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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 The study published in the Lancet took six years, Cipriani said, and included all the published and unpublished data that the scientists could find.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.
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.
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.
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.
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.
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.