Depression.

bumbledore said:
This is not true.

People have innumerable reasons for coming off medications (felt better, side-effects, drug interactions, felt worse, felt nothing, pill burden) but this doesn't mean they are psychotic by any means.

Going even further, refusal to take medication isn't necessarily a sign of mental instability either, provided that the person refusing is doing so for rational reasons. For example: "I'm not going to take my antidepressants that the doctor prescribed because I know someone who committed suicide while taking them and I'd rather go for talk therapy," is very reasonable. However, "I don't want to take antidepressants because I believe that every time I swallow a tablet, a baby dies in Africa from malaria," is not (and would be grounds for a more thorough assessment)...

Edit: What complicates this a lot further, is the concept of heterogeneity as it applies to most mental illness. Basically: my depression is the same, yet different, from yours; your depression is the same, yet different, from his; his depression is the same, yet different, from hers; and her depression is the same, yet different, from mine...

Perhaps what we consider to be "depression" is really an umbrella term for many different conditions that present in similar ways, however respond differently to individual treatments. Could explain why the antidepressant I'm taking worked for me, but not for you, or him or her...
Click to expand...

Good post. Thank you for that.

It just seems that STS knows he is not well, he know he needs to take his meds (or at least take it as a trial, see how he does on it and if it does not work for him, consult with his doctor to work out a way forward), but even knowing he needs to take meds and knowing full well and admitting to having a problem, he is refusing to take meds.

@ STS ..... do you want me to come over .... powder the tablets, mix it in with some mashed pumpkin and we can play "here comes the choo choo train?" :p
 
I have been on antidepressants since 2003. I currently take Cilift (generic version of Cipralex). The meds don't make me "happy" but they stop the despair so I can cope with living. I have tried coming off them a few times but within a month I am in the depths again. It is something I really can't help.
 
bokdrol said:
I have been on antidepressants since 2003. I currently take Cilift (generic version of Cipralex). The meds don't make me "happy" but they stop the despair so I can cope with living. I have tried coming off them a few times but within a month I am in the depths again. It is something I really can't help.
Click to expand...

Cilift is not a generic of Cipralex (Cilift is Citalopram and Cipralex is Escitalopram, a stereo isomer of Citalopram).

Not a particularly important distinction, although it is interesting that they claim escitalopram as more effective. I went from Cilift to Escitalopram, effectively doubling my dose. It quite honestly seems to have just turned off most of my emotions. I don't, in fact, like it very much. :/
 
There is a blunting of emotions, I agree, which is not ideal. But IMO it is better than the despair, lethargy, weepiness and hopelessness of unchecked depression.
 
Ockie said:
Good post. Thank you for that.

It just seems that STS knows he is not well, he know he needs to take his meds (or at least take it as a trial, see how he does on it and if it does not work for him, consult with his doctor to work out a way forward), but even knowing he needs to take meds and knowing full well and admitting to having a problem, he is refusing to take meds.

@ STS ..... do you want me to come over .... powder the tablets, mix it in with some mashed pumpkin and we can play "here comes the choo choo train?" :p
Click to expand...
People also get used to using their illness as a crutch so that they are afraid of how life would be without it. Not saying it's the case but it's very possible he just hasn't realised yet that things can be better.
 
copacetic said:
Cilift is not a generic of Cipralex (Cilift is Citalopram and Cipralex is Escitalopram, a stereo isomer of Citalopram).

Not a particularly important distinction, although it is interesting that they claim escitalopram as more effective. I went from Cilift to Escitalopram, effectively doubling my dose. It quite honestly seems to have just turned off most of my emotions. I don't, in fact, like it very much. :/
Click to expand...

Interesting observation. As it stands, there's no good evidence from systematic reviews or meta-analysis to suggest that escitalopram is superior to any of the other SSRIs. But the development of escitalopram is an interesting story to tell...

As a background (and this is part of the problem with psychiatry and psychopharmacology: big pharma):

Once a drug company creates a drug that is registered and on sale, there is normally a 10-year patent period until generics can be produced. It is argued that it takes many millions of dollars to get a drug from the lab into the pharmacy (and it does) and so the drug companies state they need this patent period in order to recoup their investment. After the 10-year patent expires, generics can be produced by other companies, which will eat up market share of the originator.

Makes sense so far? Well, drug companies are always looking for new and interesting ways to extend their patent. Usually, a change in the molecule (no matter how small) can be grounds for a patent extension... Sooooooo............

Citalopram is basically a mirror-image molecule, or enantiomer, with an R-enantiomer and an S-enantiomer. The S-enantiomer seems to be the pharmacologically active part, with the R-enantiomer essentially being redundant. When Lundbeck saw their patent on citalopram was going to expire, they simply altered the molecule in the lab, took out the R-enantiomer, and marketed it as a brand new drug. Technically, it was; but more technically, it wasn't!!! Nevertheless, they were granted another 10-year patent on escitalopram, which expired in March 2012. And they made an absolute fortune from that.

These kinds of funny things happen all the time in Big Pharma's world - recently there was a very scathing review of one particular SSRI (paroxetine) which has been used to treat childhood depression for about 10 years... Turns out, when one includes the unpublished studies, there's no evidence of efficacy whatsoever in this population, but ample evidence of harm...

Leaves the prescriber, and the patient, sometimes feeling very confused...
 
bumbledore said:
Citalopram is basically a mirror-image molecule, or enantiomer, with an R-enantiomer and an S-enantiomer. The S-enantiomer seems to be the pharmacologically active part, with the R-enantiomer essentially being redundant. When Lundbeck saw their patent on citalopram was going to expire, they simply altered the molecule in the lab, took out the R-enantiomer, and marketed it as a brand new drug. Technically, it was; but more technically, it wasn't!!! Nevertheless, they were granted another 10-year patent on escitalopram, which expired in March 2012. And they made an absolute fortune from that.

These kinds of funny things happen all the time in Big Pharma's world - recently there was a very scathing review of one particular SSRI (paroxetine) which has been used to treat childhood depression for about 10 years... Turns out, when one includes the unpublished studies, there's no evidence of efficacy whatsoever in this population, but ample evidence of harm...

Leaves the prescriber, and the patient, sometimes feeling very confused...
Click to expand...

But if they alter the molecule, then lets say it is a new molecule, meaning the old patent does not apply to the new molecule, therefore the patent on the old drug should still expire and generics can be made of that old molecule, not the new one?
 
Yep - Aware of all that. It's a fascinating industry, often one where the consumer gets the short end of the stick.

It was suggested I increase my dose in any event, and in that context it was a six of one, half dozen of the other situation.

In my personal experience, the drug (both Citalopram and Escitalopram) made a huge difference in my life - The sheer irrationality of depressive thought patterns is something I think a person has to actually experience to fully understand...
 
bokdrol said:
There is a blunting of emotions, I agree, which is not ideal. But IMO it is better than the despair, lethargy, weepiness and hopelessness of unchecked depression.
Click to expand...

Oh, I agree, and I certainly would not take the meds if the negatives did not outweigh the positives (for me, it's a difference between being able to function, and not being able to function).

I think though, the worst of it is what it does to creativity - I dabble in music, and my interest in doing so has effectively vanished.
 
Ockie said:
But if they alter the molecule, then lets say it is a new molecule, meaning the old patent does not apply to the new molecule, therefore the patent on the old drug should still expire and generics can be made of that old molecule, not the new one?
Click to expand...

Correct. I've just re-read my quoted post and it's a bit confusing in parts... Apologies.

It's a lot cheaper, and quicker, for them to make a few changes to an existing molecule and register it as a new drug. Case and point, it took 4-5 years of development from citalopram --> escitalopram, but it took about 15 years from molecule --> citalopram (process began in the 1970's). So it's quicker and cheaper for them to do it this way.

They're selling "yesterday's turd", all polished up, and calling it "gold", with protection of their intellectual property meaning they can charge whatever they want for the "gold," while the competitor's are still stuck selling "yesterday's turd"... I hope that crude metaphor makes sense?

Clarification: no offence intended by the use of the word turd! These drugs definitely do work for some people , as we've heard in this thread, and can save lives!
 
bumbledore said:
Correct. I've just re-read my quoted post and it's a bit confusing in parts... Apologies.

It's a lot cheaper, and quicker, for them to make a few changes to an existing molecule and register it as a new drug. Case and point, it took 4-5 years of development from citalopram --> escitalopram, but it took about 15 years from molecule --> citalopram (process began in the 1970's). So it's quicker and cheaper for them to do it this way.

They're selling "yesterday's turd", all polished up, and calling it "gold", with protection of their intellectual property meaning they can charge whatever they want for the "gold," while the competitor's are still stuck selling "yesterday's turd"... I hope that crude metaphor makes sense?
Click to expand...

It does lol. Well, I have no problem with using generics. In most cases yesterday's turd still works just as well as today's gold plated turd. /shrug
 
Ockie said:
It does lol. Well, I have no problem with using generics. In most cases yesterday's turd still works just as well as today's gold plated turd. /shrug
Click to expand...

Once again, 100% correct. The companies will bend over backwards to prove to you their drug is better than the generic, but there is no evidence whatsoever of superiority of one brand-drug over one generic-drug. The only difference is the price:

Generic fluoxetine - R40/month
Prozac (Eli Lily's fluoxetine) - R700/month

Madness!
 
bumbledore said:
Once again, 100% correct. The companies will bend over backwards to prove to you their drug is better than the generic, but there is no evidence whatsoever of superiority of one brand-drug over one generic-drug. The only difference is the price:

Generic fluoxetine - R40/month
Prozac (Eli Lily's fluoxetine) - R700/month

Madness!
Click to expand...

That is disgusting

/spits
 
Ockie said:
But if they alter the molecule, then lets say it is a new molecule, meaning the old patent does not apply to the new molecule, therefore the patent on the old drug should still expire and generics can be made of that old molecule, not the new one?
Click to expand...
Correct in principle but not always in practice. A molecule that is close enough to the new one could still violate aspects of the new patent and prevent a generic from the old one to be made. Many companies would rather not make the generic than risk costly lawsuits.
 
Swa said:
People also get used to using their illness as a crutch so that they are afraid of how life would be without it. Not saying it's the case but it's very possible he just hasn't realised yet that things can be better.
Click to expand...

I think that I do use it as a crutch, that i am so used to being sad and having nothing that i can't imagine what it's like to be numb and have nothing.

I also don't know how to rationalise beimg depressed for so many years, losing out on so many opportunities and friendships only now to try and undo 15 years of damage
 
Have any of you tried a psychedelic as a treatment for depression? Think there was a story on Psylocibin on carte blanche not too long ago
 
Dr. Charles Grob did some research on Ayahuasca, it seems to increase the amount of serotonin receptors. I only read the abstract, so I don't know the details. Not sure if its the DMT or the Harmala alkaloids that has the effect.
 
TheTwo said:
Have any of you tried a psychedelic as a treatment for depression? Think there was a story on Psylocibin on carte blanche not too long ago
Click to expand...

I've not, but I'd be interested in trying LSD/Psilocybin/Ketamine for this purpose.

One of the issues is though, that I'd need to stop my meds first, it's a bit of a catch-22.
 
You must log in or register to reply here.
Back
Top
Sign up to the MyBroadband newsletter
X