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sharts 6 hours ago

I thought this was already known? I can’t recall exactly but there was some research pointing to SSRIs in general as not being particularly effective at all. They were just hyped a lot and became mainstream.

area51org 6 hours ago | parent | next [-]

I wouldn't go that far, but there was a now-famous study (Princeton?) that showed that doing aerobic exercise for maybe 30 mins every day, about five days per week, was equally effective at alleviating depression symptoms.

jdietrich 4 hours ago | parent [-]

There's one big problem with that - getting seriously depressed people to do 30 minutes of exercise (or anything else) five days a week. "Get more exercise" is excellent advice for someone who feels a bit down, but it's absolutely useless for someone who can barely summon up the strength to eat or brush their teeth.

jasonfarnon 4 hours ago | parent [-]

It gets even harder if you offer them the alternative of just taking a pill. For widespread health policy, we should want the proportion of depressives who will never learn to manage it themselves because a pill is offered to be smaller than the proportion for whom the pill is effective. I had always assumed these pills were effective enough but studies like these make me wonder.

jdietrich 3 hours ago | parent [-]

They are by no means mutually exclusive. If you want depressed people to get more exercise, then a really useful starting point is to give them a pill that could rapidly increase their energy and motivation. The idea that people will be stuck on those pills forever is just lazy psychiatry; ongoing maintenance treatment is often the best option for patients with a history of severe depression and a high risk of relapse, but antidepressants are equally useful as a stepping-stone towards self-management.

Bluntly, if someone is capable of actually starting and sticking with an exercise routine, then they aren't very depressed and should not be offered medication as a first-line treatment. Antidepressants are markedly less effective in patients with milder illnesses, so psychotherapy and lifestyle interventions are a far better initial treatment option. It's only when these treatments fail - or when engaging with them is severely impaired by the severity of the illness - that medication becomes the favoured option.

atbpaca 5 hours ago | parent | prev | next [-]

Here the context is for children, not in general.

5 hours ago | parent | prev [-]
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