I’ve tried 3 SSRIs for the depression associated with schizoaffective disorder, all three worked well but I did end up switching to bupropion and it works equally well and I experience less side effects which has been amazing! I am pro-SSRI though because I think that they actually saved my life, I just currently prefer bupropion.
You're doing great with subscribers! Last time I checked you were at like 400. Congrats! Wasn't there a meta-analysis published in Lancet a few years ago addressing the question of whether antidepressants worked? Did you see that one?
It depends on the population. In mild depression it's best to just go with psychotherapy. For severe depression we see a significant separation from placebo. I think these medications are mostly symptom management and no disease modifying. This is true of most medications in psychiatry with the exception of lithium. We should always assess the need for continued use.
I have came across some well known and leading psychiatrists here (Israel) who think different ssri aren't really equally effective in ocd, and that clomipramine is far superior in their mind from ssris in regard to ocd, even if there isn't good proof about that from study results. Probably they based it on their experience and what they see in clinic. One of them told me from example that the ranking efficacy for ocd meds in descend order are clomipramine Paroxetine Escitalopram Sertraline He forgot about fluvoxamine, citalopram and fluoxetine. Im not a doctor, but patient with a limited knowledge but saw some people in forums who didn't improve on ssri but then improve with paroxetine or fluvoxamine. In paroxetine I saw it especially. And I have encountered pretty a lot who didnt improve with all ssris but improve a lot with clomipramine. So maybe there are some flaws and not enough good and good powered studies which compare ssri efficacy in ocd or compare ssri with clomipramine, the latter especially with resistant ocd patients population
There is also going to be variability among individual patients. These likely include differences in metabolism of medication among other factors. In general I think TCAs are more effective overall but have more side effects. I think OCD is difficult to treat in general with medication, but doesn't mean it's not possible. I think clomipramine is a fine option for a person who failed to respond to SSRIs.
There are many factors that go into making a medication decision and which medications will work for which patient. I'm glad you found treatment that works well for you. If you haven't subscribed to the channel please do and spread the word about what we are doing here
I’ve tried 3 SSRIs for the depression associated with schizoaffective disorder, all three worked well but I did end up switching to bupropion and it works equally well and I experience less side effects which has been amazing! I am pro-SSRI though because I think that they actually saved my life, I just currently prefer bupropion.
Glad to hear, appreciate you sharing your story here
This is a really new channel for me but I’m following and find the videos brilliant
much appreciated
Regards from Doctor from India. More power to u sir. Keep up the good work
Brilliant. Thanks for this. Would be great if you could do a video on agomelatine too!
cool will add it to the list, this is a nice antidepressant and I like melatonin in general as a CAM
I’d be interested in seeing a similar video for SGA’s when targeting Psychosis
You're doing great with subscribers! Last time I checked you were at like 400. Congrats!
Wasn't there a meta-analysis published in Lancet a few years ago addressing the question of whether antidepressants worked? Did you see that one?
It depends on the population. In mild depression it's best to just go with psychotherapy. For severe depression we see a significant separation from placebo. I think these medications are mostly symptom management and no disease modifying. This is true of most medications in psychiatry with the exception of lithium. We should always assess the need for continued use.
Great channel! Thanks a lot
Thank you, appreciate the comment let me know if there is a specific topic you need covered
I have came across some well known and leading psychiatrists here (Israel) who think different ssri aren't really equally effective in ocd, and that clomipramine is far superior in their mind from ssris in regard to ocd, even if there isn't good proof about that from study results. Probably they based it on their experience and what they see in clinic. One of them told me from example that the ranking efficacy for ocd meds in descend order are clomipramine
Paroxetine
Escitalopram
Sertraline
He forgot about fluvoxamine, citalopram and fluoxetine.
Im not a doctor, but patient with a limited knowledge but saw some people in forums who didn't improve on ssri but then improve with paroxetine or fluvoxamine. In paroxetine I saw it especially. And I have encountered pretty a lot who didnt improve with all ssris but improve a lot with clomipramine. So maybe there are some flaws and not enough good and good powered studies which compare ssri efficacy in ocd or compare ssri with clomipramine, the latter especially with resistant ocd patients population
There is also going to be variability among individual patients. These likely include differences in metabolism of medication among other factors. In general I think TCAs are more effective overall but have more side effects. I think OCD is difficult to treat in general with medication, but doesn't mean it's not possible. I think clomipramine is a fine option for a person who failed to respond to SSRIs.
I found venlefaxine and quetiapine very heplful. But there are some side effects. Buproprion didn't work well with me. We're all very unique.
There are many factors that go into making a medication decision and which medications will work for which patient. I'm glad you found treatment that works well for you. If you haven't subscribed to the channel please do and spread the word about what we are doing here
Can you review viibryd?
Sure I can review that medication, it's one of the newer ones we haven't got to as of yet but a good one to talk about