75 replies to this topic

[hooter]

QUALITY OVER QUANTITY.

That's pretty much all I have to say. I've seen stacks here of 20 things that would make my stomach lining erode just looking at it. I think this forum really needs a disclaimer for this. Exorbitant consumption and acquisition of supplements is also symptom of OCD. People do not become doctors by virtue of intuition. Better safe than sorry. Pubmed is your friend. Please limit yourselves. Research, research and more research.

I hope you can relate. Please use this thread to state certain risks, side effects, misconceptions and contraindications of popular supplements.
Here's some just to get you started, sources should be simple enough to find with these examples.

• Choline should not be taken in depression or OCD. It is anti-dopaminergic.
• Many herbal extracts accumulate heavy metals, make sure your manufacturer checks for those.
• Green tea extracts contain huge amounts of fluoride and aluminum.
• Lots of popular herbal extracts affect thyroid function. Do not mix them or take them in excessive doses. Do not take if you have thyroid problems.
• Do not mix too many anticoagulants or you are risking a brain hemmorhage.
• Methylene blue is used in treatment of priapism and can affect erectile function.
• Avoid SSRIs, they don't work and induce complacency.
• Do not mix maois and serotonergics or you are risking serotonin syndrome. This can have lethal consequences.
• Taking high doses of omega-3 should be restricted to non-salmon sources to avoid methylmercury, a strong neurotoxin that accumulates in salmon.
• Medicinal mushrooms contain iron, so if you are taking them daily get your serum iron levels checked every now and then.

Edited by hooter, 30 January 2012 - 11:48 AM.

[niner]

It's good to bear in mind that "Natural" doesn't mean "Safe". Supplements are products that exist in nature, so they are technically natural, but when we extract and concentrate them, and take them at many times the dose we might be exposed to in nature, we are doing things that we have not necessarily evolved for.

While we're considering these things, please remember, DOSE MATTERS! Effects observed at high dose, particularly in cell culture, are most likely entirely irrelevant to normal use of a compound. For example, for the treatment of priapism in one example I looked at, 100 mg of MB was injected into the corpus cavernosum. I doubt that MB will cause erectile dysfunction in anything resembling normal use. Likewise, safety at low dose does not mean high doses are OK. There are lots of products on the market that are inappropriately dosed. Some B Complexes are a case in point.

[hooter]

For example, for the treatment of priapism in one example I looked at, 100 mg of MB was injected into the corpus cavernosum. I doubt that MB will cause erectile dysfunction in anything resembling normal use.

Methylene blue inhibits hippocampal nitric oxide synthase activity in vivo.

http://www.ncbi.nlm....pubmed/10224309

This can be possibly neurotoxic and interfere with getting an erection. It wouldn't be that pronounced but the basis is there. If anyone has more pro/contra studies regarding this matter I would highly appreciate it.

Misdosed vitamins are a very overlooked problem, even I missed it! Thanks niner

Edited by hooter, 30 January 2012 - 01:32 PM.

[nowayout]

• If you take your supplements/vitamins/medications with your morning oatmeal or certain citrus fruits, their absorption may be affected.
• There is not enough evidence to recommend specific ranges of serum vitamin D beyond correction of frank deficiency. Potentially beneficial ranges of one study tend to overlap with potentially harmful ranges in another study.
• There is no evidence to support the kind megadoses of omega 3 taken by many supplement users. In men, large doses of omega 3 may potentially reduce testosterone levels.
• Some supplements or medications that potentially limit cancer may do more harm than good in people who are not genetically susceptible to that cancer.
• If a supplement or medication is good for diabetics, it is not necessarily good for you, unless you are a diabetic.
• If a supplement or medication is good for obese people, it is not necessarily good for you, unless you are obese.
• If a supplement or medication is good for people with bad lipids, it is not necessarily good for you, unless you have the same kind of bad lipids.
• If a supplement or medication is good for depressives or ADD sufferers, it is not necessarily good for you, unless you are depressed or have ADD. There is even a growing amount of evidence that many of these antidepressants or ADD meds are not even good for depression or ADD.
• Even if you have one of these things, the supplement or medication in question may be bad for you because your genetics differ from the average.

Edited by viveutvivas, 30 January 2012 - 01:38 PM.

[SATANICAT]

http://www.longecity...t-interactions/
Important thread for nootropic users.

Edit: fixed link

Edited by niner, 31 January 2012 - 01:25 AM.

[niner]

http://www.longecity...t-interactions/
Important thread for nootropic users.

That thread contains some interesting speculations (nothing more) about GTE and Rhodiola, but the part about resveratrol is a perfect example of a dosage error. They look at an effect of resveratrol on MAO, in cell culture, rather than in an animal, using a concentration ranging from 5 to 200 microM. The problem? Because of highly efficient xenobiotic metabolism in mammals, it's impossible to achieve concentrations like that in blood from an oral dose of resveratrol. Based on published dose-response data in humans, it would take an oral dose of 10 grams of high purity resveratrol just to reach the lowest concentration they looked at; 5 microM. (less if micronized) So, is resveratrol a MAOI? In theory, you could call it that, but without qualifying it as to the insane dose that would be required, calling it a MAOI will just generate a lot of unnecessary paranoia.

In vitro results are usually misleading. Take them with an enormous grain of salt. We would mostly be better off ignoring everything that wasn't done in a mammal.

[Logan]

Avoid SSRIs, they don't work and induce complacency.

Blah Blah Blah...

[hooter]

[quote name='Logan' timestamp='1327991666' post='498681']
[quote name='hooter' timestamp='1327923466' post='498565']
Avoid SSRIs, they don't work and induce complacency.
[/quote]

Blah Blah Blah...
[/quote]

Very constructive posting!

SSRIs as a result of rational drug design are based on the notion that pharmacologists knew what the hell they were doing 30 years ago. SSRIs can cause lasting sexual dysfunction and weight gain. Meta-analysis studies show that benefits do not exceed placebo for all but the absolutely most severe depression, in which the effects are still negligible. They are forced to carry suicide warnings and have contributed to the Columbine massacre.

[quote]Shortly before the Columbine shooting, Eric Harris had been rejected by Marine Corps recruiters because he was under a doctor's care and had been prescribed an anti-depressant medication. Harris was taking Luvox, an anti-depressant commonly used to treat patients with obsessive-compulsive disorder.[/quote]

[quote]The danger to police officers confronting a suicidal person on an antidepressant is quite high. Not only are there 'suicide-by cop' cases on SSRI Stories but five of them involve a suicidal person calling 911 for help and then shooting the officers who respond. The most notable case was a man in Roswell, New Mexico in 2002 who called 911 while on medication for depression, set his house on fire and then shot to death the fire chief, a paramedic, a neighbor and seriously wounded a child.[/quote]
You will find this website contains 4800+ (FOUR THOUSAND EIGHT HUNDRED) of such cases.

[quote]Hundreds of lawsuits have been filed against drug manufacturers seeking compensation for harm attributed to the use of SSRIs.[/quote]

[quote]The relationship between severity and efficacy was attributed to a reduction of the placebo effect in severely depressed patients, rather than an increase in the effect of the medication.^{[10][12][13][14][15][16]}[/quote]

[quote]
A 2010 review reached similar conclusions: in mild and moderate depression, specifically that the effect of SSRI is very small or none compared to placebo, while it is clinically significant in very severe depression.^[2][19][/quote]

[quote]
Overall, 94% of studies actually published were positive outcomes; when published and unpublished studies were included for analysis, the percentage of positive outcomes was 51%.^[106]
[/quote]

[quote]
A widely-reported 2008 meta-analysis combined 35 clinical trials submitted to the U.S. Food and Drug Administration (FDA) before licensing of four newer antidepressants (including the SSRIs paroxetine and fluoxetine, the non-SSRI antidepressantnefazodone, and the SNRI (serotonin and norepinephrine reuptake inhibitor) venlafaxine). The authors found that although the effect of antidepressants vs placebos was statistically significant, it did not exceed the NICE criteria for a clinically significant effect. In particular they found that the effect size was very small for moderate depression but increased with severity reaching 'clinical significance' for very severe depression. The relationship between severity and efficacy was attributed to a reduction of the placebo effect in severely depressed patients, rather than an increase in the effect of the medication[/quote]

[quote]Still more research illustrates that the current model for the antidepressant activity of SSRIs may be misdirected, as a drug that works entirely opposite to SSRIs - Tianeptine, a selective serotonin reuptake enhancer - also exhibits antidepressant activity, especially in patients resistant to SSRI therapy. [/quote]

[quote]
Closely related to sexual side-effects is the phenomenon of emotional blunting, or mood anesthesia. Many users of SSRIs complain of apathy, lack of motivation, emotional numbness, feelings of detachment, and indifference to surroundings. They may describe this as a feeling of "not caring about anything anymore." All SSRIs, SNRIs, and serotonergic TCAs can cause this to varying degrees, especially at high doses[/quote]

[quote]According to one source, Post-SSRI sexual dysfunction (PSSD) is an iatrogenic type of sexual dysfunction caused directly by the previous use of SSRI antidepressants.^[33]
While apparently uncommon, it can last for months, years, or sometimes indefinitely after the discontinuation of SSRIs.^[34]
One or more of the following sexual symptoms may persist or begin after the discontinuation of SSRIs:

• Decreased or absent libido
• Impotence or reduced vaginal lubrication
• Difficulty initiating or maintaining an erection or becoming aroused
• Persistent genital arousal disorder despite absence of desire
• Muted, delayed or absent orgasm (anorgasmia)
• Reduced or no experience of pleasure during orgasm (ejaculatory anhedonia)
• Premature ejaculation
• Weakened penile, vaginal or clitoral sensitivity
• Genital anesthesia
• Loss or decreased response to sexual stimuli
• Reduced semen volume
• Priapism (persistent erectile state of the penis or clitoris)

[/quote]

[quote]Several studies have found that SSRI can cause a higher risk of suicidal behavior in children and adolescents.^[35][36][37][/quote]

Outlook unpleasant.

Edited by hooter, 31 January 2012 - 10:42 AM.

[niner]

You will find this website contains 4800+ (FOUR THOUSAND EIGHT HUNDRED) of such cases.

SSRIs have some issues, but there's a huge problem with this sort of analysis. Before the days of SSRIs, antidepressants were not used very much because they had worse side effect profiles. Now we have some very tolerable drugs, and a LOT of people like them. Something like ten percent of the country is taking them. Some of the people who are taking them are unstable, and unstable people sometimes do bad things. What I'd like to know is how many of those cases would have occurred if the person had been taking a non-SSRI antidepressant or had been unmedicated? You're essentially claiming that the SSRI is causative in these cases, but I don't think that's been shown.

[nowayout]

Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America

by Robert Whitaker, provides a very interesting read on SSRIs and other antidepressant drugs.

Essentially, there is a lot of evidence that even if SSRIs may have some mild initial benefit (and even this claim is in question), they do actual harm over the long term. Whereas depression used to be a transient, self-limiting state in the vast majority of cases before SSRIs, it appears that SSRIs may themselves play a role in turning depression into a chronic disease by causing deleterious brain adaptations that are very hard to reverse, trapping patients in a downward spiral of more drugs and more depression.

[hooter]

You will find this website contains 4800+ (FOUR THOUSAND EIGHT HUNDRED) of such cases.

SSRIs have some issues, but there's a huge problem with this sort of analysis. Before the days of SSRIs, antidepressants were not used very much because they had worse side effect profiles. Now we have some very tolerable drugs, and a LOT of people like them. Something like ten percent of the country is taking them. Some of the people who are taking them are unstable, and unstable people sometimes do bad things. What I'd like to know is how many of those cases would have occurred if the person had been taking a non-SSRI antidepressant or had been unmedicated? You're essentially claiming that the SSRI is causative in these cases, but I don't think that's been shown.

Some issues? Becoming fat, lazy, apathetic and sexually useless is a mild issue? A lot of people like them. Yeah, that's much better analysis. I'm sorry but critiquing my research and then immediately phasing into a argumentum ad populum fallacy not only destroys your credibility but makes you look quite childish.

Just because the general public doesn't know any better doesn't mean they like it. SSRIs worsen bipolar disorder, one of the columbine students was bipolar. He was given SSRIs. Kablammo.

If we're going for anecdotes and fallacies, here are mine:

I am bipolar as well, and SSRIs give me uncontrollable rage. While I am a rather calm and collected person usually, on SSRIs I kicked a guy in the face so hard he got brain damage. I don't know why. It was just impossible to control myself and it didn't seem 'wrong' at all. They have made my orgasms permanently less intense. I feel like I've been stupefied.

I know a girl whose mom takes SSRIs, her father beats her and the mother watches with complete indifference. I have a friend whose SSRI addled father is eating and buying his way to death while enabling his son's alcoholism with silent submission, bringing him whiskey to his room.

I'm an immortalist and wish to exist forever. I would have myself embedded in computronium and strive for eternal life. I've never had any spontaneous self-destructive thoughts in my entire life. Taking SSRIs was the only time in my life where I considered killing people and myself. My mother killed herself a week after taking SSRIs.

Just because these people stop complaining doesn't mean they're getting better, it means they're becoming dead on the inside. This is what they make you feel like, a corpse. Nothing matters, living pill to pill in a state of ignorant pseudo-bliss. It really churns my stomach to think about it.

Also I think you are missing the cases on that site where people are declared not guilty by reason of SSRI induced insanity.

I also have trouble understanding why you dismiss meta-studies and purposely unpublished negative results. Have you taken SSRIs before? Do you know how they feel? Are you familiar with their method of action? You honestly think something with a 1% efficacy over placebo is worth permanent sexual side effects?

You do not seem to have read the main page of ssri stories or made any effort to understand my position, instead parroting the same thing every doctor tells every patient:

Antidepressants have been recognized as potential inducers of mania and psychosis since their introduction in the 1950s. Klein and Fink1 described psychosis as an adverse effect of the older tricyclic antidepressant imipramine. Since the introduction of Prozac in December, 1987, there has been a massive increase in the number of people taking antidepressants. Preda and Bowers2 reported that over 200,000 people a year in the U.S. enter a hospital with antidepressant-associated mania and/or psychosis. The subsequent harm from this prescribing can be seen in these 4,800+ stories.

Before the introduction of Prozac in Dec. 1987, less than one percent of the population in the U.S. was diagnosed with bipolar disorder – also known as manic depression. Now, with the widespread prescribing of antidepressants, the percent of the population in the United States that is diagnosed with bipolar disorder (swing from depression to mania or vice versa) has risen to 4.4%. This is almost one out of every 23 people in the U.S.


The Physicians' Desk Reference
The Physicians' Desk Reference lists the following adverse reactions (side effects) to antidepressants among a host of other physical and neuropsychiatric effects. None of these adverse reactions (side effects) is listed as Rare. They are all listed as either Frequent or as Infrequent:

Manic Reaction (Mania, e.g., Kleptomania, Pyromania, Dipsomania, Nymphomania)
Hypomania (e.g., poor judgment, over spending, impulsivity, etc.)
Abnormal Thinking
Hallucinations
Personality Disorder
Amnesia
Agitation
Psychosis
Abnormal Dreams

Emotional Lability (Or Instability)
Alcohol Abuse and/or Craving
Hostility
Paranoid Reactions
Confusion
Delusions
Sleep Disorders
Akathisia (Severe Inner Restlessness)
Discontinuation (Withdrawal) Syndrome
Impulsivity

Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America

by Robert Whitaker, provides a very interesting read on SSRIs and other antidepressant drugs.

Essentially, there is a lot of evidence that even if SSRIs may have some mild initial benefit (and even this claim is in question), they do actual harm over the long term. Whereas depression used to be a transient, self-limiting state in the vast majority of cases before SSRIs, it appears that SSRIs may themselves play a role in turning depression into a chronic disease by causing deleterious brain adaptations that are very hard to reverse, trapping patients in a downward spiral of more drugs and more depression.

Yes, I fully agree with this. Anyone who hasn't read this book, please do. A friend of mine who is a med school student was reading through new research on the pharmacology of SSRIs, and he mentioned that the mechanism of action seems to worsen the problems long term. The benefit from SSRIs is purely neurotrophic or ascribable to the sigma activity of certain new SSRIs, which explains why these are mildly more effective.

Edited by hooter, 31 January 2012 - 03:47 PM.

[hooter]

The Ministry of Health, Labor and Welfare in Japan has investigated reports where people on antidepressants have committed sudden acts of violence against others. The agency has decided torevise the warnings on the medication guide to read, "There are cases where we cannot rule out a causal relationship with the medication."

Murder Med For Depression* 2009-11-19 England
*Man Found Not Guilty of Killing Wife While Sleepwalking

Edited by hooter, 31 January 2012 - 06:46 PM.

[niner]

Hooter, I'm sorry to hear about your mom, and all the bad things you've seen and experienced. You and I are coming from such radically different points of view on this that I don't think we can argue it successfully, so I will bow out of this discussion.

[hooter]

Do not believe I am troubled. I have learned to control my emotions. Time is utterly meaningless. We exist in consciousness, automatically proceeding. I've transcended dwelling on the past. Do not pity me or feel sad for me, while I sit here and laugh.

No worries or stress, dear chap.

The proof is in the pudding. Don't just take my word for it. Read the psychopharmacology books. Look at case studies. Dig through pubmed. If you have faith in your view, take some SSRIs yourself and find out.

I'm not here to blindly destroy norms and rant about the mainstream. I just want people to make rational reasoned choices based on adequate foresight and information, which can be very difficult to impossible in times of depression. I will of course offer alternatives:

----

A very good antidepressant for example is Stablon (tianeptine), it affects NMDA and AMPA instead of serotonin and increases NGF. It improves libido and elevates mood instead of dulling it. Initially it might cause some insomnia, but eventually it also improves sleep onset and quality. It's also neuroprotective and a respiratory stimulant.

It's been shown to have greater efficacy than SSRIs in both anxiety and depressive disorders, it's tolerable in bipolar depression and doesn't cause weight gain. It is also a mild anticonvulsant and an atypical analgesic. Tianeptine improves neuropathic pain, fibromyalgia and OCD.

It's also a relatively potent memory nootropic and attention booster. (some mild benefits for ADHD as well)

---

I have taken 40+ different psych meds, 20+ herbs, 4 fungi and other intoxicants in various categories and these are the ones that I personally (not to generalize) experienced the most benefit from:

• Tianeptine (nmda antagonists have been shown to work even in very refractory cases, see ketamine depression studies for example)
• Piracetam (can worsen depression initially or at low doses when taken without fish oil, later a permanent improvement can be observed)
• Hydergine (do not use in delusional bipolar or schizophrenia, NGF booster. works in refractory depression)
• Bacopa Monnieri 20% bacosides (anxiolytic, regenerates the same parts of the brain as antidepressants)
• Vitamin D (deficiencies can exacerbate depression)
• Fish Oil (mood stabilizing, reduces suicidal behaviour)

Funnily enough these are the ones with the most rational pharmacological basis for improvement of mood and psychology, rather than receptor guessing and building an off switch.

---

There's plenty out there, no need to risk turning yourself into an anhedonic sexless zombie forever just because of a depression. The things listed will most likely improve your quality of life and your lifespan. It's not just my word, I wouldn't be taking these if there weren't enough evidence. Please just trust yourselves and look at the data. Go straight to the studies and pharmacology. Trust yourself and deal with the raw data.

Edited by hooter, 31 January 2012 - 11:07 PM.

[Ampa-omega]

Thank you for this thread hooter, although the brain is so inherently complex and research is continual discovering new things, it is wise to at least head a caution, like this thread suggest. (at least i think with the inherently thought of as dangerous such as ssris) though not every drug/supplement will have the same level of danger, i guess research will have to tell.

I too am sorry about your mom hooter, you really inspire me with your strength. thanks

Edited by Ampa-omega, 01 February 2012 - 01:54 AM.

[nupi]

SSRIs have some issues, but there's a huge problem with this sort of analysis. Before the days of SSRIs, antidepressants were not used very much because they had worse side effect profiles. Now we have some very tolerable drugs, and a LOT of people like them. Something like ten percent of the country is taking them. Some of the people who are taking them are unstable, and unstable people sometimes do bad things. What I'd like to know is how many of those cases would have occurred if the person had been taking a non-SSRI antidepressant or had been unmedicated? You're essentially claiming that the SSRI is causative in these cases, but I don't think that's been shown.

This is what bugs me as well. It is very very hard to establish causation for such phenomenons (you need GIANT RCTs which to the best of my knowledge have never been attempted)

Note: to this day, I am unsure whether I am to blame Effexor for post discontinuation effects (some sexual which truth to be told bother me little, some mood) so it's not like I have no personal experience here. However, I also know that without a potent anti depressant (and benzo, while we are at it) I may not be alive anymore... Today, if I were to advise someone depressed, I would probably suggest to try Bacopa, Wellbutrin, Rhodiola, Tianeptine or Agomelatine first, followed by a selective MAOB inhibitor (think Selegiline)

Edited by nupi, 01 February 2012 - 08:47 AM.

[hooter]

SSRIs have some issues, but there's a huge problem with this sort of analysis. Before the days of SSRIs, antidepressants were not used very much because they had worse side effect profiles. Now we have some very tolerable drugs, and a LOT of people like them. Something like ten percent of the country is taking them. Some of the people who are taking them are unstable, and unstable people sometimes do bad things. What I'd like to know is how many of those cases would have occurred if the person had been taking a non-SSRI antidepressant or had been unmedicated? You're essentially claiming that the SSRI is causative in these cases, but I don't think that's been shown.

This is what bugs me as well. It is very very hard to establish causation for such phenomenons (you need GIANT RCTs which to the best of my knowledge have never been attempted)

Note: to this day, I am unsure whether I am to blame Effexor for post discontinuation effects (some sexual which truth to be told bother me little, some mood) so it's not like I have no personal experience here. However, I also know that without a potent anti depressant (and benzo, while we are at it) I may not be alive anymore... Today, if I were to advise someone depressed, I would probably suggest to try Bacopa, Wellbutrin, Rhodiola, Tianeptine or Agomelatine first, followed by a selective MAOB inhibitor (think Selegiline)

It's absolutely adequate to understand the pharmacology and look at a myriad of interconnected evidence. The way these drugs affect the brain is detrimental.

Violence SSRIs 2001-05-11 Global ++Study: Excess of Serotonin in Brain Causes Violence

I'm sorry to reiterate again, but look at the website. Each of these has a link with a source and evidence, each of the 4800 cases. Just read for cryin' out loud!

• Homicidal Ideation Effexor 2007-05-01 Global ++Package Insert Lists Homicidal Ideation as Adverse Reaction
• Homicidal Ideation Zoloft 2008-11-03 Global ++One in Sixty-six Children Aged 17 & Under Had Homicidal Ideation in this Study from the NEJM
• Violence Paxil 2004-11-07 Global ++One Out of Five Paxil Users Surveyed by MIND Reported Violent Behavior
• Relapse of Depression Antidepressants 2011-07-20 Global ++Patients Who Took A/D's More Likely to Relapse Than Those Unmedicated Depressed Patients: Journal
• Chronic Treatment Resistant Depression SSRI & SNRI Antidepressants 2011-07-01 Global ++Possibility SSRIs Cause Chronic Treatment Resistant Depression
• Serotonin Theory SSRI & SNRI Antidepressants 2011-07-22 Global ++Serotonin Imbalance In Depressed People Does Not Exist: Journal Articles
• Homicides SSRIs 2007-11-20 Global ++SSRIs & Homicide: The New York Review of Books
• Blunting of Emotional Love SSRIs 2011-08-05 Global ++SSRIs Can Blunt Emotional Love
• Suicide SSRIs* 2006-10-16 Global ++SSRIs Can Increase the Number of Serotonin Receptors Linked to Suicide
• Ineffective SSRI Antidepressants 2010-01-05 Global ++SSRIs Ineffective For Mild to Moderate Depression: JAMA
• Treatment-Emergent Mania Antidepressants 2009-02-12 Global ++TEM Caused by SSRIs Can Lead to Damaging Behaviors, Arrest & Incarceration
• Shortening of Life Span Antidepressants & Antipsychotics 2009-10-01 Global ++Those on Antidepresants & Antipsychotics Have Shorter Life Span: Diabetes & CV: Endocrine Today
• Maladaptive Behaviors SSRIs 2007-07-07 Global ++Young Mice Given SSRIs Have Maladaptive Behaviors in Adulthood

AND THOUSANDS MORE.

Please just read the studies. I'm tired of debating this.

Edited by hooter, 01 February 2012 - 12:50 PM.

[niner]

Here is an anti-SSRI item that is not argument-by-anecdote:

Arch Intern Med. 2007 Jun 25;167(12):1246-51.
Association of low bone mineral density with selective serotonin reuptake inhibitor use by older men.
Haney EM, Chan BK, Diem SJ, Ensrud KE, Cauley JA, Barrett-Connor E, Orwoll E, Bliziotes MM; for the Osteoporotic Fractures in Men Study Group.

Department of Medicine, Oregon Health & Science University, Mailcode L-475, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA. haneye@ohsu.edu

BACKGROUND:

Selective serotonin reuptake inhibitors (SSRIs) are a widely used class of antidepressants that block the serotonin transporter. Osteoblasts and osteocytes express functional serotonin transporters; serotonin transporter gene disruption in mice results in osteopenia; and SSRI use has been associated with increased risk of hip fracture.
METHODS:

To determine whether SSRI use is associated with lower bone mineral density (BMD) in older men and to compare the results for SSRIs with those of other antidepressants, we performed a cross-sectional analysis of data from 5995 men 65 years and older participating in the prospective cohort Osteoporotic Fractures in Men Study. Main outcome measures included medication use; BMD at the femoral neck, greater trochanter, and lumbar spine measured by dual-energy x-ray absorptiometry; and potential covariates.
RESULTS:

In adjusted analyses, mean BMD among SSRI users (n=160) was 3.9% lower at the total hip and 5.9% lower at the lumbar spine compared with BMD in men reporting no antidepressant use (n=5708 [P=.002 for total hip; P<.001 for lumbar spine]). There was no significant difference among users of trazodone hydrochloride (n=52) or tricyclic antidepressants (n=99) compared with nonusers. Adjusting for variables that could be associated with BMD and/or SSRI use did not significantly alter these results. The observed difference in BMD for SSRIs is similar to that seen with glucocorticoids.
CONCLUSIONS:

In this population of men, BMD was lower among those reporting current SSRI use, but not among users of other antidepressants. Further research is needed to confirm this finding in light of widespread SSRI use and potentially important clinical implications.

PMID: 17592097 Free full text

This is an important and mostly unrecognized downside to SSRI use. One of the reasons I'm posting it in this thread is that they controlled for other covariates, particularly treated depression itself, by looking at non-ssri antidepressants. That is what has to be done in order to avoid being mislead.

[hooter]

Thank you, the physical side effects and permanent physical damage done by SSRIs is greatly underreported!

A lot of the things I've posted have medical studies backing them up. There isconcrete medical evidence that SSRIs cause suicidality, aggression and homicidal ideation. It's only a question about digging through the research. The boxes of the medication itself have to say it can cause suicidal behaviour in non-suicidal patients. If a lifespan reduction and a risk of becoming sexually worthless or killing your family in your sleep is not a problem for you, SSRIs are a good idea!

Edited by hooter, 01 February 2012 - 05:50 PM.

[nowayout]

What's the deal with tianeptine? Why isn't it available in the U.S.?

[nupi]

One of the reasons I'm posting it in this thread is that they controlled for other covariates, particularly treated depression itself, by looking at non-ssri antidepressants. That is what has to be done in order to avoid being mislead.

THIS. I also wonder if some of the extreme effects are not simply coincidences that are bound to happen with such widely prescribed drugs... But again, there is plenty wrong with SSRIs even if we ignore the extreme issues they might have

[Logan]

Thank you, the physical side effects and permanent physical damage done by SSRIs is greatly underreported!

A lot of the things I've posted have medical studies backing them up. There isconcrete medical evidence that SSRIs cause suicidality, aggression and homicidal ideation. It's only a question about digging through the research. The boxes of the medication itself have to say it can cause suicidal behaviour in non-suicidal patients. If a lifespan reduction and a risk of becoming sexually worthless or killing your family in your sleep is not a problem for you, SSRIs are a good idea!

You are taking a far too black and white, simplistic approach to looking at SSRIs. An SSRI may be a trigger, but it is likely only a trigger for that very small part of the population taking SSRIs that has suidicidal potential to begin with. You see a study, and you make a blanke statement-straight ignorance.

[Logan]

Please just read the studies. I'm tired of debating this.

Then don't debate it. Go on and live your life, and let others decide whether an SSRI is good for them or not, if the benefits outweigh the costs.

[Logan]

Outlook unpleasant.

Perhaps it is your outlook that is unpleasant.

Your views are biased. It may be a good idea to take a step back and evaluate all of what is driving you to look for reasons to think SSRIs are some evil money making scam created by big pharma. Just chill for a minute, take a deep breath, and clear your head.

[Logan]

Hooter, I "Blahed" you because the anti-SSRI zealots don't look at the big picture and all the details within it. They usually lack personal experience and the experience of knowing others that have used SSRIs. They go by flawed studies, that have not proven a damn thing. They are so biased and impassioned against SSRIs - it doesn't matter that there are millions of people out there doing pretty darn good on SSRIs, and for a long time - they just can't allow themselves to open up to the idea that SSRIs DO work for several types of psychiatric conditions, and positives that outweigh negatives to make them worth while.

Did you know that SSRIs may help to restore HPA function that has been impaired by chronic stress/anxiety/depression? Do you even know that there is enough evidence to believe that chronic depression, stress, and anxiety causes damage and alterations in the brain that are difficult to recover from, result in functional issues, and make it more likely for mental health conditions to occur again and worsen?

Try to open your mind a bit. I understand SSRIs are far from perfect, and I believe there might be something to some of the studies you posted, but I do not believe these drugs are anywhere close to causing the kind of damage to the majority of people that take them that you believe they do. You say many people do not report the damage they have suffered from SSRIs, I say the majority of people taking SSRIs don't report anything significant happening to them because they don't have anything to report. People doing well on these drugs do not get on the internet, they are just living their lives, which was the reason for taking an SSRI to begin with.

Edited by Logan, 02 February 2012 - 07:35 AM.

[Logan]

Today, if I were to advise someone depressed, I would probably suggest to try Bacopa, Wellbutrin, Rhodiola, Tianeptine or Agomelatine first, followed by a selective MAOB inhibitor (think Selegiline)

You took Effexor-very very different than an SSRI like Zoloft or Lexapro. There are many people doing very well on low doses of Lexapro, Zoloft, and Prozac. I think one of the problems with the field of psychiatry is excessive dosing for many patients. If many people had tried a 25 mg dose of Zoloft or a 2.5 mg dose of Lexapro, and just stayed there, they may have done just fine without any of the issues they experienced on higher doses.

Do you have experience with Tianeptine? This site is behind the curve when it comes to people reporting experiences on drugs and properly evaluating them. From what I've read, most people have not done as well on Tianeptine as they have on a low dose of an SSRI like Lexapro. Tianeptine is way way overrated.

Wellbutrin over low dose Lexapro or Zoloft? Man, I don't know about that one. I personally know more people that have not been able to tolerate Wellbutrin, that were able to tolerate an SSRI.

Selegiline is another one of those overhyped drugs that just does not end up cutting it in the real world.

[hooter]

I think you seem to have more emotional involvement in this than me, judging by your manic repeated posting... Maybe it is you who needs to relax?

Outlook unpleasant.

Perhaps it is your outlook that is unpleasant.

Your views are biased. It may be a good idea to take a step back and evaluate all of what is driving you to look for reasons to think SSRIs are some evil money making scam created by big pharma. Just chill for a minute, take a deep breath, and clear your head.

Information about frequent and possibly permanent iatrogenic (treatment-induced) sexual side effects are published by the pharma manufacturers themselves in the package inserts and in the American Journal of Psychiatry. Don't you think many non-suicidal people who would consider it after realizing they can never have meaningful rewarding sex again? Where the hell are you getting your information from?

I think you are either under the grave misapprehension that I base my writing on conspiracy theories. Please don't make me laugh. You are setting up a strawman fallacy to try and destabilize my position. Please quote directly where I said that 'SSRIs are an evil money making scam'. I never said this. I couldn't give less of a defecating gesture about whatever it is that you call 'big pharma'. I'm getting my information from wikipedia and pubmed. You still haven't quoted a source for anything. I've supplied 4800 links and you can't come up with one. Please stop embarassing yourself, your avatar has already done its job for you.

My view is based on both experience with 7 different SSRIs and the medical research on serotonin and rage. There are cases of completely healthy people becoming suicidal in SSRI studies. The Japanese government changed the drug labels to say that they may directly cause this sort of behavior. Do you think their medical experts are getting this information from comic books or what?

Not to offend, but you seem to be getting ahead of yourself here.Just because you can't read a medical journal and glean anything meaningful from it doesn't mean nobody else can.


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You are taking a far too black and white, simplistic approach to looking at SSRIs. An SSRI may be a trigger, but it is likely only a trigger for that very small part of the population taking SSRIs that has suidicidal potential to begin with. You see a study, and you make a blanke statement-straight ignorance.

You don't even see a study, and that's the problem. And yes I'm sure all that the 7 and 10 year olds hanging themselves is just because they were already so horribly suicidal. The fact that they just started the meds immediately before the occurrance must be a handwaving coincidence.Oh, a trigger for a small part of the population? Yeah, who cares about those few hundred thousand people right? Thousands of deaths are really worth the 10% benefit over placebo in your eyes.

Did you miss the part where I said I was an immortalist and only had suicidal thoughts on SSRIs out of 80 different psychoactives? Did you miss the studies showing people without suicidal ideation developing it? Do you realize that this affects children more than adults? Some countries don't even allow prescription of SSRIs under the age of 24. SSRIs can make healthy children suicidal. Did you miss the Japanese government's stance on this? Here's what the FDA has to say about it:

Several studies have found that SSRI can cause a higher risk of suicidal behavior in children and adolescents.^[35][36][37] For instance, a 2004 U.S. Food and Drug Administration (FDA) analysis of clinical trials on children with major depressive disorder found statistically significant increases of the risks of "possible suicidal ideation and suicidal behavior" by about 80%, and of agitation and hostility by about 130%.^[38]

Efficacy of SSRIs for the treatment of depression compared to placebo is disputed. Two meta-analyses of clinical trials found that in mild and moderate depression, which constitute the vast majority of depression cases, the effect of SSRI is very small or none compared to placebo, while in very severe depression the effect of SSRIs is clinically significant.^[2][10] However, treatment by either placebo or SSRI may have a significant effect in lower-severity depression vs. no treatment at all. All the second generation antidepressents appear equally effective/ineffective.

A 2010 review reached similar conclusions: in mild and moderate depression, specifically that the effect of SSRI is very small or none compared to placebo, while it is clinically significant in very severe depression.^[2][19]

There is only a 10% over placebo benefit and only in very severe depression. Anyone considering to take SSRIs try and ask yourself, is this really worth the possibly chronic side effects?



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As an additional bonus for you dear Logan, explain these. Please keep in mind they have several expert witnesses with medical degrees and experience testifying in court:

• 16 Year Old Stabs 15 Year Old: Will Be Tried in Youth Court Because of Bad Reaction to Prozac
• 82 Year Old Man Found Not Guilty: Med Defense
• Coed at Wellesley Found Not Guilty Due to Celexa Antidepressant Use: Stabbed Boyfriend 8 times
• Defendant Acquitted of DUI Because of Involuntary Intoxication Caused by Paxil
• Eight Dead in Nursing Home: Jury Spares Death Penalty Due to Medications
• Jury Finds Celexa Cause of Murder-Suicide: Two Physicians Testify: Foundation Demands Action
• Jury Finds Paxil Was Cause of Murder-Suicide
• Man Acquitted in Gas Station Shooting: Involuntary Intoxication by Med
• Man Cleared of Charges by Using Paxil Defense
• Man Found Not Guilty Due to Psychosis Caused by Zoloft
• Man Found Not Guilty of Assault Using Prozac Defense
• Man Found Not Guilty of Killing Wife While Sleepwalking
• Man Found Not Guilty Using Zoloft Defense
• Man Found Not Guilty: Used Zoloft Defense
• Man Released From Prison Hospital Because his Murders Were Caused by Psychosis From Depression Med
• *Mother Acquitted by Using SSRI Defense
• Mother Acquitted of Attempted Child Murder
• *Mother Stabs Daughter: Not Guilty by Reason of Drug Induced Insanity
• *Not Guilty Because of Psychosis Brought On by Prozac & Adderall
• Not Guilty by Reason of Cymbalta Induced Insanity: Man Kills Wife
• Not Guilty by Reason of Paxil Induced Insanity
• Not Guilty by Reason of Prozac Induced Insanity
• Not Guilty by Reason of Prozac Induced Insanity: Mother Kills Daughter
• Wife Given Probation After Stabbing Husband Over 200 Times: Rage Caused by Meds
• Woman Acquitted in Stabbing Incident
• Woman Kills Her Mother: Given Only 3 Years in Prison Because of Testimony Using Prozac Defense
• Woman School Teacher Who Molested 15 Year Old Male Student Found Not Guilty: Effexor Insanity
• *Woman Stabs Boyfriend: Used Prozac Defense: Placed on Probation

Edited by hooter, 02 February 2012 - 11:51 AM.

[Nootr]

Folks, never take tianeptin, coz it is used by drug takes as a cheap substitute of heroine and actually is even more harmful than heroine. It causes emergence of thromboses in your veins and in many cases leads to amputation of arms and legs. It also destroys small vessels in your eyes causing permanent damage to eyes and vision!

[hooter]

Folks, never take tianeptin, coz it is used by drug takes as a cheap substitute of heroine and actually is even more harmful than heroine. It causes emergence of thromboses in your veins and in many cases leads to amputation of arms and legs. It also destroys small vessels in your eyes causing permanent damage to eyes and vision!

Tianeptine does not cause thromboses. I've taken daily doses of tianeptine (2x the recommended dose) for 2 years! What you are referring to is Russian addicts crushing up the tablets and injecting them! The tianeptine doesn't even cause the thromboses, it's the inert coating and pill materials!

What's the deal with tianeptine? Why isn't it available in the U.S.?

Political and economic reasons. Servier, the company that created tianeptine would have to finance multi-million dollar trials and jump through FDA approval hoops and ultimately never make that money back. It wouldn't be profitable whatsoever and would allow other companies to create generic tianeptine. This might bankrupt Servier. For anyone interested, you can order genuine tianeptine from nobledrugstore.

Edited by hooter, 02 February 2012 - 06:21 PM.

[Nootr]

Yes, you are right, sorry for misinformation!