Many posters ask about alternatives for antidepressants ( they are considered triggers for rls).
This study shows that they are no better than placebos, therefore may not be necessary at all.
The study is part of a Cochrane review, so has credibility.
Obviously, see a qualified medical practitioner, before changing or going off any medication.
But this does hold out hope for some rls sufferers.
Thanks for the article.
I feel a debate coming on!
Firstly, this seems a bit of a researcher's game, like polticians' play games. They argue with each other in ideological terms often completely ignoring what the implications for normal people are.
One set of researchers (polticians) criticise the argument of another set of researchers (politicians) because they introduced "biases" so then go and introduce their own biases to "correct" for the other sets' biases.
They seem to treat ALL antidepressants the same, as far as I remember from my formal logic lessons decades ago, in a syllogism, the conclusion cannot be an "all" statement, if either of the premises are only "some" statements.
e.g. a syllogism
Premise 1 - ALL frogs are amphibians
Premise 2 - All amphibians can live in water or on land
Conclusion - Therefore All frogs can live in water or on land
The syllogism that these researchers seems to have used might go something like
ALL the studies reviewed compared SOME antidepressants to placebos
ALL (or some makes no difference) found no difference between anti-D and placebos
Therefore ALL antidepressants are no better than placebos
Or something like that, you get the idea.
There doesn't seem to be any consideration that SOME antidepressants might be better than others. Or maybe it's just the way it's reported!
Next : you could argue that whether a particular person is suffering "clinicial" depression is a matter of the subjective judgements of the person having the experience and the person diagnosing it, Even if a "depression scale" is used e.g. HADS or PHQ9 the depression score is based on the answers the person gives, (if they;e capable of giving any), but the answers are still subjective, and different people may interpret the question in different ways. This is "reliablity" i.e. the ability if a measuring tool to give consistent results. E.g. a ruler would be no good if it kept expanding and contracting, so one day it said something was 2cm long then it shrank and next day said it was 2.5 cm long.
This is like the new bridge I heard about recently, the architect designed it in meters, the engineers built it in yards - it fell down!
So, someone could say to me "I'm depressed", but there's no real way of knowing if I felt exactly the same way as they felt, would I say I was depressed?
Next the way drugs affect us each, differs.
SO, I think that possibly some drugs work for some people, some other drugs work for some other people, some drugs might not work for anybody, or no drugs work for some people.
Can you therefore conclude that NONE of the drugs work for ANYBODY?
Do note however that the article refers to "major" depression only.
I'm not sure what this means excactly, it used to be that depression was classified as "reactive" or "psychotic". These two terms don't appear to be used these days, but there were notable difference between the two. Psychotic depression was "major" and the methods of treatment could be quite extreme at one time e.g. Electro-Convulsive-Therapy or even lobotomy! They weren't particularly successful.
In that case, if the review is correct and it's found that antidepressants, (any of them) are no better than placebos for people with "major" depression, I can sort of believe it.
This does not mean however that antidepressants do not work for people with mild or moderate depression. It only means they don't work for major depression.
My opinion is, ( apart from people who have some underlying biochemical imbalance) that for people who suffer from mild to moderate depression there are non-pharmacological therapies that are just as effective as drugs, give longer term relief and increase resilience.
(they're more expensive!)
It's a shame then, that antidepressants might work for people that don't really need them and for the people that really need them, they don't work.
Does the world seem intelligently designed?
You have far too much time on your hands!😀
I'm just crap at prioritising it
DAMN Manerva, you started and ended that argument before I even pulled up for the starter - I should have read the thread before responding, rookie mistake number 2 (just after reading it and reading it wrong.
I stand by my big-pharma involvement and raise you everything Manerva has said, I knew by the time the PHQ9 bomb was dropped it was over, sorry madlegs1.
Now I am off to buy a new hat to doff at Manerva.
DANG!!🙂
I was going to contribute to this thread, but you said it all!
I did put in a caveat "apart from people who have some underlying biochemical imbalance" and I also confess I have taken antidepressants in the past for short periods on 3 occasions. I think my depressions at the time were classified as moderate, but to me they felt really bad, but were situational.
The first occasion was when I was 18 and I had no coping strategies to deal with the situation and solved the problem by leaving the situation, university.
The second situation was much later on and my wife put me in an impossible position which estranged me from my 3 daughters and I was off work foi 6 months, returned and retired the same year. I did stop the medicine, but my wife conspired with a GP and manipulated me into taking another. I only really had evidence of the conspiracy when I recently read my past medical records.
The third situation, although unfortunately I have had many failed relationships was when I was in a relationship that wasn't failing.but she ended it anyway for her own reasons which completely traumatised me. I was resisting going the medication route but became concerned when I started having terrible obsessive thoughts and was worried it was becoming "major".
When I was 18 I had amitriptyline, it didn't work.
When I was off work I had Citalopram, it did work, but I was mainly suffering anxiety, not depression. Same treatment. Withdrawal effects were quite awful.
The Dr who my wife conspired with said there was no such thing as withdrawal effects and I was having a relapse. I find it difficult to believe that all those people I found on googling it, who like me, experienced the "brain zaps" were making it up. Besides, in my psychiatruc studies I've never read that "brain zaps" were a symptom of depression. He put me on Mirtazepine. It didn't work, I got divorced anyway!
The third time was Citalopram, the obsessive thoughts declined, but I think this was largely a placebo effect. I only took it for 8 weeks.
I have more coping strategies now, I'm more resilient and I can more easily forsee anxiety provoking situations coming and avoid them.
I do sympathise with Raffs, the drug industry is massively exploitive, they're not in it for the good of the people! Profit! They do manipulate the results of trials.
And while we're at it! So are solicitors. £200 for writing a standard will that takes about 5 minutes to write.
Car keys also, a nightmare. I recently lost a car key and thought someone might have taken it. I got a quote for erasing that key from my car's computer, they said £92. I went to a key cutting shop and they quoted £70 for a replacement key that would unlock the door but not start the engine. When I asked if they could give me a key and cut the blade for me, they said thay clouldn't do it for my car. When I asked if I got a key and they cut the blade and I programmed it, they said they had to do it all and couldn't just cut the blade. Someone would have to come to my actual car, £150.
You can buy the key on ebay for £10, but you can;t get it cut and unless you know the key code, you can't programme it. I'd have to get someone to do a diagnostic to get the key code £70.
What a stitch up! It's a conspiracy.
I wonder how many doctors conspire with drug companies to use their antidepressants. (or opiates).
When they do credible studies on pharmaceutical antidepressants that weren't adulterated by big pharma that maybe I'll take the scientific industries word on non-pharmaceutical interventions:
scientificamerican.com/arti...
Now, madlegs1 - did you really need to get me on a soap box at this time of night? The only way it could have been worse if you had mentioned how cannabis wasn't therapeutic or of the dreaded soap inside the box!!!!
My husband read somewhere that 70% of antidepressants don’t work.
That’s it; Manerva said the rest.🙂
Buprenorphine and antidepressants
RLS and antidepressants
Antidepressants and RLS
Antidepressants and other meds
“Safe” antidepressants
