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Thread: The longer the depression, the less likely ADs are to work?

  1. #1
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    Default The longer the depression, the less likely ADs are to work?

    I just read a study that compared Sertraline (Zoloft) to Venlafexine (Effexor) and among other things, it mentioned the patients who had "episodes" of depression that lasted longer than 6 months, had worse outcomes from usage of either of those medications, and actually felt worse at the 8 week mark. Those with shorter episodes of depression of less than 6 months showed a marked improvement at the 6 and 8 week mark.

    I find this finding rather bleak, as my own depression doesn't manifest as "episodes". 6 months only?? That to me would suggest an external cause or temporary problem, or some kind of cyclic mood issue.

    I have felt the same for about the last 5 years and to a lesser extent, 10-20 years. Depression for me is my baseline, not an "episode".

    Is depression SUPPOSED to be episodic?? Does everyone with constant long term depression not respond to AD meds?
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    I don’t know if it’s “supposed” to be episodic, but it is for a lot of people. I’m diagnosed as bipolar, so obviously it is very episodic for me. My manic phases last for a few days but the depression usually goes on for 6-9 months. Antidepressants have never worked for me. I think I read somewhere that 20% of folks diagnosed with depression don’t respond to antidepressants (but don’t quote me on that).
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    Quote Originally Posted by dearie23 View Post
    I just read a study that compared Sertraline (Zoloft) to Venlafexine (Effexor) and among other things, it mentioned the patients who had "episodes" of depression that lasted longer than 6 months, had worse outcomes from usage of either of those medications, and actually felt worse at the 8 week mark. Those with shorter episodes of depression of less than 6 months showed a marked improvement at the 6 and 8 week mark.

    I find this finding rather bleak, as my own depression doesn't manifest as "episodes". 6 months only?? That to me would suggest an external cause or temporary problem, or some kind of cyclic mood issue.

    I have felt the same for about the last 5 years and to a lesser extent, 10-20 years. Depression for me is my baseline, not an "episode".

    Is depression SUPPOSED to be episodic?? Does everyone with constant long term depression not respond to AD meds?
    I think you are spot on here. I know a tad based on a friends experience. I also did some research into it and kept coming across medical articles mentioning the fact they lose their usefulness.
    Are you able to change between AD's by chance? I know that is a horror. Still- if you are stuck in the deep reaches of depression you have to do something right?

    Do you have an option to try Ketamine IV? I know it is not a success for all but I do know those that have had luck with it. The darn ketamine clinics are popping up all over the place at least in these parts.

    I don't think it is a permanent help but perhaps get you over a bump.

    Also, eskatamine should be around soon. A nasal spray for it.

    All I can say is as a pain patient in a hell of a bind- ketamine was useful the few times I could get it (well not from my doc sadly).

    I don't want to pony up the $ for IV that won't last long enough for me but I will say the little I had to get through a holiday was amazingly helpful without any drop out if you follow me.

    I am so sorry you are going through what you are. I do know what it feels like and I deal with it at times. Episodic I guess but a bit of permanence also.
    I cannot do AD's myself. Just don't get along.

    I was surprised the first time I heard about AD's "wearing off" and losing efficacy.
    Good luck to you.
    Helpful songsiren Rated helpful
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    All medications eventually wear off. I have heard more than once of Prozac losing it effectiveness after 9 months to a year. Possibly that is from built in obselecence so you have to pay for the latest new drug. Like they have always done with light bulbs.

    I am currently classified as mixed bipolar which as far as I can determine means mad and sad as opposed the classic bipolar which is happy and sad. For more than 30 years I have struggled with the demon of depression. I had the joy of trying every new poison the drug companies invented. Any of them with the word serotonin uptake of some sort in its description sends me to the hospital in a state of compulsive suicidal ideation.

    I have been labeled with nearly every label in that big DSM Manual, including MPD, and borderline, and a big question mark with dissociative disorder beside the depression. The psychotic stage has fortunately been left off but it was close a few times. Add some PTSD in there and its a real witches brew. The only med that has ever worked even a little is wellbutrin . I took Nardil, an MAO inhibitor for 9 months and it worked to but was oh so dangerous. I even had ECT. I even got advanced degrees in psychology to diagnose myself but that didn't work. Stimulants of all kinds have kept me alive.

    After 25 plus years of therapy I know why I am like I am. Its never pretty to figure that one out, it may help or do more harm than good. Medication alone without the introspection is pretty useless but that is JMHO. About 11 years ago I had sort of a spiritual epiphany and I realized nothing would help me except me. I started to meditate and that has helped me more than anything.

    A young woman I know is getting married today, she is a Neural Psychiatrist and she is brilliant and the fact that people like her are trying so hard to find out what causes problems like mine and how to cure them like they cure a broken keg, gives me HOPE. And in these primitive times Hope is as important as any medication.

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    Helpful songsiren, peppergirl Rated helpful
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  6. #5
    @LeeAnn Thank you for such a helpful and honest post. It makes me feel better about myself. I "ditto" all that you said.
    @dearie23 I feel so bad for you. I've had my dark days also and if you don't do something, they'll turn into months. Valium is my best friend through those times. Didn't find Zoloft or other AD meds useful or pleasant.

  7. Hi @dearie23 I’m sorry to hear about your depression. I’m a semi retired physician and I’ll try and flesh out the points u bright up. The consensus amongst most doctors is to use somthing called the Hamilton scale to measure depression both chronic and episodic. 0-7 is in the normal range and 23 or more is severe. U can do this test free on line, answer honestly then u have somthing to work with. Depression is ideally caught and treated as early as possible for the best outcomes, that said, any SSRI medication will pretty quickly knock 3-6 points off your score within a few weeks. This can be the respite some people need to kick on although it’s not a cure. Depression can be episodic for example through bereavement. However it can also be chronic, this can be for all sorts of reasons, congenital dopamine deficit etc. If u r on meds then I’d urge u to keep taking them, sometimes it can be useful to mix 2 even 3 different SSRIs. The future isn’t as bleak as u think, ask for talk therapy and CBT, even a deep connection with someone else in your position can knock as much as 10 points off your score. Like any chronic illness curing is very difficult but it definitely can be managed and your quality of life will improve dramatically for sure. Good luck and feel free to get in touch if u have any more questions.

    Dobre
    Rom

  8. The longer the depression, the less likely ADs are to work?

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