SSRI's vs CBT vs Alternative Treatments

[magni323]

Is there any recent literature on the efficacy of these treatments for depression and/or anxiety? Is there a gold standard treatment (CBT had been described as such)? SciHub is down so, I cannot search studies and many I find are abstracts and dated. Some state SSRI's are no better than placebo, others say they work. From what I have read CBT does seem to have a better track record.

- Saw it mentioned in a couple older threads but, what is the deal with Ketamine? Most of the reviews/patient experiences though for the most part positive are on Reddit so, they may be biased.

- Can CBT be done alone be it with a manual or app or does it require a professional for guidance?

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[clausewitz2]

Is there any recent literature on the efficacy of these treatments for depression and/or anxiety? Is there a gold standard treatment (CBT had been described as such)? SciHub is down so, I cannot search studies and many I find are abstracts and dated. Some state SSRI's are no better than placebo, others say they work. From what I have read CBT does seem to have a better track record.

The website you mention is back up.

- Can CBT be done alone be it with a manual or app or does it require a professional for guidance?

Your questions suggest you are not at all familiar with this field. Where are you in training/career?

 

[calvnandhobbs68]

- Saw it mentioned in a couple older threads but, what is the deal with Ketamine? Most of the reviews/patient experiences though for the most part positive are on Reddit so, they may be biased.

.....what?

 

[comp1]

I concur, we'll need to know the level of training of the OP to be able to tailor an answer. It would also help to understand why the questions are being raised. These are very complicated questions that each has many review articles written about them. These sort of very broad questions are literally why one does residency...

 

[Psychresy]

Is there any recent literature on the efficacy of these treatments for depression and/or anxiety? Is there a gold standard treatment (CBT had been described as such)? SciHub is down so, I cannot search studies and many I find are abstracts and dated. Some state SSRI's are no better than placebo, others say they work. From what I have read CBT does seem to have a better track record.

- Saw it mentioned in a couple older threads but, what is the deal with Ketamine? Most of the reviews/patient experiences though for the most part positive are on Reddit so, they may be biased.

- Can CBT be done alone be it with a manual or app or does it require a professional for guidance?

The data suggesting SSRI don't separate from placebo was in mildly depressed patients using a rating tool. I think it's safe to say they are effective in more severely depressed patients.

 

[wolfvgang22]

- Saw it mentioned in a couple older threads but, what is the deal with Ketamine? Most of the reviews/patient experiences though for the most part positive are on Reddit so, they may be biased.

Oh Lord no, please, please don't get your medical education from social media. Reddit loves anything hallucinogenic or perception altering (ketamine, LSD, mushrooms, etc) and saying anything negative about these kinds of drugs results in hate mail from the mob. You may as well ask the local high school kids and stoners on the corner what they think (and lots of times you are.) I've attached a recent article recommended by the ABPN regarding Ketamine.

Regarding SSRIs and depression, a good place to start is the STAR-D trials. We learn a lot about this seminal research in residency. Here are some links to get you started:
https://journals.sagepub.com/doi/pdf/10.1177/070674371005500303

Psychiatry Online

ps.psychiatryonline.org

Sequenced Treatment Alternatives to Relieve Depression (STAR*D) Study

Sequenced Treatment Alternatives to Relieve Depression (STAR*D) Study

www.nimh.nih.gov

I will defer to someone else to discuss anxiety and SSRIs if someone feels like it.
CBT is done best in evidence based, manualized, individual psychotherapy with a trained psychotherapist. However, apps and self-help books can be very helpful if individual therapy is not accessible, and can be a helpful supplement to CBT.

 

[smalltownpsych]

Depressed mood and anxiety are symptoms so there is not a gold standard “treatment“ for them. There are things that reduce these just like we have medicines to treat other symptoms, see aspirin for fever or headache. It doesn’t treat the cause of the fever. We don’t fully understand all the causes of the more extreme and recurring examples of these psychiatric symptoms and it is typically multiple factors. Hence the reason that we tend to use multiple treatments and studies support that as most effective. Experienced and skilled clinicians help to tailor that treatment to the individual.