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SSRI's to treat neuroses Options
sandraleesmith46
Posted: Thursday, December 10, 2009 4:51:01 AM
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In the news, I just saw a story that some studies have shown that the use of a particular class of antidepressants, selective serotonin re-uptake inhibitors, treats neuroses creating more extroverted individuals, and theoretically preventing depression from occurring. While I am all for prophylaxis, the drugs in that class have some nasty side effects, and for some of us cause extreme anxiety states. Do we want artificially-induced extroversion, on the chance it might prevent a few cases of depression? And at the risk of the health of those taking those meds long term? Such a notion will have MD's passing out SSRI's like they did penicillin for colds in the 50's and look where that's gotten us, with all the antibiotic resistent organisms floating around now... Worse, such artificial extroversion could well lead to increases in risk-taking behaviors in younger people. These are not meds to be given lightly, or to everyone. It sounds like chemically-induced "happy" people, a bit like Brave New World, and other Sci-Fi novels where drugs were used as the means of keeping people compliant. Neuroses generally respond better to cognitive therapeutic techniques than meds in any case.
Isaac Samuel
Posted: Thursday, December 10, 2009 8:07:21 AM
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sandraleesmith46 wrote:

Neuroses generally respond better to cognitive therapeutic techniques than meds in any case.

True,Therapists and Psychologists can do the job well,but when you bring the Psychiatrists to the mix
you can't avoid meds.
EllieMae
Posted: Thursday, December 10, 2009 9:56:25 AM
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Joined: 4/16/2009
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As someone who was on one for approximately 6 years I can testify to both the positive and the negative of the particular medication I was on. Ultimately I do not regret going on it and it was my idea to request it---I had a huge anxiety problem and I am positive the medication helped me with that BUT... on the negative side I suspect it is responsible for my chronic hives which I have had for almost 5 years and I also believe it was beginning to negatively affect my liver and increase my blood pressure.... so I stopped taking it about 5 months ago...which I did very, very carefully and slowly. I do not regret my decision to stop either but I still have a problem with hives... which might be because I was on the medication for so long.. My brother also tried the same medication and got hives but his appeared much quicker and it was a lot easier for him to make the connection to the medication as the cause so he stopped right away.

As for counselling, etc., the biggest draw backs to those are: Takes a long time to get to the point of solving one's issues, usually costs a lot of money and finding the right person is often difficult. Also, depending on that person, just as Isaac said you often can't avoid the meds... We have a friend in this kind of situation and he has been in this vicious cycle for about 3 years now and we truly believe it is the meds he is on that is making it worse instead of better but he's in a situation where he can't get a different therapist ("not allowed"), and can't go against her directions which kind of ties into the connection with Brave New World and other Sci-Fi stories... like Big Brother, etc..... and so I would not in any way put it past government or secret socieities with hidden agendas to be pushing the meds and attempting to create a society with the majority of the population drugged in some manner in an attempt to control behavior and/or beliefs... Or even for the most base of reasons---MONEY. There is much money to be made for Big Pharma, obviously, and they are so edept in enticing people into taking drugs or making it all seem so good (despite the required addmission of the "potential" side effects). If someone doesn't pay attention to those (& I suspect most people don't if the advertisement is to be read vs watched) then they can really hook them...and I think because most of the televised ads list the side effects in such a way as to invite a "tune-out" mode in viewers.... But I am still grateful at this point for the relief I did get and I do know it was real--I was also fortunate that I only needed half the "usual maximum daily dose", so perhaps I was spared some of the nastier ill-effects---I just thought of something... why are they called "side-effects" instead of "ill-effects"??? Probably not good for business, eh?


Articulate Dreamer
Posted: Thursday, December 10, 2009 1:17:11 PM

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The SSRIs, when they came in 2 decades ago were a huge boost to the psychiatrists' armamentarium. Then there was a scare that the first one among them (fluoxetine, better known as Prozac) might actually drive people to suicide! That fear was laid to rest after careful scrutiny of the research.
The classification of mental illnesses is tentative and hardly as precise as it should be like it is for instance in respiratory diseases or cancer. This is because basic science (neurochemistry, genetics) research has to give us many more clues to elucidate the causes of various symptoms. In their wisdom, classifiers, many of whom are cutting edge clinical researchers themselves, have largely abandoned the term 'neurosis'; the more appropriate and far less pompous term 'disorder' is preferred, though disorders include not only the neuroses.
Sadness is a part of many disorders and SSRIs are just one, though important, part of the strategies in dealing with the most common illnesses that have sadness as the major component. True, many doctors, psychiatrists, most prominently, too often take recourse to prescribing medication rather than using various forms of psychotherapy. Cognitive therapy has become the latest bandwagon, but actually differing forms of therapy have quite a significant amount of the cognitive element in them!
Isaac's contention, i must humbly admit, has some validity. Many doctors just feel too insecure if they do not write a prescription! Also, it takes great sensitivity and not a little time to be a good psychotherapist: often doctors have limited resorces of each. Then again, training too often emphasises the tangible rather than the seemingly esoteric, so that pharmacology is given great prominence at the expense of therapy.
Sandralee, thank you for this thread. We need more dissuaders of 'lotus eating', the worst form of which is the one endorsed and even initiated by the physician.
Forrest Hooper, RN
Posted: Thursday, December 10, 2009 6:00:43 PM
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Joined: 12/10/2009
Posts: 4
Neurons: 12
Location: San Diego, CA
Ideally, SSRIs are used in conjunction with therapy of some kind. Then, one is, hopefully, treating both the "nature and nurture" side of the neurosis. If neuroses reflect the over or under expression of a gene or a group of genes with a resultant chemical imbalance in the brain, perhaps SSRIs are just the beginning of medications that will actually treat the problem where it occurs. And, actually the severity of side effects is much lower with SSRIs than with other classes of psychotropics, especially the older ones like thorazine.

In terms of the worry about too much extroversion, I see the underlying assumption Sandraleesmith makes is that happiness or extroversion would be artificial because of it is being “chemically-induced.” But what level of happiness or extroversion is the normal amount (if we are considering both ‘happiness’ and ‘extroversion’ to mean something similar)? From another point of view one could say that people are actually artificially less happy and introverted due to a chemical imbalance brought about by gene(s) dysfunction(ing). In that situation the people using the medications would potentially be functioning in a way that more accurately reflects who they truly are, allowing them to more fully reach their potential. That in turn makes for happier and more productive members of society. I have never a seen a figure that represents what the cost is in terms of losses to our GDP due to mental illness, but it must be enormous.

By the way, if MDs handout drugs like candy, it’s because people are demanding them. People still demand antibiotics when they are sick with viral illnesses! Some MDs won’t give in to such demands, but with the healthcare industry now being held to the standard of ‘patient satisfaction’, some practitioners are wary of receiving negative feedback and so give in to the demand. The real problem, as I see it, lies with the uneducated consumers who refuse to listen to the expertise of their doctors. I've never understood where all the distrust comes from.
grammargeek
Posted: Thursday, December 10, 2009 6:05:44 PM
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Forrest Hooper, RN wrote:
Ideally, SSRIs are used in conjunction with therapy of some kind. Then, one is, hopefully, treating both the "nature and nurture" side of the neurosis. If neuroses reflect the over or under expression of a gene or a group of genes with a resultant chemical imbalance in the brain, perhaps SSRIs are just the beginning of medications that will actually treat the problem where it occurs. And, actually the severity of side effects is much lower with SSRIs than with other classes of psychotropics, especially the older ones like thorazine.

In terms of the worry about too much extroversion, I see the underlying assumption Sandraleesmith makes is that happiness or extroversion would be artificial because of it is being “chemically-induced.” But what level of happiness or extroversion is the normal amount (if we are considering both ‘happiness’ and ‘extroversion’ to mean something similar)? From another point of view one could say that people are actually artificially less happy and introverted due to a chemical imbalance brought about by gene(s) dysfunction(ing). In that situation the people using the medications would potentially be functioning in a way that more accurately reflects who they truly are, allowing them to more fully reach their potential. That in turn makes for happier and more productive members of society. I have never a seen a figure that represents what the cost is in terms of losses to our GDP due to mental illness, but it must be enormous.

By the way, if MDs handout drugs like candy, it’s because people are demanding them. People still demand antibiotics when they are sick with viral illnesses! Some MDs won’t give in to such demands, but with the healthcare industry now being held to the standard of ‘patient satisfaction’, some practitioners are wary of receiving negative feedback and so give in to the demand. The real problem, as I see it, lies with the uneducated consumers who refuse to listen to the expertise of their doctors. I've never understood where all the distrust comes from.


Very nice post, Forrest Hooper, RN. Thank you for your valuable contribution.

And welcome to TFD!
Geeman
Posted: Thursday, December 10, 2009 6:08:51 PM

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Joined: 10/2/2009
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We've grown so fearful of "negative" emotions these days. It makes no sense to me. Be depressed from time to time. If you're not a little depressed, angry, annoyed, jealous, anxious, afraid, sad, lonely or paranoid from time to time then that's a pretty good sign you haven't been paying attention.... (To paraphrase an old aphorism.)

Sure, people who are actually a danger to themselves or others should get some sort of medical treatment, but barring actual harm, people who are depressed should deal with it in some other way, or not at all. Be a little depressed. It won't kill you and Depeche Mode could use the album sales.
Forrest Hooper, RN
Posted: Thursday, December 10, 2009 6:19:02 PM
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Joined: 12/10/2009
Posts: 4
Neurons: 12
Location: San Diego, CA
If it was only a problem of a little depression I would agree. But again I stress that if the situation is abnormal to begin with then why not treat it? Having the blues from time to time is one thing but having constant anhedonia is quite another.
Forrest Hooper, RN
Posted: Thursday, December 10, 2009 6:20:51 PM
Rank: Newbie

Joined: 12/10/2009
Posts: 4
Neurons: 12
Location: San Diego, CA
grammargeek wrote:
Forrest Hooper, RN wrote:
Ideally, SSRIs are used in conjunction with therapy of some kind. Then, one is, hopefully, treating both the "nature and nurture" side of the neurosis. If neuroses reflect the over or under expression of a gene or a group of genes with a resultant chemical imbalance in the brain, perhaps SSRIs are just the beginning of medications that will actually treat the problem where it occurs. And, actually the severity of side effects is much lower with SSRIs than with other classes of psychotropics, especially the older ones like thorazine.

In terms of the worry about too much extroversion, I see the underlying assumption Sandraleesmith makes is that happiness or extroversion would be artificial because of it is being “chemically-induced.” But what level of happiness or extroversion is the normal amount (if we are considering both ‘happiness’ and ‘extroversion’ to mean something similar)? From another point of view one could say that people are actually artificially less happy and introverted due to a chemical imbalance brought about by gene(s) dysfunction(ing). In that situation the people using the medications would potentially be functioning in a way that more accurately reflects who they truly are, allowing them to more fully reach their potential. That in turn makes for happier and more productive members of society. I have never a seen a figure that represents what the cost is in terms of losses to our GDP due to mental illness, but it must be enormous.

By the way, if MDs handout drugs like candy, it’s because people are demanding them. People still demand antibiotics when they are sick with viral illnesses! Some MDs won’t give in to such demands, but with the healthcare industry now being held to the standard of ‘patient satisfaction’, some practitioners are wary of receiving negative feedback and so give in to the demand. The real problem, as I see it, lies with the uneducated consumers who refuse to listen to the expertise of their doctors. I've never understood where all the distrust comes from.


Very nice post, Forrest Hooper, RN. Thank you for your valuable contribution.

And welcome to TFD!


Thanks, grammargeek!
grammargeek
Posted: Thursday, December 10, 2009 6:22:44 PM
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Joined: 3/21/2009
Posts: 11,136
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Location: Arizona, U.S.
Geeman wrote:
We've grown so fearful of "negative" emotions these days. It makes no sense to me. Be depressed from time to time. If you're not a little depressed, angry, annoyed, jealous, anxious, afraid, sad, lonely or paranoid from time to time then that's a pretty good sign you haven't been paying attention.... (To paraphrase an old aphorism.)

Sure, people who are actually a danger to themselves or others should get some sort of medical treatment, but barring actual harm, people who are depressed should deal with it in some other way, or not at all. Be a little depressed. It won't kill you and Depeche Mode could use the album sales.


Geeman, a lot of discussion surrounding this topic came up the other day. I didn't see any posts from you there so I am unsure whether or not you've already seen it. Therefore, I am going to take the liberty of posting the link to it here.

http://forum.thefreedictionary.com/postst5248_The-benifits-of-simple-depression.aspx
RuthP
Posted: Thursday, December 10, 2009 6:24:50 PM

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Joined: 6/2/2009
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This was in TFD's In the News today.

The full article states it was a sample of 240 individuals randomly assigned to SSRI (Prozac)- 120 people; cognitive-behavioral therapy- 60 people; or placebo looking like Prozac- 60 people. Results between the two treatment groups were the same with respect to depression, but neurosis symptoms showed better improvement under SSRI. Placebo group did worse on both depression and neurosis.

I had several questions:
1. Who funded this?
2. Did that entity have control over publication?
3. Have there been other similar trials which remain unpublished?
4. How were the evaluations done?
5. Were the evaluators blinded?
6. Were the prescribing clinicians blinded?
7. Were the patients blinded? (Suspect so, since the placebo looked like the SSRI.)

And, a reminder: if this is the first trial of this sort, one could only say "These are very interesting results. I anxiously await independent confirmation."
Tony Miller
Posted: Thursday, December 10, 2009 10:03:52 PM
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Might want to take a look at http://www2.hull.ac.uk/news_and_events/news/2008_news_archive/february/antidepressants.aspx
Antidepressants are ineffective for most patients, study finds

26th February 2008

There is little reason to prescribe antidepressants to the majority of depressed patients, according to a group of experts, led by Professor Kirsch at the University of Hull.
Luftmarque
Posted: Friday, December 11, 2009 3:55:31 AM

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The SSRIs I've tried certainly relieved my anxiety, but they also made me feel as though I were living inside a nice fluffy pillow. Sure, I worried less, but that was mostly because I no longer gave a s**t.
sandraleesmith46
Posted: Friday, December 11, 2009 4:15:37 AM
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Location: Arizona's high deserts
[quote=Tony Miller]Might want to take a look at http://www2.hull.ac.uk/news_and_events/news/2008_news_archive/february/antidepressants.aspx
Antidepressants are ineffective for most patients, study finds

26th February 2008

There is little reason to prescribe antidepressants to the majority of depressed patients, according to a group of experts, led by Professor Kirsch at the University of Hull.[/quote
]
This fits a lot closer to accurate in my personal experience with antidepressants. Some did nothing, sime did entirely the wrong things{among those Prozac}, and some worked a little, for awhile then needed more to get the effect, and we all know how that spiral goes. I worked with a lot of those "older" drugs myself as a nurse too. I am acquainted with both sides of that fence well. I also tried some SNRI's with no better results. If you want to put people on something "blanket" like that, try SAMe and/ or DLPA. They work as well or better, in my experience. But ask some of the chocolate lovers in the forum, as they've been using DLPA regularly, whether they knew it or not. It's still my drug of choice!
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