I don't think SSRIs "mostly don't differ from placebo".
SSRIs only seem to work while you take them.
Some report side-effects that make them not worth it.
Others report that they're life-changing.
The case for Ketamine is that some periodic (but not permanent) use would bring you out of depression, rather than put it in check by indefinite drug use. As far as I understand, this is what's being challenged.
I suspect the response varies greatly by individuals: some respond a lot and some don't respond at all.
My experience with SSRIs was very positive. I took a low dose for depression for a few years and it helped significantly. I went off it a few years ago and my depression hasn't returned.
That study found a small effect size compared to placebo, and a large placebo response.
That seems consistent with OP's comment of "SSRIs...mostly don't differ from placebo" (emph added).
Also not addressed in the paper is the fact that SSRIs and SNRIs have well-known and pronounced side effects, with make it questionable whether double-blind studies are really fully blinded.
I’ve used both, ketamine and SSRI (fluoxetine to be exact). Ketamine didn’t do anything for me, other than being a funny experience, but it certainly did nothing for my depression.
Fluoxetine also didn’t magically cure my depression, but it made me more risk taking. And I certainly got the anti-depressant effect from the rewards of taking such risks (asking someone out, applying for a new job, asking for extra ketchup on your fries).
It’s still the patients job to fight the disorder, and SSRI can certainly help.
If you're gonna accuse someone of posting lies and FUD, at least have some sort of reference [0] to point to, please.
Otherwise you're just participating in a "uh-huh!", "nuh-uh!" pissing contest.
You know SSRIs can work while the serotonin hypothesis is wrong right? And no - I'm just going to asking people posting FUD, like SSRIs dont work, to stuff it. If huuhee had posted some of the review articles problematising the performance of SSRIs we could have exchanged different studies and had a discussion. But they didn't, as you didn't even if you think you did. And don't accuse me of having a pissing contest when you are the one hufffing and puffing.
Telling people to shut up needs to come with a reference. Giving your opinion doesn't. The only people who care about the fact that you disagree with them are your friends and family. Strangers only care why you disagree with them. They don't know you personally.
> The only people who care about the fact that you disagree with them are your friends and family. Strangers only care why you disagree with them. They don't know you personally.
This is exactly my point. You've hit the nail on the head.
There's a simple reference that doesn't even need to be quoted: SSRIs are approved for treating depression in all major countries on Earth. And this approval required they pass phase 3 clinical trials, demonstrating effectiveness over placebo.
Also, given that they are typically preferred over other classes of anti-depressants (try-cyclics etc), we also know they have demonstrated better effectiveness than other drugs.
Given all this, it is obviously up to the person flippantly contradicting well-established medical practice to provide citations, or rightfully be accused of spreading FUD.
Do you disagree that SSRIs are an FDA-approved treatment for depression, should I find references for that? Or do you not know what is the standard for FDA approval?
Does drug being approved by FDA prove its effectiveness? If you can demonstrate without reasonable doubt that it does, i.e. that it's virtually impossible for a drug to be both approved by the FDA and as effective as placebo, then that would make a good argument.
In any case, any argument is better than just a "Stop spreading FUD and misinformation, you antivaxxer"-style comment.
If I say there's no teacup flying in orbit of Saturn, is the burden of proof on me? Or on the person telling me to stop spreading FUD and misinformation, because everyone knows there's a teacup orbiting Saturn?
Yes the burden of proof is on you. And in this analogy, the tea cups of saturn have been regularly observed for decades, so you have your work cut out for you.
SSRIs only seem to work while you take them.
Some report side-effects that make them not worth it.
Others report that they're life-changing.
The case for Ketamine is that some periodic (but not permanent) use would bring you out of depression, rather than put it in check by indefinite drug use. As far as I understand, this is what's being challenged.