The Case Against Antidepressants

[Hyrulewarrior1978]

Ok, I know you have all been on the edge of your seats for an update (lmfao) so here it is.

TRT disclosure:
I am on 80 mg/week TC/TP blend (4:1) - 40 mg twice weekly + 400 IU twice weekly hCG. Anything above that and my Hct will get up above 50.

Doc prescribed benzo and escitalopram 10 mg daily last month. Tried the benzo for a few days and thought ok that is what drug addicts feel like, cool. Then promptly stopped. Tried the 10 mg daily escitalopram for a few days and headaches so dropped to 5 mg daily for last 4 weeks based in part from recommendation of our beloved resident AD SME @FunkOdyssey .

So after 4 weeks the panic/anxiety/heart racing outside of gym is gone. Gone. Libido is also gone. In fact everything is gone. Even trying to suffer through daily mental crucifixions during workouts I still showed up every day. Now zero motivation to workout but I can deal with that. Still very minor anxiety when I push workout but night and day difference in the gym experience.

On work side... no care. SSRIs (my anecdotal n=1) seem really effective at blunting any and all professional motivation. And blunt interpersonal motivation. Thank goodness never tried these in the old days. In summary, the SSRI really did a bang up job on the panic/anxiety/heart racing and left me more depressed and less motivated (bonus). Grateful it gave me some relief on the panic.

Confirmed everything @FunkOdyssey shared. Should be out on a street corner with my cardboard box duplex by the end of year. Peace!! J/K.

Now to practice those CBT skills and use the power of the brain to will my intentions to reality. Whoosh!!

Yea it sounds like you have a bad social anxiety disorder that was never addressed when you were younger. Exposure therapy works for that. I had that at one point, and then I grew out of it as I got older. Also mushrooms can help with that as well if you’re looking for something more natural.

 

[tareload]

Yea it sounds like you have a bad social anxiety disorder that was never addressed when you were younger. Exposure therapy works for that. I had that at one point, and then I grew out of it as I got older. Also mushrooms can help with that as well if you’re looking for something more natural.

Not that I am aware of. Around people all day long and never an issue until had the AFIB episode and then slowly the exercise induced anxiety and panic took hold. COVID wildcard. From there it then seeped into work calls and then just on walks. Interesting experience for sure.

I have done exposure therapy for trauma as well as CBT to address depression.

 

[FunkOdyssey]

Ok, I know you have all been on the edge of your seats for an update (lmfao) so here it is.

I really have been eager to hear how you're doing.

So after 4 weeks the panic/anxiety/heart racing outside of gym is gone. Gone. Libido is also gone. In fact everything is gone.

LOL

Confirmed everything @FunkOdyssey shared. Should be out on a street corner with my cardboard box duplex by the end of year.

LOL. I would have liked to be wrong but yours is a typical case of an SSRI doing what SSRIs do. At least you haven't lost your sense of humor!

I would suggest trying 2.5 mg daily once you feel comfortable to do so. It should still have considerable anti-anxiety effects and the lower dose may restore some aspects of normal human experience. It is also a natural stepping stone towards an eventual tapering off the drug.

 

[tareload]

least you haven't lost your sense of humor!

Good point. I exaggerate. Still have the humor even if little Chester does not want to come out and play any more. We will pray for him.

I can see where this SSRI stuff does take a perfectly successful overachiever and puts him on the street corner (thinking of the movie The Jerk). At least you can be calm on the corner.

 

[b19h65]

There already was a post linking to Mad In America, but this site really can't be mentioned enough, as it is also the largest hub for professionals with a very large collection of essays, blog articles, collection of research and evidence, to object to the malpractice of modern psychiatric drug prescriptions with main focus on antidepressants and antipsychotics.

There is also have a page called "The case against antipsychotics" and an analogous page about antidepressants that summarizes the entire issue and evidence:

Drug Info: Antidepressants

www.madinamerica.com

 

[b19h65]

Another piece: Antidepressants Only 15% Better Than Sugar Pills, FDA Data Show

 

[tareload]

Ok, I know you have all been on the edge of your seats for an update (lmfao) so here it is.

TRT disclosure:
I am on 80 mg/week TC/TP blend (4:1) - 40 mg twice weekly + 400 IU twice weekly hCG. Anything above that and my Hct will get up above 50.

Doc prescribed benzo and escitalopram 10 mg daily last month. Tried the benzo for a few days and thought ok that is what drug addicts feel like, cool. Then promptly stopped. Tried the 10 mg daily escitalopram for a few days and headaches so dropped to 5 mg daily for last 4 weeks based in part from recommendation of our beloved resident AD SME @FunkOdyssey .

So after 4 weeks the panic/anxiety/heart racing outside of gym is gone. Gone. Libido is also gone. In fact everything is gone. Even trying to suffer through daily mental crucifixions during workouts I still showed up every day. Now zero motivation to workout but I can deal with that. Still very minor anxiety when I push workout but night and day difference in the gym experience.

On work side... no care. SSRIs (my anecdotal n=1) seem really effective at blunting any and all professional motivation. And blunt interpersonal motivation. Thank goodness never tried these in the old days. In summary, the SSRI really did a bang up job on the panic/anxiety/heart racing and left me more depressed and less motivated (bonus). Grateful it gave me some relief on the panic.

Confirmed everything @FunkOdyssey shared. Should be out on a street corner with my cardboard box duplex by the end of year. Peace!! J/K.

Now to practice those CBT skills and use the power of the brain to will my intentions to reality. Whoosh!!

12 weeks update...

pushed through and libido and ED impacts of escitalopram have subsided. 5 mg/d of escitalopram has gotten me back to pushing it reasonably hard in the gym...maybe 80% back to where I was with no panic. Something still feels off in the chest but I am learning to ignore it. Spent a couple months at 100 mg/week TC/TP blend and last week bumped to 120 mg/week on top of 400 IU twice weekly u-hCG.

Headed back toward the sun @FunkOdyssey, wish me luck.

Frontiers | The impact of escitalopram on vagally mediated cardiovascular function to stress and the moderating effects of vigorous physical activity: a randomized controlled treatment study in healthy participants

Recent concerns over the impact of antidepressant medications, including the selective serotonin reuptake inhibitors (SSRIs), on cardiovascular function high...

www.frontiersin.org

Article of the day.

 

[tareload]

From article in last post:

While animal and human studies (Babyak et al., 2000; Engesser-Cesar et al., 2007; Arunrut et al., 2009) have indicated that the combination of exercise and antidepressant medication may confer no advantage over either treatment alone, there is another issue at stake here. Although antidepressant medication—including the tricyclic medications, the serotonin and noradrenaline reuptake inhibitor and the selective serotonin reuptake inhibitors—may have short- to medium-term benefits including the amelioration of depressive symptoms and increased resilience to stress, research has begun to highlight the longer-term adverse cardiovascular effects of antidepressants (Whang et al., 2009; Licht et al., 2010a). Reductions in HRV have been attributable to the specific effects of antidepressants (Licht et al., 2008, 2010a) while increases in HRV are associated with their cessation (Licht et al., 2010a). An epidemiological study (Whang et al., 2009) on 63,469 women aged 30–55 years without baseline coronary heart disease (CHD) reported that while depressive symptoms were associated with fatal CHD, antidepressant use (61% of participants were using an SSRI) was specifically associated with a 3.34 increased risk for sudden cardiac death even after controlling for a variety of confounds. A more recent study has reported that reduced cardiovascular fitness is associated with an increased risk of suicide over a 42 year follow-up period (Åberg et al., 2013) highlighting the importance of cardiovascular health over the lifespan. Together, these findings highlight the importance of research on the cardiovascular effects of antidepressants and specific lifestyle factors such as physical activity. The present study makes an important contribution to this effort highlighting that the cardiovascular effects of regular vigorous exercise and of an acute dose of escitalopram during stress are comparable, i.e., both are associated with a decrease in HR and an increase in HRV.


In the present study we demonstrated that acute administration of escitalopram is associated with increased vagal function under both resting and task conditions; a finding that was particularly robust for HR. This finding is consistent with reported short- to medium-term beneficial effects of SSRIs on cardiovascular and neuroendocrine responses to stress in depressed patients (e.g., Straneva-Meuse, 2004b), but contrast against longer-term research outcomes (Whang et al., 2009; Licht et al., 2010a) highlighting the adverse effects of the SSRI class of antidepressants. Here, an explanation for this apparent discrepancy is the complexity of central and autonomic 5-HT effects on cardiovascular function, which include bradycardia, associated with activation of 5-HT1A receptors, as well as tachycardia, associated with activation of 5HT2 receptors. It is possible that the effects of SSRIs shift from parasympathetic—as shown here—to sympathetic activation with increasing length of use. Further research is urgently needed on the combination of antidepressants and physical activity over longer-time frames than typical clinical trials (i.e., years rather than months).

 

[tareload]

This article describes my experience thus far:

Blunted autonomic reactivity to pharmacological panic challenge under long-term escitalopram treatment in healthy men

AbstractBackground:. Central serotonergic pathways influence brain areas involved in vagal cardiovascular regulation and, thereby, influence sympathetic ef

academic.oup.com

Good thing I listened to my Doctor. Now I can enjoy destroying the gym once again and QOL has improved significantly. Knock on wood it has only been a few months.

@Fortunate, @Belekas, @bixt and others who have wondered about TRT/TOT and exaggerated autonomic/inotropic/chronotropic effects...5 mg/day of escitalopram has me handling upping my "TRT" dose from 80 to 100 to 120 mg/week TC/TP mix much better than prior to its use. Probably another thing to watch out for as it may provide a cover to allow some of us sensitive folk to up our dose (more than we need for TRT) for ahem "hobby" purposes.

And full disclosure I am probably just late to the party from years ago about the touted low dose SSRI + TOT mix. Thanks for your patience @FunkOdyssey. It is nice to learn at the knees from someone with so much field experience.

The SSRI did nothing for my depression though which is pretty funny (no primary effect). Maybe made it a little worse. Good thing I learned how to cope with that years ago, and it allows me to lift and enjoy body dysmorphia (which helps with the depression - secondary vs primary effect).


SOLD!

 

[Vestpocket]

There are also double-blind studies that show antidepressants can be very effective, particularly when they are part of a treatment protocol (therapy, lifestyle changes, etc.). They certainly can have negative side effects in some that can overcome the benefit, but reading how you’ve gone about presenting this would lead one to believe that they are completely worthless and only harmful. There are many who would contend that antidepressants have saved their lives and have been taking them for years. Not ideal, and I think the hope is that you could wean your way off of them eventually, but I think they do have a place in treatment and should at least be considered as part of a protocol.

This is not true.

There are zero studies that show antidepressants to be "very effective." At best, there are studies that can show that there is a minimal, marginal effect, when given enough time. A 2018 metastudy showed that the average placebo match for all third generation ADs is 74%, roughly 60% of people receive no positive effect whatsoever from any particular drug, the 1MDR (one month drop-off rate) for SSRIs is 80%(!), and of the minority of people that claim a benefit, it's actually a mere 2-4 points on the rating scale being used (BDI, HDRS, etc.)

There has never been a "very effective" antidepressant drug released, to date. We have only marginal efficacy in a minority of takers, with 80% of people dropping them in the first month due to side effects or lack of efficacy, and that number climbing sharply as we get to 2, 3, and 6 months.

Funny enough, the effect of exercise (30 minutes walking) actually beats all currently existing anti-depressant drugs on the market when using the same depression rating scales. Not one pharmaceutical on the market today beats a little walking. That's how weak ADs are.

There are many studies that show exact placebo matches for popular drugs like Prozac and Wellbutrin (zero effect; I have about 5 bookmarked for Wellbutrin presently), and a very famous 2000 metastudy by an MIT PhD that looked at all the unpublished and contrary studies that were not submitted to journals and concluded that modern anti-depressants have no averaged out efficacy against depression whatsoever. (Suggesting that what we see published in journals are mostly the studies that show a lucky 2-3 point bias towards the drug, because we can find just as many that show the placebo control pill winning by the same degree when we look at what was not submitted for publication.)

I made the mistake of trying 10 or so different antidepressants over the years. Not one of them had any effect. Placebo. Junk.

The 74% placebo match (and some are higher) of antdepressant drugs versus their placebo control shows that the majority of the effect of any of these drugs is raw expectation bias.

 

[tareload]

This is not true.

There are zero studies that show antidepressants to be "very effective." At best, there are studies that can show that there is a minimal, marginal effect, when given enough time. A 2018 metastudy showed that the average placebo match for all third generation ADs is 74%, roughly 60% of people receive no positive effect whatsoever from any particular drug, the 1MDR (one month drop-off rate) for SSRIs is 80%(!), and of the minority of people that claim a benefit, it's actually a mere 2-4 points on the rating scale being used (BDI, HDRS, etc.)

There has never been a "very effective" antidepressant drug released, to date. We have only marginal efficacy in a minority of takers, with 80% of people dropping them in the first month due to side effects or lack of efficacy, and that number climbing sharply as we get to 2, 3, and 6 months.

Funny enough, the effect of exercise (30 minutes walking) actually beats all currently existing anti-depressant drugs on the market when using the same depression rating scales. Not one pharmaceutical on the market today beats a little walking. That's how weak ADs are.

There are many studies that show exact placebo matches for popular drugs like Prozac and Wellbutrin (zero effect; I have about 5 bookmarked for Wellbutrin presently), and a very famous 2000 metastudy by an MIT PhD that looked at all the unpublished and contrary studies that were not submitted to journals and concluded that modern anti-depressants have no averaged out efficacy against depression whatsoever. (Suggesting that what we see published in journals are mostly the studies that show a lucky 2-3 point bias towards the drug, because we can find just as many that show the placebo control pill winning by the same degree when we look at what was not submitted for publication.)

I made the mistake of trying 10 or so different antidepressants over the years. Not one of them had any effect. Placebo. Junk.

The 74% placebo match (and some are higher) of antdepressant drugs versus their placebo control shows that the majority of the effect of any of these drugs is raw expectation bias.

May not do much/anything for depression but sure as sh*t (complex scientific term) works on sympathetic regulation. Vast improvement in this chronic exerciser. Not even close as compared to exercise. But I have made the deal with Satan as my mood and anhedonia have gotten worse. Probably good time to add back in some nandrolone, oxandrolone and stanozolol!

And no one has commented on Rollins' masterpiece. I am disappointed in you all.

 

[tareload]

Mental Stress and Cardiovascular Health—Part I

Epidemiological studies have shown that a substantial proportion of acute coronary events occur in individuals who lack the traditional high-risk cardiovascular (CV) profile. Mental stress is an emerging risk and prognostic factor for coronary artery disease and stroke, independently of...

www.mdpi.com

The Impact of Mental Stress on Cardiovascular Health—Part II

Endothelial dysfunction is one of the earliest manifestations of atherosclerosis, contributing to its development and progression. Mental stress induces endothelial dysfunction through increased activity of the sympathetic nervous system, release of corticotropin-releasing hormone from the...

www.mdpi.com

For those of us a little more tightly wound, is the case for escitalopram hiding in plain sight?

 

[Fortunate]

This article describes my experience thus far:

Blunted autonomic reactivity to pharmacological panic challenge under long-term escitalopram treatment in healthy men

AbstractBackground:. Central serotonergic pathways influence brain areas involved in vagal cardiovascular regulation and, thereby, influence sympathetic ef

academic.oup.com

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Good thing I listened to my Doctor. Now I can enjoy destroying the gym once again and QOL has improved significantly. Knock on wood it has only been a few months.

@Fortunate, @Belekas, @bixt and others who have wondered about TRT/TOT and exaggerated autonomic/inotropic/chronotropic effects...5 mg/day of escitalopram has me handling upping my "TRT" dose from 80 to 100 to 120 mg/week TC/TP mix much better than prior to its use. Probably another thing to watch out for as it may provide a cover to allow some of us sensitive folk to up our dose (more than we need for TRT) for ahem "hobby" purposes.

And full disclosure I am probably just late to the party from years ago about the touted low dose SSRI + TOT mix. Thanks for your patience @FunkOdyssey. It is nice to learn at the knees from someone with so much field experience.

The SSRI did nothing for my depression though which is pretty funny (no primary effect). Maybe made it a little worse. Good thing I learned how to cope with that years ago, and it allows me to lift and enjoy body dysmorphia (which helps with the depression - secondary vs primary effect).


SOLD!

This is interesting. I have been oddly, tolerating a slightly higher dose of enanthate than usual. Not sure why, but I have some theories. After I watch things a little while longer, I’ll post an update. Very glad you are making progress.

 

[Fortunate]

Ma

May not do much/anything for depression but sure as sh*t (complex scientific term) works on sympathetic regulation. Vast improvement in this chronic exerciser. Not even close as compared to exercise. But I have made the deal with Satan as my mood and anhedonia have gotten worse. Probably good time to add back in some nandrolone, oxandrolone and stanozolol!

And no one has commented on Rollins' masterpiece. I am disappointed in you all.

Love Henry Rollins. Actually, every time I look at @madman’s avatar, I think of him. I think maybe it’s Henry Rollins in disguise lurking among us!

 

[tareload]

4 month SSRI update:
Holding steady at 120 mg/week TC/TP blend (4:1). Escitalopram working like a champ with the anxiety and panic. Depression and anhedonia the same. Debating next ramp up on the Test but Hct already at 48-50% on last blood draw.

 

[DS3]

This is consistent with the idea that something about excessively high or excessively stable levels of T and related hormones is numbing or depressing. The forms of TRT most likely to avoid these symptoms IMO are:

• Low/moderate doses of cypionate or enanthate injected once weekly
• Low/moderate doses of cream. Once daily application might be preferable to twice daily.
• Low/moderate doses of propionate injected ED or EOD
• Jatenzo and similar orals
• Natesto

I’m not sure how else to say it, but this bit of experiential knowledge goes hard. Rock on

 

[DS3]

I was having serious trouble with word recall on cypionate.

I feel like my cognitive function goes to crap when I take Cyp or E. Similar to you, work recall and overall verbal fluency is borderline dementia feeling.

 

[Nelson Vergel]

4 month SSRI update:
Holding steady at 120 mg/week TC/TP blend (4:1). Escitalopram working like a champ with the anxiety and panic. Depression and anhedonia the same. Debating next ramp up on the Test but Hct already at 48-50% on last blood draw.

I would not change a thing

 

[tareload]

I would not change a thing

That would be a thoughtful approach by a wise man. Gainz greed is a powerful master that torments constantly and patiently.

I used to do a little but a little wouldn't do it
So the little got more and more
I just keep tryna get a little better
Said the little better than before
I used to do a little but a little wouldn't do it
So the little got more and more
I just keep tryna get a little better
Said the little better than before

Stuck it in the middle and I shot it in the middle
And it, it drove outta my mind
I should've known better, said I wish I never met her
Said I leave it all–behind
Yowsa!

Guns N' Roses - Mr. Brownstone Lyrics | AZLyrics.com

Guns N' Roses "Mr. Brownstone": I get up around seven Get out of bed around nine And I don't worry about nothing, no Because worryin...

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[Fortunate]

That would be a thoughtful approach by a wise man. Gainz greed is a powerful master that torments constantly and patiently.

Guns N' Roses - Mr. Brownstone Lyrics | AZLyrics.com

Guns N' Roses "Mr. Brownstone": I get up around seven Get out of bed around nine And I don't worry about nothing, no Because worryin...

www.azlyrics.com

Guns!!!!

Axl was talking about something far more nefarious than anything you are doing, my friend!