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Antidepressants Work No Better Than a Placebo
Matthew Whalley writes "Researchers got hold of published and unpublished data from drug companies regarding the effectiveness of the most common antidepressant drugs. Previously, when meta-analyses have been conducted on only the published data, the drugs were shown to have a clinically significant effect. However, when the unpublished data is taken into account the difference between the effects of drug and placebo becomes clinically meaningless — just a 1 or 2 point difference on a 30-point depression rating scale — except for the most severely depressed patients. Doctors do not recommend that patients come off antidepressant drugs without support, but this study is likely to lead to a rethink regarding how the drugs are licensed and prescribed."
Thinking that you're going to not be depressed anymore makes you less depressed!
I don't care if it is a placebo - and I doubt it is - but I'm glad I finally went on Prozac.I'm a much more functional human being than I was five years ago before I started.
I have a tremendous amount of unpublished data that shows the exact opposite
And now that I know they don't work, I'm even gunna be more depressed when i take them!
I guess Tom Cruise was right?
[Fuck Beta]
o0t!
I'm not really surprised that the drugs are overperscribed. However, I do find that the subject heading is misleading.
The Scientologists were right all along!
People seem to miss something that seems very obvious to me... They think "Oh! You're depressed.. there's something wrong with you, maybe these drugs can help it" ... but depression is a _natural_ state in most living beings. Just look at dogs, they can get severely depressed, just like their owners. Sometimes, yes, a chemical imbalance is to blame and drugs can help. But more often than not a human being is depressed for a reason... bad relationship, money problems, reading about too much pain in the world from the newspaper. You name it, there are plenty of very valid reason all around us to get depressed. Our society has changed very quicktly in the past few centuries, and the past few decades, and it seems that this new way of living does not agree with a lot of people. Rush, do this, do that, look like this, behave like this, own this, spend your money more, more, etc, etc. This is all extremely stressful, and none of it to the betterment of ourselves as people. "Okay, so, I bought myself a fancy new $600 sofa. It's pretty and soft and my guests will be impressed...... Hmmm.... So, where's my scotch?"
It is no measure of health to be well adjusted to a profoundly sick society. - Krishnamurti
Even if it has almost no effect, that shouldn't matter it does help some people even if it is all in their head. And the more people who learn that they can overcome depression the better. And even if it doesn't help much it can help in the long run as they slowly work their way off and realize that added self esteem stayed with them and that they are overall happier.
A while ago somebody noticed that anti-depressant drugs don't work at all unless they have some side-effects. The side-effects remind the user that he or she is taking a wow-must-be-powerful drug, which increases its placebo effect. The upshot is that it is completely counterproductive to search for an anti-depressant drug that has no side-effects. In fact, the more side-effects the better.
I don't remember more details than this, though.
In any case, it reminds me of a similar effect in microeconomics, in which consumers would tend to evaluate a widget more favorably if they had paid more money for it.
FATMOUSE + YOU = FATMOUSE
Hairibo Gummy Fungus? Seemed to work for Amy Wong....
Monstar L
I was on Zoloft for a couple of years way back when I was a teenager. It did fuckall to help my depression, I still hated life and still contemplated suicide, but I noticed something funny after I stopped taking it (due to severe gastrointestinal side effects). A few days after I'd quit the pills cold turkey, I was thinking of something I was stressed about, and along with the common wave of emotional despair, felt a physical sinking in my chest that I realized I hadn't felt for... about two years. I laughed when I realized that that was probably the chemical reaction that the SSRI had been halting, and laughed harder the longer I contemplated what a drop in the bucket it was in the scope of the depression I was struggling with. It made me understand the extent to which the Zoloft was just targeting a symptom of a larger problem, like any number of other medications do. There may be some people whose depression truly does stem from such a one-note imbalance, and I truly hope that the medication can help them, but it doesn't surprise me that antidepressants could be so insignificant to so many others.
I just listened to the CEO of Eli Lilly speak for an hour last night, and he said most prescription drugs work at best in 80% of patients who are diagnosed with the disease it's supposed to treat. Their least effective drugs only treat 20% of patients. Until effective genomics, proteinomics, and metabonomics testing systems come out, which will show exactly how people react differently to drugs, they have to train doctors in choosing criteria where the drug will work, and ensure that they don't prescibe drugs that don't work in that circumstance. Selling drugs that don't work is an unsustainable business policy.
He talked about Strattera, a nonstimulant ADHD drug, that works works best in people with ADHD combined with clinical anxiety. Otherwise, the patient should be prescribed a stimulant based ADHD drug, which works more often in other cases.
Anyways, a lot of drug trial data is needed to find the population where the drug works. In a lot of cases the drug might not work at all. Prescribing methicillin against methicillin-resistant Staphtacaccous aureus will probably an efficacy similar to placebo.
Surely by publishing the unpublished data it's now published which means it's no longer unpublished, therefore contradicting itself?
(SIGH) nothing ever works, its hopeless!
stuff |
I could have told you that myself! Just came off antidepressants myself last month, after complaining that I cried as much with or without the pills. Only effect was that it *uhm* stopped the man-machinery to work completely, for as long as I was on the stuff. Now of course, my doctor is totally patronizing, postpones my appointments for months / doesn't provide much help because I don't obey and take the pills, and am generally left on my own when I need help the most...
Should have taken the sugar pills at least...
--the leprechaun / leprec
When they're on them they are normal and healthy. They feel so normal and healthy that they often decide they don't need them anymore - so they go off them. Then they are not normal and healthy.. they are depressed. After one too many 2am phone calls one of their friends will recommend that they go back on the anti-depressants. Soon after they will be normal and healthy again.. until the cycle repeats itself.
Must all be the placebo effect though.
How we know is more important than what we know.
I don't know about deep depression, but with rather mild depression I took a 25mg pill of Anafranil and had some 2 days of pretty much silly euphoric high.
:)
The effect wasn't mild or insignificant or anything you could consider effects of placebo. I was feeling like in very good mood, work that felt like dread before, could be finished at my standard efficiency and the effects were NOT negligible.
Of course there -were- side effects and they were quite strong (feeling of heat, including sweating and problems with sleep, lower max physical strength, getting physically tired faster, problems with urination), but first they felt like a total non-issue due to the great mood I was in, and second, the lower efficiency of my body at physical work was ballanced by increased enthusiasm and will to work more and mental efficiency was not affected (not just in subjective opinion) and no other factors of perception than general very good mood were affected (although feeling far too warm to fall asleep resulted in natural effects of insomnia).
No idea what drugs they talk about but Anafranil is THE shit
45 5F E1 04 22 CA 29 C4 93 3F 95 05 2B 79 2A B2
Sorry, I have a considerable amount of experience with family members who went the counseling route for years without seeing improvements. After finally deciding to try anti-depressants, anti-anxiety, etc., the problems they had most of their lives went away or were reduced to levels that made it easier for them to have a better life. The biggest problem I've seen is not whether they work or not, it's that GPs are the ones issuing the Rx. GPs are just that - GENERAL practitioners. The good ones admit that their knowledge of the nuances involved with the "low-level" chemical behavior of the brain is limited. A psychiatrist, someone with a medical understanding of the topic (not knocking psychologists, but their understanding is in a different area: the non-biochemical causes of issues) should be the person making the determination of just what a person should be on. They're aware of more of the potential "cocktails" of drugs (one particular drug is not enough) - both in terms of what works and what needs an additional medication to target secondary causes/effects of depression....
Bark less. Wag more.
The point is not that antidepressants don't work - the point is that diagnosis criteria for depression has been to lax for too long. "Everybody gets depressed, not everyone needs antidepressants" It makes sense that the only people who respond to antidepressants designed to fix chemical imbalance are the ones with severe depression.... who are likely to have a real chemical imbalance. These are not "happy pills" they are formulated to fix an insufficiency. Normal, mild depression from events (death, divorce, etc) has always been treated best by cognitive behavioral therapy (aka psych visits), unless you just want to zonk someone out. But, in our society, if you have a problem you get a pill. No one wants to hear "go talk to someone and get over it," so doctors write the scripts and the generally malcontent get them filled.
At least prozac worked for me, infact it worked too well and I've been take off of it and put onto something that doesn't work at all.
Sadly the doctors think my depression is because I smoke a couple of spliffs a week, it just shows how you can talk intimately to people and yet they never really know you, I was depressed long before I knew what a spliff was.
thank God the internet isn't a human right.
At least in Sweden, if you've had a deep depression and are on the way to getting good, they will stop helping you and force you to go back to work 100% immediately. If you've ever had a (real) depression you know that that is not an option. You need to start slowly before you can get up to speed or you will be back to where you started (when you got depressed/burned out). So what to do? You lie to the doctors for a while and pretend that it's still as bad as it used to be so you get a chance to recover. The doctors would understand and agree with you but they aren't allowed to sick-list you if you aren't so down that you rather starve than go outside to buy some food. So, I think this survey isn't telling the whole truth.
My other account has a 3-digit UID.
a placebo pill when I have a headache.
Swedish plasma phys. PhD student; MSc EE; knows maths, programming, electronics; finance interest; seeks opportunities
That's because the scammer aliens sold the researchers a jar of gummy fungus instead of real antidepressants.
This fits with what some other studies have shown in the past... in the short run. Depression is often cyclical; people get more or less depressed over time and will often be fine for long periods of time. So simply by taking nothing and waiting, they'll often start to feel better soon. This is why taking anti-depression meds is almost indistinguishable from a placebo in the short run, except in the most severe cases.
The real test is how effective the meds are at preventing future episodes of depression, or at least limiting how bad they are. TFA doesn't go into enough detail on the length of time over which the data was collected, so I don't know what it has to say about this.
I never knew about this study. but I've been on every type of medication from a to z. From the time I was about 6 everyone knew I was a bit off. Yhey figured it was just my intelligence at the very start. Then they started seeing the issues with authority, the issues in large groups, the lack of focus, and the destructive behavior. So they started with ADD and went from there. I've been clinically diagnosed manic depressive with acute paranoia since about the age of 15/18 (read late teens). I've been on anti depressants, but they never really did anything for me. Currently I only take mood stabilizers like lithium (600mg 2x's a day) and seroquel (400mg 2x's a day). I guess seroquel can be considered an anti depressant, but because it helps with both the up's and downs I don't consider it soley an anti depressant.
This is Slashdot! Give me the latest gadget, bug, or OS project! This ain't english class so don't confuse the two!
"A man (or woman) is as happy as they make their mind up to be"
Politics is Treachery, Religion is Brainwashing
Breaking your leg is pretty natural too. Do you not do anything against the symptoms either? Nor help the healing process?
Wasn't the unexpected result produced by including unpublished clinical data, released under FOI? If so, who was holding onto that data and why? It seems very fishy to me that anybody would be conducting studies, then deciding whether to publish them or not based on their conclusions. Clearly, by selecting which studies to publish, an interested party could present any result they wanted to - through medical journals.
You thought you could break the laws of physics without paying the PRICE?
Start prescribing Placebex for depression!
Wasn't the unexpected result produced by including unpublished clinical data, released under FOI? If so, who was holding onto that data and why? It seems very fishy to me that anybody would be conducting studies, then deciding whether to publish them or not based on their conclusions. Clearly, by selecting which studies to publish, an interested party could, in theory, present any result they wanted to. I find this extremely worrying.
You thought you could break the laws of physics without paying the PRICE?
You read the label for a lot of Anti-depressants out there and a number of them will warn you that their particular anti-depressant may not work for you and, in fact, may have the opposite effect. I want to see the standard deviation of the two groups, and before/after numbers. My guess would be that the plecebo group has a low standard deviation and rated their depression very much the same as before, while the group who actually took the anti-depressant had a higher standard deviation and a significant number of people rated their depression very differently.
Not to mention that both myself and one of my college buddies took anti-deperssants while at college and the fact of the matter is that they helped us both. I wouldn't say they made me happy, but they certainly helped me cope which gave me the opportunity to do the rest.
This seems like people are being given the drugs who don't need them. The drugs work for severely depressed people. They don't do anything special for people who aren't depressed because... they treat depression.
The drugs' success is contingent on you having the ailment they treat. Big news? I think not.
This post climbed Mt. Washington.
Being depressed is a natural state of consciousness along with being happy or whatever emotions a person may have. People have to start listening to friends and understand what giving support is as opposed to giving advice on how to fix a problem. Being that our lives are so choatic now it allows the Mental Mongers (Psychiatrists, Drug Companies) as opposed to the Disease Mongers (Doctors, Drug Companies) the abilitiy to exploit us and drag out our problems and get paid for it! Take this example. Why is it mostly boys get prescribed ADD/ADHD medicine just for being boys because they can't sit still and have alot of energy or are bored by what they are being taught when the answer is as simple as boys learn differently than girls and maybe........just maybe need a different classroom environment. Maybe we need better teachers. Blah Blah Blah. My son has been on Antidepressants and ADD medicine all of which I was against but anytime his mother or the school said boo they went and push medicine and my hands are tied but now a Doctors order supercedes my wishes. What I know with Common sense is my son needed a change that these folks couldn't bring themselves to do. As long as you have an enabler "his mother" (variation of the enabler in the addictive sense) telling him he won't like something before it is presented or served to him, or says he's always been depressed then how can he get past it and see that at least as a child those matters for him pale to the issues he'll have as an adult if he can't learn how to let things go. Thats what is the major problem for those depressed. Letting go. Mind your comments in respect of "well you don't know what I've been through" because I'm sure most people have something buried in their Pysche. The aim is to see it for what it is and if you have the same problem after many years then maybe you need to move or get some new friends, change jobs.
Can someone explain?
Seriously, Slashdot editors: be a bit more responsible when you are dealing with potentially serious and life-threatening medical conditions. The study did not find that "Antidepressants work no better than a placebo". What it seems to have found is that there is an indication that antidepressants do work for people who do have a serious depression, while there is little indication it works better than a placebo for lighter (possibly misdiagnosed) cases.
Here's the thing: a clinical depression is a serious, crippling condition. Recent research has tied its physical underpinning to a slowdown in neurogenesis in certain areas of the brain. Most likely, this slowdown is caused by the bad quality of sleep caused by continuous and prolonged stress. But whatever the cause, the end result is a brain that is physically different. Yes, this is a physical condition, one whose recovery is progressive and takes a fair amount of time. And it's precisely in this condition that antidepressants have been shown to be of help. Moreover, you cannot magically cure someone with a clinical depression by having them "snap out of it". (Would you say "snap out of it" to someone with a broken leg?)
Part of the reason why depression is so wildly misunderstood is because everyone gets the blues every now and then. That is not the same as a clinical depression. And if a misinformed doctor prescribes antidepressants to someone who just has this "pseudo-depression", then it's no surprise that antidepressants won't really make much of a difference. However, this does not invalidate that antidepressants are valuable tools in fighting real clinical depressions.
The drugs!! They do NOTHING!!
Everything I say is a lie. Except that... and that... and that, and that, and that, and that... and that.
I just wanted to comment that these drugs are used to treat more than depression.
I suffer from a mental disorder that gives me symptoms of paranoia and echolalia, yet aside from those I've never been what I would call clinically depressed. I was kind of disappointed when I finally started speaking to doctors about these things and the only solution they could offer was "anti-depressants". Seems strange for someone who's not depressed, yet I was prescribed zoloft, began taking it and noticed it completely changed my state of living for the better. I no longer have these symptoms to such a large effect that they completely inhibit my life, which was the issue beforehand when they would destroy my relationships at work, home, etc.
So they do serve some other function than for people who are clinically depressed, or think they're depressed, or whatever. There are those of us who have pretty obvious, physical and mental disabilities which are helped by them.
Disclamer first, I work for an R&D company that develops interactive voice response systems (ie: phone surveys) that are used to apply traditional depression and mental health tests in a consistent manner. My company is in part funded by grants and projects paid for by large pharma comps. Although I personally have no contact with them.
When pharma's want to do a study, they set up sites, each site will have one or more doctor and each doctor will have one or more patient who is participating. Quite often, these studies pay a bonus for each patient up to the quota, or the docs will want to try to help and fill their quota. When they do this, it introduces people into the programs who really should not be there. It's not that they are being purposely decietful or anything, they just aren't being as consistent and strict as they should be. I know this to be a fact, we have done numerous studies in which our system's performance is compared to real world docs across the US. And each and every time, our system would exclude over 20% of the patients that the doctors would enroll.
Since these studies are being poluted with people who do not reach the level of condition the drug was ment to treat, the drug will be ineffective on them. You can't "undepress" people who aren't depressed to start with. So they will reduce the effective correlation of the drug. There is also another natural bias that clinicians apply that causes a deflation of scores at the end of the study due to the double blind factor being eliminated by side effects.
In short, traditional ways of performing these studies are heavily flawed and will often result in a lower apparent effectiveness than the drug actually has.
-Rick
"Most people in the U.S. wouldn't know they live in a tyrannical state if it walked up and grabbed their junk." - MyFirs
You realize that Thorazine is an antipsychotic, not an antidepressant, right?
I write sci-fi for metalheads
Amongst the side affects of the many drugs that are prescribed, he has become overweight and now suffers from sleep apnea further complicating the depression. If anything I have learned from observation is that people suffering from depression need the support of people close to them, for the condition is like a downward spiral of physical, mental and spiritual decay. Contact, phone calls conversations, anything you can do to help unravel the root cause of the depression, like challenging the paranoid feelings all help to take power away from the disease.
For the fist time in a long time, I think I see him finally come out of it because he is starting to excercise. I don't know if the drugs helped, perhaps leveled things out and maintained the status quo. They were probably required as on several occasions I was physically attacked by him (and he is a big guy), fortunately for me (and him) I also am a big guy and have trained physical combat for most of my life. I say that because there was a strong responsibility on my part to not hurt him any more than it was required to control and disarm him. You have to realise it's not the person attacking you, it's the disease and for this reason I think that it is also can become contagious (so to speak) who do not have this capability.
I can't say whether the drugs are good or bad (just that there is a lot of them and he takes them e-v-e-r-y--d-a-y) but I do know the drugs have changed his brain chemistry forever, I often wonder if the person I grew up with is still in there, occasionally I see a glimpse. I have studied all I can about depression to learn everything I could to help him and I look forward to reading about other peoples experiences in this discussion. What I learned is that the medications are a commitment for all the people around to be aware that the critical time is when they are coming off the medication and they finally lose their apathy towards self harm, i.e they finally have enough energy to do it, signs that must be watched for if you want someone you care about to actually survive depression.
I also learned that regardless of the drugs there are two core issues that every person who suffers depression will have to face;
1) Rigorous physical excercise is that path back to mental well-being, the sooner the better and something fun and positive that helps self esteem and confidence.
2) The issues that triggered the depression will eventually have to be faced.
I hope one day it will be gone, because I don't want my family member to die from it or with it. I call it the black dog because it chases and hunts you down and occasionally I sense it coming after me, but I fight it and you have to fight it. Perhaps if people who were susceptible to depression were made to excercise it would disappear, but then the drug companies wouldn't get to sell all that expensive medication and I definitely think it is a factor in the diagnosis of this modern curse. I also think that good spinal care is a factor as I also noticed an improvement in his demeanor when this was done. Additionally I think that depression is a natural consequence to some overload of emotional stress, alas IANAP, that triggers a change to the brain chemistry.
I suspect the Metalica song Until it sleeps was written about depression as it aptly describes what is truly the modern plague of our time.
My ism, it's full of beliefs.
I think part of the problem is, these pills are being used as permanent fixes for depression. They are not happy pills, they are 'anti sad' pills. Taking anti-depressants is not like taking insulin, you do not need to be on them for the rest of your life. They are a crutch to be combined with cognitive therapy, they get you on your feet just enough to respond to other forms of therapy. When you are ready, you go off the meds, and stay with the shrink for a while. Learn your triggers, learn how to adjust your thought patterns, learn to avoid that deep black hole. The pills will not get you out of that hole, but they will turn your head upwards, and let you see the light.
Unfortunately, the pharmaceuticals have discovered there is a huge land of money in marketing these pills as life long necessities. There is almost no one with a chronic case of depression, given proper treatment, that cannot recover. The pills aren't even designed for long term consumption. No one ever stays on one pill for long, the side effects become unbearable, or you get used to the positive effects, and your doctor recommends a new one. Each switch brings a new painful cycle, because none of them work at all until they "build up in your system." This article makes me wonder if they do anything good, except of course "headache, nausea, fatigue, sexual side effects, oily discharge and vomiting."
And WTF is oily discharge?
--Nuintari
slashdot : where an opinion can be wrong.
Then it isn't a chemical imbalance. There is a difference between being unhappy and being depressed. I know that many times when I am in the grips of it, I wish I could actually feel unhappy. It's more like a fog, a lead blanket, a loss of engagement with life. A positive attitude could help, but how do you do that? "Just decide to" isn't the answer. Exercising can help, lots of things can help, but how do you decide to do those things, and then actually do them? If you have an answer, I'd love to hear it.
But I've heard people like you all my life. The "Buck up little camper," the "Just snap out of it," the "Oh stop whining," you know you aren't doing it for me. The fact that I am depressed makes you uncomfortable, maybe even challenges your ideas about the self and free will, and you just want me to shut up and go away. You don't really care if I get over it or not. At least that's what most people who talk your talk are actually like, who knows, maybe you are different. But I doubt it.
- None can love freedom heartily, but good men; the rest love not freedom, but license. -- John Milton
someone mod this up?!?
I've long wonder whether anti-depressants actually trigger suicidal thoughts or if the higher suicide rate among takers of anti-depressants is simply a function of the sample (depressed people are more likely to commit suicide).
I scream. You scream. I assume that means we're both acquainted with the problem. We proceed.
People are moody, it's part of the human condition. How a survey is answered one day might be different from another based on what the patient thinks the researcher wants to hear, or how they want to appear, or what they had for breakfast. I know there is a whole huge field of clinical researchers and statisticians who will tell me these factors can be minimized, but I'm not sure how much I believe them.
Obviously some drugs work, and it's a pretty good bet that some probably don't. I suspect most work to some degree, and that all of them have an element of placebo effect to them. I don't have a better solution of how to test, and short of somehow allowing someone else to magically live in your head, I'm not sure there is one. Ultimately, this is one data point, and I don't think we can conclude much other than "hmm, that's interesting, let's see if other studies also trend this way"
For the past 4 years or so, it's been impossible for me to focus on anything. I've had a couple pretty simple programming projects I've been wanting to do and all I have to show for it are some mockups on how I'd do it and some makefiles. I was talking with a friend who suggested that I might be depressed. Outside of being really happy, a lot of the symptoms I see online for depression I have.
/. again)? What did you do to change it?
I guess I'm posting because even if I did have it I wouldn't want to take medicine for it, I'd much rather not be pumping my brain with chemicals for the rest of my life. Is anyone else ridiculously easy to get distracted (damnit, I'm on
-Bucky
"A few days after I'd quit the pills cold turkey"
Just a note - whether or not you think your pills are helping you, don't try this. It's extremely dangerous with most medications. I'm not posting to berate the Parent, just letting others know that it's a really bad practice that can lead to serious consequences with a lot of these drugs.
...craniectomy!
Depression is actually my most prevalent symptom; I was depressed for most of my life before I was diagnosed.
I've taken quite a few different antidepressants. Paxil, which is one of the Selective Serotonin Reuptake Inhibitors, did nothing whatsoever for me - this despite drug company hype that the SSRIs are more effective than the older, non-selective serotonin reuptake inhibitors.
Paxil is (or at least was at the time) a patented, name-brand drug, and therefore expensive.
Ironically, imipramine, whose patent expired decades ago and is available quite inexpensively, works just great for me. I think imipramine is the best thing since sliced bread.
Now, don't take this to mean that Paxil won't work for you. But psychiatric medication is very tricky; some works on some people and not on others. Really the best you and your doctor can do is try different medications until you find one that works. But you should definitely try the full range of available medicines, including the older, generic ones, and not just the name-brand patented ones.
Request your free CD of my piano music.
For many suffering from medical depression, a key criteria for effective treatment with antidepressants is that -- duh -- you have to use stuff that works. Patients will try one drug after another before settling on something that works, for as long as that one works. Those that don't work? Besides being ineffective at treating the symptom, they also add a bunch of unpleasant side-effects. You won't exactly be feeling cheery using the wrong medication: you'd likely feel even more depressed.
That's the problem I have with this study: they don't address the fact that meaningful use of antidepressants only comes from selective use of the *right* antidepressants for each patient. Of course, selective sampling is exactly what statistical methods try to avoid. In fact, this study explicitly states that they include *unsuccessful* trials. Throwing all cases together like this may be statistically valid, but does not address the efficacy of *correct* use of antidepressants.
In short, this study does not enable us to come to conclusions that matter.
now what do I TAKE to help me cope?
This sig donated to Pater. Long live
I simply can't agree with these conclusions. I'm on fairly low/medium doses of Sertraline, and I have *often* found myself feeling down, starting a depressive slide, only to realize I'd missed my dose for two or three days. I have *never* started to slip into a depressed state and found that I *have* taken my meds. It's only my observations, true, but it argues strongly AGAINST the placebo effect.
The preceding comment is my own, and in no way construes an opinon of the Emperor of Mankind.
Now that this has been published, the placebo effect won't work anymore. These drug companies went through all that effort just to build up the placebo effect, and you go ahead and ruin it. Gee, thanks. Bloody do-gooder.
Cue an anonymous poster presenting clear evidence that Scientology thought up and funded this "study" of these psychiatric drugs...
Fascism trolls keeping me up every night. When I starts a preachin', he HITS ME WITH HIS REICH!
According to my network news, any time someone goes off their meds a lot of innocent people get shot.
Maybe someone should do a study on that.
The Church of Scientology.
Now, stop jumping on my couch!
"Flyin' in just a sweet place,
Never been known to fail..."
This is very, very important. You can do long and lasting damage by quitting antidepressant medication cold turkey.
I suffered from severe panic attacks / anxiety disorder before going on the Efexor AD. Boy did that drug work for me. From basically thinking that I would have to spend the rest of my life at home sedated by Sobril and the like I am now a functioning member of society. I take care of my son and have a good job and I can handle most anything life throws at me. I tried going off the drug half a year ago. That was a wierd experience. I first started noticing it when I would get random "electric jolts" going through my body. Then the panic attacks returned (for me its the caveman fight-flee reflex firing off for no reason). I am very happy to be back on the drug. Oh yeah, and I went to cognitive therapy, but the drugs are far more effective.
Have a look at Peter Kramer's Against Depression first of all, for a clinician's observations of SSRI's in real use.
Then notice this is one of those meta-studies, where someone uses a collection of other studies to try and draw a conclusion. At this point, the statistics are getting pretty hairy, and there's a real problem with selection effects: what studies are being used? Did they have the same criteria? How are the criteria normalized?
The answers usually are: "the ones the author could get access to data for"; "no"; and "badly".
The result is that these studies, more even that usual, tend to confirm whatever the authors believed in the first place.
If you think about it in computer-science terms, you can think of this as an information-theoretic problem: there cannot be more bits in the output of the study than there were in the inputs, and necessarily the study introduces noise. Here we have a metastudy that has as input some strong positive results, and some null-hypothesis results (ie, "no better than placebo"). The result is "only weakly better than the placebo."
Surprise.
Smoking pot works better than placebo for me.
One study. Not reproduced. That isn't science. It is more likely to be due to talk-therapists wanting to keep their jobs, since so many other studies show that they do work, powerfully, and that talk-therapy -lengthens- recovery time by about 50%. . .
I've found that taking MDMA (extacy) about every 3-4 months helps me stave off any depression.
I know a few depressed people and a couple bipolar people, and I also know the clinical definition of "depression", and boy, having "lots of hobbies" and doing "many different things" does not fucking compute.
Depressed people have trouble enjoying things that they used to find enjoyable -- that includes hobby --, that's the god damned definition. They also have trouble getting things done, that's the god damned definition too.
Ergo, if you enjoy lots of hobbies and do lots of stuff -- you're probably not depressed! Very depressed people can't get out of the bed, for fuck's sake.
This is like reporting that canes and walkers don't actually help most people move faster than they would without them.
Duh.
My blog: http://www.seebs.net/log/ --- My iPhone/iPad app: http://www.seebs.net/seebsfrac/
and letting me think that a religious group is behind this study? (nothing against religion -just throwing the obvious out there)
Different people have different metabolisms. Depression is not only caused by insufficient active serortonin, it is also caused by insufficient dopamine and insufficient norepinephrine and occasionally other neurotransmitters. Too many medical doctors have erroneous views from outdated medical school classes in their past. 1) people are genetically different, have different metabolisms and this affects the processing of various medications, including SSRIs, dopamine medications and norepinephrine medications. 2) this also means that people respond differently to different SSRIs. An endocrinologist friend of mine told me that SSRIs will affect a whole host of neurotransmitter and other biological systems, differently from each other. It just isn't that simple, and the body is not a simple black box.
Studies don't get published for a number of reasons. Perhaps they were quashed by the pharmaceutical interests, but perhaps they were not published because they were poorly run, suffered from an experimental bias, because they failed to actually demonstrate anything, or because they would never pass the scrutiny of peer review.
And, who funded this meta analysis? What biases do they have? There are a variety of groups that are morally or religiously opposed to psycho-pharmaceuticals, and many of those are no more hesitant than the pharmaceutical interests to manipulate data and the scientific publishing process to support their view.
(a meta-analysis is where instead of doing lab work, someone tries to assemble some literature on the issue, and plays with the numbers to make it work together, even though the original studies are often performed in very different ways and looking at very different results.)
Long story short? Big grain of salt recommended.
More Caffeine. NOW
Posters here never cease to amaze me. When I read the summary I was preparing for the worst, "scientological" comments from ignorant children for some reason (sorry I doubted). I made a choice to do without years ago and struggled to realize depression was reality, a storm with a beginning, middle and end, a shallow or deep river to be crossed. Newton's 2nd Law of Motion (for the depression, what goes down must come up), and the movie A Beautiful Mind (for the mania, to recognize the irrational and ignore it), did more for me than reuptake inhibitors, but I never questioned their necessity for those who have trouble seeing brain states for what they are, who it may not occur to to try and step out of themselves to see themselves from above, and adjust behavior accordingly (because, even if we must take responsibility for how we feel, whether caused by external or internal conditions, that's all we can control, what we do and say). Its said 'misery loves company,' and I have to slightly shamefully admit I am happier to realize I am not alone. Thank you slashdot posters for being empathic, contemplative and intelligent, but most of all for not being like posters at Digg (re: TOS: And the Children Shall Lead).
The Admin and the Engineer
MDs need to know this stuff, many do not. Journalists don't even begin to have a clue. Who funded the study? Qui buono? Where are the replicating studies? Was the methodology valid?
#1 Most important thing that NEEDS to be said about SSRI's: DO NOT QUIT THEM COLD TURKEY!
Many people have some fairly serious side effects - dizziness, nausea, sleeplessness, "buzzing" sensations inside the head, and these side effects can last anywhere from a week to YEARS - so it is important to consult your doctor, and get off them slowly. The most serious side-effect (coupled with the sleeplessness) is SEVERE IRRITABILITY. People with no violent tendencies have been known to react with violence, to normal, everyday frustrations.
#2: sure, they're prescribed in many cases where they don't need to be - that does not mean they don't "work" - they'll have some effect. They are powerful drugs. They can mask all sorts of neurotic and anxiety-related symptoms and syndromes. But people with Compulsions and related disorders may still act out in other ways, because those anxieties and feelings are still there, just suppressed. These drugs can be great tools for getting someone with a severe anxiety issue to "come out of their shell" to get therapy, or other help. But they should NEVER be used for long-term treatment of an anxiety disorder - ESPECIALLY anger-management issues. (which is a very popular usage, and VERY DANGEROUS - in fact, I'd say it constitutes a negligent public health threat). People with these kinds of disorders need to learn cognitive tools to manage their thoughts and feelings. Taking a drug to suppress them is NOT a constructive way to deal with this problem.
#3: I'm sure they work just fine for severely depressed people. That's what this study shows. That's not the point.
The point is: They've been prescribed way too often for inappropriate purposes, by doctors who have no idea what they are or how they work, as a means for them to quickly treat a symptom for which they are not qualified to treat, and for which they otherwise would not get paid to treat; or quite possibly - they might otherwise not be able to get treated AT ALL - given the way insurance companies throw up a bureaucratic wall of red-tape for any referral, or REAL handling of a patient's problem..
This is a direct result of the structure of our national health care system: from our drug-patents, our insurance regulations and loopholes, and the way they force doctors into making treatment choices that are not the best for their patients. The end result is tens, even hundreds of thousands of patients who are now on long-term regimes of dangerous mind-altering drugs they should not be on - risking these severe withdraw symptoms, AND, paying elevated, patent-protected prices for drugs, which is sucking the life-blood out of our struggling national economy. (as companies struggle to provide health insurance for working employees!)
These are my friends, See how they glisten. See this one shine, how he smiles in the light.
Here's where I'm confused - the original studies showed a difference between placebo or they wouldn't have been approved in the first place by USDA. Now somebody's coming and 'meta-analyzing' and saying "Nope, there's no difference between placebo and the anti-depressant in moderate cases". I might buy that anti-depressants are over prescribed, but not this guy's analysis of these studies.
My own personal experience is that depression is best explained as a SINE wave with the x-axis being time and the y-axis being happiness. Let's say most normal people average out at zero happiness (a neutral state) with an upper max of three and a lower minimum of negative three. My own personal 'zero line' is probably negative four without medical intervention. With medication, my 'zero line' is artificially raised to roughly negative one. With medication the lows are 'higher' and the highs are 'lower'
My own depression started with my divorce but there has been a family history of it, specifically a sibling. I worked through the divorce and moved on with my life both professionally and personally. And I've had a few times where a drug interaction has turned my medication off. So I've discovered I can't go off my meds or I'll return to full clinical depression as opposed to being on 'maintenance'.
I don't buy this guy's meta-analysis - I don't see the FDA approving a drug that's a placebo. I think he's padding his language with phrases like "most severe" cases - but then again, it's not like we can point to depression or measure it on a scale. (ZOMG, this one goes to ELEVEN!)
As one of the comments to TFA notes, one problem with the studies reviewed is that the trials may not have been long enough to detect differences. They were mostly 6 week trials, with a few shorter and a few longer. That may not be long enough to pick up a significant difference. The effects for some can peak between 6-8 weeks. Disclaimer: I am a psychologist.
What you are talking about is not clinical depression. It is neurosis. Neurosis is very treatable with talk therapy alone, but is often helped by anti-anxiety medications as well.
- None can love freedom heartily, but good men; the rest love not freedom, but license. -- John Milton
"Studies" like this make me sick. There's mountains of evidence -- MOUNTAINS -- that antidepressants PLUS "talk therapy" is the best combination to deal with clinical depression.
Anyone who does not believe that antidepressants are required for those who need them need to get their own heads examined. There are fundamental biological and even physical differences (size of the hippocampus, for example) between clinically depressed and "normal" people. There are demonstrated effects that antidepressants assist in generating the necessary chemicals needed for these people to survive. If they don't get the right treatment -- talk therapy and/or medication -- they can die (suicide).
I was originally hesitant when I was first offered antidepressants. I viewed this as my mind "failing" (as an issue with the mind, you think you can tackle it through thought). A family member made it very clear to me the folly in my thoughts (which, coincidently, is a symptom of depression -- illogical thought patterns). "If you had to take insulin, would you avoid it because you felt 'you didn't need it'? If you had to take blood pressure medication would you do that?" The answer, for most reasonable people, is no.
...I can comfortably say that antidepressants aren't all that.
This is not to say that they have no effect, though.
The way that an antidepressant works (from the point of view of someone that isn't a chemist/biologist/pharmacist) is that it's much like a compression filter: it chops off the bottom end and the top end of emotional response. The purpose of them is not to 'make you happy' - that would cause a mass addiction problem, I reckon. They take you out of the horrific depths of depression, be it suicidal or not, and give you enough breathing space to gain some perspective.
There are people who cannot cope without antidepressants. Most of us (depressives, that is) can survive without them, though, once we've managed to level ourselves out a bit. I personally found them to be pretty hard work: anything that messes with your brain chemistry tends to have other results, too: I became prone to very short bursts of high activity, with long, long periods of lethargy and listlessness. Think stoned but jittery, with moments of sharp and fast clarity.
The important thing to remember is that there is a vast difference between mild depression, and very serious depression. Serious depression will stay with you for your entire life, while mild depression is more transitory. It hits you hard, regardless of whether it's 'mild' or not, but it's less likely to come back in any significant capacity if it's milder depression.
Don't forget that by muting the depths of depression, you can actually benefit a lot with the alleviation of many of the other associated problems. I found that my horrific insomnia (as in 1-2 hours of real sleep a night, tops) started to ease, purely because my mind wasn't working overtime on considering and worrying about my problems. That proved to be enough to help me start to fix myself, which is, I believe, the real purpose of antidepressants. Despite my doctor's belief that they're some kind of magic bullet...
http://xkcd.com/313/
It's just a touch disheartening to read this study telling me that I've been paying out the anus for antidepressants for months when I could have just been eating sugar pills. That's fantastic. All this just makes me want to take a lead pill, if you get my meaning. But no, instead I'm going to go for a 2 mile walk, which was also prescribed by my doctor because it will raise my seratonin levels... but will it really? Or am I just going to think that my seratonin levels are rising and it is actually making some kind of a difference in the whacked out way my brain operates? I wonder what Darwin would think of depression, it seems rather incongruous with "survival of the fittest" to be pumping all us clinically depressed folks full of drugs (that may or may not actually be doing anything!) and encouraging us to go on living, and one day pass on our genes. Well, I'm sure the pharmaceutical companies are happy about that, anyways. Keep crankin' out those depressed folks, and we'll keep thinking up fancy names for our expensive placebos!
Why are they unpublished? Sure the first thought may be to "because they didn't have the outcome the sponsor wanted", but I bet a large number of them were unpublished because the results were weird and it was soon found that a control variable was messed up, or they were inadvertently found to be testing a variable they didn't anticipate, etc.
Though the fact that this guy is very anti-psychiatry makes the whole thing suspect anyway.
This result; that is there is no clinically significant effect except on those with severe depression obviously indicates that these drugs are very over-prescribed. Since they are generally addictive and have strong side effects, it means to me that there is behavior on the part of their proponents and prescribers that at least rises to a highly unethical level and possibly to the level of criminality.
drugs are bad, mmmmmm kaaaaaaayyy.
Try reading the hardest book I have ever picked up.
"The Art of Happiness"
Really, really hard for me to read. That is because I keep stopping and wrestling with the concepts, observations and ideas presented in the book.
It has definitely made me happier, more willing to stop and see the "big picture" (whatever that is).
The greatest impact this book has had on me has been to accept other people as viable human beings, with faults and problems, and to see we are all really just trying to be happy.
Oh, yeah, the placebos show that almost all of us have the power within ourselves to change the way we think, feel and respond.
- I live the greatest adventure anyone could possibly desire. - Tosk the Hunted
The methodology used to conclude that antidepressants are not significantly more effective than placebos is based on comparative HRSD scores (a 21 question survey designed to assess things like insomnia, feelings of suicide, sexual response, etc).
Reading through the report, I feel the methodology used is flawed, as only aggregate HRSD scores are reported. Since SSRIs often cause physiological effects not present in placebos like headache (one of the HRSD metrics), significantly decreased libidio (another), and possible changes to sleep patterns (yet another), it may well be that certain HRSD metrics were lowered, while others were signficantly improved. This paper does not address this possibility. I make no other observation other than raising doubt on the conclusions these researchers came to.
sloth jr
I'm not sure I would agree with that, but I would......
Could you give something, doc?
The class of antidepressants discussed in the article (SSRIs) are also prescribed for conditions other than depression. They are also indicated to treat OCD, anxiety disorders, and even chronic pain. TFA only looks at how SSRIs treat depression. That's yet another way in which the headline is misleading.
Was this study done by scientologists? clinical depression != unhappiness
I've always said that just because you can treat it doesn't make it a disease...as someone with both a personal and long family history of depression, I've always said it was just the same as those damned annoying people who are always happy - for some reason nobody ever tried to say _that_ was a disease...but I guess I was wrong. You _can't_ really treat it. Well, I mean, obviously you can, just not through drugs and surgery.
Isn't it weird that this story has received major coverage in the British press and next to none in the American press? Was it the timing of the release? Is it that the British press understands statistics better than the American press? Vice-versa? Or does the British press have more respect for its readership than the American press has? Or is it related to the fact that Prozac was created by an American company? All in all, the difference in availability of this news in newspapers of the different countries is fairly astonishing. I take an SSRI and it seems to work for me, but I'm willing to accept that a placebo would have worked as well. I wish publication of meta-analyses like this one, including unpublished as well as published results, was required by US law.
If a drug's user could tell whether it was the placebo effect or not, we wouldn't need double-blind clinical trials. It's not "autosuggestion"; it affects your body chemistry identically to a real drug.
I have suffered from two periods of depression in my life... both were diagnosed as "adjustment disorder", and occurred after the painful breakup of long term relationships. I know what you're thinking... a slashdot poster who's been with a woman, OMG NFW... but hear me out.
The realization that the depression was hitting a dangerous level only occurred a week, or even weeks, after the event that initially triggered it. I experienced the "self-fulfilling downward spiral" that some people mentioned, where I stewed and pined in my inability to force change on certain aspects of my life... until I did the responsible thing and saw a doctor. They were quick to prescribe me with Welbutrin in the first instance, and Paxil for the second. I went to counseling during these periods of medication... each time I was done with the medicine and the counseling within 3 months. But it wasn't the medicine or the counseling that changed me, it was my own determination to not live like that any more.
By the end of these medication periods, I could feel a difference, and it was clear the medicine was not necessary any longer. But it definitely helped to "numb the pain" so that I could deal with broader issues, like other posters have suggested. It allowed me to realize that the source of my pain was not the particular girls that I had lost, but it was my own personal emptiness and lack of identity... my extreme dependence on others, when not satisfied, that caused these feelings. When you depend greatly on other people, but are too down to even leave the house, it can get out of control quickly. When your mind races, replaying memories and considering countless "what-ifs", even sleeping can become a difficult proposition.
The first time wasn't as big of a life changing experience, but the second time, I realized that I needed to forget about everything else and figure out who I am, what is unique about me, what makes me happy without relying on anybody other than myself, etc. I realized that no matter what happened, my family would always be there to the end. I also realized that my diet at the time was not equipping my brain/body with the proper nutrients to perform at its best. I improved my relationship with my family members (who were very supportive), I began exercising, eating healthy, and supplimenting my diet accordingly, I accepted myself for who I am, and I took control of my life. I actually broke all my habits and routines and reconstructed my life. It took a lot of discipline, but I was determined.
This was 4-5 years ago, and I can honestly say that I've felt emotionally invincible since then. My awareness of my actions and my feelings has improved greatly, I've committed myself to several productive hobbies, and since then have had quite a few happy relationships, with minimal sadness occurring at the breakups. Note that this was different from the pattern of depression. Sadness is only short-lived. This isn't to say that I don't experience my ups and downs, but the downs never last more than they're supposed to because I know I can count on myself and the things I know to be true.
It's kinda funny how it took hitting an emotional bottom to really discover what I had to do in life to be truly happy.
Now I look back and laugh at myself for even sweating those chicks.
Move all sig!
It's interesting. Basically, people with the short form of the seratonin synthesis gene are prone to depression, if they have a traumatic triggering event or events at the right stage of their development. The researcher who did the experiment tested herself and found she had the short form, but had not experienced any major trauma growing up, and so wasn't herself prone to depression.
By chemical imbalance I mean, "Unable to properly synthesize enough seratonin for normal functioning." The thing that medication does, for those suffering from real, clinical depression, is it lets us get over the hurdle of, "How do we motivate ourselves to do thing things we know will help get us out of it?" I mean, that's the real killer. You know what to do to get yourself out, you just don't have the motivation to do it, even knowing it will help. The medication lets us engage that motivation enough to get out of it.
That's the thing this study doesn't take into account. You need to do more than just take the pills, they only kick-start the process.
- None can love freedom heartily, but good men; the rest love not freedom, but license. -- John Milton
I'd withhold judgment until there is more research. Some common sense:
(a) Prozac has been with us for some 30+ years; if it did absolutely nothing, I'd think some news would come to light before this.
(b) I've known several people with depression, anxiety, and manic-depression, and I've *seen* the difference. One time the pharmacy got a mix-up and gave one person the wrong pills - they were taking them for a week before the error was discovered. Symptoms *did* return, and the person was mystified as to why.
(c) Most anti-depressants fall under the category of "SRI" - serotonin reuptake inhibitors. Have you ever taken one of these yourself? I've tried several kinds, both out of curiosity and to determine side effects. Some of them are powerful enough to keep you in bed all day with the shakes. Definitely not something that happens with a sugar pill.
I know the word of an AC counts for squat around here, but it's posted for your consideration anyway.
Sounds like the grandparent post hit a little too close to home for somebody.
I think you're wildly overestimating how much anyone cares about your medical history, or, for that matter, what think about anything.
This story is depressing, and the comments relating to it are more so.
I agree absolutely. But I'd suggest that in that example, they were probably mis-diagnosed. One of the criteria for clinical depression is that there hasn't been any major upsets like getting dumped or a parent dying or losing your job or something.
I think it was in 'reason' magazine, there was an article about the over-diagnosis of depression that was titled something like "Is Tony Soprano Depressed?".
I think a lot of the confusion is that people who are not _truly_ depressed are being treated as if they were (i.e., whip out the prescription pad!), even if they're not formally given the diagnosis of depression.
There was a study done back when they'd put electrodes in your brain, where you apply the electrodes to this part, the person smells something funny, put the electrodes somewhere else, they feel cold, etc, where they discovered that they could stimulate a part of the brain and make people laugh. Some psychologists did a study where they'd stimulate that 'laugh center' and then they'd ask the subject, "why did you laugh just now?".
Almost nobody said "Y'know, I really don't know, I just laughed, I guess", almost all subjects would say something like "well, they way that doctor's wearing his lab coat, he's so funny!"
The point is, if you have a brain state change, one tends to attribute a _cause_ to it, and if one isn't there, then people will use their imagination to fill in the blanks.
So maybe you really did just 'choose to be happy', but maybe you had a change in your brain state due to an unknown/hidden factor, and you attributed a cause to it.
If it was that easy to just figure out that "happiness is a choice", then everybody would do it.
The plural form of "anecdote" is "anecdotes", not "evidence".
Respectfully, unless you've been conducting top-secret research about the brain that you haven't shared with the rest of the world, you can't possibly know that.
The sopranos is a great example, actually, of somebody who isn't actually depressed, but has been mis-diagnosed as such. A major depressive episode doesn't look like anything depicted on 'the sopranos'. If you think Tony Soprano is depressed, then you haven't read the DSM-IV diagnostic criteria.
Having lived with two different women at times with serious clinical depression I can tell you it looks nothing like Tony Soprano. Unless I missed the episode where Tony spend 3 or 4 days crying and unable/unwilling to get out of bed except to go to the bathroom. Depression is utterly crippling, when someone's in a depressive episode, and it defies any attempt at treatment.
I agree completely that drug companies want to make everybody take a pill every time they feel a little bit blue 'cause they lost their job, but if you think you can 'think your way out of depression' then you have never seen a real life example.
If you'd ever seen anybody in the midst of a depressive episode, then you wouldn't say they chose that, any more than you'd say somebody with cancer chose to get sick.
The plural form of "anecdote" is "anecdotes", not "evidence".
Damn. Every time one of these studies is posted, my brother (diagnosed as bipolar, aka "manic depressive", about 15 years ago) decides to go off his damn meds, ultimately resulting in his hospitalization. This subsequently results in my missing several days of work while I clean up the mess he's left behind. Once his meds are balanced again, all is right with the world once more.
A couple of notes for the blissfully uninformed slashdot crowd:
* Depressed != unhappy. People who are clinically depressed do not "choose" to be depressed; they simply are. Saying that someone who is clinically depressed should "get over themselves" is as offensive as telling a cancer patient that it's all in their head.
* Clinical depression oftentimes has no root cause. No triggering event. No loss, grief, death in family, etc. In these cases, analysis/counselling alone provides little benefit. Counselling can help a person learn to deal with their depression, but it won't help folks in this position.
* Exercise is not the ultimate solution. My brother trains for and runs marathons. He's probably in better shape than a majority of slashdot readers. It's the medication that helps him lead a normal life.
* For the love of god, if you're taking antidepressants, don't stop taking them suddenly! If you want to stop taking them, work with your doctor to taper off. These drugs alter your brain chemistry in subtle and not-so-subtle ways; stopping them suddenly can have horrible side effects (including possible psychotic break and suicidal episodes).
There is an extremely common pattern of behavior among patients who take psychiatric drugs: the drugs make them feel more balanced. They feel more or less normal for a period of time, forgetting the initial symptoms that made them start taking the drug in the first place. So they stop; maybe they don't like the side effects, maybe they just don't think they need them any more.
I'm not at all arguing the fact that these drugs are over-prescribed; they most certainly are. Most people taking them probably don't need them. Taking an antidepressant when you're sad is akin to taking percocet for a headache; completely inappropriate under the circumstances. I'm not a doctor, nor do I play one on TV; I've just got a wacky brother for whom these medications are extremely effective.
"[Sertraline's] half-life in the body is 13-45 hours and is about 1.5 times longer in women (32 hours) than in men (22 hours)"
(determining the source of this quote is left as an exercise for the reader *g*)
It would seem like this could easily lead to withdrawals after 2 days. You're probably thinking of fluoxetine, which does have a very long half-life.
Medium cat is MEDIUM.
A proper double-blind study in such cases will use "active placebos", which are placebos that attempt to mimic the drug's side-effects well enough that neither the patient nor their doctor can tell from the side-effects alone whether the patient has gotten the real drug or the placebo.
Unfortunately they're not used that often, partly because it significantly increases the expense of the study to develop and use an active placebo, and partly because it makes it less likely that the study will show a positive outcome.
10 PRINT CHR$(205.5+RND(1)); : GOTO 10
I know a number of other people whose lives were saved by Prozac and Wellbutrin.
Since when was Slashdot in the business of spreading Scientologist propaganda?
"It is our blasphemy which has made us great, and will sustain us, and which the gods secretly admire in us." - Zelazny
Almost nobody said "Y'know, I really don't know, I just laughed, I guess", almost all subjects would say something like "well, they way that doctor's wearing his lab coat, he's so funny!" Hmm,odd. Wouldn't they kinda suspect that it may have something to do with these electrodes stuck up their brain?
Medium cat is MEDIUM.
The posts should read "SOME Anti-depressants..." and "SOME people". TFA referenced is similarly titled misleadingly. Within TFA, they state they studied four drugs (out of dozens used for the same problem). It is absolutely no surprise that some people don't respond to SSRIs. Doctors are well aware some people require different kinds of medication, and change prescriptions accordingly.
First, about 3% of people are allergic to SSRIs. They suffer "serotonin storm" when they take these. Second, some people have mood swings which look like bipolar but have a different source. Lamotragine and lithium carbonate are effective for these, SSRIs aren't. The later is particularly true for people who, when their swings are stabilized, have a baseline which is significantly higher or lower than "normal". Third, some people have imbalances in other neurotransmitters which cause imbalances in monoamine oxidase, the enzyme that recycles the amine transmitters (dopamine, serotonin, epinephrine and norepinephrine). An example of this is vitiligo, the skin condition that causes patches of albino-like skin. What doesn't turn into melanin (skin pigment) turns into epinephrine and norepinephrine, sometimes several times the normal amount. The body then produces an equivalent amount of MAO to cope with this over-productions. But the same MAO degrades the relatively normal amount of dopamine and serotonin, producing symptoms similar to (respectively) Parkinson's and depression. Dopaminergic drugs (ie. L-DOPA) and serotinergic drugs (SSRIs) don't work for these. MAO inhibitors won't either because they leave the epinephrine and norepinephrine too high (in the body rather that the brain, these are known as arenalin and noradrenalin; you can guess the potential problem here).
Very few people actually have a biologically based shortage of serotonin production, for which SSRIs are designed. More, but by no means a majority have such a temporary (though chronic and self-reinforcing) imbalance due to being situationally depressed resulting in such and imbalance. For those, and for the far more people have imbalances of other types, or simply situational depression it is the situation that needs changed, not the neurotransmitters. There are also those who have suffered a lesion or other brain dysfunction in either the areas that produce or react to serotonin. SSRIs can't possibly correct these problems.
This story is no more surprising than one that finds that the four most used antibiotics are often not effective. These too are specialized for certain things. When they don't work, others are used. The old stand-by sulfa is still used when the newer antibiotics aren't effective.
In any case SSRIs are not intended to "cure" depression except in those few who actually have a biological and reversible deficiency in serotonin production or reception/reaction. In most people they are intended to ameliorate the symptoms so the person can have the ability to work on the situational cause of the depression. Without doing the latter the former is a waste of time and the depression will continue.
Finally, there are people with chronic diseases such as cancer, Parkinson's, or organic brain damage such as post-stroke lesions with brain dysfunction which makes them understandably depressed. As long as the disease continues they will continue to be depressed, and no amount of SSRI will change that.
Despite all these, SSRIs are the first drugs tried for depression. If they don't work, as is frequently the case, psychiatrists are accustom to trying different classes of drugs. If they determine the causes is another reason such as those noted, they won't even start with SSRIs.
TFA looks like something significant, and potentially cases of misdiagnosis or misprescription, except to those who actually treat the conditions for which these drugsare sometimes used. Those who treat are completely familiar with the ideas presented, and much more besides. About the only use for TFA is to tell the public that if they're taking S
"I may be synthetic, but I'm not stupid." -- Bishop 341-B
I was in a period in my life where I was alone, didn't seem to have any real friends, let alone a girlfriend, was a barfly every night.. hated my life for the most part.. what happened was that my brother took a course in school, and they made him read this book "Psycho-Cybernetics" (nothing to do with Scientology) as part of the course.. he left it and some other crap at my house one day, and I was bored and read a good part of it.. This is where I read of "choosing to be happy".. It's a simple concept I know, but here is basically the gist of it..
Most people think.. If I had this car, or job, or money, or girlfriend (etc.. etc..) THEN I will be happy.. but being an unhappy person is most likely keeping you from getting these things that supposedly will suddenly make you happy.. Who wants to be around (or hire) an unhappy person ? ,,, Happiness IS a state of mind (other than chemical imbalance).. So you choose to be happy first.. then when you do get the job/car/girlfriend it is like gravy on top of the happiness.
As I said, it's a simple concept,, and will not work for people with serious chemical problems.. but if you think about it, it makes sense.. Perhaps it works for me, because I want it to.. or maybe something else as you say changed in my brain.. who knows.. all I know is I changed myself from wanting happiness to being happy, and everything else that comes is just extra... I have been through some serious crap in my life since, I've had some bad, and a lot of good too.. and I've always remembered reading that, and that's the way I choose to be.
waiting for ad.doubleclick.net
> In what way is depression *not* all in your head?
One needs to be careful with the expression "in your head" because not everyone will understand the same thing when you say it that way.
Let me give you an example. Suppose your computer acts weird, and you take it in for diagnostics. You are told the problem occurs in the CPU (versus hard drive, graphics card etc.). However there are still significant differences between a hardware or a software error.
I just want to make sure you are aware that depression is *not* considered to be a 'software' error. You cannot fix it by 'rebooting with a clean disk'. It is a hardware error manifested with chemical changes in your brain which were not known to be reversible by meditation, will power etc. (for every patient at least). These factors were assumed to affect the speed of your recovery, but the consesus until now was that counteracting the chemical imbalance may be necessary to start the healing.
Now these findings indicate that the belief that the patient will get better has more effect than previously thought, maybe that is the only thing that is at work.
If you meant to say that: 'You see I told you so, it is in their thoughts only!', then however arrogant that may sound to researchers in the field, you may actually turn out to be right. But I would take a closer look at these studies first, there could be many reasons why they were not out in the open until now.
That's the funny thing about this kind of research. I've read about the same thing when researchers stimulate other parts of the4 brain. People really, really want to believe their impulses come from the self. The fact that someone can inject impulses into their brain creates cognitive dissonance. In order to maintain their sense of self, they have to internalize the impulse, even if they know it came from a wire.
- None can love freedom heartily, but good men; the rest love not freedom, but license. -- John Milton
It is no great discovery at all that chemical substances can affect cognition and affect. There are many perfectly ordinary examples: e.g., alcohol, marijuana. But from your experience of this at the hand of various prescription drugs, you're jumping to the conclusion that just because drugs are sufficient to provoke such effects, that they are therefore >necessary for such effects to happen, and therefore, that "depression" is "a chemical imbalance in the brain."
...quite depressing. :)
Long before there were SSRI's there were medications that were effective in addressing major clinical depression. They were largely disregarded once the SSRI's were released as the side effects were supposed to be greatly reduced with the advent of SSRI's.
The study discussed is targeting SSRI's that are, for the most part, fairly similar, thus they are all categorized under the SSRI umbrella.
Anyone who doubts the existence of major clinical depression (MCD) has never experienced it. Can it be treated without any medication at all? Is exercise and a good diet (definition of good diet is, of course, dependent on your point of view) enough to "cure" major clinical depression? If one learns and uses cognitive therapy techniques can depression be overcome?
I suspect that MCD has many causes, some simple, others complex. Some people with MCD are going to experience relief with talk therapy. The question is: Does talk therapy last? Or is recurrence almost a certainty? The same question can be asked of the use of medications. If one improves significantly on a medication, maintains that improvement for a term of say 6 months, and then slowly comes off the medication will MCD remain in remission indefinitely?
Studies suggest that those who experience MCD once have a greater chance of it recurring than those who have never experienced it.
I agree whole-heartedly with a post above that suggests one seek the advice of a good psychiatrist if considering medications. A good psychiatrist is one who reads everything he/she can find about the disease. A good psychiatrist is one who is experienced enough to recognize the nuances that suggest which of many neurotransmitters are likely involved in MCD. I don't recall the total number of neurotransmitters that "might" be involved but it's a large number and science only has a finger on the pulse of a handful. Different medications affect different neurotransmitters. If, as I mentioned, the causes of MCD are multiple then it makes sense that trial-and-error with what is available at present is going to be necessary until science finds a way to accurately diagnose cause and effect of MCD. And in 20% of cases they aren't going to find anything that works yet. Finding a psychiatrist who is intimately aquainted with all the known causes of MCD and all the known effects of current medications is the shortest route to whatever relief medication can offer. Such a physician will also offer other, alternative options such as exercise, diet, social support through family and friends, and counseling as needed.
Placebo effect is very real--I agree entirely with that. However, as those who have had to endure endless months on one antidepressant after another while in a state of mind that leaves no room for hope for the future can tell you, the placebo effect is very short lived for those with real MCD.
How to address the placebo effect is an important avenue for science to follow. Theoretically a physician could recommend a vitamin or combination of vitamins, saving the patient a great deal of money, in the hope of invoking the placebo effect. However, word-of-mouth will soon squash that. Anyone reading this knows about snopes.com and search engines and can quickly learn that they are being given a placebo.
To assert and imply that there are no arguments against the chemical basis for depression maybe similar to arguing that chemistry can solve any or all problems in the brain, as if no other models over brain function work.
There are many ways to approach a model on brain function that utilize a framework not based entirely on chemical reactions, but if the mind controls the body, then shouldn't people that are bombarded with negative thoughts or negative outcomes exhibit specific identifiable characteristics that can be tracked and traced over time and therefore be shown to modify whether or not one takes drugs to modify these expressions or not. Couldn't the brain maybe modify the chemical structure alone after repeated exposure to negative emotions or thoughts and defy the model of depression by subverting these processes from overriding the function of the brain?
To believe that brain modification only occurs under specific conditions mostly direct chemical stimulation or inhibition confers too much authority to the chemical model alone. Chemicals are you but you are not chemicals alone, some force acts upon the brain that has eluded science even to this day, I think maybe that explains the function of placebo as well as spontaneous remission in cancer patients. These outcomes defy chemical models by themselves as sole actors and creators of outcomes. There are many books written by educated PHD's and MD's that refute the chemical model acting alone and refute the "imbalance" model as well.
My question maybe more along the lines of how do people whom exhibit depression yet have no verifiable chemical imbalance through the use of modern tools for measurement such as FMRI still fall into a imbalance model? There appears to me at least some major reasearch awaiting funding on why some people don't exhibit the same chemical reactions when placed under observation, why brains can differ to such large measured degrees and why some people that don't measure out at all under the current tools of observation still request and state depression for reasons other than malingering.
Personally, I am growing weary of a chemical based solution for a few reasons.
1. People can behave badly and blame the behavior on a genetic trait out of there ability to control.
2. People can ignore very uncomfotable information and thoughts that have to be accounted for and understood by making their minds unconscious and unaware through drug modification, this especially can be useful to governments for obvious bad purposes.
3. Free will seems to be contradicted through a chemical model theory, without such ability to make the world around you through action why would a person bother to attempt to improve themselves, why would one change or grow if the model only allows for strict chemical adherance to a specific set of chemistry laws.
4. With one model held above all others, that pretty much turns the argument into a finished research, when in fact too many anomalies exist to rule out possible dangers in the use of many of the drugs that are currently offered as harmless, as someone else said "like candy" to people. What are the long term effects of useage and what are the effects of dependency and who benefits from major usage as well as model paradigm control over the reasearch.
5. Where do chemical drugs that are "bad" fit into the brain models, such as non-addictive chemicals such as LSD, etc. Do these drugs simply go into a dustbin due to moral ignorance? Or do we have many studies yet to undertake that are currently being repressed to support more harmful and addictive approaches?
I would encourage anyone in the drug chemical paradigm to consider other fields of research including physics as well as other areas of research in reading materials such as Blaming the brain, or Toxic Psychiatry by Breggin. There are many people that disagree with the current fad over the tools of measurement being capable of representing all of neurological understanding. Another thing to keep in mind maybe the
I know that in a certain Soviet Russia, you take anti-depressants.
(please laugh)
"They said I probly shouldn't fly with just one eye," "I am Bender. Please insert girder."
I heard from a friend of mine (phd philosophy student) about how one of his colleagues had 'hung out his shingle' offering 'philosophical counseling'.
The idea that, if you're not happy, it might have something to do with the way that you see the world, your assumptions about what you want, what makes life meaningful, etc.
Now, I think that sort of thing can help a lot of people, probably. But expecting that to cure somebody from a major depressive episode is like expecting to find a cream or a salve to re-grow a limb, unfortunately.
After living with two different women who had depression, I have times when I feel like the only treatment is quarantine.
The plural form of "anecdote" is "anecdotes", not "evidence".
Well in my case the woman I lived with, put herself in self imposed quarantine from the world (except me).. It was very difficult to live with.. you want to help, but there is nothing you can do that will really help.. and difficult to go to work and try an live your normal life when you know she's at home stuck in a depression often sitting in a dark room thinking about suicide at the worst of times.. the only way it worked, caused me to miss out on a lot of sleep, so that she would be sleeping most of the time I was not actually with her.. I lived for several years on 5 hours or less sleep a night.
waiting for ad.doubleclick.net
I can't help but be reminded of this article:
Pharmaceutical Company Says Its New Anti-Depressant Is 'Worthless And Dumb'
Blancmange
Proper sleep, good Omega3 fishoil and therapy would do wonders to many patients. Sometimes i think depression is a completely natural reaction to totally unmanagable living conditions..
You called him hysterical!
This story is at least two years old. Can't we have new news on a news site?
I don't mean to cause any disrespect to depressed people, I've fought with it myself throughout my life. The way I see it is that you have two very simple choices.
Of course, the drugs will allow the old pathways to continue to be improperly reinforced, and eventually you will have to come off the drugs and use the new patterns you developed and get rid of the old ones.
It's also important to discuss the fact that our system of medicine is drug-driven, and while psychology could be considered on the fringes of medicine, from doctor to doctor you will find a variance in how loyal they are to the drug culture.
Graduate students and most professors are no smarter than undergrads.
They're just older.
A lot of people are told they are depressed and put on antidepressants, even though the scenarios you outline only apply to a minority. For the vast majority of people on these drugs, they are gratuitous, and a distraction from solving the real problems which have to do with controlling negativity as you pointed out.
This is easy for everyone: doctors want to help and this is the fast way, patients want relief and this is the fast way, drug companies want money and this is the fast way. The patient is the pawn in this game and is no further along on their recovery.
Perhaps you need to learn what meta-analysis is.
I wouldn't lose hope. If you read some above comments, I would take this "meta"-paper with a gel-tab of salt.
Atlas Shrugged : Thematic Story
"Rigorous physical excercise is that path back to mental well-being, the sooner the better and something fun and positive that helps self esteem and confidence."
No. I have an irregular heartbeat which is taxing my nervous system and has caused deep depression for nearly all of my life. It's not an uncommon occurrence according to the various psychs and cardiologists I've seen.
I also run, lift weights, bike, hike, and generally enjoy physicality.
It's not as simple as getting physically fit. Sure, working out is a great way to keep your mind and body in a better place than just sitting there, but telling someone with depression that it's as simple as hitting the gym is setting themselves up for even more pain and yourself up for an egg on the face. This is one of the most depressing thing about depression, in my experience and those of acquaintances I know in similar situations : People telling you to cheer up or hit the gym in order to solve your problems really have no clue what they're talking about. Are you in the mood to really ruin the day of someone suffering true depression? Tell them to "cheer up" or hit the gym to solve their ills. This makes it very, very difficult to relate to a great deal of those around you because it simply *has* to be as cut and dry as "getting in shape and keeping occupied". It's not. It simply is not.
I've suffered from depression since my teen years, went very bad in my half 20s.
Tried various kind of psychotherapies, but the only way to get functioning again was by taking some kind of drugs, be it SSRIs, tricyclics or mild atypical antideps like SAM-e or 5-HTP (still taking them).
Of course there were side-effects, and sometimes the cure made me worse, but without meds I wouldn't even have been able to drag myself to the therapist studio.
I wonder what sample they used for the study.
50 years ago, chronic obesity wasn't the problem it is now. Neither was depression.
One of the things that has happened in between is that almost nobody gets enough exercise in the course of their average day. What I mean by that is, since we all drive everywhere etc., the only people who get proper exercise are those who take special pains to do so.
I've never had depression, I'm about as far away from being 'at risk' of it as you can get, but I've known a half-dozen of people who've suffered from utterly _crippling_ depression. The type where you someone won't even get out of bed for days.
None of them got what I would describe as (or what a doctor would call) appropriate amounts of exercise.
Now, of course, this is a chicken-egg scenario. I don't imagine when you're in the midst of a depressive episode that you feel like hitting the gym or joining a karate club, right?
Now, I know my sample of say, at most 10, ain't exactly scientific, but does anybody know of someone who has depression and hits the gym 3 times a week?
As a final note, one of the things you can say conclusively about the epidemic of depression is that it tends to increase with industrialization. Now, sure, lots of other things happen as industrialization goes up other than driving more and walking less, but I wonder if anybody's looked into it?
The plural form of "anecdote" is "anecdotes", not "evidence".
If the situation's really hopeless, that means that there's no way you can improve it.
Which means it's as good as it can get.
In other words, it's perfect. Right?
Why not promote this in a more positive light? Change the headline to "placebo effective treatment for mild depression"!
I am one of these people more or less. My depression makes me angry and apparently I become a raging aggressive ass when I go off my meds. I feel like I ma being completely normal and rational "if a little down" and everybody else has to flee before me in terror.
The fact of the matter is, this "article" sounds like some COS anti-psych bull.
There _are_ plenty of people who _shouldn't_ be on these drugs, but are. These people are playing with fate. If you don't need these drugs you better _hope_ you are one of the people they don't effect.
If you _are_ one of the people who _should_ be on these drugs, there is no "talking yourself out of it". The people who need the drugs only to get well enough for therapy are lucky.
I've been cycling on and off these drugs once every year or two for a good 18 years. Its worst when one simply stops working after a while, but sure enough, sometimes you think you have everything fixed and good, and you feel the "need to check" and _wham_, Godzilla takes Tokyo.
Innocent people shouldn't be forced to pay for inferior software development.
--"Code Complete" Microsoft Press
The most positive influence we can have on depressive illness and community awareness is to change its name.
"Depression" simply has too many connotations in general society and the term itself muddies the waters when trying to educate the general public as to its impact on people suffering from it and those around them.
"Suffering from depression" and "feeling depressed" are not the same thing, and, IMHO, we need are better term for differentiating between the two. What that word should be, I don't know - I'm not a medical specialist - but even the comments here on slashdot indicate how poorly people understand depression as an illness.
Take a look here to see how over-utilised the word is..
There's a long-running dispute over this, which isn't helped by the fact that it's caught up in a turf war between psychiatrists and psychologists. Psychiatrists generally can prescribe drugs, and come from a pharmacology-heavy M.D. background, and tend to play up the role of drugs in treatment. Psychologists cannot prescribe drugs except in a few limited circumstances, come from a therapy-heavy Ph.D. background, and tend to play down the role of drugs in treatment. There are both cultural and economic reasons for the turf war there.
But in any case you can find a bunch of conflicting studies on whether therapy, drugs, some combination, or neither are the best treatment method in a variety of cases.
10 PRINT CHR$(205.5+RND(1)); : GOTO 10
In fact, the Parent is also true. It is unlikely to cause long lasting damage in most patients, but depending on the drugs (or number of drugs) you are taking, it can be a dangerous and poor choice. You should always speak to a Doctor when you suddenly stop a medication, especially a psychoactive one.
In any event, the drugs mostly discussed in these comments are SSRIs (Selective Seratonin Reuptake Inhibitors).
There is a specific syndrome called SSRI discontinuation syndrome:
http://www.postgradmed.com/issues/2003/08_03/ditto.htm
In case that website doesn't strike you as scholarly, how about Medline:
(Fluoxetine is Prozac)
"It may take 4 to 5 weeks or longer before you feel the full benefit of fluoxetine. Continue to take fluoxetine even if you feel well. Do not stop taking fluoxetine without talking to your doctor. If you suddenly stop taking fluoxetine, you may experience withdrawal symptoms such as mood changes, irritability, agitation, dizziness, numbness or tingling in the hands or feet, anxiety, confusion, headache, tiredness, and difficulty falling asleep or staying asleep. Your doctor will probably decrease your dose gradually."
So, you're right. The affects of abrupt continuation aren't likely to be anything as severe as death, but the above cluster of symptoms doesn't strike me as anything I'd like to have.
Stop and drop(r), America's favourite suicide booth since 2008.
Stop and drop(r) is a registered trademark of the Kavork Inc and associates all rights reserverd. Kavork Inc is a fully owned subsidiary of Johnson and Johnson. (c)2008.
Calling someone a "hater" only means you can not rationally rebut their argument.
When you read these articles, please remember that the well known studies that discuss the efficacy of SSRIs vs. placebo are in relation to unipolar depression. Bipolar disorder (mania or hypomania alternating with depression) is a very different condition, and is usually treated with a combination of mood stabilizers (lithium, Depakote, Lamictal, etc.) and antidepressants (SSRIs, Wellbutrin, etc.).
I don't know about Canada, but in the US only a Psychiatrists can. (Psychiatric training includes earning an MD, whereas Psychologists' training does not. Part of the MD training involves learning about drugs and physiological reactions to them. However, whether or not Psychiatrists are very good MDs, well...that's another question.)
I CAN say that on two occasions in my life, when I was spiraling downwards towards clinical depression (couldn't sleep, couldn't move, was suicidal) therapy and Paxil worked for me. That is, therapy the first time, and Paxil the second time. Fortunately, both times I was able to regain my mental and emotional equilibrium.
However, from what I've seen in my time in group therapy, neither of these tools are always effective for all people. In general, severe and sustained childhood abuse, whether emotional or physical or sexual, can cause the most debilitating dysfunctions in adults. One result of such abuse is a deep rooted anger, which if unexpressed and repressed, CAN lead to severe depression. From where I sat during my years of therapy, observing fellow group members trying to come to grips with their horrific pasts, it was hard to believe that taking pills would resolve their anguish (at best, it might mask it), but it was equally clear that endlessly rehashing their past sometimes kept them trapped in it.
This should also be qualified to add that not all people suffering from clinical depression were on the receiving end of severe and/or sustained abuse. And making the disease more puzzling is that some victims of abuse manage to work their way into being reasonably happy and productive adults. As far as I can tell, there's no really good "predictor" of who's likely to suffer from clinical depression and who isn't -- anymore than being able to rely on either therapy or anti-depressants as a cure for the disease. Indeed, a bad therapist can do even more harm. (And trust me, they're out there.)
The only word of encouragement I can give is to keep trying. If one therapist doesn't work, try another. (There are many different schools of therapy, and one type might work for you where another type doesn't. For example, Rational-Emotive Therapy doesn't really focus on the patient's past, but more on the "let's just deal with what's on your plate now" approach.) If anti-depressants don't do a thing for you, give them up, and try alternative healing techniques: acupuncture, meditation, yoga, and so on. Some of the simplest techniques, such as daily meditation or prayer can be surprisingly effective. These all may sound very la-di-dah and new age-y kind of silly, but what have you got to lose but a little bit of dignity, and what if something you try triggers an insight and leads to progress? I tried something called "dream therapy" once, which I wouldn't necessarily do again, but it did provide me with an insight into my relationship with the rest of the world that I would never have grasped with years of conventional therapy, and which was a real "aha" moment for me. And no, that didn't "fix" me either, but it did give me an understanding of why I was behaving certain ways, and from there I could start re-examining my fundamental approach to life.
You might want to try a placebo.
Since the fall of 2001, I have been dealing with true clinical depression. If I recall correctly, it usually has to last for a couple weeks to be a clinical depression since low times are natural if you can link them to situation but if you fail to bounce back then life becomes horribly bland and unbearable. For those who have not dealt with it, some of the symptoms are a lack of interest in most activities and constant tiredness that sleep can't remedy. The closest I can explain to a person who has not felt true clinical depression is to think of a time when your nose was so congested that it made it hard to taste food. In clinical depression, all your senses become numbed, so with your vision you may feel everything looks like a shade of grey and colors don't pop as much.
It was post 9-11 that I started to downward spiral and by Feb 2002, I could not even bear to even go to work and concerned friends and coworkers intervened to get me help at the hospital after I stopped going in and refused to answer the phone for a week. Fortunately, I my employer had a good mental health policy so I was able to keep employment then return to work after I got treatment and started taking the anti-depressent Effexor. However, I only took this for a few months until the summer and then the doctor took me off them. The following Sept 2002 I started to feel the depression coming back so I went back to the doctor to get back on Effexor but it seemed to not bring me back up but kept me from dropping any further. By the end of March 2003 I was back to my old self but then in the next few months I started to become manic. After a couple of hospital stays between June 2003 and September 2003 I came back down and was diagnosed as bipolar and given some drugs for that as well. However, I fell into a depression again by the end of September 2003 and my family. For the next years, I lived with my parents and the long term disability payed the bills. I have been taking various medications and doses but seem to remain stuck in a depressed state even through the summer months. I finally started feeling better in December 2006 and started online grad school and a working a bit by fixing computers as my own business. Things were going well but the medications have more negative side effects than benefits so by the summer of 2007 I was put on a medication holiday by my doctor so I was taking nothing but had to report every 2-3 months to see how I was doing. I am glad to report that I doing better since stopping the medications and will be complete with school in May and have found a special girl and will be getting married in May.
Congrats if you read all of that. My point is that many of these drugs ar hit and miss so it take trial and error for each patient to find what works and what can actually make the problem worse. I think the Effexor may have even made the manic episode come on stronger. The other meds that I have taken the past few years may have initially helped but then became an inhibtor to actually getting to the normal range and left me in a semi-depressed state. I was fortunate that I had a good employer and the foresite to take a long term disability insurance policy so I still have income and since I am on a medical unpaid leave of absence and still get medical insurance from that employer.
I Cater to the Needs of Stupid People. - from a coffee mug Christmas gift
So after 4+ years of my website writing the lie of psychotropic medicines has arrived! That's good. It has been a long time coming so I shall savor my victory a long time also => ../mental health how to quit the meds properly age of bipolars and the issue of brain oxygen deprivation.pdf Hmm, I wonder what else I could be right about and how long it will take for my boomerang to come back with similar results: http://www.newpath4.com/fluidenergyartworkenginesrriley20032007.htm . How about that the world's droughts moving from place to place is worsened by PUMPING OUR DRINKING WATER INTO OIL DEPOSITS. I could get used to Victory and the resulting lessening of depression! And even though my completed deer-inspired engine is having some "break in time" to achieve acceptance, (1st Ever 200 plus mpg 700 hp Cardiac Arrest 600 mph Engine) that too shall pass, soon.
Industrial Age 2 + How-to Stop Malignant Cancers.
- RG>
Hey pal, this isn't a pleasantforest, so don't waste my time with pleasantries!
8) Pot, is the best antidepressant, or was I supposed to say Cannabis? Legality, or Illegality aside, there are several illicit street drugs, which are widely used, which suggest at this point, "symptoms of a larger problem." Maybe, it's a spiritual problem? And...so...
Don't you think...? Or don't you?
No, it's not irresponsible, or grossly misleading, it's borderline criminal, IMHO.
Sociopathic, at least.
My wife was misprescribed SSRIs decades ago. The pills didn't help much at all, certainly not for long, and she decided unilaterally to stop them. BIG fucking problem, DO NOT ATTEMPT THIS AT HOME.
Seriously, that headline, like the shabby reporting I saw on BBC World about the report, is certainly likely to encourage some poor misguided individual to stop their meds unilaterally.
Doing so is well known to cause EXTREME moods and behaviour, and I'm very happy to say that my wife did NOT go through with the far-too-common withdrawal-induced suicidal tendencies.
I think it's really sad that whoever this kdawson person is thinks that it's ok to sensationalise such a topic. Please change the title, please. I wouldn't wish upon kdawson or any human being, the anguish and torture of dealing with cold turkey withdrawal from SSRIs.
Please kdawson, please can't you change it?
New England Journal of Medicine
Volume 358:252-260, Number 3
January 17, 2008
http://content.nejm.org/cgi/content/short/358/3/252
Selective Publication of Antidepressant Trials and Its Influence on Apparent Efficacy
Erick H. Turner, M.D., Annette M. Matthews, M.D., Eftihia Linardatos, B.S., Robert A. Tell, L.C.S.W., and Robert Rosenthal, Ph.D.
ABSTRACT
Background Evidence-based medicine is valuable to the extent that the evidence base is complete and unbiased. Selective publication of clinical trials -- and the outcomes within those trials -- can lead to unrealistic estimates of drug effectiveness and alter the apparent risk-benefit ratio.
Methods We obtained reviews from the Food and Drug Administration (FDA) for studies of 12 antidepressant agents involving 12,564 patients. We conducted a systematic literature search to identify matching publications. For trials that were reported in the literature, we compared the published outcomes with the FDA outcomes. We also compared the effect size derived from the published reports with the effect size derived from the entire FDA data set.
Results Among 74 FDA-registered studies, 31%, accounting for 3449 study participants, were not published. Whether and how the studies were published were associated with the study outcome. A total of 37 studies viewed by the FDA as having positive results were published; 1 study viewed as positive was not published. Studies viewed by the FDA as having negative or questionable results were, with 3 exceptions, either not published (22 studies) or published in a way that, in our opinion, conveyed a positive outcome (11 studies). According to the published literature, it appeared that 94% of the trials conducted were positive. By contrast, the FDA analysis showed that 51% were positive. Separate meta-analyses of the FDA and journal data sets showed that the increase in effect size ranged from 11 to 69% for individual drugs and was 32% overall.
Conclusions We cannot determine whether the bias observed resulted from a failure to submit manuscripts on the part of authors and sponsors, from decisions by journal editors and reviewers not to publish, or both. Selective reporting of clinical trial results may have adverse consequences for researchers, study participants, health care professionals, and patients.
Thanx.
;-)
See my earlier post (or is it my later post?)
Damn! These SSRIs!...
.
- aqk
F U
Why is it that when an article says something works, people are suspicious of bias, but when an article says something doesn't work, everyone thinks it's objective science? IT'S ALL BIAS. Sigh. Anyone wonder why it is that all of a sudden we see so many articles about how SSRIs don't work? For 20 years, all we heard was SSRIs were panaceas. Now... ... as if we have new data? Someone FOIAed the second Zapruder film?
News at 11:00...
IANAL but write like a drunk one.
I know triathletes and marathon runners that are depressed (people that by definition do the 3 things you mention).
I don't understand how somebody can make such an stupid statement.
You don't like to be in clinical depression hell. Whatever you had does not remotely compare to what clinically depressed people suffer.
IANAL but write like a drunk one.
If depressed people find out their meds are as good as a tic tac, then we're going to have a problem.