Talk:Antidepressant

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British- or American- style English?[edit]

I know there are many more pressing issues (such as trimming content, finding more reliable sources, etc.) but had wondered which style to use while copyediting.

Right now, it's about 50/50, with US/U.S.; behavior/behaviour; randomize/randomise; stigmatize/stigmatise; characterized/characterise; popularize/popularise; etc.

I don't think "neutral-English" can be achieved here. Right now the article is leaning a bit in favor of American English, because many of the studies seem to use American English, and many of the suffixes are pretty uniformly -ize, but the exceptions made me unsure.

Also, anybody mind if I tag the article with {{dmy}} (day-month-year) dating style? meteor_sandwich_yum (talk) 10:43, 28 November 2013 (UTC)

The DMY template is fine with me. I always use American since I don't know the words that are different in British English (except obvious ones like colour). Seppi333 (talk) 17:43, 28 November 2013 (UTC)

Anti depressants are very unpredictable. The doctor uses a trial and error and hopes[edit]

One doctor told me when use these medication the is absolutes its a like pulling one out and wait and that does not work lets pull another one out of our"BUCKET" when dealing the psycho tropic medicines we have "gone nowhere" we have no idea how they "really do work in the brain. The side effects profile is better . We have "fancy" release systems As far as positive results :in the antidepressants we compare it to the one . Impramine is the "gold' standard" still: to compare to' — Preceding unsigned comment added by 71.204.184.191 (talk) 18:16, 25 January 2014 (UTC)

CNN bit removed from placebo section[edit]

This had nothing to do with placebo comparisons unless a great leap of SYNTH is employed. It isn't immediately clear where in the article, or whether, this bit should go; I've moved it here for now. petrarchan47tc 23:36, 31 May 2014 (UTC)

  • In 2005, antidepressants became the most prescribed drug in the United States, causing more debate over the issue. Some doctors believe this is a positive sign that people are finally seeking help for their issues. Others disagree, saying that this shows that people are becoming too dependent on antidepressants.[1]
References
  1. ^ "CDC: Antidepressants most prescribed drugs in U.S". CNN. 9 July 2007. Archived from the original on 2013-12-11. Retrieved 21 May 2011. 

Suicidal ideation[edit]

The summary in this article includes some cherry-picking and leads to a conclusion not found in RS or in the main article. For this reason, I have removed those references and added from the summary of the "Antidepressants and suicide" article in this edit. Although it's been changed quite a bit, I'll add this template to be safe: Template:Copied petrarchan47tc 22:43, 8 June 2014 (UTC)

I disagree with your edit, your edit summary states:

'Rmvd cherry-picking, summarized from main article (where there is no mention that only in the beginning of treatment is the risk greater, as was previously stated here)'

But the main article states 'Fourteen years later, warning labels were put on antidepressants suggesting particular difficulties during the early phase of treatment' So there is reference to problems at the beginning of treatment which is synonymous to early phase.

You've removed an FDA reference, that's a strong reference. You've also removed a meta-analysis (Risk of suicidality in clinical trials of antidepressants in adults: analysis of proprietary data submitted to US Food and Drug) which is a high level of evidence. The meta-analysis agrees with the main article that the increased risk for suicide from antidepressant use is age dependent and decreases with increasing age. There is also a Cochrane Review reference that's been removed.

I don't think you should assume the main article is superior. I think the meta-analysis study should be in the main article. I don't see any evidence of cherry picking. Woodywoodpeckerthe3rd (talk) 23:09, 8 June 2014 (UTC)

I've reverted it. The older version was better referenced, more detailed, and more precise. Petrarchan47, why would you remove a meta-analysis supported statement that the risk of suicide is lowered by anti-depressants in those over 25 unless you have better references saying that this is incorrect? I did not see any mention of such references. Formerly 98 (talk) 23:24, 8 June 2014 (UTC)

Please don't undo this work, it contains much more information. There was a cherry-picked mention from one review stating that only in the beginning of treatment is suicidal ideation increased. First you wrote that in the first few weeks this is the case - which is not found in the source. Then it was changed to "at the beginning of treatment". I would rather see more references stating this relationship, as I can't find support for it. I will revert but leave the reference in place (sans claim that effect is only found in early days of usage). I did not mean to remove any claim that risk is lowered once over 25. I thought my version was pretty clear that this is a risk for younger people. petrarchan47tc 23:30, 8 June 2014 (UTC)
You removed it because it was less detailed, but added an unsupported detail about "in the early stages". You removed:
It remains controversial whether increased risk of suicide is due to the medication (a paradoxical effect) or part of the depression itself. The antidepressant may enable those who are severely depressed, and who ordinarily would be paralyzed by their depression, to become more alert and act out suicidal urges before fully recovered from their depressive episode.[1][2] The increased risk for suicidality and suicidal behaviour among young adults approaches that seen in children and adolescents.[3]
References
  1. ^ Cite error: The named reference Levine-Antonuccio-Healy was invoked but never defined (see the help page).
  2. ^ "SSRI Antidepressants". Patient.co.uk. 2010-10-27. Retrieved 2012-11-30. 
  3. ^ Stone, M.; Laughren, T.; Jones, M L.; Levenson, M.; Holland, P C.; Hughes, A.; Hammad, T. A; Temple, R.; Rochester, G. (2009). "Risk of suicidality in clinical trials of antidepressants in adults: Analysis of proprietary data submitted to US Food and Drug Administration". BMJ 339: b2880. doi:10.1136/bmj.b2880. PMC 2725270. PMID 19671933. 
It makes no sense to argue that you want more detail while removing an entire paragraph. I don't want to edit war, but this makes no sense. petrarchan47tc 23:34, 8 June 2014 (UTC)

Hey Petrarchan47,

Let me look and find some more references. This seems to be "common knowledge" among the psychiatrists I know, but the source is not a great one I acknowledge. Formerly 98 (talk) 23:35, 8 June 2014 (UTC)

Here is what the UK National Institute for Clinical and Health Excellence says:

"A person with depression started on antidepressants who is considered to present an increased suicide risk or is younger than 30 years (because of the potential increased prevalence of suicidal thoughts in the early stages of antidepressant treatment for this group) should normally be seen after 1 week and frequently thereafter as appropriate until the risk is no longer considered clinically important."

is that good enough? Formerly 98 (talk) 23:39, 8 June 2014 (UTC)

It's good enough to maybe add if given attribution, ie, "According to...". However in my knowledge this is WP:FRINGE, and that is evidenced by the fact that you could find only one reference to it. So the previous two versions of this had undue weight. I don't think the statement warrants inclusion with only one reference. This is a claim I have never heard (and I have a good number of Psychiatrists in my family, fwiw). petrarchan47tc 23:53, 8 June 2014 (UTC)
On further consideration, no, this one reference is not good enough. It's 5 years old. A recent MEDRS or two would be great. petrarchan47tc 23:59, 8 June 2014 (UTC)

Ive heard a lot of arguments on Wikipedia before, but this is the first time I've heard NICE called fringe. Do you know who NICE is???? Formerly 98 (talk) 03:59, 9 June 2014 (UTC)

sexual side effects[edit]

just gathering most recent reviews here for use in the future

  • Schweitzer I, Maguire K, Ng C. Sexual side-effects of contemporary antidepressants: review. Aust N Z J Psychiatry. 2009 Sep;43(9):795-808. PMID 19670052
  • Serretti A1, Chiesa A. Treatment-emergent sexual dysfunction related to antidepressants: a meta-analysis. J Clin Psychopharmacol. 2009 Jun;29(3):259-66. PMID 19440080 (already cited)
  • Kennedy SH, Rizvi S. Sexual dysfunction, depression, and the impact of antidepressants. J Clin Psychopharmacol. 2009 Apr;29(2):157-64. PMID 19512977
  • Gartlehner G et al. Comparative benefits and harms of second-generation antidepressants: background paper for the American College of Physicians. Ann Intern Med. 2008 Nov 18;149(10):734-50. PMID 19017592

still hunting. Jytdog (talk) 12:02, 5 August 2014 (UTC)

problem with an extract[edit]

  • hello,

i decided to write on the "talk" of this article because i have a problem with an extract of this article. the extract: "In the late 1990s, some investigators thought that the fact that symptoms emerged when antidepressants were discontinued might mean that antidepressants were causing addiction, and some used the term "withdrawal syndrome" to describe the symptoms. Addictive substances cause physiological dependence, so that drug withdrawal causes suffering. These theories were abandoned, since addiction leads to drug-seeking behavior, and people taking antidepressants do not exhibit drug-seeking behavior. The term "withdrawal syndrome" is no longer used with respect to antidepressants, to avoid confusion with problems that arise from addiction.[1]"

the history of the problem: i wanted to traduct this extract for the french version. i have see your source, this: http://www.ncbi.nlm.nih.gov/pubmed/16913164 and i would like to read the complete article so i search the complete article and i find it here: http://www.aafp.org/afp/2006/0801/p449.html

and i decided to read the article to understand the argument to says that symptoms of discontinuation antidepressant are not caused by dependance or addiction or that the term "withdrawal syndrome" is no longer use. and after reading this article, there are no mention of that anywhere. the source don't justify this extract. and the extract need to be reformulated or deleted.

i think the debate "dependance or not and "syndrome or not" is not close; and putting this extract without justification close the debat.

for exemple in french wiki you read this: here http://fr.wikipedia.org/wiki/Antid%C3%A9presseur in this section: "Syndrome de sevrage et dépendance" : "Les antidépresseurs IRS peuvent entraîner à l'arrêt un syndrome de sevrage. Une méta-analyse danoise a conclu qu'il s'agit de dépendance32. La revue Prescrire a en 2008 rouvert le débat sur la dépendance en publiant un extrait du livre Medicines out of Control? Antidepressants and the Conspiracy of Goodwill de Charles Medawar et Anita Hardon. L'extrait choisi évoque la dépendance aux antidépresseurs et l'absence de reconnaissance de cette dépendance par le milieu médical. Ce livre a également reçu un des prix Prescrire34.

i hope you will understund what is written in this extract of french wiki.

thanks for reading

(consider that i am not often on the english wiki and perhaps i will not read your response. but you can contact me in the french wiki, the adresse of the account is in my user's page) Vatadoshu (talk) 11:42, 29 January 2015 (UTC)

  • yes, the french wikipedia has different standards than English WP. The controversy over addiction is old and ended about 10 years ago in the scientific community. I rechecked pubmed and found a recent review on this, and have added content to the article based on it. It notes that some drugs sold only in France are more prone to abuse (but even that abuse is rare and mostly limited to people who already had substance abuse issues). Jytdog (talk) 12:11, 29 January 2015 (UTC)
  • perhaps the controversy is ended about 10 years" but it is staying that the "reference" n°112 has no link with the sentence, you may delete the reference.
i didn't talk about substance abuse or misuse, you seem to have no look at the french extract i posted.
i talked about this study http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2011.03686.x/abstract;jsessionid=B0150DB6760E20579DCD1939A7F804B6.f04t01 dated of 2012 so recent. that conclude: "Withdrawal reactions to selective serotonin re-uptake inhibitors appear to be similar to those for benzodiazepines; referring to these reactions as part of a dependence syndrome in the case of benzodiazepines, but not selective serotonin re-uptake inhibitors, does not seem rational". but do what you want. Vatadoshu (talk) 12:55, 29 January 2015 (UTC)
hi - thanks for pointing out again PMID 21992148. I added content based on that, as well as the 2 responses, which re-iterated the scientific consensus. The section of the French article you pointed me to has unsourced content in it and a dead link. Seems written by someone with an ax to grind. Thanks again for raising these issues. The article has been improved with more sources now! Jytdog (talk) 13:14, 29 January 2015 (UTC)