Apparently some #depression patients, on meds for years, get terrible withdrawal symptoms trying to get off the #drugs. Not only that, it isn’t clear the meds are better than placebos: https://nyti.ms/2GK795C

So, serious question: can you get withdrawal symptoms discontinuing a #placebo?

@wrenpile @pnathan Yes, absolutely you can.

But the discontinuation effects following cessation of anti-depressant drugs aren't necessarily a placebo effect just because the drugs don't work better than placebo for depression. They do act on the body, just not in ways that always treat depression.

We don't really know how they work when they do help, either. They do something. Sometimes that something helps. I think they're a good tool when you've got to try *something*.

@wrenpile @pnathan Also, negative discontinuation effects from coming off of antidepressants don't require you to be on the drug for years. I had pretty bad ones coming off citalopram after months, and that was tapering off according to instructions from my GP (I had intolerable side effects while taking it).

@artsyhonker @wrenpile my understanding is that SSRIs can have brutal withdrawals and long term problems. ... sometimes...

@pnathan @artsyhonker @wrenpile Yes, they can. My point, though, is that they are drugs, and working "no better than placebo" for the thing they are supposed to treat doesn't change this.

@pnathan @artsyhonker @wrenpile Of course, there are also cases where they work pretty well and the withdrawal is not only the crappy discontinuation effects but the return of full-blown clinical depression.

We don't really know how they work, but we do know some people are more functional if they take them long-term.