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Do Antidepressants Work or What?

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Subscribe to Healthcare Triage! https://bit.ly/2GlEYWG A huge meta-analysis came out recently looking at how effective antidepressants actually are. It turns out, the results are complicated, and we had a hard time reducing all the stuff in this study to a headline. So, the title's a question, and that's the way it is. Aaron has a book out now! It’s called The Bad Food Bible: How and Why to Eat Sinfully. You can order a copy now!!! Amazon - http://amzn.to/2hGvhKw Barnes & Noble - https://www.barnesandnoble.com/w/the-bad-food-bible-aaron-carroll/1125338472?ean=9780544952560 Indiebound - http://www.indiebound.org/book/9780544952560?aff=dhoom09 iBooks - http://itunes.apple.com/us/book?isbn=9780544952577&uo=8&at=1010lwmG Google - http://books.google.com/books?vid=ISBN9780544952577 Kobo - http://www.kobobooks.com/search/search.html?q=9780544952577 Any local bookstore you might frequent. You can ask for the book by name or ISBN 978-0544952560 John Green -- Executive Producer Stan Muller -- Director, Producer Aaron Carroll -- Writer Mark Olsen – Graphics Meredith Danko – Social Media http://www.twitter.com/aaronecarroll http://www.twitter.com/crashcoursestan http://www.twitter.com/johngreen http://www.twitter.com/olsenvideo And the housekeeping: 1) You can support Healthcare Triage on Patreon: http://vid.io/xqXr Every little bit helps make the show better! 2) Check out our Facebook page: http://goo.gl/LnOq5z 3) We still have merchandise available at http://www.hctmerch.com
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Текстовые комментарии (201)
ihartevil (27 дней назад)
When the government was trying to make cenk take down vids they admitted prenatile vitamins are useless and if anything will hurt the fetus like I have been saying so GO FUCK YOURSELF
korikafez (28 дней назад)
4:36
Hunter Ellis (1 месяц назад)
At the end of the day. If it's banned from all sports (highly stigmatized) "IT WORKS"!!!
Michael Ingling (2 месяца назад)
Antidepressants increase depression and anxiety in kids and are known to cause a permanently depressed/anxious state, yet prescriptions to minors are still allowed. Why didn't you mention this?
Ashley Sheeder (2 месяца назад)
Can you do a video on TMS... Trans-cranial Magnetic Stimulation?
Matt Carls (3 месяца назад)
They only work for one thing, i graduated hs last year and there are alot of kids taking antidepressents , mostly getting them illegally and i live in a suburban neighborhood, kids forget who they are when theyre on those, and most act out when they forgot to take the pill that day (withdrawls)not to mention none of the kids that take them all the time even know what day it is, 80’s had crack, 2000’s are the years of benzos and opiates
Some Random (4 месяца назад)
https://www.youtube.com/watch?v=n0v0jUeFGQ0
Lycerion (4 месяца назад)
Why *don't* we have a patreon for research...?
WINSTON SMITH (4 месяца назад)
Big pharma loves them. They are real money makers. And from my personal experience they are bullshit!
Jurgen Engelbosch (4 месяца назад)
Usually I never comment on videos. But this shirt and tie totally not fitting together just is asking to be pointed out. That being said amazing content. Reminds me a lot of the book missed connections.
RegalBookery (5 месяцев назад)
Yes. Love, someone who is alive right now because of my dopamine reuptake meds.
Stupid Google (5 месяцев назад)
Oh no, antidepressants are god's gift to Earth and never have any negative outcomes for the people thrust onto them. Or so I've been told by some SciShow viewers, despite the real experiences on myself and other people. The flaws in the system aren't hard to see when you're willing to view them objectively. I can tell you right out you're lucky if your prescriber bothers to tell you the advantages and disadvantages of each medication. I take umbrage with the whole "chemicals" assumption in the first place, but it's the practice that's most alarming, and all the money swirling around it. And it's really annoying when you know you've had numerous negative experiences, but everyone keeps trying to sell you on the same idea, the idea of insanity. And who knows what these things have done to me long-term? I don't want more pills! I want a different situation.
bananian (6 месяцев назад)
I don't understand those who complain that it doesn't work. If it doesn't work, then stop taking it? If fish oil, diet, and vitamins work for you, then have those things!
Ace_RKO (6 месяцев назад)
I understand the usuuefulness of meta analysis studies and other forms of data collection and examination for professionals who know what they are doing to be better at their job, but considering how often and how easily studies can be manipulated to show certain results they didn't receive. 11 major studies on anti depressants repackaged to give conflicting outcomes? If someone says "here's some data and research" nowadays are they really saying anything at all?
Emma Schwerkolt (6 месяцев назад)
What about all the other indications for antidepressants? They are not just used for depression!
Henrik Mathisen (6 месяцев назад)
When you say "depression" are you just referring to clinical depression or are other diagnosis included in that spectrum? Like anxiety disorders and panic disorders?
soulshinobi (6 месяцев назад)
How and why are there no links to this meta-analysis in the description??? Cite your sources!!
Sorrel Johnson (6 месяцев назад)
What about the other disorders like OCD that SSRIs are prescribed for?
Charleston Coryea (6 месяцев назад)
Yes, they work. The problem is some work great for some people and do absolutely nothing for others (or sometimes bad things). It's frustrating. I have crippling OCD and it took 31 different medications to find one that worked. Once I got on a good dose it changed my life. I without a doubt still have OCD and some days are better than others but the drug gave me my life back.
EauClaireFTW (6 месяцев назад)
When my healthcare folks knew I had issues with depression I had to fill out a completely degrading "smiley chart" before being seen. Even when I wasn't being seen for something related to depression out came the chart. I changed healthcare providers and hoped the "smiley chart" would go away. It didn't. I changed providers again, didn't transfer my records, didn't tell them about my depression issues, and started working on the depression on my own, found a few helpful books, started doing yoga and meditating, that sort of thing. Now-a-days my depression issues are still there, but are better managed than when I was using the healthcare system and I don't have to worry about being degraded when I have to see a doctor about a sinus infection.
lynnthegreat10 (4 месяца назад)
I know the "smiley chart" you speak of lol. It is so dehumanizing. If you score too low on the "smiley chart", you need antidepressants! It's like they push that crap without regard for individual circumstances. They don't even care to find out if your depression is triggered by a situation (most likely), they just want you on their drugs.
Phillip Morrison (6 месяцев назад)
you should do a similar video for for anxiety, ADD, ADHD, and anti psychotic medications
Suchnothing (6 месяцев назад)
Without watching the video - YES. If you need them, and your brain chemistry is right for them, they work.
lynnthegreat10 (4 месяца назад)
We have a scientist over here guys.
Shane F (6 месяцев назад)
Also, there's very minimal research on withdrawal from many of these drugs, take Effexor for instance. Its withdrawal is extremely strong and hits just like PCP. I've seen a close relative go only a day and a half without it a couple times, and they become a completely different person. it's about the worst thing I have seen them go through.
David Aaron (6 месяцев назад)
Where are the links to the meta-analysis reports? Also please don't wear stripes and checks - It looks terrible in general, but worse in a digital format
Laura P (6 месяцев назад)
Clinical best practice indicates that people have best outcomes with combined pharmaceutical and psychotherapeutic support. Could you review this evidence as well?
Jynx C. (6 месяцев назад)
Further Research List: (I keep thinking dysthymia) 1) How well do antidepressants work for milder symptoms that fall short of major depression? 2) How well do antidepressants work longer than 2 months, especially for mild symptoms? 3) Does long term antidepressant use outperform placebo?
LJ the snail boy (6 месяцев назад)
Antidepressants work very well for me(ive been on the same one for almost two years. The only negative side effect ive had is a lowered metabolism, and therefore weight gain. And I have severe major depression, anxiety, and anorexia nervosa as a result of ASD. I've recovered from all 3 too
Evan Breen (6 месяцев назад)
The source card for the main study is incorrect. The card looks to be recycled from the first Ioannidis paper, not updated for the more recent network meta-analysis. Would it be possible to add a link to the meta-analysis in the description? I got really excited and was hoping to read it.
Evan Breen (6 месяцев назад)
Nevermind, found it. Here's the MLA citation: Cipriani, Andrea, et al. "Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis." The Lancet (2018). And here is a link to the paper: https://goo.gl/QJkmJY Still might be a good idea to add this to the description
Rae Prite (6 месяцев назад)
Would you consider doing a video on bipolar depression, and how it's different from major/minor depression? I've only been able to gather vague and/or limited info so far on the topic and I really want to understand it better
codediporpal (6 месяцев назад)
My sisters CAT is on antidepressants.
Rosario Candelero (5 месяцев назад)
I really believe antidepressants work, but how to fix dying communities, loss of social interaction, alienation at work and hopelessness?? You could mitigate the feelings, but you will need more to forget.
m e (6 месяцев назад)
So how would we/the patients demand the research themselves in a meaningful way?
Chris Harris (6 месяцев назад)
This video generated more questions than answers.
lynnthegreat10 (4 месяца назад)
That is the point.
declup (6 месяцев назад)
May I request that you discuss the diagnosis and treatment of avoidant personality disorder (and/or related anxiety disorders)?
Michelle Altman (6 месяцев назад)
Why do doctors prescribed antidepressants for people with fibromyalgia and other chronic pain conditions as the first medicines to try even when depression isn't a big factor in the diagnosis at the time?
Dan and Candace Parrott (5 месяцев назад)
Michelle Altman my guess is some numbing effect as far as widespread pain. I take a tricyclic for CFS. It doesn't change my mood, but it helps me sleep at night as well as keeps me from feeling sleepy during the day. Before starting it, I couldn't get out of bed most days, not because I felt sad, but because I had very severe fatigue.
hippopajamas (6 месяцев назад)
I understand that an individual instance does NOT represent a trend, but- I have depression ans have tried a bunch of kinds of medications over the years. I am on one and seem to be doing SO much better, and I can assure you my life situation has not improved. It makes it far more manageable. I am pretty sure I would be dead without them. (I am a strong advocate for using them along side therapy, though!!! It isn't some miracle pill and I understand that.)
Zina B. (6 месяцев назад)
After being depressed and anxious since I was a kid, that eventually progressed into me not being able to leave my house for almost a year, I started an antidepressant and antianxiety 6 months ago. Already I am able to leave my house every single day and interact with people without sweating, my heart racing, and scratching myself to the point of bleeding. Other methods have helped but not this much. Though obviously this is not the case for everyone (I had a horrible reaction to prozac) it does work for some people, and for those people it can 100% change their life. I finally have the ability to seek out and try other treatments. This medication may just be an aid to get to a slightly better place, just enough to be able to go from there.
Noelle Matteson (6 месяцев назад)
I'm so glad this is a source I can go to that looks at medication critically without throwing it all under the "big pharma" and "natural resources are better" bus. (Not saying big pharma doesn't exist, but as someone who grew up with no medicine whatsoever, I have no trust in those who say all, or even most, medication is bad.)
Snapple and Cats (6 месяцев назад)
Could you please make a video covering the PACE trial that falsely claimed GET and CBT are effective treatments for Myalgic Encephalomyelitis?
Nikki Burt (6 месяцев назад)
Love the pop ups with journal information for the citations!
Laiel Shepherd (6 месяцев назад)
Even as a person with severe chronic depression, antidepressants are risky and their effects highly variable. I've been prescribed some that have made my symptoms much worse, caused me great pain, and the like. Finding the right balance of psychiatric medication is a moving target--my needs change over the years, as do the effects I experience from some medications or combinations. I do wish psychiatric medicine had more of a grounding in science than it currently does.
Jennifer Isaacs (6 месяцев назад)
Problem with one size fits all health generalization and stereotypes is in reality not everyone can react the same way. I can see why anti Baxter's are paranoid about health care because of such bullshit.
John Faria (6 месяцев назад)
Well you said that those studies from the meta-analysis were conducted from 1987 to 2004. Haven’t antidepressants improved vastly from the early 1990s?
thatjillgirl (6 месяцев назад)
Ehhhh there are more options now, and some of them work in new and different ways. But ever since fluoxetine came out in 1987, SSRIs have remained the typical first line treatment option for depression. And the newer, non-SSRI meds don't necessarily work *better*, just differently, which means they may help some people who fail SSRIs, but they aren't necessarily better for everyone. With anti-depressants, you kind of have to just try different things until you find what works.
philophos (6 месяцев назад)
You guys should put up non-auto generated English captions on the vids.
tetsubo57 (6 месяцев назад)
I recently began taking Zoloft. I'm in the 'life changing' category. If I have any say in it, I'll never stop taking it.
Hans Schroeder (6 месяцев назад)
Thank you for covering this complicated topic.
Rob Wilson (6 месяцев назад)
I would love to have a psychiatrist on the HCT Podcast. ^.^
Caroline (6 месяцев назад)
So what does this mean for people with chronic depression? I am unclear whether the data says anything conclusive. If not, other than non-pharmacological treatments such as talk therapy, are there treatment recommendations?
yaniv148 (6 месяцев назад)
(I'm not a doctor, but you should research this and find out for yourself) L-Tryptophan works great to fight depression on demand. It is a natural amino acid our body consumes and uses anyway, and does not have the dependency (AKA addiction) that industrial anti depression drugs have. It works by naturally increasing Serotonin production by supplying the material to make more. A process the body regulates so overdose is impossible. While industrial drugs break body processes to keep Serotonin from metabolizing, which can have bad side effect on your mental abilities restful sleep and procreation. It Works withing minutes and is mild, unlike the industrial drugs that may take weeks to have an effect and must be taken regularly. Be warned that people on commercial anti-depressants needs to detox before using Tryptophan as the mixture of the two can lead to too much Serotonin in your system which is bad. There was an incident where poisoned Tryptophan caused some damage, some conspiracy theory regarding the debut of Prozac which happened at the same time exists, but to this day internet articles discussing Tryptophan mention that case, so draw your own conclusions.
firefox5926 (6 месяцев назад)
pharmac thanks you :)
Abbott Abbott (6 месяцев назад)
Link to paper?
TheSpinningLily (6 месяцев назад)
Hi Aaron. Love the series. However do feel like you could have mentioned the Lancet study published in February 2018 comparing efficacy of antidepressants. It was another paper that got a lot of coverage, here in the UK and I felt like it would have been relevant. Also mentioning how researchers distinguish between 'limited' or 'small' efficacy would have been interesting Regards Lily
ooooneeee (4 месяца назад)
TheSpinningLily thanks for mentioning it! I found it at https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32802-7/fulltext
Gray Sloth (6 месяцев назад)
I have quite a few criticisms of many aspects of psychology, mental illness and psychiatry specifically. Let me first state that I do believe there are useful aspects of psychology, the mind exists, people have behaviors, these things can be observed and studied, however, the claims often put forward by psychiatry are often dubious at best and pseudoscience at worst. In truth, there is no such thing as mental illness. So-called "Mental illnesses" cannot be literally diseases since they merely refer to the undesirable thoughts, feelings, and behaviors of persons. Classifying thoughts, feelings, and behaviors as diseases is a logical and semantic error, like classifying the whale as a fish. As the whale is not a fish, mental illness is not a disease. Individuals with brain diseases (bad brains, example: tumor, epilepsy, Alzheimer's) or kidney diseases (bad kidneys) are literally sick. Individuals with mental diseases (bad thoughts or behaviors), like societies with economic diseases (bad fiscal policies), are metaphorically sick. The serious and dangerous consequences of the misclassification of (mis)behavior as illness are that it provides an ideological justification for state-sponsored discrimination under the guise of medical treatment. Psychiatry is not a legitimate field of empirical scientific observation, like say neurology. Rather, psychiatry is merely modern prescribed moral philosophy masquerading as science. So-called mental illnesses do not have biological evidence of disease, and no physical empirical objective observations of someone's brain or "brain chemicals" are made to diagnose these "illnesses"; simply the moral judgment by a psychiatrist that a person's thoughts feelings or behaviors are wrong. Until 1974 psychiatry classified homosexuality as a mental illness, up until then Homosexuality was listed in the DSM and considered a disease, not because there was any objective way to biologically measure that someone was homosexual and that homosexuality was a result of some sort of brain damage, homosexuality was, like all mental illnesses, merely a behavior that was judged as wrong. Homosexuality was eventually cured of its disease status, not because someone made some breakthrough discovery that being gay wasn't some sort of mental disease, neurological or otherwise, but because the would-be LGBT movement of the time protested this classification and psychiatry bowed to the political pressure. Psychiatry is medicalized bigotry, it is a weapon in the toolbox of state-sponsored oppression. "Mental illnesses" are not real diseases of the body or brain, they are the thoughts feelings and behaviors our unelected moral arbitrators deem as disruptive to social order. Science is a method, a set of steps used to make empirical inferences about the universe. It is making testable, repeatable, and falsifiable observation and concluding some logically necessary truth or law based on those observations. However, psychiatry and its claims of mental illness actually fail this method, "mental illnesses" are not based on observation simply assertion that fundamentally fail to be falsifiable. Read about the Rosenhan experiment, a person pretending the be mentally ill is indistinguishable from a person who allegedly is mentally ill. I could go to a doctor and claim I have all the symptoms of lung cancer, but one scan and they would tell me to get the fuck out, a real disease can't be faked for long because it can be shown objectively to be absent, mental illness, on the other hand, could just be an Oscar award winning performance in disguise and there is no way to prove otherwise. The claim that certain thoughts, feelings, or (mis)behaviors are not only just wrong, but literally some kind of disease like cancer or the flu, can not only not be proven right, it's Not Even Wrong. To be clear, I am not saying mental suffering is not real, I am not saying people don't engage in disadvantageous thoughts feelings and behaviors that they would like to change and would be in their best interest to do so, there is simply no evidence that such things are literally illness like diabetes or the flu since there is no evidence of objective measurable damage or infection, only at best differences, but differences aren't diseases. My position is that so-called mental illnesses are the natural human reaction to loss or to ongoing hardship/drudgery and that severe mental illnesses are the normal reaction to a major loss or to ongoing hardship/drudgery that is particularly arduous. It is not something that needs to be "treated" as a medical condition; rather, it can be alleviated, either by supporting individuals through their loss or actively helping them identify and extricate themselves from the harmful circumstances. Many people point to effectiveness of drugs as proof mental illness is real and that it is being treated by those drugs, but what drugs do, in some cases, is provide an altered mental state, which some people find preferable to disadvantageous mental states, this doesn't demonstrate a correction of a "Chemical imbalance" rather all this demonstrates is that doing mind-altering drugs is fun and useful which is not something I disagree with. Personally I am pro-drug, if drugs can help, whether it be some smoka da ganja or antidepressants, if it improves your life then I am in favor of you having safe access to it. However I am critical of the current paradigm of psychiatry framing often dangerous psychoactive drugs as treating an underlying illness for which there is no evidence of existing, and can potentially do a great deal more harm than good. The issue here is not whether people should or shouldn't take these pills. That's each person's individual choice. The issue is psychiatry pushing these dangerous brain-disruptive chemicals on people, under the religious farce that they have an illness, for which the pills are the necessary, effective, and safe treatment. So in summary, I do believe people suffer greatly as a result of undesirable and disadvantages thoughts, feelings, and behaviors, such as depression, however viewing this through the lens of "disease" is incorrect and dangerous and psychiatry lacks legitimacy as a field of science. So-called mental illness are just the result of problems with living, life is hard, people have struggles, biases, funky beliefs, etc. Humans are complex and fallible, but none of that is disease, those are simply the symptoms of our terminal humanity.
lynnthegreat10 (4 месяца назад)
OH MY GOD THANK YOU!!!! This was beautifully written. I agree with you 100%, as someone who has been "diagnosed" with Bi-polar disorder. I just don't believe it. I had a friend who was losing her grip on reality. she was doing crazy things, putting herself & others at risk/in danger for no particular reason. She was letting herself go. She was self obsessed & turned into a terrible friend. Then she came to me one day SO HAPPY that her psychiatrist diagnosed her with "Borderline personality disorder". Because ever since that day, she has blamed all the shitty things she does on that "illness". She would literally cheat on her boyfriends & say "I did it because of my mental illness, it is who I am, I can't HELP it". PATHETIC! So sorry to the people in this world who are emotionally suffering. I feel you, I hear you. As a world that is more connected than ever before, we feel more lonely than we ever did before. It does things to peoples minds. We all have our own way of interpreting the world, & processing information. Making sense of things. Sometimes our brains make sense of things in a bad way. People become obsessive. People become depressed. We have extreme anxiety, we over-eat/under-eat. Humans in general are neurotic to the core. That is the curse that comes with the gift of superior intelligence to all other living creatures. It is a fact of life. Life is suffering. Indeed as you said, these negative emotions are NOT diseases. It boils down to a lack of control, in my opinion. We all react differently to feeling helpless. That is why it feels so good to help other people. We can help make a difference in other peoples lives, we have some control. I have been struck with severe situational depression. (Not depressive disorder) It can take over your life. But we need to learn to overcome ourselves. We are our own obstacle. No one in this world knows whats best for you, better than yourself. Seriously. I overcame a long-term heroin addiction, by myself. It was one of the most empowering things I have ever done. I now have a better idea of what I am capable of. I lost 50 pounds, another wonderful thing I have done for myself. I did these things because I have an internal locus of control. & I truly believe that I am in charge of my own destiny, as much as a human could be. The idea that these negative emotions are not circumstantial but instead biological & genetic is dangerous. My father has "Bi-polar disorder", they tell me it is genetic, & that I have it, also. I watched my father who was one of the smartest, funniest people I have ever known turn into a zombie from all of the anti-depressants & medications they have him on. He is almost not even the same person anymore. Who is to say that he is "better" now? I miss my dad. Taking the control away from the individual & telling them that they are powerless over their own mental condition is something unheard-of to me. That statement alone seems more like a marketing campaign for the pharma company rather than good advice from a doctor. Thank you for speaking up, for the truth as you see it.
Gray Sloth (4 месяца назад)
@ Rber H I am not a doctor, nor do I have any formal education on this topic, but I have been the victim the psychiatric system long enough to understand how it works. Also, you have taken away the complete opposite message from my comment, I don't believe homosexuality is a psychological disorder, because I do not believe the concept of "psychological disorder" is real. I do believe there are such things as thoughts, feelings, and behaviors that some people find undesirable and those people should be given the help and support to overcome or learn to accept on a case by case basis, but this has nothing to do with illness, disease, or disorder, rather just the inevitable problems with living. Now when discussing this topic, I consider anyone who even comes close to presenting the position that "Maybe homosexuality IS a mental disorder" to have fortified the discussion. Though normally this does not happen as brazenly as you have done. So all I will say to you is, provide evidence or a rational argument for your claim that homosexuality is a mental disorder or I will simply dismiss it as the meaningless assertion that it is.
Rbər H (4 месяца назад)
Gray Sloth I read the beggining and I guess you are a Medial Doctor aren't you? Sure homosexuality is a psychological disorder, if you don't believe read from psychology of Frojd as I have studied his work for a long time.
Gray Sloth (6 месяцев назад)
@Zina B. False beliefs can be useful, that makes them no less false. Many people find the belief in god to be very helpful believe but that makes it no less fictional. Someone could equally assert "Saying god is not real is what pushed me to attempt suicide", that doesn't make god any more real. So though you might have found the belief in mental illness as an explanation for your suffering comforting, that isn't actually evidence it's true. There is no such thing as an objectively good life because the quality of a life is fundamentally subjective, what might be good to one person would be bad to another. Taking you at your word that you had no apparent problems in your life all that is true is that you had an undesirable mental state and mind-altering drugs changed your mental state to a more comfortable one. Again, mind-altering drugs are fun and useful, this is no secret, but it's no more evidence that these drugs are correcting a disease than the positive effects of smoking pot are evidence of a THC deficient. Mind-altering drugs can just make you feel good, that's a great thing, and I want everyone to have safe and informed access to these drugs without psychiatrist denying them access for over a decade on the basis that they don't have a disease there is not even evidence of existing. Also, ad-hominem attacks against me are not arguments that I am wrong. I am sorry what I have to say upsets you, but I would rather tell people an uncomfortable truth than a comforting lie.
Zina B. (6 месяцев назад)
Gray Sloth again, you are a horrible person. You can try to justify your position all you want but mental illness is real. We didn't know cancer was real until advances were made, how do you know that is not the case here? To deny that people have serious mental illnesses that require treatment is damaging and dangerous. I really hope you aren't spreading this to people in your own life. There is proof this stuff exists. Just because you haven't lived it doesn't mean it isn't real. If you have not seen the proof, you need to get out more. You need to interact with a wider variety of people. You, and people like you who try to discredit that people have different brains than yours are so damaging. Fuck you.
nerdwriterfighter (6 месяцев назад)
The effectiveness of anti-depressants has to do with the person. Everyone is different. I have dealt with major depressicw depression for a long time and anti-depressants has helped me cope and control it. For me, most of my medications worked while I was on them one in particular did not. Just because it is not effective for one person, it doesn't mean that it works for everyone. And for some people, medications don't help, which is also fine. We need to stop looking at it as a one size fits all and look at it more individually
Sai (6 месяцев назад)
For some reason, this video entirely omits long-term severe depression. It mentions long-term mild, and acute major, but those aren't exclusive.
tenou213 (6 месяцев назад)
I love this channel. Maybe you guys should register with Brave for more flexible fan support options
Monica Nguyen (6 месяцев назад)
Out of curiosity, I absolutely love HT since I'm in the medical field myself, but is Dr. Carroll an MD or DO?
Leon (6 месяцев назад)
MD, with a masters in health services research.
roflex2 (6 месяцев назад)
My guess as to why this is so hard to fix is the fact that depression is a normal feeling that people should feel from time to times and not necessarily a chemical problem, if you work long hours, have no partner and live alone I would argue you should feel depressed, you are living so far from what humans did 20,000 years ago. We should look to curing our life styles that are lonely and lacking family. Look at rat park, social improvements can cure drug addiction, I'm sure they can help cure depression.
bananian (6 месяцев назад)
roflex2 Well you would want to treat those things or prevent them, wouldn't you?
roflex2 (6 месяцев назад)
But it is normal to get the flu or cancer....
bananian (6 месяцев назад)
The thing is that the person is probably alone or undesirable because he is depressed and lack motivation. Depression isn't just sadness as you have implied. It impacts your ability to function in day to day activities. It's like saying it's normal to get the flu or cancer.
Andrew Pickard (6 месяцев назад)
Melody Patten No one said that clinical depression is situational or that there is an easy solution to helping a person that suffers from it. Restructuring a society so that fewer people are likely to become clinically depressed is an extremely complex task, it's obviously not going to be as easy with humans as it is with rats—but that doesn't mean that we should ignore the results from rat park or give up and say it isn't possible to structure a society for ourselves that is more conducive to mental well-being. Why do you assume that we have no knowledge on the subject? We're on a healthcare triage video, for goodness sakes. I've experienced MDD for years and have read lots of literature on the subject.
Melody Patten (6 месяцев назад)
Depression is not a normal feeling that people feel, that is sadness. Depression is much more complex than an emotion and often involves unpleasant physical symptoms as well as psychiatric symptoms. You are assuming there is an external cause of depression, and while that is true in some cases it is naive to assume that the majority of people with MDD are experiencing something situational. While an engaging social life can help improve symptoms in many people it is not a cure-all. Please do not act like you have all the answers to a complex assortment of illnesses that millions of people have suffered with for thousands of years.
Michael Wade (6 месяцев назад)
This is purely speculative, but if people are prescribed a drug that's been on the market long enough to start picking up detractors and anecdata saying it doesn't work or has some strong negative side effects, a newly released medication wouldn't have that same history to overcome as far as a negative bias possibly influencing perceived patient benefit. An established but possibly negatively "reviewed" drug would bias patients against it while a new one would not yet have those expected weaknesses or questioned (not questionable) efficacy. Just a thought. The brain is weird like that.
Ryan Verhoef (4 месяца назад)
Wayne Gale The solution to bad psychiatry is better psychiatry, not throwing it out completely. Look up some of the research on Ketamine in the treatment of depression. It's likely that Ketamine sessions will replace traditional anti-depressants in the future and these sessions will have to be prescribed by a psychiatrist or physician.
Juan Polla Larga Stamosa (4 месяца назад)
Psychiatry; the great embarrassing failure of modern science.
thatjillgirl (6 месяцев назад)
I had a similar thought. A previous video on this channel mentioned that patients experience a placebo effect more often/more strongly when they are told that their placebo is an expensive or brand name drug than when they are told that their placebo is a generic. New drugs would be brand name only and may trick the brain into a larger perceived benefit compared to older drugs available in generic.
Amir (6 месяцев назад)
Have been on prozac.. xanax.. effexor.. all dont work on me.. ON ME atleast.. im sure it works on other..
bshay513 (6 месяцев назад)
Do you teach any CE course? You should... I'd sign up.
John Heller (6 месяцев назад)
As an Epidemiologist, and in this case a patient, I super-appreciate this video. Thanks, Healthcare Triage!
pvrunner8 (6 месяцев назад)
I'd love to see a video about bipolar depression and antidepressants!
gadfly cuisine (6 месяцев назад)
If I may paraphrase a joke from Craig Ferguson: "Yes, these pills are a crutch... Who cares?! You don't kick a crutch out from under a one legged person and tell him to hop!"
Ty Johnson (1 месяц назад)
+Ashley Sheeder like?
Ashley Sheeder (2 месяца назад)
There's other treatment options
Juan Polla Larga Stamosa (4 месяца назад)
of course they work. i flush them down the toilet every morning instead of swallowing them and I haven't been admitted to a hospital since.
Roland Kristo (4 месяца назад)
Cool hypothesis, could be tested.
Stephanie C (6 месяцев назад)
gadfly cuisine I feel this.
Joshua Osborne (6 месяцев назад)
I previously had very serious depression and anxiety and took medication for years. I did eventually begin to feel better and am now able to manage my symptoms and mindset, but I should note that I spent a lot of time in therapy and that the majority of the things that permit me to control my reactions now and helped me cope with things then were breakthroughs in therapy sessions. I am now off of medication entirely and, although I still have some issues, they are far from as bad as they used to be. I didn’t really notice any differences while I was on the medication alone (before going to therapy) but I can definitely say I noticed a difference when I was decreasing dosage and when they were no longer present. Thank you for bringing this information to light. It helps me think about my previous use and how, althought it seemed to work with me (in conjunction to other forms of treatment), it mat not work well with others
Mathew Chui (6 месяцев назад)
so medications that are indicated for major depression are likely not clinically effective when people don't have major depression... go figure?
Guilherme Jung (6 месяцев назад)
It would be nice if you list the articles in the description.
Yuri Matias (5 месяцев назад)
The baseline here is that Psychiatry is an art of trial and error.
greenfire61 (6 месяцев назад)
Was there an editing issue? You said recent study but the graphic referred to one from 2008?
Dylan Bystedt (6 месяцев назад)
When being prescribed anti-depressants, my doctor wrote out an x/y graph. X being effectiveness, and Y being acceptability. Based on this graph he let me choose. What do you think of doctors having a tool like this? His was made on his interpretation of research he's read, but wouldn't something based on clinical research and measured values, that's standardized be better?
surfraider31 (6 месяцев назад)
Fun fact: the overall effect size of the 'these things work' study was SMALLER than the effect of the first 'these things don't work study' XD
Sherubii (6 месяцев назад)
As someone who's been in and out of psych hospitals for the past few years, I can say with certainty that antidepressants work. Just not for everyone. Unfortunately I've been unable to find a medication that works for me, but that doesn't mean that they shouldn't be tried by people. A modest amount of relief from symptoms is better than no relief at all.
JAKE RIEGER (4 месяца назад)
Only if that relief isn't paired with nasty side effects which seems to be the case with every antidepressant I've tried
Juan Polla Larga Stamosa (4 месяца назад)
as someone who has been to psych hospitals i can tell you with certainty that psychiatry is the great failure of modern science. I'm so happy that toxic life destroying garbage is no tin my system anymore. FUCK psychiatry.
karen bennett (6 месяцев назад)
Since the 90s I've been on nearly all the available anti-depressants at one time or another (except tricyclics, not a good idea for someone with major depressive disorder too easy to use to commit suicide with) they all have side affects and some work better than others. But, and this is a big but, they help me function but they don't "fix" me. Drugs may dampen the blackness but talk therapy brings back the sunlight and gives me the tools to deal deal with the cloudy days.
Dean Speerbrecher (6 месяцев назад)
This is an eye opener.
Tomas Beblar (6 месяцев назад)
Great video as always Dr.Carroll. I just ordered a "to the research" mug and can't wait to flaunt it at work :)
Anthony (6 месяцев назад)
I've never tried to kill myself not on antidepressants, yet every time I've taken antidepressants, I have tried to kill myself... Almost always within the first month of use, I have severe bipolar, and yet, I still try to kill myself. Some of the antidepressants I've taken, have caused other side effects like withdraws and panic attacks.
Dan and Candace Parrott (5 месяцев назад)
Prozac made me suicidal as a teen
Nurmi Husa (6 месяцев назад)
Anthony Murka: finest health care money can buy. No money? No health care. A holocaust in slow motion and one fully supported by the GOP.
Anthony (6 месяцев назад)
I can't choose my doctor or actually afford to go to a doctor. I make to much money to get free or reduced enough health insurance, but because of preexisting conditions the cost of health insurance per month is more than I make in a month (after rent). I actually loved being on lithium, if it wasn't for the need for blood tests and a general unwillingness of doctors to prescribe medications they don't get paid to prescribe, I would likely still be taking that. As for the pharmacist question, I did that once, the pharmacists said "your file suggests you shouldn't be taking this without supervision", so I never filled that prescription. The problem was that the pharmacy still charged me for the prescription and then called a collection agency, apparently insurance does not pay for prescriptions you refuse to pick up, and the costs out of pocket for 30 pills I never got was 5,254 dollars, ruining my credit forever.
Nurmi Husa (6 месяцев назад)
Anthony Shop for a new doctor. If you need your finger bandaged or a broken bone set, most of them can handle that quiet effectively. But the more complicated your condition, the fewer docs are qualified to deal with the interplay of your issues. The first and most important skill to look for is an ability to LISTEN. It’s also fairly rare, sadly. Remember, you are hiring them not the other way around. They are there to help YOU. If they aren’t helping, you fire them and move on. And by now you’ve learned not to take anything they say as gospel. Research every suggestion thrown at you. It should NOT have to be this way, but pretending otherwise is fatal. You know more about your particular situation than anyone else. That hard won knowledge must be respected. If it isn’t, move on. Over the past ten years I went through several docs until I found one I could work with. He’s great, but I had to work to find him.
Melody Patten (6 месяцев назад)
From all the literature I've read people with bipolar disorder are often prescribed a combination of medications including antidepressants and mood stabilizers like lithium carbonate to attempt to manage both their manic and depressive symptoms. As for the suicidal ideation that is a common side effect for a reason! The first thing antidepressants start to fix is your energy levels and willpower, so while you're still depressed you all of a sudden have the energy and commitment to follow through on any ideas of suicide you may have been having. All antidepressants have a black box warning because of this and physicians are supposed to carefully monitor patients during the first few weeks of treatment. I'm sorry your doctor is not communicating about these things with you in a meaningful way, and although it is the responsibility of your doctor and pharmacist to keep you well informed about the medications you are taking sometimes you need to take matters into your own hands. Talk to your pharmacist next time you pick up your prescription, that's a large part of what they're paid to do. Do your own research on proposed medications as well, so you can have a say in your treatment. It's hard and crappy to go through testing different meds but you can't give up! I believe that you will become well again and live your life to the fullest <3
natalie ramsey (6 месяцев назад)
Please please do an episode on the new FDA approved migraine medicine coming out soon! It’s the first time in over 20 years a migraine medicine was put on the market and all us chronic migraine suffers are kinda freaking out about it! 😃
Nurmi Husa (6 месяцев назад)
I have been battling depression and out of control anxiety for decades - let me repeat that word “decades”. In my particular case, the medical “experts“ have either been utterly useless, or have actively made my condition worse. I’m not alone. I know far too many people who have had a similar pile of “unsatisfactory results” to put it politely. Let me tell you what I have learned – because I am constantly researching anything to do with my own condition. What I have learned is that depression and anxiety arise from a variety of causes. No one thing can ever be blamed. In many cases, perhaps even in most cases, and certainly in my case, the word is comorbidity. People like me suffer from several things that are seriously wrong. And medical “science“ is determined to treat people like me as if only one thing were wrong. And medicate accordingly. And if those meds kale your other conditions worse? Oh well, never mind. I won’t put up with that shit anymore. If you say depression to a doctor they will throw an SSRI at you whether or not that’s appropriate in your particular situation. They just throw pills at you and say check back weeks later. And if after a couple months you’re not better, they throw different pills at you. They believe that only low seratonin can be the problem. But low dopamine also results in what can be diagnosed as “depression”. When serotonin meds were thrown at me I didn’t get better I got worse. I had terrible side effects. Which is perfectly understandable since I didn’t have low serotonin I had low dopamine. They medicated the wrong thing. (A cast on your right leg is great if your right leg is broken. Not so successful of it’s your left leg that needs one.) Now I supplement for dopamine and it makes a huge difference. I have recently come to understand that I also suffer from low GABA. That’s harder to supplement for. But I do and that helps some. If you have depression, anxiety - or to be honest almost any chronic condition - Do not rely on your doctor to solve your problem. You must actively be involved in researching what’s out there and what could be wrong with you. Doctors have 10-15 minutes with you to solve your issues and if you have more than one they’re overwhelmed and they’re simply not able to do the job. Also, most of them assume you know nothing about your problems, and talk down to you. They do not understand that you could teach them mountains about coping skills - if they were open to learning anything. Diet, exercise, probiotics, supplements, meditation, acupuncture, breathing exercises, neurobiofeedback, oh God the list just goes on and on – thing is, you just keep trying things because what works today will not work tomorrow or next week. Might work again in a few weeks, months or years...or never again. You just can’t predict anything but constant change with certainty. And you have to do that all on your own because doctors just don’t have the time or training or willingness to listen. Yes, that’s changing. Younger doctors are more open to new ideas, but the battle is ongoing.
KittyCow (4 месяца назад)
You might already be aware, but phenibut is a long lasting (14-20 hours) gaba b substitute, and if you have a deficiency in gaba i would recommend trying it. Im not sure how effective it would be, since my understanding of gaba is that its tolerance is astronomically affected by the duration of its presence and not the level of stimulation, but it would be worth a try. Its also dirt cheap, with a theraputic dose being around .5 grams and 100 grams being $28
Juan Polla Larga Stamosa (4 месяца назад)
I can't tell you how happy I am to be off of psychiatric meds for the years since I stopped. I thought my life would never be normal again but slowly with each day i flushed my dose down the toilet instead of swallowing it my life returned to normal.
Nurmi Husa (6 месяцев назад)
Hannah In my case, I put two and two together. Over a year or so a decade ago they ran me through most of the SSRIs with nothing but nasty side effects to show for the torture. One I settled in and took for about a year and a half, not because it did anything for me, but it didn’t have the terrible side effects the others did. I took it to shut up friends and family and doctor who kept insisting I had to take something. (I don’t put up with that pressure any longer.) Then a few years, I got to seriously reading up on neurotransmitters and discovered that low dopamine depression is a thing for a small minority of folks. The description of how that differed with low seratonin depression caught my eye. It described MY experience much better than the low seratonin depression picture painted. Also, reading up on what boosts dopamine also stuck home. Matched up with various coping skills I’d figured out on my own. Sadly there isn’t much in pharmacology to address low dopamine, but I did discover a supplement called L-tyrosine that seems to help some folks. I tracked it down and found out that I’m some of those folks. It provides your body with more of what you need to make more of your own dopamine. Been taking it now for three years? 3000mg a day is the dose that works for me.
roflex2 (6 месяцев назад)
There is no way to test. Not without sticking a needle into your brain, and even then there is no baseline to compare it against.
Hannah (6 месяцев назад)
I have a question. How do I know whether my problem is a lack of serotonin or rather dopamine?
Tingting Li (6 месяцев назад)
I fell into a major depression few years ago. At one point i couldn't eat solid food for months, weighed less than 80 lbs, and had panic attacks all day. Stigma (especially in asian families) of mental health aid being "crutches" prevented me from seeking help. It got worse and worse until I realized I might not make it out alive unless i sought out medical help. Doctors put me on anti-depressants (tried a few to find the right one) and very low dose of xanax and I was able to slowly have a functional life again. I'm almost fully recovered now and have not needed any medication for almost a year. Antidepressants work and they save lives.
May the Science be with You (1 месяц назад)
+virgin can't you read? She said she got antidepressents AND xanax. not that xanax is an antidepresent. It's often part of a depression treatment, as it also has anti depressive effects in the short term.
virgen virgen (1 месяц назад)
Xanax is not a antidepressant
Angela M (6 месяцев назад)
Tingting Li This was my exact situation (except my family is hispanic). The meds saved my life.
moonkenzie (6 месяцев назад)
I'm very happy that you're doing so much better and that you found the right drug <3
Tracy Stoller (6 месяцев назад)
I am so glad you got meds that helped. I wish you a blessed and long life.
WarmPotato (6 месяцев назад)
Still say that drugs should be a last resort after significant lifestyle and dietary changes.
Malika Thueler (1 месяц назад)
If you're already depressed you probably don't have the energy yo make significant lifestyle change
bananian (6 месяцев назад)
duchessconlon Antidepressants get a bad rep.
duchessconlon (6 месяцев назад)
Before I was on medication, I simply did not have the energy or motivation to make significant lifestyle changes. I would try to exercise, but could not keep it up as a long-term habit because depression left me without enough energy to do the basic tasks of daily life, much less getting to the gym. And this persisted for many miserable years, so I think it's safe to say if I could have made these changes, I would have done so. Now that I'm on a medication that works for me, I exercise 3-4 hours a week, sometimes more. And I have been doing this for over a year now without losing motivation. The only thing I regret about taking antidepressants is that I didn't start sooner.
thatjillgirl (6 месяцев назад)
I agree that it's great and ideal if you can get by with nonpharmacologic treatment alone. However, when you're suffering the apathetic and anhedonic effects of depression, it can feel totally pointless, meaningless, or exhausting to even try to make those lifestyle changes. Sometimes you need medication to help get over the initial hump, and that's okay. Lifestyle-related changes can come later.
I Makeup Stuff (6 месяцев назад)
Some people cannot make those lifestyle changes without the drug.
Brad Bourgeois (6 месяцев назад)
My wife has been on them for 10 years, she seems to get worse and worse, I've asked her to get off them but she just tells me I'm not a doctor.
PIRATER0B0TNINJA (6 месяцев назад)
Antidepressants are just one piece of the puzzle for managing depression. Diet, exercise, socializing, and consistent sleep patterns are critical as well. Antidepressants aren’t a cure, but a crutch that gives you the edge you need to climb out of the deepest abysses. Depression sucks. But there are ways to make it suck less.
Weapon Valhalla (6 месяцев назад)
Brad God doesn't exist but I do! In the future when I make trillions off the eternal youth drug I'll fund research to help fix, if not cure your wife's depression along with many other things to help humanity out.
therabbithat (6 месяцев назад)
Brad Bourgeois when she's better she can work on her resilience. that's a good reason to go to counselling. CBT is most effective in the shortest time but they've all been proven to work I recommend a book called "feeling good" by David m burns. if she won't go to counselling best of luck to you and your wife <3
TheNerdyVlogger (6 месяцев назад)
I’ve been on antidepressants for 7 years. They keep me alive and functional. They don’t work for me on their own. I need to take a second medicine for specifically for anxiety. Many people only see moderate improvements on one type medication.
Caroline (6 месяцев назад)
She's kind of right. I mean, even if she wanted to stop, she can't just quit. That's not how these meds work. Going cold turkey can be life-threatening. And the fear of the devil you don't know can be crippling. Instead, try suggesting she talk to her doctor about what's going on and try a different medication. It's entirely possible she hasn't mentioned her issues with her meds because she doesn't want to rock the boat. My friend is like that with his ADD medication.
Greggers Butterfingers (6 месяцев назад)
I work all over U.S.A. no real home. Had bouts of crying and waking up 1am 2 am with severe panic attacks. I was prescribed 40 mg of Paxil ( 10mg for one week then ramp up to 20 mg then 30 to 40.... ) worked perfectly for me! No more panic attacks. Calmed me down enough to get my sh*t together. I also have a solid work ethic (before and defanantly after!) I think the pills along with wanting to be better is what pulled me thru....
lynnthegreat10 (4 месяца назад)
I was prescribed Paxil & I felt suicidal within 24 hours of taking it. I felt empty & I perceived the world to move slowly around me. It was one of the most horrifying experiences I have ever had. Glad it worked for you.
Laura Farr (6 месяцев назад)
I really appreciate the emphasis on clinical research fundamentals that you included. The inclusion of statistical vs clinical significance is a big indicator that news outlets often overstate the meaning of a meta-analysis. Thanks!
missiworld (6 месяцев назад)
This is what I love about the channel, too. It makes his videos super helpful for my pre-med research methods students when teaching them statistics.
Daniel Turner (6 месяцев назад)
Hey! The source for the second study was unchanged, thought you should know! 😄 edit: I mean the recent one that was covering literature including 2016 info and it says the study for 2008 as the source still :)
science.smiles (6 месяцев назад)
I believe this should get you there: http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(17)32802-7.pdf
RomanoProductions (6 месяцев назад)
You forget France with the most people using the more antidepressants and anxiolitics in all the universes. I am French
RomanoProductions (6 месяцев назад)
+Miciah Masters: yes reimbursed, the social security system will pay. But yes it doesn't mean people will really take the AD. Same abuse exists with methadone for reselling to drug addicts
Miciah Masters (6 месяцев назад)
> get prescription for AD and get refunded Wouldn't that artificially inflate statistics on people "using" antidepressants? (Or did you mean "reimbursed"?)
RomanoProductions (6 месяцев назад)
KezoZydis, we have social security here, you can see 3 MDs a day to get prescription for AD and get refunded for everything, major abuses can happen, we don't have enough psychoterapy specialists so MD prescribe AD because it is better than nothing
Michael Wade (6 месяцев назад)
(citation needed)
Sweet T (6 месяцев назад)
I'm so glad for your channel! The more I see fads appear on headlines the more thankful I am for being exposed to 1) the levels of rigor in research 2) an example of interpreting research (rather than exaggerating it) AND 3) specific explanations regarding common misconceptions Keep up the incredible work, folks of Healthcare Triage!
UncleBibby47 (6 месяцев назад)
some of the lines, it feels like he's saying them really fast and not focusing on them so we won't pay attention to them... and the quote from that scientist guy sounded like he was critical of media saying "the drugs work"..... is this whole video misrepresenting the whole thing?
UncleBibby47 (6 месяцев назад)
ok... fair enough! i believe you...
Daniel Turner (6 месяцев назад)
UncleBibby47 no. He's critical of people making broad claims without enough evidence. He has a video talking about the potential effects of SSRI's on unborn children when their mother takes them. He said that the fears were probably overblown especially since the mothers are probably taking them because they feel it provides a benefit and depression can be bad for outcomes as well. He's not perfect, but he's really good at being very fair and sticking to the facts. He's just a fast talking guy. 😉
TheGreen Jarret (6 месяцев назад)
Depressants, like alcohol, refined sugar and MSG are openly sold. Doesnt matter if they work or not, its a vicious circle. Destructive as can be.
TheGreen Jarret (6 месяцев назад)
So depressant are not the same thing than depressors, right ? And there are depressions but Depression is not the same, right ? Ya'll good with words what about that : SUBCLINICAL Stop a drunk from alcohol, sugars/flours and MSG abruptely and you'll learn how disruptive they are on mood economy. Ya'll addicted.
John Macintosh (6 месяцев назад)
TheGreen Jarret msg and sugar are not depressants. The term depressant is descriptive of the suppression of neurological activity, not of causing depression. TL;DR: Those aren't depressants, and even if they were, that doesn't mean they would cause depression.
TheGreen Jarret (6 месяцев назад)
NCBI
roflex2 (6 месяцев назад)
Alcohol is a CNS depressant, not an actual "causes depression depressant". Sure it can cause depression, but that isn't what they mean by depressant.
Michael Wade (6 месяцев назад)
Annakin Vader probably page three of Google.

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