an antidepressant alone is the only thing that can help us because our illness is purely biologically based."
> >
> > I guess what I am saying is that I believe we can do many things to set ourselves up and our lives up in a way that we can reduce the likeliness of having a major relapse that we can't seem to pull ourselves out of.> This seems like a fundamental insight about the nature of psychoactive drugs. One has to give the drugs a chance -- the molecules don't just interact with our brains, they interact with our minds. O perhaps it's more accurate to say our minds interact with the molecules. This is a place Western science is very reluctant to go, I realize.
>
> This is not the same as the placebo effect, either. It's not the belief that the drug will work that improves a person's illness, but the person's active support of the drug's effects.
>
> Two caveats: 1) There are some mental conditions that are so severe the above does not apply. 2) One has to be careful not to adopt a "blame the patient" attitude, but the person taking psych drugs needs to be encouraged to make the sorts of choices that will work with the drug(s) to change the way he/she experiences the world.
Great post.The brain determines the mind as the mind sculpts the brain.
- Scott
Posted by linkadge on June 15, 2010, at 15:38:51
In reply to Re: Do AD's Help Prevent Future Depression?, posted by morganator on June 13, 2010, at 12:53:50
Sometimes depression is just a warning sign for people to change their behavior (overwork, job they hate, bad relationships etc). Instead, by just taking a drug, you convince yourself that the problem is all in your head. This can be much more palatable.
Linkadge
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