Do Antidepressants Work? Maybe Not.

Zyprexa_Ho · Apr 9, 2016

Thanks for all the comments people. Was just looking for some good discussion of the topic

PG2018 · Apr 10, 2016

Thanks for all the comments people. Was just looking for some good discussion of the topic

Well, you got it. I'm OK with continuing if anyone else is in. Maybe we could make a sticky.

CountryMomma, ASN, RN · Apr 10, 2016

Well, you got it. I'm OK with continuing if anyone else is in. Maybe we could make a sticky.

Stress Diathesis Model or lack of nurture alters nature.

You mean discussing further how chronic cyclic MDD is really more "mommy didn't love me" and less "I'm missing something between my synapses, I think I'll sleep for 20 hours, cry about burnt toast, and wonder about my sanity"?

No thanks, I'll pass. I'll keep on the zonagran and effexor, keep my job, and appreciate each day I have.

PG2018 · Apr 10, 2016

You mean discussing further how chronic cyclic MDD is really more "mommy didn't love me" and less "I'm missing something between my synapses, I think I'll sleep for 20 hours, cry about burnt toast, and wonder about my sanity"?
No thanks, I'll pass. I'll keep on the zonagran and effexor, keep my job, and appreciate each day I have.

I didn't suggest at all that psychosocial issues cause depression. If you will study up, you might see that what we think of as depression is merely a symptomatic presentation of, who knows, maybe twenty different disorders characterized by genetic defect, inflammatory processes, etc. The genetic anomaly could predisposition one to be more reactive to stress and thus amidst a stressful environment one may become depressed (stress diathesis model). Conversely, no abnormal biochemical or organic processes are present but repeat stress exposure influences neuroplasticity and an organic cause of depression is at hand.

You're really being critical, and I anticipate that it's a lack of understanding. That's OK, and that's exactly why we need professionally relevant discussions such as these on allnurses. For too long, medicine touted the monoamine influences of depression because it's what technology let us work with. Nothing was ever conclusive that too much or too little 5HT, NE, DA, and others cause depression. We have never quantified serum or CSF monoamine levels with any generalizability. Essentially, agents that boosted certain neurotransmitters were implemented with eventual response and remission of psychiatric symptomology.

The trend now is genomic and neurobiological research lending itself to the likely overhyped fMRI studies (which are often reportedly published with substantial methodological errors according to a NEJM report I recently read).

elkpark · Apr 10, 2016

I didn't suggest at all that psychosocial issues cause depression. If you will study up, you might see that what we think of as depression is merely a symptomatic presentation of, who knows, maybe twenty different disorders characterized by genetic defect, inflammatory processes, etc. The genetic anomaly could predisposition one to be more reactive to stress and thus amidst a stressful environment one may become depressed (stress diathesis model). Conversely, no abnormal biochemical or organic processes are present but repeat stress exposure influences neuroplasticity and an organic cause of depression is at hand.
You're really being critical, and I anticipate that it's a lack of understanding. That's OK, and that's exactly why we need professionally relevant discussions such as these on allnurses. For too long, medicine touted the monoamine influences of depression because it's what technology let us work with. Nothing was ever conclusive that too much or too little 5HT, NE, DA, and others cause depression. We have never quantified serum or CSF monoamine levels with any generalizability. Essentially, agents that boosted certain neurotransmitters were implemented with eventual response and remission of psychiatric symptomology.
The trend now is genomic and neurobiological research lending itself to the likely overhyped fMRI studies (which are often reportedly published with substantial methodological errors according to a NEJM report I recently read).

Bottom line, nobody knows. The theory du jour upon which the current antidepressant medications are predicated is the "neurotransmitters out of whack" model, but I guarantee that, 30 years from now, that will look as primitive and ignorant as psychodynamic and object relations theories seem to many people nowadays.

Farawyn · Apr 10, 2016

That's when the brain chips come in!

ixchel · Apr 10, 2016

That's when the brain chips come in!

If they include locators, I'm in. The libertarians are gonna be mad, though.