Re-Analysis of Medical Study Reverses Conclusions -- Paxil Unsafe For Teenagers

An anonymous reader writes: The NY Times is covering a new paper in the journal BMJ which re-analyzed data from a 2001 paper, coming to the opposite conclusions of the earlier study. The BMJ paper covers the effectiveness and safety of two antidepressant drugs for adolescent use, and the authors were able to re-analyze the original data after the release of previously confidential documents. The BMJ editors call into question some of the integrity of previous publishing, noting that none of the authors listed on 2001 paper actually wrote the original manuscript, and call for results of clinical trials to be made freely available so the science community can verify and self-correct results. The BMJ has released the study and provided an accompanying press release (PDF).

Comments

In Soviet Russia

[tripleevenfall]

In Soviet Russia, integrity questions you!

Why do teens *need* all these drugs???

[cayenne8]

Good Lord, We had no inclination of taking the slew of pharmaceutical drugs back in my day as a teen. Ok, sure, we had plenty of "parking lot" drugs we often had fun with...but as far as systemized drugging of kids, we did just fine without all the anti-depressants turning kids into zombies so early ln life.

I can't imagine we're doing these young teens and pre-teens any good with all this. We didn't need it in the past and we all came out well adjusted (always a few exceptions), so why in God's name do we feel the need to start drugging kids from such an early age ?

It is just big Pharma selling more wares, getting folks hooked early?

Between "Attention deficit disorder" (formerly known as being "a boy")...and now anti-depressants, can a kid that was once considered normal growing up and developing with all the fun times and turbulent times grow up today without the first inclination be to DRUG THEM?

Re:Why do teens *need* all these drugs???

[hyperar]

Because pharma companies want money?

Re:Why do teens *need* all these drugs???

[gstoddart]

Sure, but if fabricating science to sell a product for an application not approved or supported by the science really needs to be the kind of thing which leads to very significant legal action and penalties.

Essentially they fabricated a study to support a use of a drug, and the conclusions in that study were not founded .. because it wasn't a real study.

Sorry, but that's pretty much a criminal activity in my books.

Re:Why do teens *need* all these drugs???

[gmack]

Don't blame just "Big Pharma" Parents prefer the drugs because it's less humiliating than thinking something went wrong with their parenting and at any rate it's a less time consuming fix that going to a physiologist. Teachers prefer the drugs because they let them keep kits seated for longer. Doctors prefer the drugs because it's easier than trying to get a child/teen to eat properly.

Big Pharma can hardly be blamed for selling us all something we begged them for in the first place.
 

Re:Why do teens *need* all these drugs???

[Alicat1194]

I was put on Paxil (Aropax in Australia) at 16. It was literally life-changing. Previously I had random panic attacks, with no specific trigger - sometimes up to 4 a day. Leaving the house to go anywhere but school without triggering an attack was impossible, and even school could be hit-and-miss. Add OCD to the mix, and lets just say, it wasn't exactly a lot of fun.

Two weeks after beginning paroxetine, I went to a friends house for a sleep over for the first time in just under a decade. I remember leaving my house without any feelings of anxiety or dread, and remarking to my Mum that "this is how normal people must feel!".

Yes, I'll agree that in some cases these drugs are prescribed too quickly, and too easily, and they aren't side-effect free (hellooo ridiculously easy bruising!). But for the rest of us, they're worth their weight in gold (ie: the only way you'll take them off me is from my cold, dead, anxiety-sweat drenched hands).

Re:Why do teens *need* all these drugs???

[cayenne8]

So you're questioning if pharmaceutical companies invent disease?

No, I am questioning all the DISEASE period. At the very least, I'm questioning the over diagnosis of so many diseases.

Re:Why do teens *need* all these drugs???

[cayenne8]

It's because of the growing economic inequality. Back in the 60s or 70s, just graduating with a BA from a state university was a respectable accomplishment and let you enjoy a middle class lifestyle. Hell, with a high school diploma and a good union you could live a solidly middle class life. Today, if your kid doesn't make it into a top five business or tech school, they are pretty much doomed to a lifetime of desperately struggling to avoid poverty. So, if your kid isn't studying as hard as he needs to in order to stay on track for that future Wharton MBA, then you better get him on some drugs. If a teenager makes one mistake (assuming he's not a big money 1% offspring) then he will be barred from a decent standard of living.

Seriously??

Where do you live where life is this bad for kids if they aren't in the 1%? What is your definition of the 1%...anyone making over $40K or something?

Not being in the top 5 of your class, is not a sentence to poverty anywhere I have lived or know about in the US. What city and state do you find a child's future so dismal?

Re:Why do teens *need* all these drugs???

[cayenne8]

I know these drugs help some folks.

But I have to guess your situation is a very niche one....an extreme outlier to most kids' situation.

Normal anxiety and angst is a part of growing up and learning to deal with things. I'm afraid that way too often today, what should be normal levels of this type stress, is being treated with drugs, instead of teachings of how to live and deal with this.

Extreme cases like you have, of course require more tx, but I would still guess that your extreme case is in the minority of the human population numbers.

Re:Why do teens *need* all these drugs???

[kheldan]

..OK, I agree in part with what you're saying. However much I believe that these conditions (depression, ADD/ADHD) are real, I also believe that two factors have contributed greatly towards the proliferation of medications to 'treat' them: One, it makes the pharma-industrial complex loads of profit. Two, the bean counters that de-facto run the healthcare industry love the stuff, because it's far cheaper than cognitive therapy to teach people to fix their own problems.

By the way, ADD/ADHD are not just 'boy' conditions, I've known at least one female who had them as well, and in her case, she wasn't able to cope with day-to-day life anywhere near as well before Adderall. Myself I was diagnosed with ADHD as an adult -- but by that time I'd developed so many coping mechanisms that medication really didn't need to be used; it did, however, answer lots and lots of questions about how an why thigns happened for me over the course of my life -- knowledge which I applied to my already-existing coping mechanisms to further refine them. Once you understand ADD/ADHD, you realize that you can leverage it into an advantage in your life instead of something that holds you back.

Anyway.. used to suffer from depression also (in part a side effect of dealing with ADHD). Learning to address the actual problems instead of 'putting a band-aid' on them with medication proved to be far more effective, but much more work initially; regardless I'm an advocate of cognitive therapy in one form or another far more than I am of medication, which in my opinion should be used only on a short-term basis while you're learning to deal with what's bothering you.

No doubt, I'll get lots and lots of heat for daring to voice my experience and opinions on this subject. I don't care. There are better long-term ways to deal with these problems than being on medication the rest of your life, and I feel people need to know this. There are rare exceptions, of course, where medication is the only way to keep someone from destroying themselves, and I acknowledge that here, too. But anyone that says medication is the only way to deal with these problems has been brainwashed into believing that.

[[[Bracing for the incoming hate]]]

Re:Why do teens *need* all these drugs???

[gstoddart]

Troll?? Really?? This is from the last link in the summary:

Results The efficacy of paroxetine and imipramine was not statistically or clinically significantly different from placebo for any prespecified primary or secondary efficacy outcome. HAM-D scores decreased by 10.7 (least squares mean) (95% confidence interval 9.1 to 12.3), 9.0 (7.4 to 10.5), and 9.1 (7.5 to 10.7) points, respectively, for the paroxetine, imipramine and placebo groups (P=0.20). There were clinically significant increases in harms, including suicidal ideation and behaviour and other serious adverse events in the paroxetine group and cardiovascular problems in the imipramine group.

Conclusions Neither paroxetine nor high dose imipramine showed efficacy for major depression in adolescents, and there was an increase in harms with both drugs. Access to primary data from trials has important implications for both clinical practice and research, including that published conclusions about efficacy and safety should not be read as authoritative. The reanalysis of Study 329 illustrates the necessity of making primary trial data and protocols available to increase the rigour of the evidence base.

Unless you work for GSK or are one of the original authors, my summary of the conclusions is pretty damned accurate: they fucking lied about badly done science.

Re:Why do teens *need* all these drugs???

[macs4all]

Essentially they fabricated a study to support a use of a drug, and the conclusions in that study were not founded .. because it wasn't a real study.

Sorry, but that's pretty much a criminal activity in my books.

But in the collusive atmosphere that is the relationship between Big Pharma and the FDA, it's known as "Just another workday".

Witness the story of the now-rejected Centocor/Lilly Anti-Septic Shock Drug, HA1A, or "Centoxin". My best friend's father died in September, 1992 after being given Centoxin in lieu of the standard treatments for Septic Shock (steriods, aggressive antibiotics). He was part of the "second" Centoxin study (the one that was HALTED by the FDA, due to an unacceptable death rate...)

The "collusion" comes when the FDA, who discovered that Centocor was "cooking the books" on the FIRST study, didn't simply turn over Centocor (and Lilly) to the DoJ, instead of "giving them another chance to LIE better" with a SECOND study.

Worse yet, when my friend was asked to give "informed consent" to administer Centoxin, it was represented as the ONLY POSSIBLE TREATMENT for Septic Shock (however, they never mentioned that it ONLY worked on gram-negative sepsis, and that it HAD to be given within 120 MINUTES of the onset of symptoms, which they already knew YEARS before that study, and which time had LONG passed in his case); however, a quick cruise through the Physician's Desk Reference (PDR) lists SEVERAL antibiotics (such as Amoxicillin/Clavulinate, Clindamycin and Inipenem, to name a few) which are listed as treatment for Sepsis, and then Steroids and other anti-inflammatory drugs are given to reduce the deadly inflammatory response (primarily from the release of Interuekin-1 (IL1), IIRC) (sometimes your immune system is your worst enemy!), to try to stop your body from killing its own organs.

Re:Why do teens *need* all these drugs???

[The Grim Reefer]

I don't know how old you are, but there was actually punishment for misbehaving when I was in school. In elementary school, our principal had a cricket bat looking paddle that had holes drilled in it and the bright red letters on it spelled out "The Board of Education". He had it on the wall behind his desk. There were maybe half a dozen times during the year that it actually got used. It was rare enough that everyone knew about it in the school and was the main topic of discussion on the playground for a couple of days afterward. Of course the meeting with "The Board of Education" was the least of your worries. Most of us were more afraid of the punishment we'd get when we got home.

I'm sure there was what could be considered actual physical abuse back then too. But I don't think it was a prevalent as we're led to believe it was. The fear of punishment was a strong motivator for not behaving too badly, or at least not so openly. There was typically one, maybe two, at most, kids that occasionally caused problems in class when I was a kid. The teachers usually had some way of embarrassing them or punishing them to behave. But that sort of thing isn't allowed any longer. When my daughter was in elementary school, there were no less than half a dozen kids who were constantly being suspended or put on some sort of sticker program in any given year. In a class of thirty, having six to ten kids acting up is pretty damn counter productive if you ask me.

Don't get me wrong, I'm not saying we should beating our kids for the hell of it, but in some cases corporal punishment seems to be an effective solution. I have to think it's better to do that when they're young than to have a child with no real boundaries get in trouble with the law when they get older.

Re:Why do teens *need* all these drugs???

[Alicat1194]

How do you know that you would not have had the same repsonse if not a better one if you were given a placebo??

Oddly enough, my mother did try placebos at one point (she was a nurse, so was in to that sort of stuff). She would give me what I later found out was a small amount of milk with vanilla essence in it, and tell me it was "medicine". It worked to calm the panic somewhat, but not prevent it from occurring (and oddly enough, I'd rather it just didn't occur full-stop).

However once I hit puberty pretty much everything went out of the window (thanks hormones!). Even now I have noticed that I'm more likely to have problems during certain points in the hormone cycle.

Add to that that I've been on three different versions (paroxetine, sertraline and venlafaxine), and had very different experiences from each. If I was only experiencing the placebo effect, I'd expect to have a similar outcome from each, but that wasn't the case (Paroxetine was good, but lost efficacy. Sertraline was awesome for the OCD (stopped it dead), middling on the anxiety, and made me an emotional mess. Venlafaxine is good for the anxiety, but only passable for the OCD).

Re:Why do teens *need* all these drugs???

[sjames]

There's plenty of blame to go around. Pharma doesn't get off the hook since they fabricated a study that claims one of their big sellers is safe when it is nothing of the sort.

Schools are the prime pushers of these drugs. Many parents oppose it but bend to pressure from the school. Nobody seems willing to even consider that all the no child left behind, time on task, zero tolerance crap is perhaps the problem. Surprise surprise, close off all ways to blow off steam and pressure builds to the breaking point. Or perhaps it's the way the social contract is being stepwise rewritten to read "all your base are belong to us". Study hard, get good grades, get a degree and find yourself unemployed and in perma-debt anyway.

Be honest. If you were in their shoes, just starting out, watching the news every night as recommended, not yet fully programmed to swallow the lies, might you be a bit depressed about it? Perhaps feel an urge to act out from time to time?

Re:Why do teens *need* all these drugs???

[Anonymous Coward]

I graduated high school in 2006 and had to endure the worst of the 2008 recession when I was just starting my career. If you aren't a NINJA/haven't entered the workforce recently, IMHO you have no idea WTF you are talking about.

Re:Why do teens *need* all these drugs???

[tburkhol]

Good Lord, We had no inclination of taking the slew of pharmaceutical drugs back in my day as a teen. Ok, sure, we had plenty of "parking lot" drugs we often had fun with...but as far as systemized drugging of kids, we did just fine without all the anti-depressants turning kids into zombies so early ln life.

But I have a right to be happy all the time. I live in the greatest country earth has ever known and my parents provide me with every possible comfort and advantage. Coasting through life as I have, without any serious challenges or impediments, I should be the happiest kid on earth. If I'm not, it's clearly a neural imbalance, and there's a drug for that.

Re:Why do teens *need* all these drugs???

[sjames]

Seriously. Have you not seen the studies suggesting that a degree now barely pays for itself? Were you unaware of the growing trend towards calling the police for what used to be considered a simple school disciplinary incident? Surely you know that a criminal record limits opportunities!

Re:Why do teens *need* all these drugs???

[avandesande]

That's BS. My son was diagnosed with HFA and PDD when he was in grade school and the psychologist wanted to put him on a course of 5 drugs. She had the little pharmaceutical pads, pens, etc all over her office. Of course we refused but she pushed hard.

I am confident that he would have been ruined if we had relented. Don't tell me that there isn't a profit motive here for pharmaceutical companies! Without the advertising for drugs (for those who are younger this used to be outlawed) and doctors pushing the stuff there would be very few parents clamoring for the stuff.

Re:Why do teens *need* all these drugs???

[MagickalMyst]

"Troll?? Really??"

Obviously big pharma's minions have infested Slashdot.

Your comment is 100% valid, amigo.

If I had mod points....

Re:Why do teens *need* all these drugs???

[Alicat1194]

I'll admit, my situation was a little weird, and we did try other options before going the drug route (CBT, relaxation techniques, exercise, etc). I was also lucky in that my parents were very invested and involved, and took the time to work with me to try and fix it without pharmaceutical intervention. If they'd been more time-poor, or less involved (as a lot of parents these days seem to be), it's possible that drugs would have been the first choice, rather than the last.

I also think it depends on the country and medical system you're part of - before my doctor would agree to prescribe anything I had to go to a psychiatrist for evaluation. Australia is also pretty well regulated, so we don't get "talk to your doctor" type advertising, which may have an impact

Re:Why do teens *need* all these drugs???

[cayenne8]

I don't know how old you are, but there was actually punishment for misbehaving when I was in school. In elementary school, our principal had a cricket bat looking paddle that had holes drilled in it and the bright red letters on it spelled out "The Board of Education". He had it on the wall behind his desk. There were maybe half a dozen times during the year that it actually got used. It was rare enough that everyone knew about it in the school and was the main topic of discussion on the playground for a couple of days afterward. Of course the meeting with "The Board of Education" was the least of your worries. Most of us were more afraid of the punishment we'd get when we got home.

Yep, I'm likely in your age group, I got my ass whupped at school a time or two..and yes, it was when I got HOME that I was most worried..hahaha.

But for the most part, my teachers were cool. What would happen, I'd usually finish my work fast and early and then be bored, and start distracting my neighbors. That began to earn me having my desk up closer to the teacher where she could keep an eye on me, or give me something else to do.

I would come up with new and creative things to do in class...I was a handful for sure, but I was a happy friendly kid, and while I was a PITA to many teachers, the same ones would tell my parents that they really liked me and just needed help keeping me in control.

But, thankfully...they didn't have the Attention Deficit syndrome diagnosis back then, and I wasn't drugged. I just sometimes had to be "extra supervised". All in all, I think I turned out fine.

Re:Why do teens *need* all these drugs???

[hyperar]

Sure, but if fabricating science to sell a product for an application not approved or supported by the science really needs to be the kind of thing which leads to very significant legal action and penalties.

Essentially they fabricated a study to support a use of a drug, and the conclusions in that study were not founded .. because it wasn't a real study.

Sorry, but that's pretty much a criminal activity in my books.

It's not the first time something like this happens, a couple of months ago there was an article on how most studies results couldn't be reproduced, it seems that this was a standard for pharmaceutical companies.

Re:Why do teens *need* all these drugs???

[sjames]

That article also touches on how drugs get so expensive. We hear all about how many very expensive studies come to nothing and how the one success has to pay for all those failures. But in the case of Centocor, they had the golden opportunity to avoid the big costs by admitting early on that it wasn't all it should be. But they had "go fever" by then and so wasted boatloads of money trying to ram it through approval anyway. Perhaps if they would stop looking at their early studies as obstacles to be overcome and see them as valuable information to be considered instead, they wouldn't have to make up for so many losses when they have a success.

Re:Why do teens *need* all these drugs???

[thoromyr]

join the club... there are moderators that use "-1 Troll" for "I didn't like or agree with"

Re:Why do teens *need* all these drugs???

[DerekLyons]

Good Lord, We had no inclination of taking the slew of pharmaceutical drugs back in my day as a teen.

So?
 
You aren't (by implication) a teen anymore. You may not however be old (or mature) enough to grasp that times change.
 
When I was a teen, lo these many decades ago, society was different too... and not necessarily better. Tying one on an Friday night and then driving home was completely acceptable. Even though it killed people. A guy getting a girl drunk and raping her was just "boys will be boys" - and if she wore anything that might be considered 'sexy', she was a slut and it was her fault for "leading him on anyway".
 
I have no desire to go back to those days.
 

We didn't need it in the past and we all came out well adjusted (always a few exceptions)

No, we didn't "all come out well adjusted". Some did. Others turned into recluses. Others carried on day by day but suffered a half life in silence. Others turned to alcohol, or weed, or... worse. Yet others could no longer bear the pain because society has a deep stigma against not being "well adjusted" and chose the ultimate way out. You only think they turned out "well adjusted" because you've rejected the notion that things might be other than their surface appearance out of hand.
 
I have at least three classmates who might have made it out of their early twenties if back then assholes like you hadn't made idiot claims like "we had no inclination to diagnose and treat mental illnesses and we turned out well adjusted". I have two cousins my age who might be useful members of society rather than living in a bottle if they hadn't been taught growing up that "real men don't seek treatment", an attitude born of the same ignorance you spout.
 
I have no desire to go back to those days either.

Re:Why do teens *need* all these drugs???

[GuB-42]

Because back in the days, psychological illnesses weren't properly considered.
ADHD and depression are real diseases. It is not the same thing as "being excited" and "feeling down". In the same way that being stuck with a high fever is not the same thing as "being lazy". A proper diagnosis followed by a proper treatment is a good thing and certainly better than doing nothing, even if it involves drugs. And no, these drugs aren't designed to turn you into a zombie unless you are about to kill yourself and the only alternative is a padded cell and a straightjacket.
And there is a difference between boys being boys and failing constantly at school despite above average intelligence and favorable conditions.

And you think things were better in the past? They used to give fucking heroin to kids to calm them down...

Re:Why do teens *need* all these drugs???

[drinkypoo]

But for the most part, my teachers were cool. What would happen, I'd usually finish my work fast and early and then be bored, and start distracting my neighbors. That began to earn me having my desk up closer to the teacher where she could keep an eye on me, or give me something else to do.

I still have the stuff the school sent home about me refusing to put my head down on my desk and do nothing when I was done before everyone else. It's too bad they didn't try to engage me instead of putting me out on the sidewalk writing lines. I still can't so much as sign a check without wrist pain.

Re:Why do teens *need* all these drugs???

[hackwrench]

Somebody needs to do a study on whether your generation came out "well-adjusted". What does that even mean though?

Re:Why do teens *need* all these drugs???

[WalrusSlayer]

Of course extreme cases are a minority. That changes nothing. These kids, the extreme cases, need the medicine. Need.

This is similar to the largely pointless debate on antidepressants in general. Anyone who hasn't had clinical depression has no fucking clue what it's like. I was one the most motivated, self-starter, hard-working, emotionally balanced people out there, until my life circumstances changed immensely in my 40's. It took me a long time to recognize that I had clinical depression, since the slide was so gradual and I never ever could envision myself having this problem. Fortunately the first med I tried was extremely effective, and I was just shocked at how far I had slid once I was more like myself again. Oh the time I wasted while in the fog of depression and not even really knowing it. Life's too short.

The same is true with ADHD. Unless you have kids with true ADHD, you're clueless. I never imagined having to deal with a medication regimen with my own kids. If we could get off this train, we would, but they are essentially learning disabled without them. This is not "kids will be kids". It's a real disability, and ADHD children are very fortunate to be growing up in a time where it can be treated such they can live more fulfilling lives.

Or in other words: "what he said". It's easy to be an armchair Public Health Expert when you aren't affected by the condition in question. Real life is a lot messier.

Re:Why do teens *need* all these drugs???

[HornWumpus]

Just because this is the first recession you paid attention to, doesn't make it the first recession.

Re:Why do teens *need* all these drugs???

[HornWumpus]

There have always been many schools that were wastes of money. What changed is it used to be that only stupid rich kids went to 'Evergreen state', now anybody can get a loan.

Re:Why do teens *need* all these drugs???

[mescobal]

As a Psychiatrist and long-time Slashdot reader I feel really disappointed reading the reactions of people whose oppinion in technical matters I respect a lot. But after > 20 years of "in-the-trench" psychiatry (public and private settings) I've seen (BY FAR) more good than harm as consequence of our practice. I can say I helped a number of people, lots of them using SSRI. We are aware of the industry and its tactics, and the wax-and-wane of science. But most of my colleagues act in good faith following procedures tested in our gold-standard double blind placebo-controlled trials. Medicine CAN do harm sometimes, that's not new. But when you add all up, there's a net benefit. Just my 0.02

Re:Why do teens *need* all these drugs???

[cellocgw]

I'd usually finish my work fast and early and then be bored, and start distracting my neighbors. That began to earn me having my desk up closer to the teacher where she could keep an eye on me, or give me something else to do.

I would come up with new and creative things to do in class...

All of which in no way suggests ADD/ADHD. ADD kids are generally incapable of focussing on the assigned task and thus do **not** finish their work. Any vaguely competent teacher (or MD) can tell the difference between an ADD kid and a smart kid who's bored to the point of disruptance.

Re:Why do teens *need* all these drugs???

[AdamHaun]

Good Lord, We had no inclination of taking the slew of pharmaceutical drugs back in my day as a teen ... we did just fine without all the anti-depressants turning kids into zombies so early ln life.

What makes you think you would have known all about other people's mental illnesses when you were a teenager? Or who was medicated, or who attempted suicide? The first instinct most people (and their families) have is to *hide* their mental illness, and that's only if they make it past denial in the first place. SSRIs are usually taken once a day at home. When I went on Prozac in high school 15+ years ago I didn't tell anyone, and I don't think anyone knew. People noticed that I was in a better mood, and my grades went up, but it's not like there was a sign over my head that said "I don't want to kill myself anymore."

Re:Why do teens *need* all these drugs???

[macs4all]

That article also touches on how drugs get so expensive. We hear all about how many very expensive studies come to nothing and how the one success has to pay for all those failures. But in the case of Centocor, they had the golden opportunity to avoid the big costs by admitting early on that it wasn't all it should be. But they had "go fever" by then and so wasted boatloads of money trying to ram it through approval anyway. Perhaps if they would stop looking at their early studies as obstacles to be overcome and see them as valuable information to be considered instead, they wouldn't have to make up for so many losses when they have a success.

Actually, Centoxin was just a "Stocking Stuffer" (albeit, at a projected $3500 a DOSE, a potentially VERY profitable one!) to Lilly. Lilly actually wanted a DIFFERENT Centocor Drug, ReoPro, which ended up actually being a good heart drug, but as part of the terms of the Centocor/Lilly deal, they agreed to "help" Centocor get Centoxin through the (second) FDA approval process. I actually mostly blame Centoxin's inventor, T. Zimmerman, who, when you start reading some of the published papers BEFORE even the FIRST FDA Study, KNEW that Centoxin was effective in basically ZERO cases (because of the 120 minute time-limit, and because it actually made those with Gram-Positive infections WORSE (or DEAD)); but basically buried those facts in statistics so that her "baby" (Centoxin) would continue to be funded.

In doing a little research for my earlier post, I see that she is STILL working for Centocor; so either they never figured that out (which I did several years ago, in just a day or two's worth of research), OR they simply BURIED their knowledge of that, as well. Perhaps because of that golden "carrot" that they were chasing. But, I would say that it was JUST a little more sinister than simple "gold fever"...

Re:Why do teens *need* all these drugs???

[JazzLad]

Man, I wish I had mod points, I don't agree with that at all ... ;)

Re:Why do teens *need* all these drugs???

[GungaDan]

CBT? How is cock and ball torture going to help teenage anxiety?

Re:Why do teens *need* all these drugs???

[dj245]

Troll?? Really?? This is from the last link in the summary:

Results The efficacy of paroxetine and imipramine was not statistically or clinically significantly different from placebo for any prespecified primary or secondary efficacy outcome. HAM-D scores decreased by 10.7 (least squares mean) (95% confidence interval 9.1 to 12.3), 9.0 (7.4 to 10.5), and 9.1 (7.5 to 10.7) points, respectively, for the paroxetine, imipramine and placebo groups (P=0.20). There were clinically significant increases in harms, including suicidal ideation and behaviour and other serious adverse events in the paroxetine group and cardiovascular problems in the imipramine group.

Conclusions Neither paroxetine nor high dose imipramine showed efficacy for major depression in adolescents, and there was an increase in harms with both drugs. Access to primary data from trials has important implications for both clinical practice and research, including that published conclusions about efficacy and safety should not be read as authoritative. The reanalysis of Study 329 illustrates the necessity of making primary trial data and protocols available to increase the rigour of the evidence base.

Unless you work for GSK or are one of the original authors, my summary of the conclusions is pretty damned accurate: they fucking lied about badly done science.

This is exactly why I have completely given up on most prescription medications for managing my mental problems. This is not the only one which has been proven to be useless. Most are no better, or only very slightly better, than nothing.

I'm now on prescription Vyvanse (speed) and marijuana to manage my condition. These are real drugs with real effects. I don't need to wonder "do these drugs do anything at all?". They definitely do "something". The only questions left to answer then are "Is this effect helpful for me?" and "Is the effect big enough to justify the side effects". People shouldn't need to question whether a drug works or not. These drug company shenanigans have stalled mental health treatment for decades.

Re:Why do teens *need* all these drugs???

[WalrusSlayer]

Agreed. Though I will concede that it is also true that Big Pharma pushes their drugs when they are not needed or could even be harmful. Both extremes are true. There are people who really need these drugs and really benefit from them, and there are evil drug companies that push these drugs on everyone and do harm by doing so. Neither fact negates the other.

And I will readily admit that I have not personally witnessed drug-pushing, overdiagnosis, or the mythical lazy attitude of "just give 'em drugs and it will be easier". If that's truly out there in any quantity, that indeed can do harm.

I have seen parents refuse the drug route when their child could so clearly be helped by reducing their ADHD symptoms, to the point where the social harm of leaving it untreated is heartbreaking to witness. I've also seen people not get over their stigma of antidepressants and suffer needlessly, which is equally discouraging. But, people have to find their own path.

Re:Why do teens *need* all these drugs???

[thoromyr]

you kid (I think), but as it so happens I've got mod points (again, seems I have them ost of the time anymore) and so I'm looking more at the moderation of posts. And I've noticed an unhappy amount of this phenomena. Right now I can counter mod (and I do), but it is a problem.

Years ago I had a post modded into oblivion because I pointed out Microsoft's video controller was not the first (Sony's eye toy was the example used). I'm assuming that meta moderation cleared it up because I've always had excellent karma despite the ocassional Troll/disagree.

I'd rather post than mod, and since I bothered started to logging in again I'm getting mod points. That often go unused because I'm posting. Personally, if I've modded in an article and there's a post I disagree with I'll look for a counterpost to mod up. If there isn't I'll decide between posting anonymously or undoing the moderation. I never down mod.

Re:Why do teens *need* all these drugs???

[JazzLad]

I tend to look for ACs with something meaningful to say to mod & usually I'll pick 1 story when I get points & dump all my points into that one (so I can post in the others).

Re:Why do teens *need* all these drugs???

[xenotransplant]

100k in NYC won't even get you a curb side fridge box.

Re:Why do teens *need* all these drugs???

[david_thornley]

I've seen occasional suggestions that LSD might have psychiatric value. However, we would have to get at least a little rationality into the drug schedules to find out. Every so often, it seems like the US government decides, for no particular reason, that some drug can have no legitimate use.

Glad it worked for you, though.

Re:Why do teens *need* all these drugs???

[david_thornley]

If you're depressed about actual problems, you're missing out on the full clinical depression experience. Trust me on this.

As far as your opinion about the use of medication, I'm glad it's only your opinion and you're willing to let the professionals help people anyway. I take it that cognitive therapy worked for you, and that's good. I've been through cognitive therapy for depression, too, and that and the antidepressants got me through. Based on my experience, I suggest antidepressants and cognitive therapy combined rather than either independently, and that lifetime medication may be necessary.

I perceive you as someone who had a bad case of depression, found something that worked, and thinks it will work for everyone. I've seen it many times before: someone who has a bad problem doesn't really realize that other people can have worse, or different, and feels that people who need more help aren't doing things right.

Please pardon me if I seem too emotional. Earlier this week I attended the funeral of an old friend who refused to take antidepressants.

Re:Why do teens *need* all these drugs???

[Razed By TV]

General response:
About a month ago, I saw an article on Huffington Post by a doctor claiming that diphenhydramine was not effective for getting to sleep/staying asleep and that there was no research supporting its use . I said to myself, "this sounds like bullshit." So I googled it, and found studies supporting its use. So some doctor may have gotten himself a lot of advertising by giving lots of people bad advice. That was the first thing I thought of when I saw this article.

It may in fact be true that paroxetine is not useful in treating most adolescents. On the other hand, it may be that some people just want to make a name for themselves. (Not that I trust GSK, either...)

Responding to Alicat1194:
I've had depression and been off and on all sorts of medications. I was on Paxil for a few months during my teenage years, and while it didn't magically fix my problems, it did make life much more tolerable, especially with anxiety. 10+ years later, during another episode of depression, I was diagnosed as having bipolar depression (family history plus I developed mania from citalopram. Escitalopram did not induce mania previously, strangely enough.) My current therapist is reconsidering the bipolar diagnosis. I've been through lithium and a couple mood stabilizers, and I'm now back on Paxil. The others had little to no effect. I credit Paxil more than any other drug for improving my mental state. Of course, at this point, I am no longer an adolescent.

To GP:
I think that the pressures on teens are higher now than they use to be. Instead of go to school, then get a job or go to college, there is maintaining an online social presence, figuring out how you're going to support yourself when wages haven't kept up with inflation, and the increase of college costs with a decrease in returns from a higher education.

I don't disagree that recreational drugs have therapeutic value. However, the current social climate makes them unsavory, and the kids who have the means will seek therapy. These kids end up on a pill, as there is no authority advocating marijuana use.

Re:Why do teens *need* all these drugs???

[Alicat1194]

Well, considering I'm female, it would be one way of relieving stress...

Re: Why do teens *need* all these drugs???

[cthulhu11]

No, we didn't. Those of us being bullied by your kind were miserable, the ones who survived that is. I would be dead were it not for Zoloft.

Re:Why do teens *need* all these drugs???

[gzuckier]

Good Lord, We had no inclination of taking the slew of pharmaceutical drugs back in my day as a teen. Ok, sure, we had plenty of "parking lot" drugs we often had fun with...but as far as systemized drugging of kids, we did just fine without all the anti-depressants turning kids into zombies so early ln life.

I can't imagine we're doing these young teens and pre-teens any good with all this. We didn't need it in the past and we all came out well adjusted (always a few exceptions), so why in God's name do we feel the need to start drugging kids from such an early age ?

It is just big Pharma selling more wares, getting folks hooked early?

Between "Attention deficit disorder" (formerly known as being "a boy")...and now anti-depressants, can a kid that was once considered normal growing up and developing with all the fun times and turbulent times grow up today without the first inclination be to DRUG THEM?

Medical thinking? "I don't know what's causing your problem, or even if you have a problem at all. Let me give you some drugs that have problems associated with them, then you won't suffer from problems of unknown cause any more"
some of you probably think I'm kidding.

Re: Why do teens *need* all these drugs???

[HornWumpus]

Which numbers?

For tech employment, there were none worse than the Clinton .com bust.

Those that were worse, predate 'tech employment' as a segment.

Unreliable/Un-reproducible studies

[harshath.jr]

What else is new.

The Scientologists Got This One Right

[macs4all]

I normally can't stand the pompous, pseudo-intellectualism and general asshattery that permeates throughout the Scientology pseudo-religion and all that are involved therein; but they are spot-on when it comes to the over-prescribing of dangerous psychomeds, and SSRIs are universally at the head of that list.

SSRIs are E-VIL, period. And unless you have one of the VERY few conditions for which they ARE effective, most notably, OCD (but NOT bipolar disorder nor depression!), they should be used sparingly, or even better, not at all.

Disclaimer: IANAD.

Re:The Scientologists Got This One Right

[gstoddart]

but they are spot-on when it comes to the over-prescribing of dangerous psychomeds

Even a broken clock is right now and then by sheer luck.

Why Scientology disregards this shit is still batshit crazy rantings, and has nothing to do with science ... it has everything to do with the aliens trapped in your brain you haven't paid Scientology to remove yet.

That insane ramblings of people who believe stupid things occasionally coincides with actual facts doesn't lend any credibility to those insane ramblings of people who believe stupid things.

Sorry, but a "religion" written by a science fiction author who basically said "the real money is in starting a religion" isn't credible just because they disagree with anti-depressants.

The culmination of this belief system is Tom Cruise jumping on a couch spouting off about what he'd been trained to say.

Re:The Scientologists Got This One Right

[Spamalope]

I was prescribed Paxil due to a misdiagnosis. Wow, that was awful. Whatever positive things it was supposed to do never happened, but if you wanted your sex drive destroyed and to have every sleeping moment be the most vivid dreams it did that for me. Of course, all of the dreams were directed by Steven King and I woke up screaming in a cold sweat but they were vivid. And if I could get back to sleep I'd have another just as bad on a new topic (they didn't repeat). I watched a friend be driven into paranoia by SSRIs. As the affects of the drug ripped her life apart, her doctor kept increasing her dose to 'fix it'. When last I heard from her, she'd lost her license, been fired and lost most of her friends -- an addicts journey except that she was following her doctors instructions.

It's interesting to me to see that some people have really been helped. That suggests that doctors need much narrower guidelines for prescribing these drugs.

Re:The Scientologists Got This One Right

[DerekLyons]

I normally can't stand the pompous, pseudo-intellectualism and general asshattery that permeates throughout the Scientology pseudo-religion

I read that as "the Slashdot pseudo-religion", which fits too.

Re:The Scientologists Got This One Right

[david_thornley]

You are wrong. In the case of an old friend whose funeral I went to on Monday, who refused to take antidepressants, dead wrong. I think that the reason why he's dead and I'm alive is the antidepressants.

If you don't understand something that can literally be a matter of life and death (and it's obvious that you don't), don't make sweeping statements about what should and should not be used.

While I wish actual depression on nobody, I assure you that you'd be best off with drugs and cognitive therapy both if you had it.

Re:The Scientologists Got This One Right

[david_thornley]

The side effects of Paxil and similar drugs vary wildly from person to person. When I had problems with it, I went back to the psychiatrist and got switched to Zoloft, which had no serious side effects for me (it made a friend of mine feel like his skin was trying to crawl off). If your psychiatrist didn't encourage that, I'd suspect you didn't get a good one. As far as your friend, there are two possibilities: she was descending into schizophrenia anyway and her doctor was incompetent (there's other drugs for schizophrenia), or she got unusual side effects and her doctor was incompetent.

Things work better when you're not being treated by a quack or incompetent.

Old news

[OverlordQ]

I mean, look what Paxil did for Miranda

Prudence and judgment...

[frank_adrian314159]

It would not seem prudent that one should be significantly altering neurochemistry during periods of high levels of neuroplasticity. On the other hand, we've been altering our own neurochemistry for entertainment purposes forever. As such, I'm sort of meh on the whole thing. We all do chemicals each day - even if it's only by ingesting food, water, and air.

I doubt good (and, yes, there are a lot of good ones out there, if you actually look) doctors are handing out SSRI's like candy to kids. When they do, it's usually at the urging of a mental health counsellor and with prodding from parents. As such, it's not prescribed that much (in this age range). It's not like it's Methylphenidate (whose overprescription, in my opinion, is a much bigger issue).

Re:Prudence and judgment...

[afidel]

As such, it's not prescribed that much (in this age range).

That is VERY wrong:

Despite this, more than 2 million prescriptions were written for U.S. children and teenagers in 2002, link

Re:Prudence and judgment...

[Pseudonymous Powers]

I doubt good (and, yes, there are a lot of good ones out there, if you actually look) doctors are handing out SSRI's like candy to kids.

I'm not sure about that. I think there's a indeed a lot of that sort of thing going on. One of my relatives went in to get a checkup, was asked whether they were happy, answered honestly that life was just okay, and so they recommended low-dose antidepressants. Another acquaintance went in for a checkup, was told that they were slightly overweight, and had antidepressants prescribed more-or-less as an appetite suppressant. I swear I'm not making any of that up.

I gather that a large percentage of patients nowadays only go to the doctor as a necessary step toward getting specific drugs that they believe they need. They are almost universally obliged, or they find another doctor. Modern doctors, perhaps as a consequence of this, seldom seem hesitant to recommend medication to alleviate the symptoms of the human condition. Supply and demand. You've got to give the people what they want, or go out of business.

Is medicine actually science anymore?

[Nutria]

The amount of fraud and incompetence in medical and psychological "studies" (along with the utter *fail* of peer review make me think that Medicine and Psychology drove off the rails into Snake Oil World many decades ago.

Re:Is medicine actually science anymore?

[dj245]

The amount of fraud and incompetence in medical and psychological "studies" (along with the utter *fail* of peer review make me think that Medicine and Psychology drove off the rails into Snake Oil World many decades ago.

This reminds me of the joke "What do you call the medical student with a final GPA equivalent of D- ? Generally you have to call them 'doctor' ". More terrifying than funny, but half of all doctors are, by definition, below average.

Re:Is medicine actually science anymore?

[Nutria]

Louis Pasteur comes to mind, as does Alexander Fleming.

Of course, neither of them were actually MDs.

speaking from experience, i can understand.

[nimbius]

as a kid I took Paxil briefly for depression, but never received any therapy so it was basically worthless. the drug was pretty brutal. I could function at school, but at 14 i felt like i was a drugged 40 year old junkie. I was exhausted all the time and had a near constant headache. between the nervousness and weight loss after the first year, i certainly wasnt depressed anymore but i was an emotional tire fire. I became violently opposed to the idea of dating, physical contact, or interpersonal relationship and extremely paranoid around adults. I still dont rememeber why this was, but I kept a notebook log of places to avoid and things people said.

And it got worse. Kicking paxil after highschool took an entire year of auditory hallucinations, nightmares, suicidal thoughts, crying, you name it.

Re:speaking from experience, i can understand.

[Anonymous Coward]

This isn't about you, or even about Paxil. It's about complete lack of integrity in the pharmaceutical and medical community. I'm sure if anyone cared to dig deeper, this is a bigger ethical issue that anything Blatter and his cronies at FIFA could ever dream up. But that won't happen because A) the general population is scientifically illiterate and B) *all* of the major news outlets rely on Big Pharma advertising dollars and will not do anything to jeopardize that revenue stream.

But, OMG!! Soccer in the desert?!? Something must be done!

No hate.

[DerekLyons]

No hate, just admiration for being one of the few willing to stand up to the pseudo scientific asshattery of the Slashdot Hivemind.

Re:No hate.

[kheldan]

I don't think all of which you refer to is 'pseudo scientific asshattery' (although some of it is, and a fair chunk of that is just garden-variety Internet trolls being trolls), I think that many are either young enough to not know anything other than what HMO doctors and the media have told them is 'true', and the ones that aren't young are either uninformed/misinformed, or they actually think that all doctors are near-omniscient beings (i.e., what they say is Word Of God). Honestly, if I'd've always believed and done every last thing that came out of some doctors' mouth, I'd be in rather poor shape right now, I think; there are 'doctors', then there are 'Doctors', if you get my drift. Let the patient beware! ;-)

Re:No hate.

[david_thornley]

If doctors were that all-powerful, my struggle with depression would have been a lot shorter. I assure you that I am informed on the subject, having found it a very important thing to learn about, have long since learned not to trust the media, and my opinions on the use of antidepressants appear to differ from yours.

Re:No hate.

[kheldan]

Friend, I've been in one too many 'discussions' (read as: violent, pointless, online arguments) on this subject to ever want to get in one with someone ever again. You do what you feel works best for you, and please allow my opinion to stand as-is, with the understanding that it in no way, shape, or form, is intended to demean, degrade, or invalidate you or your own life-experiences. We good?

Re:No hate.

[david_thornley]

Sure. As long as you're willing to accept my opinion as a well-considered opinion based on evidence (which you are of course free to disagree with), which is not what I inferred from the post I replied to. We're good. My apologies for getting touchy on the subject, due to personal reasons.

Personal anecdote time

[FunkSoulBrother]

Paxil got me out of the house when I was 24, bumming around playing WoW in depression with while my girlfriend worked after my mom died.

The tapering off was a bitch though, but I'm super grateful for it. Stopped having panic attacks and anxiety, built a career in software that fulfills me 10 years later.

Would a placebo have worked the same or even better? Quite possibly.

It's the Pax.

[nevermore94]

It's the Pax. The G-23 Paxilon Hydrochlorate that we added to the air processors. It was supposed to calm the population, weed out aggression. Well, it works. The people here stopped fighting. And then they stopped everything else. They stopped going to work, they stopped breeding, talking, eating. There's 30 million people here, and they all just let themselves die.
  - Serenity

At first, art imitates life. Then, life will imitate art.

Re:Took them long enough

[david_thornley]

I'm going to suggest here that giving an antidepressant to somebody who's feeling depressed because of something is dumb. However, if you get an actual case of clinical depression, take the antidepressants. It could be the difference between a reasonably normal life and years of emotional agony ending in suicide.