Our latest YouTube hangout (#EBMHchat) discussed editor Dr Andrea Cipriani’s recently-published network meta-analysis of the efficacy and acceptability of 21 antidepressant medications, for major depressive disorder. Dr Cipriani and Digital Content Editor Dr Michael Ostacher were joined by Professor Benoit Mulsant, Professor Roy Perlis and Dr Erick Turner, who discussed the results of the study and their implications for clinical practice and patient choice.
This research garnered widespread media coverage, with commentators acknowledging that antidepressants “are not snake oil or a conspiracy – they work”. The evidence inspired freelance journalist Holly Brockwell to tweet “damn right they work. Took until the third try to find the one that works best for me, but man was it worth it. Never be afraid to ask for help, that’s why it’s there”. One person (@WayTooLateTV) responded “thank you for sharing this. I’m diagnosed as having disorganized schizoaffective disorder… Meds worked for me,” inspiring Holly’s hashtag.
Although Holly couldn’t make the hangout, we caught up with her to ask her views on the study and the importance of social media in connecting research findings to people taking or considering taking antidepressant medication.
What led up to you creating #MedsWorkedForMe?
I’ve long had issues with the way antidepressants and other mental health meds are perceived in society. One of the primary reasons is that I lost my dad to suicide when I was five years old, and I think there’s a good chance he would still be with us if he’d felt able to ask for help. The stigma against mental health treatments – “crazy pills,” “happy pills” – is strong, and can be fatal.
Personally, I’ve been on antidepressants for most of my adult life, because I need them. I don’t feel bad about that, and I’m quite happy to openly discuss it (as I did on Twitter, in the lead-up to creating the hashtag). However, a lot of people don’t have that freedom, so I feel it’s my responsibility as someone with something of a platform to talk about it and help to normalise it.
The fact is, antidepressants help with the chemical balance in your brain. That’s not something you can think or exercise your way out of, any more than you could fix kidney disease by going for a run. Yet that’s always the suggestion – “just exercise instead!” It’s insulting, and people replying to the hashtag with that kind of thing got short shrift from me.
I take 40mg of Fluoxetine (better known as Prozac) every day, after Citalopram and Sertraline didn’t work for me. If the type of medicine you’re on isn’t working for you, keep trying. It’s frustrating, but most people eventually find one they’re happy with, and it makes such a difference to your life.
How did people respond to #MedsWorkedForMe?
As ever with Twitter, the responses were a very mixed bag. The majority were kind and supportive, with lots of people telling their own stories. There was a lot of inspiring stuff in there, as well as some amazing help and advice offered, from veteran SSRI-takers to newbies. Some people even decided to get help for the first time after reading the tweets, which is incredible.
There were also lots of heart breaking stories in the same vein as my dad’s – people whose lives might have been saved if they’d felt able to talk openly about their mental health. As a result, though, their relatives left behind are keen to help others, and that’s why a lot of them participated in the hashtag discussion.
Finally, there were the trolls. Some people said nasty things about people who take tablets, others attacked people who died by suicide, and then the more well-meaning but just as useless responses about pharma conspiracies, clean eating, miracle cures, etcetera, came in. They were in the minority, though, and even I learnt a lot from the discussions that branched off from my hashtag.
What do you think about this meta-analysis?
I found it really interesting that fluoxetine was found to be one of the less effective antidepressants, as it was like a revelation to me when I started on it. The thing is, though, everyone’s brain is different and reacts totally differently to the same drug. Which can be frustrating when your friend found her sparkle again by taking sertraline and all you got was a dry mouth and a headache, but thankfully we live in an age where there are loads of choices and overall, it’s pretty clear that they work for the majority of people.
That last bit is important, though – that’s why the hashtag was “meds worked FOR ME,” not “meds work.” Some people sadly don’t find that meds work for them, and we shouldn’t pretend that’s not true.
You’re on Twitter “all the time”. What’s the role of social media in relation to
patients or service users, carers and researchers?
Social media has been both a blessing and a curse for academia. When I was studying Linguistics at the University of York, conversational social posts on sites like Twitter and Facebook made really useful corpora of real-world, real-time language use. For other disciplines, the applications are less obvious, but for medical science in particular, ‘social’ can be a real double-edged sword.
On the one hand, social sites make it easier to recruit participants for studies, especially when you’re targeting a very niche population (I often see study recruitment posts on Reddit, for instance). And they make it easier to spread the word about published studies and interesting results. But social is also responsible for simplifying and distorting findings to fit the short attention spans of sites like Twitter, and commentary from non-expert journalists and laypeople can mislead.
I’d like to think #MedsWorkedForMe was a useful adjunct conversation to the study it sprang from.
Do you have a final thought for readers?
If you’re currently taking a medication that doesn’t work for you, go back and ask for something else. Don’t be afraid to advocate for yourself, this is your life and your body. Similarly, if you’ve never taken antidepressants but feel you might benefit, please talk to a professional. If they’re not helpful, talk to another one. And don’t forget, the Samaritans are there day or night if you need to talk about anything. It’s free in the UK from any phone, just dial 116 123.