Heroin, interestingly enough. IIRC they screened pain medicine recipients for depressive symptoms and in this way determined opiates relieve major depression more efficaciously than SSRIs.

consider quitting while you're ahead.

Yes, and a close relative (oxycodone) is something I’ve had experience with and can confirm it’s quite good at curing the depression. The problem is the permanent brain damage and/or death it will cause when taken long-term. Link < https://www.drugabuse.gov/publications/research-reports/hero...>

I don't see opiates as a tenable longterm solution but I mentioned heroin because it's only long term side effect as far as I know is constipation, which can be managed. Same with morphine.

My point in bringing this up is why accept SSRIs if they have more side effects and are less efficacious than heroin?

Heroin is highly addictive and has a high risk of overdose. There are alternatives to SSRIs, such as SNRIs and tricyclics.

Both irrelevant with medical supervision. SSRIs are highly addictive too; many people never stop taking them.

Overdose is not impossible just because there's a guy in a white suit telling you what to do. People will still take more than they should.

> SSRIs aren't addictive [1]

There are also a large number of side effects and risks associated with heroin; it's not just constipation as you say. [2]

[1] https://www.mayoclinic.org/diseases-conditions/depression/in....

[2] https://www.drugabuse.gov/publications/drugfacts/heroin

Did you read your 2nd link? All of the typically bad sides in the second grouping are related to poor hygiene and needle sharing. The first grouping is more benign than most antidepressant sides.

Yes, I did. Nowhere does it say that. If you want to get a point of reference for what heroin might look like if it wasn't a street drug, oxycodone is quite similar yet distributed without the additives found on the street since it is manufactured by big pharma. Still, it is associated with respiratory depression.

I know it doesn't say that but it should be obvious most of them are due to poor IV administration. You don't need to administer heroin or morphine via IV.

True, people occasionally OD on prescription medication, but it's usually as a rebound after having the prescription withdrawn and then finding more drugs.

That can happen with prescription drugs too though. People lose access to their insurance and then end up going off the drug too fast.

The bottom line is, don't you think if they could sell more of this drug, they would? Opiates are a pretty terrible choice for an antidepressant for multiple reasons.

> Opiates are a pretty terrible choice for an antidepressant for multiple reasons.

You've failed to present this. That opiates are bad is just dogma left around from the first religious-linked anti-drug pushes. I think they are inappropriate, but in the same way SSRIs are inappropriate, and have explained my position.

E.g. a UK study found that if you just give people all the heroin they want they quit after 2 years. There are no other complications than constipation.

> There are no other complications than constipation.

You keep saying this, ignoring the fact that I showed (with a citation) that it is addictive, which is a complication. This is a pointless discussion, since the dogma is that you are pro-opiate past the point of reason. I seriously doubt you’ve even tried this drug.