This is an archive of past discussions. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page. |
Archive 1 | Archive 2 | Archive 3 |
Would someone familiar with the chemical action of these drugs please add this.
Why not, Zundark? -- AV
I was filling in a link from Multiple Sclerosis. Is that so bad? RoseParks
It was BF's contribution that I was objecting to, not yours. -- Zundark, 2001 Oct 22
Someone added ® signs to the trademarked drug names, and Zundark removed them. This information is accurate (the names really are trademarks) and is generally included in descriptive texts. If we're going to use commercial brand names (and I see no reason not to), then we should do it correctly. -- LDC
Why is it only correct if you put a ® after it? We've used "Intel" and "Pentium" and numerous other registered trademarks in Wikipedia without using a ®. Are you going to go through and "correct" all these? It will look a mess. -- Zundark, 2001 Oct 22
I agree, it could get very messy (Pentium should be labelled, Intel should not). It's also hard to track down which are officially registered and which aren't. This is an editorial decision that should be made carefully, though, since it can piss of very rich people if you don't do it right. I don't have a copy of CMS with me at the moment, but I believe that in things like newspaper and magazine articles, the first use of a trademarked name is generally labelled. Larger works often just have a prologue that says "these terms...are trademarks or service marks of...". Perhaps Wikipedia could just have a statement of policy somewhere. --LDC
I have to take offense to the following:
are affected, but only selectively those that are responsible for the the mood and, thus, the depression. This gives way too much credit to the schleps who designed these drugs and their understanding of brain function as it relates to mood, which is minimal. In general this article makes the biochemists out to be some sort of gods. The reality is much closer to saying that they had some rough idea of what to do, stabbed in the near-dark, and fortuitously got it right. Depression and the brain in general is NOT well enough understood for drug design to be wholly "rational", and this article needs to reflect that. Thoughts? Graft, 26 September 2002
Someone has added
Hmm. What is it then? —Preceding unsigned comment added by The Anome ( talk • contribs) 25 January 2003
Effexor inhibits reuptake of both serotonin and norepinephrine. -- Someone else 01:07 Jan 25, 2003 (UTC)
Effexor is a phenothalymine bicyclic antidepressant. It's mechanism is SNRI meaning it inhibits the reuptake of Serotonin and Norepinephrine. It also has a weak reuptake inhibiting effect on Dopamine. -- Sim
Guys, it's late, I'm tired and pissed off, but who is this Allen Frances chap? I'm not in a mood to look him up right now.
Exactly why does he say that psychiatric conditions have no underlying physical mechanism? If they don't have one, why do psychiatric medications tend to work (not always as intended)? And what did Julius Axelrod get his Nobel on? Will he propose next that Phantom limb pain does not exist?
Pilatus 22:20, 13 Jan 2005 (UTC)
Sounds like a scientology insert to me, but I guess everyone wants to keep it in as one of those "some people say..." issues. Allen J Frances is the former chairman of Duke University Medical Center and a contributing editor of the DSM-IV, I supsect he has been quoted out of context here, the EDITOR of the DSM-IV is unlikely to believe that "psychiatry’s claim that mental illnesses are brain diseases... is not true". The elipsis is highly suspect. In fact, I think this quote is so suspect I am removing it until we can get a real source. protohiro 3 July 2005 18:40 (UTC)
It is off topic in an article on a medication anyway. The whole first part of the paragraph with its discussion on whether mental diseases exist doesn't belong here.-- Fenice 3 July 2005 19:00 (UTC)
I actually sent Dr Frances an email to see if this quote was even his, so we'll see. protohiro 3 July 2005 19:02 (UTC)
More likely than what? Children not receiving treatment? Children without depression? Children who like candy? This is important. Can you link to a study or something?
I'm removing the line until someone can clarify. -- Ntg 04:06, 23 Jan 2005 (UTC)
I think it comes from the FDA blackbox warning:
"Pooled analyses of short-term (4 to 16 weeks) placebo-controlled trials of 9 antidepressant drugs (SSRIs and others) in children and adolescents with major depressive disorder (MDD), obsessive compulsive disorder (OCD), or other psychiatric disorders (a total of 24 trials involving over 4400 patients) have revealed a greater risk of adverse events representing suicidal thinking or behavior (suicidality) during the first few months of treatment in those receiving antidepressants. The average risk of such events in patients receiving antidepressants was 4%, twice the placebo risk of 2%. No suicides occurred in these trials."
http://www.fda.gov/cder/drug/antidepressants/PI_template.pdf
http://www.fda.gov/cder/drug/antidepressants/MDD_alldruglist.pdf
Sublium, 1 July 2005
Someone anonymous messily removed the list of fluoxetine SSRIs; as there was no explanation or apparent reason, I put them back. If there *was* in fact a reason, could the anonymous person please explain here. Thank you. Junkyardprince | Talk 16:43, 14 Feb 2005 (UTC)
Does anyone know why, or have any further information regarding SSRIs used in the treatment of irritable bowel syndrome. I just found that a little odd and I was wondering if anyone knew any further information on it.
I feel that as it stands this article focuses on the critcisms of SSRIs without clearly stating why these drugs are perscribed and the benefits that the vast majority of the psychiatric professions sees in patients on the drugs. Thoughts? protohiro 17:31, 22 July 2005 (UTC)
It seems to me that the first part of the article clearly states the reasons SSRIs are prescribed. See the second paragraph. I suppose from the part "Effects not well understood" and the person on this talk page asking how this helps IBS that the benefits of SSRIs are disputed. If you would like to put in some studies that showed benefits, I'm sure that would be fine, but there were also studies that didn't show benefits and even showed harmful effects. I recall one on Prozac in particular that had been covered up that, when it came out, caused quite a scandal a few years ago and IIRC was the impetus leading to the warning labels today.
Do you have a source that, in fact, the "vast majority of the psychiatric professions" sees positive caused by SSRIs? The Royal College of Psychiatrists reports that antidepressants greatly improve depression in 50 to 65% of patients but that 25 to 35% show similar improvement on placebos. [1] It seems to me that patients who improve because of antidepressants (and not just because they are taking a pill) constitutes a minority. Perhaps a confirmation bias on the part of some in the psychiatric professions? AmyBeth 17:00:49, 2005-08-03 (UTC)
Your read of the statistics is flawed. You can't subtract the percentage that improved on placebo from those that improved on the medication (thats not how statistics work). You can only say that SSRIs where around twice as effective as placebo. I suspect most scientists and doctors would say this strongly suggests these are effective medications. protohiro 23:01, 12 June 2006 (UTC)
The length and wording of the 5-HTP section at the end of this article seems to indicate a hidden agenda towards promoting 5-HTP and a bias against SSRIs or "medical" treatment of depression (almost to the point of recommending turkey, for example, instead of SSRIs to treat depression). Could it be shortened, revised or removed altogether? Remember, this article is about SSRIs in general, not just about their main application in medicine today. Perhaps the 5-HTP section would be more useful as an article of its own, with a one-sentence reference here for the purpose of linking?
I've moved the 5-HTP section into its own article, and changed the "newer medications" section to be inclusive of 5-HTP supplements (thus "other medications for treating depression") with a warning that 5-HTP has not been scientifically proven to treat depression (i.e.: it's not used in mainstream medicine, but some "natural healing" professionals recommend it). Personally, I think self-medication is very dangerous, especially when dealing with diseases that affect behavior and judgment, but I have refrained from stating this in the article as to avoid the appearance of bias against "natural healing" professionals.
How it works section has two contradictory statements. In 1989, the FDA made tryptophan available by prescription only, ... and Pharmaceutical grade L-tryptophan is currently available over the counter in the U.S.
Did some qualifier get deleted ? Could someone who is familiar with the situation be available to make the info correct ?
An anonymous editor keeps on returning to push one particular point: the fact that SSRIs may affect libido and the persistence of these symptoms after discontinuation of them.
He has now finally started citing sources. The source offered for the incidence of SD in SSRI treatment cited 83%. I easily found studies with a much more conservative estimate (and the anon has been cherry picking), although these involved other drugs. It remains to be seen how much of the sexual dysfunction can actually be attributed to the SSRI, considering that people with depression are not likely to be very libidinous in the first place.
The evidence offered for persistence of SD after discontinuation is extremely thin, to the point that I've removed it all again. It's an abstract of a case report involving ONE PATIENT! As for Stuart Shipko's experience - if he could write this up into a peer-reviewed publication we would actually be able to cite him. JFW | T@lk 04:27, 17 October 2005 (UTC)
Good, you're in press. Come back when the paper is out. Or perhaps wait until the 100 cases have been analysed. For now, this is all original research. Animal models are rubbish for this kind of thing, which is why I removed the reference. People are not animals, and rat sexual behaviour is not human sexual behaviour. Who says rats are good animal models for SSRI pharmacology anyway? Do they get depressed?
My agenda is that you simply cannot denounce a whole class of generally useful and reliable medication as harmful on the basis of doubtful evidence. I fight this agenda on a large number of health-related topics on Wikipedia, and if this is undesirable to you feel free to issue a WP:RFC. JFW | T@lk 05:13, 17 October 2005 (UTC)
OK, I will come back when the paper is out. You say that animal models are "rubbish"? LOL What about all of the preclinical testing in animals that is performed before drugs go to human trials? Are they "rubbish" too? Do rats get depressed? Well, there are many animal models of depression and anxiety - if you want to dispute them all, you are welcome to, but don't expect to be taken seriously by me. You are basically negating thousands of experiments. As for "denouncing" SSRIs, you said it, not me. I am merely pointing out a major, major overlooked persistent side effect of these medications that has been massively ignored. I've got more important things to do than bicker with you about this issue any more. I have plans to address this point in more democratic, impartial, and sceintifically open forums. You have got a very restrictive attitude (based on what authority, I wonder), that seems to be contrary to the very point of Wikipedia in the first place. And I question why you seem to be so *pro* these medications. Anyway, ttyl. Shibidee
[personal attack removed], if animal models are "rubbish for an encyclopedia" then I suggest you delete the entire contents of this article from Wikipedia. LOL
http://en.wikipedia.org/wiki/Animal_model
I can't be bothered to address your other points because I find them just as silly as the first one, and as I said it's time for me to abandon this nonsense. Good luck with your further censorship initiatives. LOL. Shibidee
Are you familiar with the term "Miereneuker"...and did you get your long-sought promotion at the Wikipolice? Shibidee
Hi. Yes, thank you. The sexual side effects of SSRIs are well established, but the persistence of these effects in quite a high percentage of former users has so far gone unnoticed. Part of the problem is the complexity of gene regulation in the human brain which is, after all, the most complex thing in the known universe. Do a Pubmed search for "antidepressant" and "gene expression" and you will find hundreds of articles. As we all know, the major effect of SSRIs is to block the reuptake of serotonin, but they have a multitude of secondary effects. When you have so many secondary effects there is no a priori reason to assume that the effects are fully reversible just by removing the initial agent. The same is true for some other drugs such as nicotine, which has lasting effects on the brain's reward system long after chronic administration has ceased ( http://www.newswise.com/articles/view/514937/). Everybody has assumed so far that the effects of psychoactive substances are reversible, and they seem to be in most people, but it also appears, based on emerging data, that in a significant percentage of former users the gene expression gets "stuck". In the case of SSRIs, it then has to be nudged back to the right expression pattern using other agents - testosterone, dopamine agonists, ginkgo biloba etc. Anyway, I will address this problem in an article next year after we have more case reports, animal work, and other data. Shibidee
Wolff, As I said, I have no intention of putting my data and theories back in the article until they have been published in the medical literature. You are obviously far too obsessed about blocking the material and I don't have time for this. I find your authoritative tone quite preposterous, and have the distinct feeling I'm being cyber-stalked. As I already mentioned, one of these papers is already in press, and others will be submitted soon. Also, I have a lot of interest from journalists who want to cover the topic, so I can't really be bothered to engage in a petty squabble with you when I can go through the mainstream media. BTW, the Wikipolice comment was only semi-sarcastic ( http://en.wikipedia.org/wiki/User_talk:84.66.181.168). Shibidee
To answer your sarcastic comment about "the horrors of mankind etc." would require a detailed treatise that I don't have time to get into with you. I'd rather save it for a journal article or a book. So you don't like "wolff", huh? Would you prefer "sheep"? Till next year... Shibidee
Niesen - What, like Wolff was "civil and amiable" to me from the start?? Give me a break. Shibidee
As someone who as personally experienced the devastating persistent sexual side effects of SSRIs years after discontinuance I find it disappointing that the Wikipeida page seems state that it is not possible. From reading above the above arguments I understand the rational for not including this info but wonder if maybe we can come to a compromise that is less strong in promoting that it can't happen. Since we can't include information saying that SSRIs cause persistent sexual dysfunction becase we currently don't have proof could we at least not say that it doesn't happen? I have seen no proof that shows that there is no long term persistence. The short term proof is documented well. The reference saying that normal sexual function returns after discontinuance could be removed or at least it could be toned down to say that the majority of the time its turns to normal. I would like to find some middle ground here because as it stand I think the page makes a judgement that all sexual dysfunction gos away after the drug is stopped. I should also point out that we are not only talking about libido here but actual physical functioning. In my personal case libido mostly returned but functioning did not. -- James
I think the current wording is much better. Because its occurrence is not the norm I think it will take time to become widely known and properly researched/documented. In my case it appears the SSRIs have done something to my dopamine system and I have had some initial response with my doctor using dopamine agonists to try to correct the problem. From what I am told its not uncommon for dopamine to decrease when serotonin is boosted with SSRIs but for most people this returns to normal after discontinuance. James
I am by no means an expert on SSRIs and similar drugs, though I have read something about their effects and mechanisms. My conclusion would seem to be that no one really knows how the hell they work. however, to address the point being argued here, these drugs are specifically chosen to induce long-term permanent changes in brain chemistry. It therefore seems inconceivable to me that they would not create long term side effects in exactly the same way they create long term effects. The fact that side effects go away may in part be a measure of the long-term ineffectiveness of such drugs. Sandpiper 00:44, 4 November 2005 (UTC)
Comment. I am responding to the RFC request on Wikipedia:Requests for comment/Maths, natural science, and technology. Reviewing the history of edits and the above discussion, I don't think the two studies previously referenced in the article [2] [3] are enough to support the assertion that persistence of SD after discontinuation occurs in humans. Edwardian 06:03, 17 October 2005 (UTC)
Comment. I am responding to the RFC as well. Until more substantial, published, peer-reviewed research is available, we should stick to what's proven in the medical literature with regards to persistence of SD. InvictaHOG 16:16, 20 October 2005 (UTC)
When does a victim decide to stop rationalizing abuse from an offender? Perhaps at that psychological threshold of tolerance, serotonin reuptake is inhibited rather than facilitated within the subject. Beadtot10/18/2005 04:51, 19 October 2005 (UTC)
The following note was left in the article by User:12.149.141.14:
Please see serotonin and 5-HTP. -- Jitse Niesen ( talk) 02:02, 5 November 2005 (UTC)
This looks legitimate. However, the sentence "SSRIs meet the World Health Organization definition of 'addictive'" probably should be sourced. The closest I could find was here, which states "In the 1960s the World Health Organization recommended that both terms be abandoned in favour of dependence, which can exist in various degrees of severity." Is there a better source for the claim? -- Arcadian 17:49, 13 December 2005 (UTC)
It's Sim, I'm the one who re-wrote the intro then someone changed it back. First, I felt it should be very simple and brief because most readers aren't medical professionals. The reverted intro is too detailed and sometimes people just want a quick explanation in layman's terms.
As for the remark about them being called _The Wonder Drugs_, it's a reference to the face that SSRIs are the polar opposite to TCAs and MAOIs in that they have no dangerous overdose effects or drug interactions. Nothing to do with effectiveness, they just are so safe which is a wonder compared to TCAs and MAOIs which are extremely dangerous meds. —The preceding unsigned comment was added by Simman2 ( talk • contribs) .
Fenice, I have taken SSRIs and currently take a TCA. I suffer from Obsessive-Compulsive Disorder.
I'll write more about SSRI safety for you later, go to run right now.
-- Sim
Why isn't the stuff on suicidal ideation in the section on side effects? It is a side effect (and a serious one, too) yet that section doesn't even mention it. 24.4.248.59 22:30, 19 February 2006 (UTC)
As the production error responsible for the contamination would have been easily correctable, some critics have suggested that this appears to have been done to make money for the manufacturers of SSRIs. This bureaucratic action neglecting the most important fact established regarding the biochemistry of tryptophan: that it is an essential amino acid that humans cannot live without eating, led to renewed questioning as to whether the FDA was a science based or political agency.
This section was recently deleted from the article. Any comments? Kim Bruning 13:46, 21 February 2006 (UTC)
The article claims that antidepressants have been shown to be neurotoxic. Nothing could be farther from the truth. Numerous studies have indicated that SSRIs may actually promote neurogenesis, quite the opposite effect. If no one can supply evidence of purported neurotoxicity, I am going to remove the claims, as they are currently devoid of any scientific basis, and in the light of new research suggesting an effect to the contrary, ridiculous. -- Muugokszhiion 05:18, 10 May 2006 (UTC)
I totaly agree. SSRI promote neurogenesis protect against stress and depression related volume (maybe neuron) loss in the hippocampus. even for very high doses no proof of neurotoxicity. particular SSRI may even be neuroprotective in stroke yet needs more proof.
Should be deleted. Neurobio 01:41, 18 May 2006 (UTC)
More and more the science will see, that many depressions are not coming by a lack of serotonin. Some are the result of lack of noradrenalin and also a surplus of stress.hormones, such like cortisol. This of course only, if the depression is endogenous, which is a small minority of d. The many side.effects of SSRI (selective serotinon reuptake inhibitors) make this therapy dangerous! -- Fackel 21:35, 30 May 2006 (UTC)
This is an archive of past discussions. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page. |
Archive 1 | Archive 2 | Archive 3 |
Would someone familiar with the chemical action of these drugs please add this.
Why not, Zundark? -- AV
I was filling in a link from Multiple Sclerosis. Is that so bad? RoseParks
It was BF's contribution that I was objecting to, not yours. -- Zundark, 2001 Oct 22
Someone added ® signs to the trademarked drug names, and Zundark removed them. This information is accurate (the names really are trademarks) and is generally included in descriptive texts. If we're going to use commercial brand names (and I see no reason not to), then we should do it correctly. -- LDC
Why is it only correct if you put a ® after it? We've used "Intel" and "Pentium" and numerous other registered trademarks in Wikipedia without using a ®. Are you going to go through and "correct" all these? It will look a mess. -- Zundark, 2001 Oct 22
I agree, it could get very messy (Pentium should be labelled, Intel should not). It's also hard to track down which are officially registered and which aren't. This is an editorial decision that should be made carefully, though, since it can piss of very rich people if you don't do it right. I don't have a copy of CMS with me at the moment, but I believe that in things like newspaper and magazine articles, the first use of a trademarked name is generally labelled. Larger works often just have a prologue that says "these terms...are trademarks or service marks of...". Perhaps Wikipedia could just have a statement of policy somewhere. --LDC
I have to take offense to the following:
are affected, but only selectively those that are responsible for the the mood and, thus, the depression. This gives way too much credit to the schleps who designed these drugs and their understanding of brain function as it relates to mood, which is minimal. In general this article makes the biochemists out to be some sort of gods. The reality is much closer to saying that they had some rough idea of what to do, stabbed in the near-dark, and fortuitously got it right. Depression and the brain in general is NOT well enough understood for drug design to be wholly "rational", and this article needs to reflect that. Thoughts? Graft, 26 September 2002
Someone has added
Hmm. What is it then? —Preceding unsigned comment added by The Anome ( talk • contribs) 25 January 2003
Effexor inhibits reuptake of both serotonin and norepinephrine. -- Someone else 01:07 Jan 25, 2003 (UTC)
Effexor is a phenothalymine bicyclic antidepressant. It's mechanism is SNRI meaning it inhibits the reuptake of Serotonin and Norepinephrine. It also has a weak reuptake inhibiting effect on Dopamine. -- Sim
Guys, it's late, I'm tired and pissed off, but who is this Allen Frances chap? I'm not in a mood to look him up right now.
Exactly why does he say that psychiatric conditions have no underlying physical mechanism? If they don't have one, why do psychiatric medications tend to work (not always as intended)? And what did Julius Axelrod get his Nobel on? Will he propose next that Phantom limb pain does not exist?
Pilatus 22:20, 13 Jan 2005 (UTC)
Sounds like a scientology insert to me, but I guess everyone wants to keep it in as one of those "some people say..." issues. Allen J Frances is the former chairman of Duke University Medical Center and a contributing editor of the DSM-IV, I supsect he has been quoted out of context here, the EDITOR of the DSM-IV is unlikely to believe that "psychiatry’s claim that mental illnesses are brain diseases... is not true". The elipsis is highly suspect. In fact, I think this quote is so suspect I am removing it until we can get a real source. protohiro 3 July 2005 18:40 (UTC)
It is off topic in an article on a medication anyway. The whole first part of the paragraph with its discussion on whether mental diseases exist doesn't belong here.-- Fenice 3 July 2005 19:00 (UTC)
I actually sent Dr Frances an email to see if this quote was even his, so we'll see. protohiro 3 July 2005 19:02 (UTC)
More likely than what? Children not receiving treatment? Children without depression? Children who like candy? This is important. Can you link to a study or something?
I'm removing the line until someone can clarify. -- Ntg 04:06, 23 Jan 2005 (UTC)
I think it comes from the FDA blackbox warning:
"Pooled analyses of short-term (4 to 16 weeks) placebo-controlled trials of 9 antidepressant drugs (SSRIs and others) in children and adolescents with major depressive disorder (MDD), obsessive compulsive disorder (OCD), or other psychiatric disorders (a total of 24 trials involving over 4400 patients) have revealed a greater risk of adverse events representing suicidal thinking or behavior (suicidality) during the first few months of treatment in those receiving antidepressants. The average risk of such events in patients receiving antidepressants was 4%, twice the placebo risk of 2%. No suicides occurred in these trials."
http://www.fda.gov/cder/drug/antidepressants/PI_template.pdf
http://www.fda.gov/cder/drug/antidepressants/MDD_alldruglist.pdf
Sublium, 1 July 2005
Someone anonymous messily removed the list of fluoxetine SSRIs; as there was no explanation or apparent reason, I put them back. If there *was* in fact a reason, could the anonymous person please explain here. Thank you. Junkyardprince | Talk 16:43, 14 Feb 2005 (UTC)
Does anyone know why, or have any further information regarding SSRIs used in the treatment of irritable bowel syndrome. I just found that a little odd and I was wondering if anyone knew any further information on it.
I feel that as it stands this article focuses on the critcisms of SSRIs without clearly stating why these drugs are perscribed and the benefits that the vast majority of the psychiatric professions sees in patients on the drugs. Thoughts? protohiro 17:31, 22 July 2005 (UTC)
It seems to me that the first part of the article clearly states the reasons SSRIs are prescribed. See the second paragraph. I suppose from the part "Effects not well understood" and the person on this talk page asking how this helps IBS that the benefits of SSRIs are disputed. If you would like to put in some studies that showed benefits, I'm sure that would be fine, but there were also studies that didn't show benefits and even showed harmful effects. I recall one on Prozac in particular that had been covered up that, when it came out, caused quite a scandal a few years ago and IIRC was the impetus leading to the warning labels today.
Do you have a source that, in fact, the "vast majority of the psychiatric professions" sees positive caused by SSRIs? The Royal College of Psychiatrists reports that antidepressants greatly improve depression in 50 to 65% of patients but that 25 to 35% show similar improvement on placebos. [1] It seems to me that patients who improve because of antidepressants (and not just because they are taking a pill) constitutes a minority. Perhaps a confirmation bias on the part of some in the psychiatric professions? AmyBeth 17:00:49, 2005-08-03 (UTC)
Your read of the statistics is flawed. You can't subtract the percentage that improved on placebo from those that improved on the medication (thats not how statistics work). You can only say that SSRIs where around twice as effective as placebo. I suspect most scientists and doctors would say this strongly suggests these are effective medications. protohiro 23:01, 12 June 2006 (UTC)
The length and wording of the 5-HTP section at the end of this article seems to indicate a hidden agenda towards promoting 5-HTP and a bias against SSRIs or "medical" treatment of depression (almost to the point of recommending turkey, for example, instead of SSRIs to treat depression). Could it be shortened, revised or removed altogether? Remember, this article is about SSRIs in general, not just about their main application in medicine today. Perhaps the 5-HTP section would be more useful as an article of its own, with a one-sentence reference here for the purpose of linking?
I've moved the 5-HTP section into its own article, and changed the "newer medications" section to be inclusive of 5-HTP supplements (thus "other medications for treating depression") with a warning that 5-HTP has not been scientifically proven to treat depression (i.e.: it's not used in mainstream medicine, but some "natural healing" professionals recommend it). Personally, I think self-medication is very dangerous, especially when dealing with diseases that affect behavior and judgment, but I have refrained from stating this in the article as to avoid the appearance of bias against "natural healing" professionals.
How it works section has two contradictory statements. In 1989, the FDA made tryptophan available by prescription only, ... and Pharmaceutical grade L-tryptophan is currently available over the counter in the U.S.
Did some qualifier get deleted ? Could someone who is familiar with the situation be available to make the info correct ?
An anonymous editor keeps on returning to push one particular point: the fact that SSRIs may affect libido and the persistence of these symptoms after discontinuation of them.
He has now finally started citing sources. The source offered for the incidence of SD in SSRI treatment cited 83%. I easily found studies with a much more conservative estimate (and the anon has been cherry picking), although these involved other drugs. It remains to be seen how much of the sexual dysfunction can actually be attributed to the SSRI, considering that people with depression are not likely to be very libidinous in the first place.
The evidence offered for persistence of SD after discontinuation is extremely thin, to the point that I've removed it all again. It's an abstract of a case report involving ONE PATIENT! As for Stuart Shipko's experience - if he could write this up into a peer-reviewed publication we would actually be able to cite him. JFW | T@lk 04:27, 17 October 2005 (UTC)
Good, you're in press. Come back when the paper is out. Or perhaps wait until the 100 cases have been analysed. For now, this is all original research. Animal models are rubbish for this kind of thing, which is why I removed the reference. People are not animals, and rat sexual behaviour is not human sexual behaviour. Who says rats are good animal models for SSRI pharmacology anyway? Do they get depressed?
My agenda is that you simply cannot denounce a whole class of generally useful and reliable medication as harmful on the basis of doubtful evidence. I fight this agenda on a large number of health-related topics on Wikipedia, and if this is undesirable to you feel free to issue a WP:RFC. JFW | T@lk 05:13, 17 October 2005 (UTC)
OK, I will come back when the paper is out. You say that animal models are "rubbish"? LOL What about all of the preclinical testing in animals that is performed before drugs go to human trials? Are they "rubbish" too? Do rats get depressed? Well, there are many animal models of depression and anxiety - if you want to dispute them all, you are welcome to, but don't expect to be taken seriously by me. You are basically negating thousands of experiments. As for "denouncing" SSRIs, you said it, not me. I am merely pointing out a major, major overlooked persistent side effect of these medications that has been massively ignored. I've got more important things to do than bicker with you about this issue any more. I have plans to address this point in more democratic, impartial, and sceintifically open forums. You have got a very restrictive attitude (based on what authority, I wonder), that seems to be contrary to the very point of Wikipedia in the first place. And I question why you seem to be so *pro* these medications. Anyway, ttyl. Shibidee
[personal attack removed], if animal models are "rubbish for an encyclopedia" then I suggest you delete the entire contents of this article from Wikipedia. LOL
http://en.wikipedia.org/wiki/Animal_model
I can't be bothered to address your other points because I find them just as silly as the first one, and as I said it's time for me to abandon this nonsense. Good luck with your further censorship initiatives. LOL. Shibidee
Are you familiar with the term "Miereneuker"...and did you get your long-sought promotion at the Wikipolice? Shibidee
Hi. Yes, thank you. The sexual side effects of SSRIs are well established, but the persistence of these effects in quite a high percentage of former users has so far gone unnoticed. Part of the problem is the complexity of gene regulation in the human brain which is, after all, the most complex thing in the known universe. Do a Pubmed search for "antidepressant" and "gene expression" and you will find hundreds of articles. As we all know, the major effect of SSRIs is to block the reuptake of serotonin, but they have a multitude of secondary effects. When you have so many secondary effects there is no a priori reason to assume that the effects are fully reversible just by removing the initial agent. The same is true for some other drugs such as nicotine, which has lasting effects on the brain's reward system long after chronic administration has ceased ( http://www.newswise.com/articles/view/514937/). Everybody has assumed so far that the effects of psychoactive substances are reversible, and they seem to be in most people, but it also appears, based on emerging data, that in a significant percentage of former users the gene expression gets "stuck". In the case of SSRIs, it then has to be nudged back to the right expression pattern using other agents - testosterone, dopamine agonists, ginkgo biloba etc. Anyway, I will address this problem in an article next year after we have more case reports, animal work, and other data. Shibidee
Wolff, As I said, I have no intention of putting my data and theories back in the article until they have been published in the medical literature. You are obviously far too obsessed about blocking the material and I don't have time for this. I find your authoritative tone quite preposterous, and have the distinct feeling I'm being cyber-stalked. As I already mentioned, one of these papers is already in press, and others will be submitted soon. Also, I have a lot of interest from journalists who want to cover the topic, so I can't really be bothered to engage in a petty squabble with you when I can go through the mainstream media. BTW, the Wikipolice comment was only semi-sarcastic ( http://en.wikipedia.org/wiki/User_talk:84.66.181.168). Shibidee
To answer your sarcastic comment about "the horrors of mankind etc." would require a detailed treatise that I don't have time to get into with you. I'd rather save it for a journal article or a book. So you don't like "wolff", huh? Would you prefer "sheep"? Till next year... Shibidee
Niesen - What, like Wolff was "civil and amiable" to me from the start?? Give me a break. Shibidee
As someone who as personally experienced the devastating persistent sexual side effects of SSRIs years after discontinuance I find it disappointing that the Wikipeida page seems state that it is not possible. From reading above the above arguments I understand the rational for not including this info but wonder if maybe we can come to a compromise that is less strong in promoting that it can't happen. Since we can't include information saying that SSRIs cause persistent sexual dysfunction becase we currently don't have proof could we at least not say that it doesn't happen? I have seen no proof that shows that there is no long term persistence. The short term proof is documented well. The reference saying that normal sexual function returns after discontinuance could be removed or at least it could be toned down to say that the majority of the time its turns to normal. I would like to find some middle ground here because as it stand I think the page makes a judgement that all sexual dysfunction gos away after the drug is stopped. I should also point out that we are not only talking about libido here but actual physical functioning. In my personal case libido mostly returned but functioning did not. -- James
I think the current wording is much better. Because its occurrence is not the norm I think it will take time to become widely known and properly researched/documented. In my case it appears the SSRIs have done something to my dopamine system and I have had some initial response with my doctor using dopamine agonists to try to correct the problem. From what I am told its not uncommon for dopamine to decrease when serotonin is boosted with SSRIs but for most people this returns to normal after discontinuance. James
I am by no means an expert on SSRIs and similar drugs, though I have read something about their effects and mechanisms. My conclusion would seem to be that no one really knows how the hell they work. however, to address the point being argued here, these drugs are specifically chosen to induce long-term permanent changes in brain chemistry. It therefore seems inconceivable to me that they would not create long term side effects in exactly the same way they create long term effects. The fact that side effects go away may in part be a measure of the long-term ineffectiveness of such drugs. Sandpiper 00:44, 4 November 2005 (UTC)
Comment. I am responding to the RFC request on Wikipedia:Requests for comment/Maths, natural science, and technology. Reviewing the history of edits and the above discussion, I don't think the two studies previously referenced in the article [2] [3] are enough to support the assertion that persistence of SD after discontinuation occurs in humans. Edwardian 06:03, 17 October 2005 (UTC)
Comment. I am responding to the RFC as well. Until more substantial, published, peer-reviewed research is available, we should stick to what's proven in the medical literature with regards to persistence of SD. InvictaHOG 16:16, 20 October 2005 (UTC)
When does a victim decide to stop rationalizing abuse from an offender? Perhaps at that psychological threshold of tolerance, serotonin reuptake is inhibited rather than facilitated within the subject. Beadtot10/18/2005 04:51, 19 October 2005 (UTC)
The following note was left in the article by User:12.149.141.14:
Please see serotonin and 5-HTP. -- Jitse Niesen ( talk) 02:02, 5 November 2005 (UTC)
This looks legitimate. However, the sentence "SSRIs meet the World Health Organization definition of 'addictive'" probably should be sourced. The closest I could find was here, which states "In the 1960s the World Health Organization recommended that both terms be abandoned in favour of dependence, which can exist in various degrees of severity." Is there a better source for the claim? -- Arcadian 17:49, 13 December 2005 (UTC)
It's Sim, I'm the one who re-wrote the intro then someone changed it back. First, I felt it should be very simple and brief because most readers aren't medical professionals. The reverted intro is too detailed and sometimes people just want a quick explanation in layman's terms.
As for the remark about them being called _The Wonder Drugs_, it's a reference to the face that SSRIs are the polar opposite to TCAs and MAOIs in that they have no dangerous overdose effects or drug interactions. Nothing to do with effectiveness, they just are so safe which is a wonder compared to TCAs and MAOIs which are extremely dangerous meds. —The preceding unsigned comment was added by Simman2 ( talk • contribs) .
Fenice, I have taken SSRIs and currently take a TCA. I suffer from Obsessive-Compulsive Disorder.
I'll write more about SSRI safety for you later, go to run right now.
-- Sim
Why isn't the stuff on suicidal ideation in the section on side effects? It is a side effect (and a serious one, too) yet that section doesn't even mention it. 24.4.248.59 22:30, 19 February 2006 (UTC)
As the production error responsible for the contamination would have been easily correctable, some critics have suggested that this appears to have been done to make money for the manufacturers of SSRIs. This bureaucratic action neglecting the most important fact established regarding the biochemistry of tryptophan: that it is an essential amino acid that humans cannot live without eating, led to renewed questioning as to whether the FDA was a science based or political agency.
This section was recently deleted from the article. Any comments? Kim Bruning 13:46, 21 February 2006 (UTC)
The article claims that antidepressants have been shown to be neurotoxic. Nothing could be farther from the truth. Numerous studies have indicated that SSRIs may actually promote neurogenesis, quite the opposite effect. If no one can supply evidence of purported neurotoxicity, I am going to remove the claims, as they are currently devoid of any scientific basis, and in the light of new research suggesting an effect to the contrary, ridiculous. -- Muugokszhiion 05:18, 10 May 2006 (UTC)
I totaly agree. SSRI promote neurogenesis protect against stress and depression related volume (maybe neuron) loss in the hippocampus. even for very high doses no proof of neurotoxicity. particular SSRI may even be neuroprotective in stroke yet needs more proof.
Should be deleted. Neurobio 01:41, 18 May 2006 (UTC)
More and more the science will see, that many depressions are not coming by a lack of serotonin. Some are the result of lack of noradrenalin and also a surplus of stress.hormones, such like cortisol. This of course only, if the depression is endogenous, which is a small minority of d. The many side.effects of SSRI (selective serotinon reuptake inhibitors) make this therapy dangerous! -- Fackel 21:35, 30 May 2006 (UTC)