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Major New Study Confirms Antidepressants Really Do Work (theguardian.com)
According to authors of a groundbreaking study, antidepressants really do work in treating depression, though some are more effective than others. "Millions more people around the world should be prescribed pills or offered talking therapies, which work equally well for moderate to severe depression, say the doctors, noting that just one in six people receive proper treatment in the rich world -- and one in 27 in the developing world," reports The Guardian. From the report: "Antidepressants are an effective tool for depression. Untreated depression is a huge problem because of the burden to society," said Andrea Cipriani of the NIHR Oxford Health Biomedical Research Centre, who led the study. The debate over antidepressants has unfortunately often been ideological, said Cipriani. Some doctors and patients have doubts over whether they work at all and point to the big placebo effect -- in trials, those given dummy pills also improve to some degree. Some people suspect drug companies of fiddling trial results. Some patients simply do not want to take pills for a mental health condition. The study published in the Lancet took six years, Cipriani said, and included all the published and unpublished data that the scientists could find. It was carried out by a team of international experts. They looked at results after eight weeks of more than 500 trials involving either a drug versus placebo or comparing two different medicines. The most famous antidepressant of them all, Prozac -- now out of patent and known by its generic name, fluoxetine -- was one of the least effective but best tolerated, measured by a low drop-out rate in the trials or fewer side-effects reported. The most effective of the drugs was amitriptyline, which was the sixth best tolerated.
- between chronic depression, caused by imbalances in neurotransmitter production or reuptake, and depression caused by living in depressing circumstances. Antidepressants are routinely prescribed for both cases.
I guess if your life sucks, it's easier to take pills so you won't bother anyone with suicide attempts, rather than address the problems of your circumstances. I'm glad I stopped taking them; my life sucks, but I can acknowledge that, and I'd rather deal with that knowledge than be a po-faced zombie again.
Only 2% of studies showing antidepressants aren't effective get published:
https://www.ted.com/talks/ben_goldacre_what_doctors_don_t_know_about_the_drugs_they_prescribe
This is a meta-analysis. Back when I was in grad school, we'd throw these in the garbage. You cannot account for controls across tens of studies, much less hundreds of studies. Unless the authors legitimately did a replication study writing before the meta-analysis, they're next to useless.
Beware of things that say things are confirmed without a doubt. Doubt is essential in all things involving science and research. You must continually doubt your axioms and question things; replication the true you think you know to be true.
https://khanism.org/science/doubt/
I know for me personally, anti-depressants were awful. The side effects were bad and I never liked taking them. I feel like regular behavioral therapy and talking with a good psychologist who'd help me see my options and my negative ways of thinking helped significantly more than anything else.
That being said, I know they help some people too, either real of placebo, with major depression. Doctor's are afraid to try therapy without drugs because of the liability if the patient harms themselves. I think this is really sad and that these drugs are way over prescribed. It's a tough issue to balance, but claiming crap like this study does (which is probably funded by the industry anyway) just leads to more confirmation bias and less incentive to come up with more effective treatments.
Who cares?
Anti-depressants are like being told oh, you're sad, here's a pil, now shut the fuck up and get back to work.
After having to tolerate a sibling on antidepressants for over 25 years, I'm in the camp who's experiences differ from what the study says, I see no difference and in reality deterioration. Having also had to deal with a somatic and a cerebral narcissist, I can also tell you no matter how strong you think you are, other peoples mental illness *will* cause you to have a mental illness. In my case PTSD, which made me somewhat dangerous.
In other words, mental illness is contagious.
What I learned is it is essential for your sovereign individuality to minimise contact with mentally ill people in your life before you can begin to recover your own sanity. Then you do the last thing you want to do, face the pain. Face what the deceitful actions of what others did to you and write it all down event by troubling event. What this does is help you process the emotions in a controllable way, this is difficult if you are living with an abuser. What this helps with is state control, preventing Amygdala hijack and re-regulate your HPA axis. You can die if you end up in a state of adrenal failure.
I was on the receiving end of two narcissists because of the child abuse I endured. When I claim that, I'm refering to the DSM and mean they both exhibited 5 of the nine traits of a cluster B abuser and are probably diagnosable by a trained professional. Trouble is, they don't think anything is wrong with them and they lie lie lie all the time. One was a covert narcissist and destroyed my life twice before I figured it out.
Worst thing about it though is realising that it made me attracted to these type of people and opened me up for further abuse by other anti-social people and one probable occupational psychopath. I was part of the problem. In writing it all down I processed the emotions and that made me a lot harder to manipulate because it is the unprocessed emotions that 'Those people' can detect in you and use to manipulate you. Once you clear that, you are less prone to abuse and you can start to develop boundaries and coping strategies. If you are depressed, check to see if you have too many assholes in your life. Chances are there are more than one. You know the ones who constantly stoke anger in you - "Those People" who get their thrills by trying to put you into a state of Amygdala hyjack. That want to show everyone how crazy you are so they can indulge in being right. That's all they have and they are usually losers - no you can't fix them.
So, what I am saying here is it's all too easy to just take a pill, it's bullshit. Face the pain and become a fully functional human being before you become as damaged as I was. You will feel fucking terrible while you do it, however a few weeks afterwards you will be amazed at the good things that start happening to you. The narcissists will still be losers.
If you are hurting and you are reading this, please know, it's possible to escape. It's not easy but you owe it to yourself.
My ism, it's full of beliefs.
For anyone reading the comments, you should listen to your doctor and trust your experiences. There are different types of depression, and the stigma that you can see prevalent in these comments that you should 'just stop being sad' is a plague in of itself. I am bipolar, and spent the majority of my life being a useless piece of shit who would wake up one day and start training to be an engineer and fall asleep that night alone under a bridge trying to kill myself. I would miss a bus and decide that was a sign that I was a failure in life. None of this is normal, and none of it was my fault. It is a genetic condition, and I spent years telling myself the medication would be a crutch that would make it worse, and that I was strong enough to 'do it on my own'. I didn't want to be one of these pathetic people that everyone talks about.
But then I found a job I loved, and I didn't want to ruin it like I had so many times before. I decided to get help. I saw a doctor. I started seeing a therapist. I started taking my medications. I wake up now and take my pills and sometimes I forget how hard life used to be, and I can never say enough how amazing it is to be in that position. Not everyone will find the right combination of medications. Maybe your therapist or doctor sucks. Keep fighting. Get a new one. Ignore these trolls who don't struggle the way we struggle and keep pushing yourself.
There are communities out there to support, help, and guide you. Become a part of those communities and don't let the ignorance of the masses tell you that you can't get better. If you are still reading this, the odds are that you have a voice in the back of your mind that keeps tell you that, anyway.
So a study of a bunch of studies (run by industry insiders) that showed antidepressants work showed that after analyzing these studies that antidepressants work.
So studies that individually come to a positive result also collectively come to a positive result? I think this is a phenomenon we need to study!
How about a novel approach. Have people who understand statistics, medicine and psychology (but have no links to drug companies or reason for bias) try to recreate the results of past studies or run large-scale, carefully controlled new studies. And don't use drug company money to fund the study.
Read the article, or even the linked Lancet article, which says:
Funding
National Institute for Health Research Oxford Health Biomedical Research Centre and the Japan Society for the Promotion of Science.
Which I think means 100% government funding. It also gives the exact methology -- a systematic search for, and integration of data from, all published studies that met stated criteria.
Last line in the abstract gives the funding — National Institute for Health Research Oxford Health Biomedical Research Centre and the Japan Society for the Promotion of Science. it’s independent.
The authors are heavy hitters in the evidence synthesis field, with names on key articles. John Ioannidis, author of the famous paper “Why most published research findings are false”, and numerous other articles pointing out the pitfalls and limitations of evidence based medicine. Higgins is a co-author of the Cochrane Collaboration Handbook (the bible for systematic reviews), Cipriani and Salanti are key players in the development of the methods for network meta-analysis.
This is as good as it gets for medical evidence synthesis. A large dataset, expert authors, and findings that will come under scrutiny. Haven’t read the paper yet, but I’d expect the major limitations to be publication bias — the constant concern that negative studies don’t get published — risk of bias in individual studies, since many of those are pharma-funded, and whether the pooled papers fulfil the assumptions needed for network meta-analysis. There are formal methods for assessing the potential impact, and the discussion will get to grips with those questions. So will the commentary around it in other journals. See PLoS Medicine, for instance.
Sometimes I get afraid that people thinks science is magic. It isn't. That people think there are wast conspiracies everywhere. There aren't.
You say you want a vaccine. That indicates you have no idea what a vaccine is. And you want it for something we still don't know how it works _but_ we know is a spectra of different symptoms that require a spectra of drugs to be chosen for a certain individual/patient. You don't realize how medical science works instead claiming things that
This is beyond stupid. You are requesting something that wouldn't work (vaccine) for something we still don't know enough about (depression) to do something magical (become real) and the fact magic doesn't work is an indication of a major conspiracy.
I don't think you need antidepressants, your condition requires another kind of medication.
I don't doubt that antidepressants work, or can work well for some individuals based on exactly what the drug does and what afflictions are being suffered, but I do wonder if we're going to run into a problem where we try to use them to treat symptoms rather than fixing underlying problems. I think that, much like obesity, a lot of the increase we're seeing in depression is related to changes in lifestyle. People don't get outdoors as much, eat as healthily, or get as much exercise and humans are still as much the animal as we've always been and subject to the consequences of that.
I'd like to think that they can be used appropriately to help people get out of a rut so that they can start fixing the underlying problems in their lives, and there are probably some people who are born with some condition that might necessitate using antidepressants their whole life much like some people need insulin, but I have a sneaking suspicion that in reality we'll just throw loads of pills at people with great abandon or no care to fix the underlying problems that would allow them to function without that medication. I think this is true for a lot of things, not just antidepressants.
The first fucking thing they do when they prescribe you with antidepressants is MAKE SURE YOU'RE NOT SAD ABOUT SOMETHING. Like really, understand that doctors ask about all of this.
Laws are rules for the court, but merely a bottom bar to hit for life. Think beyond laws in your actions always.
Or, we stop our worship of the false God Nature, and start realizing that our bodies are no longer adequate to the task at hand. Instead of punishing ourselves for living how we want to live, we start figuring out how to live how we want to live without the consequences (or alternately, change the instinct driving our motivation). Chemicals are one such help.
We don't go outside because obviously we don't want to. It's dirty, the weather is unpredictable, there are animals & insects carrying disease, too hot/too cold, too bright/to dim. Etc. Wherein we have a plethora of technologies to fix these problems in small space indoors. We may have created some problems in so doing, we need to determine what they are and design them out. If we need more UV exposure, we have product for that. If indoor air quality is low, we have product for that.
We eat poorly primarily due to what our body is telling us about food, and why it is telling us these things. The drive for more fat and more starches is not surprising if you consider that starvation was a major concern in our evolution, and managing it was key to survival. Fat and starch cravings push the unformed mind to make good survival choices. We're well past that now in most of the world, and what our bodies are demanding is no longer optimal for our health. We either need to suppress these instincts or deal with the symptoms. It seems like suppression is probably the way to go, the other side is mostly whack-a-mole.
Sleep is a tougher nut to crack. Losing 33% of our day (or more, depending on who you talk to) is a huge imposition. It seems unlikely that we're soon going to turn in to a society that can simply sleep when it wants, nor that we will actually want it if given the choice. We probably should be focusing on ways to get the most out of what little sleep we get. It seems we understand all of this very little right now. Other choices might be that since we are no longer held to a farmer's schedule, maybe work schedules based on rising with the sun are not necessary or ideal.
In the meantime, while we bake actual solutions up, things that treat the symptoms seem fine. Provide the side-effects are known and the users are free to do the cost benefit analysis. I personally stay away from anti-depressants, not because I do not need them (I am fairly certain I do), but the side effects are sketchy.
This is beyond stupid.
There should be a vaccine for stupidity.
I have been a pharmacist for many years.
Pharmaceutical companies funding fake scientific journals to create the "look and feel of a peer-reviewed publication to serve as a marketing tool" or to elicit favorable study results is a far more common problem then you think...
https://www.the-scientist.com/...
https://www.bloomberg.com/news...
https://www.washingtonpost.com...
Physicians prescribing medications because they are getting kickbacks from the pharmaceutics companies is nothing new either...
http://www.chicagotribune.com/...
And hell, your prescription coverage employs a formulary that is driven just as choosing drugs because they provide cost savings as it is by scientific data showing greater efficacy.
Science isn't magic but neither are scientists omnipotent grand wizards fighting for the side of good. They are just as corruptible as anyone else on this planet. Corporations are still driven by profit above all other concerns, even ones that are staffed by research scientists.
Blind faith in "science" (technology) is just as dangerous, if not more so, then blind faith in religion. Skepticism is a cornerstone of scientific inquiry. If you aren't practicing it, your doing it wrong.
Being truly depressed is like being in a dark place you can't get out of. You get a new job, but it is still there. You exercise, but it is still there. If it's an anxiety-type, then it can keep you up all night worrying about things that don't matter. You tell yourself that it doesn't matter, but it doesn't make a difference because your brain goes to that dark place and it doesn't make a difference. It's like trying to will yourself out of having a headache.
Laws are rules for the court, but merely a bottom bar to hit for life. Think beyond laws in your actions always.
Of all those under treatment a small fraction end up being in that category.
And we don't know if that figure would have been higher or lower without treatment.
If builders built buildings the way programmers wrote programs, then the first woodpecker would destroy civilization.
Quote from the actual study:
"We excluded quasi-randomised trials and trials that were incomplete or included 20% or more of participants with bipolar disorder, psychotic depression, or treatment-resistant depression". (emphasis mine)
So yeah, it works, unless it doesn't, in which case we'll exclude those instances. No true Scotsman indeed.
You know? I've always been such an advocate for technology and science that I would have immediately been on-board 100% with everything you said there. But as I've gotten older, I've experienced things that make me question some of that. For example, I've never been a "morning person", always preferring to sleep in until my body wants to get up (usually by 11AM or thereabouts), and like to stay up until 1AM or so. But I recently visited with some friends of mine who have a small house on a bunch of land out in the country, and live a pretty "simple" lifestyle compared to what I've designed for myself. Sure, they have "Internet" -- but their only connection consists of a Sprint LTE hotspot. For them, most of their Internet usage is Facebook on their cellphones or small games or apps downloaded onto them. They own exactly 1 Windows laptop, that sits on a small desk in the living room and gets used randomly by whoever needs it for something. (Typically - they seem to use it to download photos off their digital cameras.)
They spend most of their free time doing outdoorsy things. They have a swimming pool, 4-wheelers they can drive around on all the land out there, etc. They build bonfires when it's cool and invite neighbors and friends over for meals, to drink and just to have conversations. The guy's wife likes to do a lot of arts and crafts using "found" materials from a local junk yard they visit and scour through regularly.
It's the type of lifestyle I always said was "NOT for me!" ... but I found within hours of spending time with them, my stress levels just dropped off. They went to bed earlier than I would have normally called it a night, but I had no problem getting right to sleep since we had done a lot of more physical activity with all the outdoors stuff that day. They woke up bright and early and I found it just felt "right" to be up with the sun like that.
I guess what I found more enlightening was how quickly I adapted to that "farmer's schedule" they kept, even though it had NOTHING to do with farming!
Don't get me wrong.... When I got back home from that trip, I was content to fall right back into my usual patterns and was happy to have all my technology back. But it made me ask myself if a lot of our struggles are just the result of our choices -- and not so much a case of "worshiping that false god, nature"? The more things you own, the more the things begin to own you. That's a quote I read someplace and I see a lot of truth to it. How much additional stress and hassle is in my life because I have "to do" lists filled with errands to runs or items to buy to maintain my stuff? And how often are we eating poorly because time has become such a precious commodity for us, with our artificially busy schedules we've created? I'm not really ready to throw it all away and become the next Luddite, living in a secluded log cabin. But I'm realizing we're paying the price, in many ways, for trying to enhance our lives with all the tech we surround ourselves with. It gives but it takes away too. Maybe it's more of a "wash" than we think, compared to not living this way?