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Zoloft vesus Exercise

You're depressed. For some reason, you have been led to believe doctors will know just how to help you. So you visit a psychiatrist, and he prescribes Prozac, Zoloft, or something else along those lines.

Is that really the best course of treatment?

Turns there are studies which seem to indicate it would be better if he'd skip the Zoloft, and tell you to enroll in a local health club or spend more time outdoors. Of course, he won't get a kickback for that advice. (Though perhaps they should start negotiating with Bally's for one?)

In 2000, a study was done which showed exercise was as good as Zoloft at relieving depression for the tested individuals. In fact, there were some indications it was better over the long term:

Six months after the end of the study, those who had been in the exercise group had significantly lower depression relapse rates than those in the Zoloft or combination groups.

And a later study [pdf] showed this was indeed the case:

The new study, which followed the same participants for an additional six months, found that patients who continued to exercise after completing the initial trial were much less likely to see their depression return than the other patients. Only 8 percent of patients in the exercise group had their depression return, while 38 percent of the drug-only group and 31 percent of the exercise-plus-drug group relapsed.

In other words, if you're exercising, taking Zoloft makes it four times as likely you'll replase into depression as if you didn't!

So, given this new information we, the collective, now possess, are psychiatrists now first exploring exercise instead of prescribing psychotrophic drugs?

Not from what I can see.

Comments

Thank you for this post! I was just prescribed Zoloft and Clonazepam because I'm having heart palpitations and complained of having trouble getting to sleep-not depression. First off, I don't even like to take aspirin. Secondly, I figure, "How did people in the past get along without all these social anxiety drugs?"

I have a pretty stressful job that requires an extensive amount of travelling, and as your post mentioned, I spend WAY more time indoors when not travelling. Flipping the tube back and forth between CNN and Fox watching them run the same stories over and over again probably exacerbates the problem (had to cut down on that). The prospect of going to the mid-east AGAIN doesn't help.

Oh, and I forgot to mention I haven't taken either, flushed the Zoloft down the toilet, and after reading the side-effects and possible side-effects of abruptly quitting Clonacrappam, seizures! I plan to flush those too.

I like your website! One can get some useful information with a little critical reading.

Posted by: Angelo on September 23, 2003 12:35 AM

I forgot to add that an MD! not a shrink, prescribed the Zoloft and Clonazepam. An MD! What am I missing here? Can you say, pharmaceutical lobby?

Posted by: Angelo on September 23, 2003 12:38 AM

Angelo: Amazing, isn't it?

Posted by: Tim on September 23, 2003 12:55 AM

Tim, bless you for bringing this to people's attention! I'm sure I sound like a crusader whenever I hear about a friend or relative who has been prescribed these drugs because I am VERY much against them in all but the most dire cases (and only when they are prescribed by a psychiatrist).

I was put on Prozac, then Paxil then Serzone by an MD when I complained of feeling moody after the death of my mothers. I was seeing a social worker at the time for grief counseling, and she never suggested that I was "depressed," but the MD was sure the drugs would help. He assured me they were "perfectly safe."

Prozac made me crazy. I couldn't sleep for days and couldn't concentrate or do my job.

Paxil turned me into a narcoleptic, falling asleep at the wheel, standing up on the subway, at my desk, you name it.

Serzone's side-effects were less pronounced, but I completely lost my sex drive. Every time I complained about the drugs, the doctor insisted I stay on them saying that it was more important for me to be control the moods. At one point, he even compared the pills to blood pressure medicine--something I'd have to take my whole life if I wanted to be "even-keeled."

Just one problem...I wasn't depressed, I was grieving! So when I was done, I was popping pills for no reason. I did some research and discovered how the drugs were probably making me worse (I did feel progressively more depressed by the week, not least of all because I felt dead inside with no sex drive, no appetite, no real DRIVE of any kind). I read about how to take myself off the drugs and did (gradually), and I felt INSTANTLY better!

Just one problem, I've NEVER regained my full sex drive (not to be too personal). I've seen doctors since, and they say that I may have permanently altered my brain chemistry and that there might be nothing I can do to get back to my full "self." I feel like someone cut off my arm in a way, and I'm angry, but there's nothing I can do except warn others. The side effects ARE serious. They don't know how they will affect each person. They don't understand dosages yet, or long-term effects on men vs women, and kids shouldn't take them at all!

But that hasn' stopped doctors, even schools, from prescribing these potent pills for everything from a persistant bad mood to suicidal thoughts. Never do they prescribe exercise. Never do they insist on counseling. In my case, sadly, I was seeing a social worker who deferred to the "medically trained" doctor's opinion, so even though her "gut" told her this was extreme treatement for what was essentially garden variety grief and sadness, she didn' want to question his judgment.

My feeling is, unless you're thinking of killing yourself, try exercise. Try talk therapy. Try chocolate for chrissakes! But stay away from psychoactive drugs as if you're life depends upon it, because it just might!

Posted by: Deb on October 7, 2003 04:07 PM

Oh dear. So sorry!

Thanks, at least I recovered eventually. Live and learn I guess.

I also am starting to look at a future involving far less hair, and looked into the alternatives.

Sorry if any of the following is redundant to your research, but I figured I might as well put it out there.

Saw Palmetto seems similar to Finesteride, but with slightly fewer side effects. It inhibits 5Alpha reductase type 1 and 2 ( finesteride only inhibited one of them) and does
so without inhibiting the cellular capacity to secrete PSA. (I can't remember the exact benefit of the prostate secreting PSA, but presumably it has a function.)

Personally I've given up on all anti-androgens, including saw palmetto, though. I'd rather work with my body than against it.

A lower fat, lower calorie diet with aerobic exericse seems the best route (apropos the original post.) Aerobic exercise (unlike strength training) increases SHBG (sex hormone binding globulin) so that your testosterone is there if you need it, but is 'bound' and so testosterone will not be converted to DHT, which is the androgen which accelerates hair loss. (Not that DHT is really bad, outside of hair loss. Ironically, DHT actually increases hair growth before it seems to age the cells somehow. It seems like male pattern baldness results from senecent cells, or cells which are 'old' at the cellular level. )

Mold has a horrid effect on hair.

Resveratrol + grape skin extract (I don't know if grape SEED extract serves the same purpose) seems to be the most interesting treatment I've found. No side effects that I'm aware of (though I could see some mild problems, theoretically, from someone who took it long term without getting a moderate amount of K1 in their diet from green vegetables, or was on a blood thinner which inhibited K1. Also, it could interfere with the breakdown of some drugs, including statins, similar to problems caused by grapefruit, via inhibition of cytochrome p450 enzymes ) Resveratrol has a fair number of benefits to health in other ways as well.

While I don't know of any longterms studies of resveratrol in the western world regarding hair loss, the plant Polygonum multiflorum (ho shou wu) has an apparent history of promoting hair health in China. I've read that it has 'resveratrol-like compounds.' P. multiflorum is a botanical relative of Polygonum cuspidatum, which is often used in resveratrol supplements in the west. As interesting as Chinese medicine is, the quality control is awful. So resveratrol + grape skin extract may be a good,safe, readily available substitute for a traditional Chinese cure. Just a thought, in case you're still doing research.

Country Life has an interesting blend. Some aspect of it (either resveratrol or pine bark extract) seemed to boost my aerobic capacity, which was interesting.

Posted by: Ryan W. on March 2, 2010 04:17 AM

Jo - I don't know if you're still reading this, but I'm curious; do you need a lot less sleep than most people? Maybe 5 or 6 hours only? The reason that I ask is that if your anxiety is from high levels of orexins/hypocretins and not from some kind of trauma, there's some anecdotal evidence that anti-histamines might be helpful. Antihistamines tend to be less likely to lead to addiction and tolerance than GABAergics. In addition to handling excess orexins, some anti-histamines have a mild SSRI effect.

I may be off base. And some people with anxiety have a very bad reaction to event OTC antihistamines. But I just thought I'd mention that.

From a preliminary 2010 literature review showing results that were favorable to anti-histamines but insufficient to reccomend them yet in clinical practice.

MAIN RESULTS: The search yielded 39 studies. We included five studies in the review with a total of 884 participants. We excluded 31 studies and designated three as awaiting assessment. The data from the included studies provide some evidence that hydroxyzine is more effective than placebo for GAD (odds ratio (OR) 0.30, 95% CI 0.15 to 0.58) and that it is also acceptable/tolerable (OR 1.00, 95% CI 0.63 to 1.58) (OR 1.49, 95% CI 0.92 to 2.40). Compared to other anxiolytic agents (benzodiazepines and buspirone), hydroxyzine was equivalent in terms of efficacy, acceptability and tolerability (hydroxyzine vs chloridiazepoxide: OR 0.75, 95% CI 0.35 to 1.62; hydroxyzine vs buspirone efficacy OR 0.76, 95% CI 0.40 to 1.42). In terms of side effects, hydroxyzine was associated with a higher rate of sleepiness/drowsiness than the active comparators (OR 1.74, 95% CI 0.86 to 3.53). There was, however, a high risk of bias in the included studies.

AUTHORS' CONCLUSIONS: The included studies did not report on all the outcomes that were pre-specified in the protocol for this review. Even though more effective than placebo, due to the high risk of bias of the included studies, the small number of studies and the overall small sample size, it is not possible to recommend hydroxyzine as a reliable first-line treatment in GAD.


source

Posted by: Ryan W. on April 14, 2011 10:50 PM

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