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I'm on Prozac. Mild side effects? When I started with it, my muscles hurt for weeks. I had to quit coffee (temporarily). I had to stop exercising (temporarily), and I was also very tired for weeks. Slowly all of that became less severe, though it never truly went away. Add to that, when I started my partner was about to bare our first-born. It was a hell of a time in my life, in many ways. A rollercoaster for sure. I still need to be very careful with alcohol (about twice as strong effect). One glass of alcohol at a cocktail party at Friday afternoon on work can rub the wrong way, as it did the other day.

> It’s fuether compounded by the fact that most antidepressants have severe or annoying side effects.

As does Prozac.

Nearly all medicine have side effects. People should be informed about them (it is included with the medicine, at least here).

When depressed or suicidal, the advice of going to your doctor is good. The advice to be open about anti depressants as well (though you didn't give it, one could deduce it from your post). The advice to go for this specific brand because "no severe or annoying side effects? Bad advice.

Honestly, I had less side effects from Zyban/Bupropion and Citalopram.

Full disclosure: I don't use Prozac/Fluoxetine for depression (though one could argue I suffer from depression); I used it so I can better cope with autism.

>Nearly all medicine have side effects. People should be informed about them (it is included with the medicine, at least here).

Most medicine has minimal side effects for most people. "Very common" side effects are ones that effect 10% of people taking the medication.

People should be aware that side effects are possible, but they are unlikely. Going in with the attitude that side effects are inevitable makes one more susceptible to the placebo effect causing them.

Most people will experience noticeable side effects from antidepressants for at least a week. It doesn't sound like you ever tried one honestly.

This is not true. Whether I've been on one is not relevant information, though my personal experience also says this is not true.

We ran a clinical trial of a very common antidepressant. Blinding was difficult because on the active arm damn near everyone had observable side-effects within 40 minutes of administration. Clearly not related to the placebo effect in this case, only the pharmacist knew what was in the capsules until the nausea started.

>Clearly not related to the placebo effect in this case, only the pharmacist knew what was in the capsules until the nausea started.

Right, and it could only be the placebo effect if those capsules contained sugar.

I used it so I can better cope with autism.

Has it actually worked? Your post outlines all of the bad things you've experienced, but has it, on the balance of things, been worth it?

TL;DR: psychiatrist and apothecary need to evaluate that in my country. If it wasn't worth it, I'd have quit long ago. The alcohol side effect, for example, is annoying. However being tired for weeks, and muscle pain having more severe impact, that was and is highly annoying.

To answer your question though. According to myself: Yes. According to the people around me: Yes. The people around me are more positive about it than I am, but they generally don't suffer from the side effects. Basically, I have less sharp edges. I am, basically, less sensitive. The moment I'm most sensitive is during public transport. E.g. commute. I go back from work, I sit alone, and at end of people hopping on two people sit on the other side of me and start eating Burger King. Which smells. Well, yeah, I still can't act that away (or fake it till I make it). They notice I am annoyed by it. I give them looks.

Also, keep in mind, that there are other options available, but these also have side effects. From what I gathered, the other common treatment option contained an anti-psychotic with severe side effects.

Thanks, this was interesting. I'm also autistic but have been lucky enough to adapt my life around it (short commute, private office, understanding people I delegate to, live in a very small quiet city, etc. so public transport is not even an option.) Taking medication isn't something I want to do, but I'm interested to know how/if it's working for others.

This reads like advertising copy.

Prozac has a number of potential side effects as well as needing commitment and a staged withdrawal.

This is a dangerous comment and should be burried.

edit: this isn't to say I don't think antidepressants are a fantastic tool; just that I don't think you should be going to your doctor and asking for a specific flavour of drugs because you heard about them on the internet. It's a really serious discussion - people should be going to their doctor and asking asking the possible (and best) solution to their personal circumstance.

I can tell you from firsthand experience for more than a year that the only effects I’ve noticed are slightly decreased libido. That’s generally considered TMI, which is why I didn’t mention it. But if I’m going to be honest and open, well...

Other than that, the side effects have included a renewed appreciation for life and and an ability not to have a sense of impending doom engulf my soul.

I was careful to say “my one datapoint.” Obviously, it’s not a miracle cure, and everyone is different. But it’s somewhat remarkable to diff my life vs what it was.

I’m a scientist at heart. I try to rule out placebo effect, and not attribute everything to one simple change. But a hearing aid is a simple change too.

The reason I’m speaking up is that it’s incredibly tempting to do nothing and to try to deal with your problems on your own. But it feels like that’s the real danger. Even if you succeed, why live life that way? It’s like succeeding in punching through a concrete wall for no reason. Much easier to use a sledgehammer.

You can always stop taking it. In fact, it wasn’t till I stopped for a month that I realized it had actually been working.

My experience tells me you’re are dangerously wrong to portray your experience with a single medication to be representative of anything.

I’m bipolar and spend a significant amount of time helping out in a support group for people with mental health issues. All of them have vastly different experiences. One medication I was on had terrible side effects while someone else was saved by it.

My current mix of medications would put some of the people I’ve helped immediately in the hospital. I myself have been sent to the ER by my psychiatrist due to a medication I was on.

Many psychiatric medications can’t be stopped without serious risks yet I’ve know people who have stopped all their medications and been fine. Others have permanent damage.

The only thing consistent with medication is that everyone is different.

Citalopram also works wonders, that said it’s only half of the equation to healing your psyche.

It’s important to remember that drugs affect everyone differently. But an antidepressant can be a good first step to getting out of a rut (even if exercise for SOME is as effective).

I've known many people who've been helped in a non-trivial way by antidepressants. Furthermore I had a colleague commit suicide recently due to depression.

His comment is not dangerous, it's encouraging. Pharmaceuticals all have side effects and must be taken with care, I've known literally no one that went into antidepressants ignorant of those things.

I don't think so. Buproprion is supposed to be the most side-effect free antidepressant yet it seems to have permanently messed up my sex drive. If I had the choice of the two I'd probably have kept my sex drive and tried something else.

Hmm - if it had recommended antidepressants in general it would be reasonable advice. But there are lots of them, and no a priori reason to pick a specific one.

Most medication has side effects.

Prozac has among the lowest side effect profiles for anti-depressants and is dirt cheap since it's long out of patent. That's why it's often the first thing tried despite not having the highest rate of effectiveness, as far as I understand it.

All anti-depressants have severe or annoying side effects for some people. Most anti-depressants have almost no side effects for most people. The trick is to change prescriptions until you find one you like.

(I'm on my third prescription, and have no complaints.)

> Most anti-depressants have almost no side effects for most people.

This isn't true for all anti-depressants, especially when you look at dosage.

For example, if you look at clinical trial data and studies for a certain drug, 60% of people experienced weight gain. Another drug caused nausea in nearly 70% of patients.

Paroxetine has a reported sexual dysfunction rate of nearly 75%, and patients who take 20mg of vortioxetine report a similar rate of sexual dysfunction after several weeks, but nearly none at all when taking 10mg daily.

You're right, of course. However, first, I think you'd be hard pressed to find someone who prefers depression to sexual dysfunction, weight gain, or nausea. Second, you can just try different medications until you find one that has none of the above problems.

To be honest, I find the discussion of side-effects in anti-depressants really strange. Depression is an extremely dangerous, life-threatening, life-ruining condition. The side effects, when they are present, are typically trivial. However, I have met many people who have not begun a course of medication because they were worried about them.

> However, first, I think you'd be hard pressed to find someone who prefers depression to sexual dysfunction, weight gain, or nausea.

All three of those can be depressing in their own right. In the past, I stopped what was effective treatment with certain drugs because of those side-effects.

If you look at the clinical trial data for vortioxetine, the nausea component was so bad that many people dropped out of the study altogether.

I guess I have never experienced weight gain, and I don't really care much about sexual dysfunction, but I really don't get how these things aren't completely irrelevant in comparison to depression. To me, it's like somebody saying they might not take chemo because they have such beautiful hair.

As for nausea, it's my understanding that it typically shows up pretty quickly, so I don't see what the problem is with just changing the medication.

Newer antidepressants have less/different side-effects compared to older antidepressants like Prozac.

5-HT1A agonism relieves a lot of symptoms commonly associated with SSRIs, so does antagonism of 5-HT2A, 5-HT2C (Prozac does this), 5-HT3, 5-HT7 and certain adrenergic receptors. Some newer drugs target these receptors.

Are 5-HT2A and 5-HT2C related to 5-HT2B at all? Don't psychedelics like LSD, DMT, and MDMA non-selectively target those receptors?

Traditional psychedelics are 5-HT2A agonists, while 5-HT2A antagonism or inverse agonism is associated with an anxiolytic and antidepressant effect.

Certain psychedelics like psilocybin are 5-HT2C agonists, which is responsible for the anxiety, dysphoria and nausea that some people experience when they consume it.

> Are 5-HT2A and 5-HT2C related to 5-HT2B at all?

You'd really need to look at in vivo binding profiles when it comes to serotonergic drugs. Some drugs are selective for other receptor subtypes compared to 5-HT2B, others aren't. Almost all antidepressants are tested for 5-HT2B affinity because of the association with heart disease and birth defects, and because of the lawsuits that resulted from them.

I'm glad Prozac didn't have noticeable side effects for you, but it's an SSRI - a lot of people have very noticeable side effects with drugs in this class, including Prozac.

Prozac is not better than other antidepressants. It's good that you didn't experience side effects, but you can't generalize from that.