I’ll drink to that

August 15, 2014 § 47 Comments

For someone who is depressed but doesn’t need immediate hospitalization, alcohol is a more effective and safer pharmacological treatment than antidepressants, if a drug is really necessary. It is better to avoid psychotropic remedies entirely; but if you are going to go there, at least do something that is a known quantity with a track record and a properly balanced social infrastructure.

Alcohol is something about which we have plentiful independent information: it isn’t caught in the vortex of economically motivated disinformation that David Healy exposes in Pharmageddon. Because its long term heavy use carries enough social stigma there is still some incentive not to get trapped in a situation of physical dependency, or to get out of one if you find yourself there. Nobody is going to stage an intervention to help you kick the SSRIs, but alcohol comes with some built in social mechanisms to help. Alcohol is quite effective at helping a person feel better in the short term, probably more effective than SSRIs; and it doesn’t come pre-packaged with a credentialed doctor who will hold you hostage to the prescription pad on the one side, and lecture you to keep drinking and not ‘go off your meds’ when you get to the point where the benefits are outweighed by detriments on the other. And nothing prevents you from having a qualified physician monitor your alcohol use.

So my advice to most people is that it is far safer to take up drinking than it is to see a psychiatrist, if you simply have to have a pharmacological remedy.

§ 47 Responses to I’ll drink to that

  • karenjo12 says:

    I sincerely hope you get sued by the relatives of someone who hurts himself or others because you peddled this Scientology nonsense. Psych meds have powerful side effects but are no less necessary for people with mental illness than insulin is for a diabetic. If you wouldn’t tell a diabetic to quit insulin, you should not tell a psych patient to quit their medication.

  • Zippy says:

    karenjo12:
    As always, these are just my layman’s views based on my own experiences and I am not and do not claim to be an expert. I also don’t claim to be a scientologist.

    Type 1 and type 2 diabetes are entirely different animals, and someone with type 2 actually would be better off without meds if diet and exercise can keep things under control. In any case though while the comparison to diabetes makes good psychotropic drug marketing, like all analogies it has its limits.

    There are certainly some psychiatric patients who need constant supervision, and that includes anyone who is more likely than a healthy person to hurt themselves or others. Supervision is probably more important than treatment in those cases, frankly; but in any case my post explicitly isn’t directed at those kinds of cases.

  • Peter Blood says:

    Because I took medical advice from some blogger named “Zippy Catholic”. Lolz.

  • CJ says:

    It’s right there in Proverbs 31:6.

    It’s amazing that, after all the controversial stuff you’ve written about, SSRI would generate the most vitriolic comments I’ve seen on this blog.

    I wonder if it’s because people think that by disapproving of the standard of care drugs, you’re saying the depression isn’t a “real” disease.

  • vetdoctor says:

    Depression runs in my family and many of us have been on antidepressants. None of us became violent and, to varying effect, all improved. On the other hand my dad was an alcoholic. In my world proposing replacing psychotropic drugs with alcohol would get a very strong reaction from my family members less disposed to dispassionate consideration of the cost/benefit of various medications. It is hard to separate the passions from logic and, perhaps, not entirely desirable.

  • Zippy says:

    CJ:

    I wonder if it’s because people think that by disapproving of the standard of care drugs, you’re saying the depression isn’t a “real” disease.

    My point isn’t that depression isn’t real, it is that hugging the psychotropic drug tar baby is effervescently dangerous in the ways described (and others besides); and for people who are doing it to feel better (as opposed to those who need supervision to protect themselves and others), alcohol is actually less dangerous for all the reasons given (and others besides).

    Lots of folks in this ‘sphere are wary of ‘marriage 2.0’; very few are appropriately wary of ‘medicine 2.0’.

  • Zippy says:

    vetdoctor:

    It is hard to separate the passions from logic and, perhaps, not entirely desirable.

    That is a fair point, and I am sure applies to myself as much as to anyone else.

    Here is David Healy on alcohol.

  • […] Source: Zippy Catholic […]

  • Svar says:

    I don’t know about depression, but hands down, alcohol is one of the best drugs for PTSD. Very few things come close.

  • Lydia says:

    Wine is also better as a cough medicine than hydrocodone because safer and fewer side effects. Also, if you leave wine sitting around for six months, it doesn’t get over-concentrated through evaporation or separation of contents raising the danger of accidental overdose, whereas you really have to worry about that with any liquid medications that contain potentially dangerous ingredients. I think doctors should prescribe wine even for little kids as a cough medicine. (Note, I have never given a child wine as medicine. This is just a theoretical opinion.)

  • Mike says:

    At what age would Dr. Zippy propose the alcohol treatment for depression? Is 6 old enough?

    Ffs, this post is even less responsible — to put it gently — than your previous one. What a load of crap.

    Even a basic search, of the kind 1st graders are capable, would inform you that alcohol acts as a depressant. No responsible mental health professional would *ever* suggest drinking as a remedy for depression.

    You are better at writing pseudo-intellectual religionist screeds than dispensing advice on mental health. Please quit doing that already.

  • William Luse says:

    No responsible mental health professional would *ever* suggest drinking as a remedy for depression.

    He didn’t propose it as a remedy.

    You are better at writing pseudo-intellectual religionist screeds..

    Exposed at last.

  • Svar says:

    “Even a basic search, of the kind 1st graders are capable, would inform you that alcohol acts as a depressant. No responsible mental health professional would *ever* suggest drinking as a remedy for depression.”

    That is referring to the physical effects on the body not the emotional or mental ones.

    I personally disagree with Zippy’s belief that alcohol would be safer than SSRIs for the long term but I do agree that in the safe term(one time situation) it is safer and far more effective that SSRIs and less addictive than other drugs that are also used for very severe depression like amphetamines and methylphenidate.

    6 year olds shouldn’t be on anything, alcohol, ritalin, or SSRIs.

    “You are better at writing pseudo-intellectual religionist screeds..”

    Explain to me why they are “pseudo-intellectual”. Is this just a slur or is there a substantial justification for this claim?

    It’s funny how whenever a liberal disagrees with something, instead of arguing the mainpoints they feel content with ranting and raving and throwing around big words they barely even know the meaning of like “pseudo-science”, “revisionism”, or “pseudo-intellectual”. To be honest, all of the schnitzing and mewling just sounds faggy and ridiculous. I wonder if they realize this.

  • Zippy says:

    Svar:
    Long term use of any psychotropic is dangerous. But the advantage when it comes to alcohol is that everyone knows it, and knows what the signs are of a problem.

    Alcohol is very similar to benzodiazepines, which are sometimes effective against depression. The similarity is why Librium is frequently used to wean people off of alcohol.

  • Svar says:

    @ Zippy

    “But the advantage when it comes to alcohol is that everyone knows it, and knows what the signs are of a problem.”

    Alcohol is not as quickly addictive as opiates or meth but it is extremely addictive after a longer period and once a person is physically addicted, it easily surpasses the severity of opiate or meth addiction. The problem with addiction is that it slowly creeps up on a person and before you know it, they’re spiraling out of control. People know the signs of alcohol, coke, meth, and heroin addiction but they still get addicted.

  • slumlord says:

    A band of assassins speak:

    http://www.nejm.org/doi/full/10.1056/NEJMp078015

    For the tinfoil brigade, this excerpt should help.

    There may be controversy about the risk posed by antidepressants, but there is none about the risk associated with untreated depression: estimates of the lifetime risk of suicide in depressed persons range from 2.2 to 15%, depending on the population under study — not to mention the considerable suffering and functional impairment caused by this illness.5 In contrast, the FDA meta-analyses reveal an absolute risk of suicide in patients taking investigational antidepressants of 0.01%. Granted, this rate reflects risk during the short duration of a randomized trial, typically 4 to 12 weeks, but suicide is clearly an extremely rare treatment-emergent phenomenon.

    As for alcohol consumption for the treatment of suicide, the advocacy of it is not just dumb but bordering on the advocacy of evil.

    In contrast, alcohol use was a significant differentiating factor between adolescents who had attempted suicide compared to those with suicidal ideation only, with severity of depressed mood not being significant. However, there was also a significant interaction effect such that for adolescents with suicidal ideation and low levels of depression, increased frequency of alcohol use was associated with increased odds of a suicide attempt. These findings suggest that alcohol use may hasten the transition from suicidal ideation to suicide attempt in adolescents with low levels of depressed mood.

    From,

    http://onlinelibrary.wiley.com/doi/10.1111/sltb.12050/full

  • Paul J Cella says:

    Slumlord’s remarkable powers as an interpretative reader permit him to take this sentence —

    For someone who is depressed but doesn’t need immediate hospitalization, alcohol is a more effective and safer pharmacological treatment than antidepressants, if a drug is really necessary.

    — and render it as “[advocating] alcohol consumption for the treatment of suicide.”

    As I said, remarkable.

  • Alte says:

    Well, I agree, but I’m in Europe. Much more cork-popping than pill-popping over here. The demonization of booze and smoking seems to be a lingering effect of (notoriously anti-popery) Prohibition that the pharma industry has successfully yoked itself to. I suppose it’s the follow-up to lithium.

    I’d go further and say regular, light drinking prevents people from becoming depressed in the first place, as long as it’s social drinking. People are so isolated and a good beer fest brings them together again.

  • slumlord says:

    English not your first language Paul?

    Read the quote.

    Again.

    Many people who are depressed attempt to commit suicide after imbibing alcohol. Hospitalised or not. The quotes put forward above have nothing to do with the the treatment of suicide rather the second quote illustrates the potential baleful effects of alcohol on depressive patients as advocated by the host of this blog.

    I highlighted it especially for you.

    But then again I’m a tool of big pharma, and shit, what would I know?

  • jf12 says:

    Self-medicating only becomes problematic if the person wants to self-medicate. It’s always best if the person has to be restrained and forced to imbibe to get him to take his medicine.

  • Bill McEnaney says:

    Hmm, for about 25 years, my mom detoxed alcoholics and other drug addicts at a drug rehabilitation hospital where the staff thought alcohol was a depressant.

  • Zippy says:

    Bill McEnaney:
    Note that what I am saying is threefold:

    People who need supervision should be supervised.

    People who don’t need supervision should not medicate.

    People who don’t need supervision but insist on medicating – that is, people who refuse to follow my basic advice – should use something about which sane social attitudes and structures exist, because it is inherently safer. Sane attitudes and structures exist when it comes to alcohol. The attitudes and structures which exist around prescription drugs are insane.

    Also, the term ‘depressant’ is used to mean a number of different things. Benzodiazepines and alcohol do act on the GABA system, which has a calming CNS effect. But ‘calming CNS effect’ and ‘I feel so depressed’ are not the same thing.

  • Zippy says:

    Svar:
    SSRI’s can also be highly physically addictive, and it also sneaks up, etc.

  • Zippy says:

    slumlord:

    The quotes put forward above have nothing to do with the the treatment of suicide rather the second quote illustrates the potential baleful effects of alcohol on depressive patients

    Right: it is quite risky to medicate for mood, no matter what medication is used, which is why my first bit of advice is not to do it. My follow-up advice on the selection of medication is for people who choose to ignore my primary advice.

    What makes alcohol less risky is that the social structures (information, understanding, practices, attitudes, law, etc) around it are sane, whereas the social structures around prescription psychotropics are insane.

  • Zippy says:

    Bruce Charlton summarizes the literature on SSRI’s:

    In practice SSRIs are given to a large group of about 15 percent of the population outside of hospital, in general practice and outpatient psychiatry – people who suffer unpleasant symptoms such as anxiety, worry, severe and unpleasant mood swings, chronic unhappiness, guilt and so on – people in distress but people who continue to live at home, continue to look after themselves, often continue to work.

    This group of SSRI-users do not intrinsically have a raised suicide rate – if they were not taking drugs, they would be no more likely to kill themselves than normal controls.

    *

    It is thoroughly established that SSRIs increase suicide rates.

    (Emphasis mine)

  • Svar says:

    “calming CNS effect. But ‘calming CNS effect’ and ‘I feel so depressed’ are not the same thing.”

    Indeed and this isn’t just a common error that occurs amongst laymen, even mental health professionals make this mistake.

  • Mike says:

    “People who don’t need supervision but insist on medicating – that is, *people who refuse to follow my basic advice* [?] – should use something about which sane social attitudes and structures exist, because it is inherently safer. ”

    Absolute and potentially *very* harmful nonsense. There is nothing “sane” about our attitudes and “structures” (do you mean bars, detox centers, and AA meetings?) when it comes to alcohol, other than its age-regulated legality (which can be easily disregarded).

    And are you seriously saying that people should follow your advice?

    What has made you decide to start dispensing medical advice on mental health issues, Zippy?

    It is clear as day you do not know what you are talking about. You are NOT qualified — unless you have a medical or psychology degree that we don’t know about (do you?), and you are also NOT well informed on the matter.

    What’s more, you are purposely choosing to disregard widely available data showing how nonsensical your ideas are. It is irrational, at best, and quite possibly harmful to others who may not realize how unqualified you are to discuss this subject.

    Please stop.

    You’ve stated your belief that antidepressants induce suicidal thoughts and impulsive behavior. Fine. There is some legitimate and well-documented debate about it, and you’ve chosen to speak on one side of it, with the zeal of a layman. It is your right to do so. But please do not put yourself in a position of authority dispensing advice to people who suffer from mental problems.

    The best advice on the matter you could possibly offer would be that they should do as much of their own research as possible, and should consult a qualified professional (not necessarily in that order).

    And before you continue extolling our “sane” approach to alcohol as an antidepressant or other magical cure, you may want to familiarize yourself with data on chronic diseases and deaths associated with alcohol consumption.

    Alcohol is not as safe or “sane” in comparison with psychotropic drugs as you believe. We do not fully understand its effects on our bodies, but we do know that its prolonged consumption is associated with anemia, cancer*, cardiovascular disease, high blood pressure, cirrhosis, dementia (yes), depression (yes), seizures, gout, pancreatitis, and nerve damage. That’s not including the “plain” alcohol addiction and its social and other consequences (emotional and physical abuse, broken families, joblessness, homelessness, etc.)

    *The latest cancer research, summed up in the title of the review paper published in Medscape Oncology earlier this year, indicates that
    “No Amount of Alcohol is Safe.” http://www.medscape.com/viewarticle/824237

    In case you cannot access the paper, here is one quote:

    “(…) when it comes to cancer, no amount of alcohol is safe.[1] That is the conclusion of the 2014 World Cancer Report (WCR), issued by the World Health Organization’s International Agency for Research on Cancer (IARC).

    Declared a carcinogen by the IARC in 1988,[2] alcohol is causally related to several cancers. “We have known for a long time that alcohol causes esophageal cancer, says Jürgen Rehm, PhD, WCR contributor on alcohol consumption, and Senior Scientist at the Centre for Addictions and Mental Health in Toronto, Ontario, Canada, “but the relationship with other tumors, such as breast cancer, has come to our attention only in the past 10-15 years.”

    (…) A causal relationship exists between alcohol consumption and cancers of the mouth, pharynx, larynx, esophagus, colon-rectum, liver, and female breast; a significant relationship also exists between alcohol consumption and pancreatic cancer.[1]

    Links have also been made between alcohol consumption and leukemia; multiple myeloma; and cancers of the cervix, vulva, vagina, and skin (…).”

  • Mike says:

    ‘But ‘calming CNS effect’ and ‘I feel so depressed’ are not the same thing.”

    Alcohol is both a depressant and a depressogenic (i.e., it induces depression with a prolonged, and sometimes even not, use).

    Plenty of data about it at your fingertips, should you want to learn more.

    Here’s one study to start with:
    http://alcalc.oxfordjournals.org/content/41/5/473.full

    THE ASSOCIATION BETWEEN ALCOHOL MISUSE AND SUICIDAL BEHAVIOUR

    (skipping to) Results: There is evidence to suggest alcohol misuse predisposes to suicidal behaviour through its depressogenic effects and promotion of adverse life events, and both behaviours may share a common genetic predisposition. Acute alcohol use can also precipitate suicidal behaviours through induction of negative affect and impairment of problem-solving skills, as well as aggravation of impulsive personality traits, possibly through effects on serotonergic neurotransmission. Conclusions: Effective interventions for problem drinking may help reduce suicide rates. At a public health level, reducing overall alcohol consumption may be beneficial, and the measures shown to be most effective in this regard are those that aim to restrict availability of alcohol.

  • Zippy says:

    Mike:

    The best advice on the matter you could possibly offer would be that they should do as much of their own research as possible, and should consult a qualified professional (not necessarily in that order).

    I always encourage people to do their own due diligence, and frequently point out that making important decisions based on something a pseudonymous Internet clown called “Zippy” posted on a blog would be crazy and stupid. I try to help people think and point out things they may be blind to for a variety of reasons. Where they go from there is up to them.

    That said, I do know what I am talking about here, through a combination of deep experience at the tip of the spear and due diligence.

    The very way people react to the suggestion of alcohol shows that social attitudes and understandings about using it to alter mood are pretty healthy and well informed. Most folks think it is a bad idea to use alcohol to deal with a serious mood problem, certainly long term, and that is indeed a healthy attitude to have.

    The problem isn’t that people react to the suggestion of alcohol the way they do. The problem is that they don’t react to the suggestion of other psychotropics the same way they react to the suggestion of alcohol.

    The social structures around prescription psychotropics are dysfunctional beyond what anyone who has not seen it go wrong first hand would believe — kind of like people who don’t understand the dysfunction of the divorce mill without experiencing it first hand. Things are even more dystopian than even the skeptics think. That’s why I recommend that those who haven’t seen it firsthand read Healy’s well documented books — that will at least give them a partial understanding of the extent to which things have gone wrong, and why physicians like slumlord don’t see it despite their best intentions.

  • sunshinemary says:

    The thing that concerns me about SSRIs is that they are pushed for EVERYthing, not just depression, but the side-effects don’t discriminate. When my husband was quitting smoking a number of years ago, our doctor prescribed him a medication called Zyban which had proven effective in reducing nicotine craving. He started taking it and almost immediately began having horrifyingly violent and realistic nightmares every time he fell asleep; he also had trouble sleeping for more than a few hours at a time. I started looking more critically at what Zyban is – turns out, it’s just a high dose of Wellbutrin, something which was not explained to us.

    My doctor also tried to put me on SSRIs for chronic insomnia but I refused. A friend’s pediatrician wanted to put her seven-year-old on SSRIs because she was extremely anxious. Another friend took (and still takes) them for migraine headaches and even took them while pregnant; interestingly, they are now finding that taking SSRIs while pregnant can have consequences for the child.

    It seems like doctors push them for every ailment.

  • Svar says:

    Sunshine, wellbutrin is not an SSRI, it’s a cathione which is in the amphetamine class. Bath salts are a different type of cathione and the cheap street version. No wonder your husband couldn’t sleep.

  • sunshinemary says:

    Oh, is that right? I read that it was an anti-depressant and just assumed it was an SSRI. Just now when I googled it, I see that the symptoms my husband experienced are now listed as a “call your doctor immediately if you experience this” set of side-effects, but when he took it back then, that wasn’t mentioned at all.

  • OhReilly says:

    The very way people react to the suggestion of alcohol shows that social attitudes and understandings about using it to alter mood are pretty healthy and well informed. Most folks think it is a bad idea to use alcohol to deal with a serious mood problem, certainly long term, and that is indeed a healthy attitude to have.

    The problem isn’t that people react to the suggestion of alcohol the way they do. The problem is that they don’t react to the suggestion of other psychotropics the same way they react to the suggestion of alcohol.

    This. People need to take a break and read and understand these words instead of resorting to whining and infantile knee-jerk reactions aimed at Zippy.

  • Mike T says:

    It seems to me that the real issue with alcohol versus SSRIs is probably one of diagnosis. If you are a case study in actual, real clinical depression then you are also sufficiently at risk for suicide that alcohol is not an acceptable alternative. Most “depressed people” are probably that way for a variety of reasons, none of which are due to imbalances in mental chemistry. I would hazard to guess that most depression is actually a subconscious reaction to cultural nihilism and having to work harder for less.

  • Zippy says:

    Mike T:

    If you are a case study in actual, real clinical depression then you are also sufficiently at risk for suicide that alcohol is not an acceptable alternative.

    If that is the case then providing psychotropics without constant supervision is grossly irresponsible, since psychotropics in general increase suicide risk. In an outpatient situation the patient is taking responsibility for himself by definition. If that is the case, alcohol is less bad than prescription psychotropics (though still worse than nothing at all) for all the reasons given.

  • Liz says:

    I read your blog because of the trainwreck value. It’s usually funny reading the word masturbation that goes on. This one isn’t funny. You are grossly misinformed on how the brain works. Stick to how you think you are gaming women. That’s much more entertaining and gives us lots to giggle about.

  • Hrodgar says:

    Liz:

    It is patently obvious you either do not in fact read this blog on a regular basis or do not understand it. If you did, you would know that its author views Game as inherently immoral, and in any case no more effective than a placebo. That being the case, you will, I hope, excuse me if I proceed to regard your other claims as without merit until such time as you can demonstrate otherwise.

  • sunshinemary says:

    Stick to how you think you are gaming women.

    Oh Liz, you’ve confused Zippy Catholic with Tom Cruise. Don’t be embarrassed, I’m sure that happens to him all the time. Anyway, just to clarify for you, Zippy is the guy who writes a lot about how game is illogical/immoral:

    End Game

    The central paradox of “Christian Game”

    Mathematical illiteracy and Game

    Zen Game, or, you can only frame pictures and pictures aren’t reality

    and this is Tom Cruise (salty language warning) playing a character that teaches men game:

    See the difference, dear?

  • […] Avoid anti-depressants. Drink instead. […]

  • Chris says:

    A better first step when depression hits is to look for an organic cause, like Lyme disease which can cause severe depression. Look up Amy Tan’s story about Lyme & depression.

  • […] the prescription pad. Even though a drug like alcohol objectively has a similar profile of risks and benefits for improving mood to other drugs, it is unsuitable because it cannot be an instrument of social […]

  • outis says:

    What kind of people need supervision and medication? Not that it matters, but I agree with Zippy about the dangers of SSRIs. Do you think the same about lithium for people diagnosed with manic depressive illness? Or antipsychotics for schizophrenics?

  • Insane people (or people who go in and out of sanity) need supervision.

    While perhaps not as bad as SSRIs, antipsychotics are also dangerous and can prolong schizophrenic hallucinations. I would never encourage someone to use any type of psychotropic to deal with a serious mental problem.

  • […] number of cranky-pants folks got rather wound up when I pointed out that alcohol is safer than psychotropic drugs, specifically because we have solid believable objective public knowledge about alcohol. […]

  • […] one tribe or other has become, fairly or unfairly, disproportionately associated with that sin.  Alcohol abuse doesn’t become immune to criticism in virtue of its (fair or unfair) association with the […]

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