effectiveness of anti-depression tablets

stupidusername

I'm on prozac for moderate depression. I'm on 40mg a day, two tablets since September of last year. Prior to this I was on a single dose, can't remember for how long but only a couple of months. Prior to this, which is where it started I began on Lexapro (with a different doctor). Didn't really find the lexapro great, and so my doctor changed me to prozac. When I went back to him to review it, he doubled the dose, and then on reviewing that I told him I'd had a good few weeks and so he said I should stick with this for 6 months, giving me a 6 month prescription.

I've been thinking lately that it seems to not do anything good for me. It has made a slight difference in terms of my confidence (in some ways) but has basically had no other positive effects (but a few negatives). So i've decided to go back to the doctor, to discuss it with him, and maybe go on something else. I've an appointment for Thursday. But it's got me wondering what I'm expecting from tablets. before I was on anything, the idea of being on medication was like it's going to be a magical automatic fix, and it wasn't. So I dealt with it, but that wasn't doing any good so when I moved to prozac and then when I had those good weeks, I thought this is as good as its going to get. It hasn't even been good since then anyway. But just wondering is it completely stupid to expect that these would do anything for me? And if so, what's the point in taking them? What has anyone else expected to get from them, and have your expectation been met? It's hard to believe but surely some people must find them good....?

star-pants

It's not stupid to think that medication might help improve your condition be it physical or emotional.
I was on different medication for my fibromyalgia, and the one that helped most I'd a bad reaction to and couldn't take. The others seemed to be more bad than good so after discussing with my doctor I decided to take a break, see the difference again.

If somethings not working for you - you need to discuss it all with your doctor, tell them what good or bad it's doing, and see if they can help you figure it out, decide about dosage or even alternative to what you're on.
Medication affects different people in different ways. What might work for one won't always work for another. But hopefully you can come up with a solution after discussing with your doctor.

Kevster

As long as the side-effects aren't too bad, just stay on the medication and get into the habit of just taking it at the designated times. Lexapro is an effective drug, but it's effects re barely noticeable if you 'sit around' waiting for it to work. These things take time, so just take it (prozac, in youre case now) and get on with your life. Too many patients expect these drugs to take all of their pain away, but that is never the case. Most of the recovery work must come from you.

Kevin

stupidusername

Kevster wrote: »

As long as the side-effects aren't too bad, just stay on the medication and get into the habit of just taking it at the designated times. Lexapro is an effective drug, but it's effects re barely noticeable if you 'sit around' waiting for it to work. These things take time, so just take it (prozac, in youre case now) and get on with your life. Too many patients expect these drugs to take all of their pain away, but that is never the case. Most of the recovery work must come from you.

Kevin

Thanks for the input....but are you saying I shouldn't even question what it's doing for me? I'm on a double dose since September so it's not like I haven't given it time... I just kinda feel like it's silly to be taking so many tablets for nothing.

alias141282

OP, as regards medication there are responders and non-responders. Recent reviews of the research have shown that the effectiveness of antidepressants is actually quite limited above and beyond placebo in all but the most severe cases of depression.
http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0050045

If the medication isn't working for you maybe try Cognitive Behavioural Psychotherapy. Try to get an appointment with a psychologist. http://www.psihq.ie/Find%20a%20Psychologist2.pdf

There aren't any quick fixes. It takes a bit of time and work to learn to manage your mood and to learn to tolerate distress without getting caught up in a spiral of rumination and self-blame.

Read some of the stuff Tony Bates has written: http://www.rte.ie/radio1/marianfinucane/1185304.html

Or his book: http://www.amazon.com/Understanding-Overcoming-Depression-Common-Approach/dp/1580910319

Maybe check out mindfulness: http://mbct.co.uk/about-mbct/

http://www.mindfulnesstapes.com/

stupidusername

thanks alias. I'm interested in trying to sort things out myself, i'm still waiting to hear from the public service about counselling (waiting for months now) as i'm unemployed and can't really afford to pay huge sums for it. I am interested in CBT as i think this is what I need more than counselling, but does anyone happen to know if there's any way I could access this service with my medical card??? I can't afford to pay it myself, and I don't want to continue as I am.

I don't really expect the anti-d's to make everything perfect but did expect something better than this. My doctor isn't very interested / nice so I don't like the idea of facing him to talk to him about this not working at all. Im fearing he's just going to say - well they're not going to fix you! I know...... I just only want to be on them if they're going to do something.

stupidusername

I went to the doctor today. Before I even got to tell him what i was there for he told me he got a letter from the HSE (presumably) about the counselling I had requested. So I thought I'd be getting an appointment soon. But he told me they said 'no'. I was like what? He said the letter said their services were better given to people who needed it more. I'm stunned.

So I he told me they suggested in place of counselling to up my dose of medication, or to change me to an SNRI. Which I also can't believe.

Is it just me or does this service seem an absolute joke?

Well I went on to talk to him about changing to something else anyway. He wasn't even going to ask how I was finding my current meds. I kinda forced him to listen to the big side effects. So anyway he's changed me to Efexor. Though I'd already looked up SNRIs as I thought he might suggest this. And the big thing is it could affect people with heart problems. I've undiagnosed SVT, cannot get a doctor to actually confirm it, hence it's undiagnosed. They just keep telling me it's nothing. So i mentioned this to him, and of course even after telling me SNRIs don't work with the heart, and looking up online what possible problems there are, he looked through my old records (about the SVT) and said he'd no problems prescribing Efexor for me.

I think it's getting to the point where I have to change doctors. He's unbelievable. I would've been bothered more about him, only for the letter from the HSE. Can you believe this?

I'm unemployed and cannot afford to pay 50-100 euros a week for sessions. And as it'll be minimum 3 weeks before there's a chance these tablets will do anything, and I can't get counselling / therapy until I can afford it myself. So much for seeking help when you need it.

adm

I've been on Efexor for several years and it has helped me.
Just so you know though it's pretty hard to get off - should you want to.
I don't as I think it's helping. I've been on a few different ones over the years.
It helps though it is by no means a miracle cure.

It's pretty unbelievable about the counselling – up the medication instead of counselling? Unreal that they would say that.

Novella

There are places where you can get counselling on a what you can afford basis. www.dctc.ie
I'd recommend looking into that.

On the effectiveness of anti-depressants, well, they have been proven in studies to work so...
For me, personally, I've been on Zispin for a while now and sometimes I have periods of immense positivity, where I feel like I can do anything etc. I have down days as well, but I mean, I don't expect a tablet to be a miracle fix. It's not a pill of happiness.
I never really had glimpses of 'maybe things will be ok' before though, so for me, I'd say Zispin has helped me, even if only sometimes.

It can be trial and error too, finding the medication that works for you, so don't give up.

stupidusername

Novella wrote: »

There are places where you can get counselling on a what you can afford basis. www.dctc.ie
I'd recommend looking into that.

On the effectiveness of anti-depressants, well, they have been proven in studies to work so...
For me, personally, I've been on Zispin for a while now and sometimes I have periods of immense positivity, where I feel like I can do anything etc. I have down days as well, but I mean, I don't expect a tablet to be a miracle fix. It's not a pill of happiness.
I never really had glimpses of 'maybe things will be ok' before though, so for me, I'd say Zispin has helped me, even if only sometimes.

It can be trial and error too, finding the medication that works for you, so don't give up.

Thanks, but I don't live in Dublin.

Novella

stupidusername wrote: »

Thanks, but I don't live in Dublin.

You could try : www.lowcostcounselling.org then.
There are counsellors outside of Dublin on that. Sorry, I should have asked your location first!

stupidusername

Novella wrote: »

You could try : www.lowcostcounselling.org then.
There are counsellors outside of Dublin on that. Sorry, I should have asked your location first!

Again, thanks, but none of them are anywhere near where I am.

stupidusername

adm wrote: »

I've been on Efexor for several years and it has helped me.
Just so you know though it's pretty hard to get off - should you want to.
I don't as I think it's helping. I've been on a few different ones over the years.
It helps though it is by no means a miracle cure.

It's pretty unbelievable about the counselling – up the medication instead of counselling? Unreal that they would say that.

Thanks for the reply. One thing I suppose I do worry about is coming off this stuff, as I think my doctors think i should only need it for a year. Don't know how they guess that though. Maybe my original doctor said that based on starting on them after my mam died last year, maybe she thought that's what my depression was mostly from. i don't know.

I really can't believe it about the counselling. I've spent ages since trying to find a way of getting some help, but just can't seem to. It's so sad to think that there's no one in the country that you can get help from. Have you had any therapy?

Undead

Kevster wrote: »

As long as the side-effects aren't too bad, just stay on the medication and get into the habit of just taking it at the designated times. Lexapro is an effective drug, but it's effects re barely noticeable if you 'sit around' waiting for it to work. These things take time, so just take it (prozac, in youre case now) and get on with your life. Too many patients expect these drugs to take all of their pain away, but that is never the case. Most of the recovery work must come from you.

Kevin

Probably not the best time nor place, but I physically make Lexapro, two batches of it a day! Don't take this the wrong way, but I'm glad to hear of somebody using it. I don't mean that in a bad way, its just when you work for a large American company, you never hear or see, or expect to hear or see the results of your hard work. Just thought it interesting that someone in Ireland is using what I make on a daily basis. Sorry if i sound insensitive.

nesf

alias141282 wrote: »

OP, as regards medication there are responders and non-responders. Recent reviews of the research have shown that the effectiveness of antidepressants is actually quite limited above and beyond placebo in all but the most severe cases of depression.
http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0050045

That study is of only 4 of the newer antidepressants and shouldn't be taken as being indicitive of antidepressents in general, especially ones from different classes such as tricyclics, MAOIs and so on.

nesf

stupidusername wrote: »

I went to the doctor today. Before I even got to tell him what i was there for he told me he got a letter from the HSE (presumably) about the counselling I had requested. So I thought I'd be getting an appointment soon. But he told me they said 'no'. I was like what? He said the letter said their services were better given to people who needed it more. I'm stunned.

So I he told me they suggested in place of counselling to up my dose of medication, or to change me to an SNRI. Which I also can't believe.

Is it just me or does this service seem an absolute joke?

The uncomfortable truth is that we have limited resources in health care in general and just like how you won't get referred to a consultant for a straightforward chest infection you often will find resources are rationed and given out to those in the greatest need first. It's a bitch but life's like that and you just need to get on with it and get over it and move on with things. It's a real pity because councelling for milder depression is often a very, very good option but since mental illness isn't particularly well funded versus the number of patients needing care, services need to be rationed and doled out on a "greatest need" basis.*

*This is especially true if you live in a rural area or somewhere else where low population density means very few counselling spots available to be given out to patients. I had a 40 mile roundtrip to see my counsellor and a 70 mile roundtrip to see my psychiatrist when I was a teenager for example growing up in a rural and fairly sparsely populated area.

stupidusername

Went back to the doctor today for an early review of efexor, and to up the dose after two weeks of being on 37.5mg. He asked about the side effects, i told him i still have extreme tiredness (i need to sleep during the day every day) and he said that could be the depression. Though I told him twice while I was there I know it's the meds, I've always been out of energy, but never before have i had to sleep so much, as I have since i've been on double prozac.

Again he ignored it, though it's really a big deal to me. And I said if i get a job it could be a problem. THEN he said almost delighted to himself that well if i'm looking for a job I couldn't be too badly depressed. I said I don't want a job (have a lot of worries about that) but I have to get one (especially as i can't get any counselling through the HSE), and he said still it's a good thing as if I was severely depressed i'd be completely hopeless about the future, and wouldn't even consider getting a job. I couldn't believe it. I actually felt worse coming out of there. He basically belittles everything I say to him.

What am I meant to do? I've gotten a CBT book to try work at things myself, but don't know what else I can do for help. Though I suppose wanting to get help itself is a sign of a lack of depression. feckin hell. Any ideas anyone?

nesf

stupidusername wrote: »

Went back to the doctor today for an early review of efexor, and to up the dose after two weeks of being on 37.5mg. He asked about the side effects, i told him i still have extreme tiredness (i need to sleep during the day every day) and he said that could be the depression. Though I told him twice while I was there I know it's the meds, I've always been out of energy, but never before have i had to sleep so much, as I have since i've been on double prozac.

Again he ignored it, though it's really a big deal to me. And I said if i get a job it could be a problem. THEN he said almost delighted to himself that well if i'm looking for a job I couldn't be too badly depressed. I said I don't want a job (have a lot of worries about that) but I have to get one (especially as i can't get any counselling through the HSE), and he said still it's a good thing as if I was severely depressed i'd be completely hopeless about the future, and wouldn't even consider getting a job. I couldn't believe it. I actually felt worse coming out of there. He basically belittles everything I say to him.

What am I meant to do? I've gotten a CBT book to try work at things myself, but don't know what else I can do for help. Though I suppose wanting to get help itself is a sign of a lack of depression. feckin hell. Any ideas anyone?

He's partially right. That you can even focus enough that you know you need a job is a good sign! Not that that's much comfort to you but believe me it's a good sign.

Efexor is a drug that is given to people for chronic fatigue syndrome. It's very much an "upper." I don't want to say it isn't the cause of the fatigue but honestly, the drug tends to have exactly the opposite effect (insomnia) on people most of the time. I'd stick with it and give the drugs a chance, 2 weeks is too short a period of time to judge an antidepressant anyway (usually give them 4-6 weeks before deciding whether they've had an effect).

Odysseus

stupidusername wrote: »

Went back to the doctor today for an early review of efexor, and to up the dose after two weeks of being on 37.5mg. He asked about the side effects, i told him i still have extreme tiredness (i need to sleep during the day every day) and he said that could be the depression. Though I told him twice while I was there I know it's the meds, I've always been out of energy, but never before have i had to sleep so much, as I have since i've been on double prozac.

Again he ignored it, though it's really a big deal to me. And I said if i get a job it could be a problem. THEN he said almost delighted to himself that well if i'm looking for a job I couldn't be too badly depressed. I said I don't want a job (have a lot of worries about that) but I have to get one (especially as i can't get any counselling through the HSE), and he said still it's a good thing as if I was severely depressed i'd be completely hopeless about the future, and wouldn't even consider getting a job. I couldn't believe it. I actually felt worse coming out of there. He basically belittles everything I say to him.

What am I meant to do? I've gotten a CBT book to try work at things myself, but don't know what else I can do for help. Though I suppose wanting to get help itself is a sign of a lack of depression. feckin hell. Any ideas anyone?

There has to be some form of low cost counselling service near you, check out you local directories. CBT may help you, but it not the be all and end all of psychotherapeutic interventions, you may benefit from a other modality just as well.

Sadly you can often get that type of response from a GP, in a way he correct, if you were profundly depressed you would not be thinking about work, but you may also need hospitalisation if it was that bad. There is a continumm of depression; just because you not on the very severe scale doesn't give the GP the right to negate you suffering. Anyway best of luck with it.

mark_jmc

I have been taking effexor for the last 10 years, just as another poster mentioned it is an extremely difficult drug to come off. It works very well for me so I would envisage being on this medication for life.

I know that effexor gets a lot of stick online but for me it has been a wonder drug with little side effects. Im an example of a situation where anti depressants have worked and are working very successfully