I just caught the headline in Newsweek. It seems that most of these drugs only work as well as placebos.
So the question becomes: what about the massive clinical trials that these drugs were subjected to? The US Government requires that prescription medications be “safe and effective”. Were all of these trials faked?
This seems like sensationalist reporting…or could the US public and medical establishment be duped in such fashion?
Or is depression a totally misunderstood affliction?
We recently discussed this at length in MPSIMS. The summary “antidepressants don’t work (better than placebos)” is, to put it mildly, extremely overly simplistic and in severe cases a potentially dangerous statement to make.
Many studies haven’t been published (around 40% according to that article), so really, much of the common wisdom (whether it’s accurate or not) may be based on an incomplete data set.
Another major point discussed at great length in the other thread is that these drugs may be effective…for a select group of people. Depression may be caused by a chemical imbalance, the specifics of which will vary from person to person. It may also be purely a behavioral/situational thing, and the only treatment someone needs is a change in their routine, or to finally get a new job, or so on.
And a third point: many, if not most, clinical trials are paid for directly by the pharmaceutical company, so while I don’t have a cite, I’m comfortable saying: “Yes, many of the trial results were probably tampered with.”
Possible, but I wouldn’t put this down as probable. I work in medical research (on the other side of things, at a medical center), and we pretty much always deal with an independent monitoring group that collects the data from our site, checks us to make sure we’re analyzing things correctly and performing in an ethical fashion, and so on. In the studies I’ve worked with where there’s a control treatment, it isn’t until the data is analyzed that the “codes” are broken and it’s revealed who got the study drug versus the control (either placebo or an approved drug). I know there’s room for misconduct but it’s not a bad system overall.
Plus, yeah, pretty much all of the initial research for a drug is paid for by the company that’s developing it. After all, another company isn’t going to, and the government isn’t going to toss money around for no good reason - well, one hopes not. :smack: After a drug is approved, you might well see various foundations or the government doing their own comparative testing of something new versus standard treatments - the department I work in is involved in a few of these now - but not so likely before approval.
They work for me.
I’ve used them and I can say when I take certain ones they work VERY fast on me or else it’s a total plecebo effect. I’ve used them for panic attack, and they start working in hours (I’ve used Paxil and Imipramine). Now I’ve also used Prozac for panic and it did nothing for me. So I’m not sure if it’s a real placebo effect or not.
When you do studies you must do double blind studies, that is neither the patient nor the person administering your drug knows which is which.
I bring this up because a side effect of antidepressents for me was very vivid dreams. This is especially obvious to me as I rarely dream. If I go on, say Paxil for two or three days my dreams will be very vivid, then the effect dies off. Then when I go off of, say Paxil, the vivid dreams come back for a day or so, till the drug goes out of my system.
Again, I bring this up, because if I was involved in a study in order to properly study me you would have to come up with a placebo that would mock me having vivid dreams. Because if I didn’t get them, I’d know I got the placebo.
This is why the zinc lozenges are so hard to study. In order to get the benefit you have to such the zinc lozenge not swallow it. And as anyone who has used zinc lozenges knows there is a very unique taste to that lozenge, and testers have never been able to come up with a placebo that tastes close enough to fool people.
So you can’t do a proper double blind study. So your results are compromised, it’s better than an educated guess but not definiative like a double blind study.
Years ago, Prozac may have saved my life. So I’m OK with anti-depressants.
Joe
I remember it was Newsweek that was touting Prozac back in the 80s when it first came out as a great scientific revolution. FLASH: Newsweek is still full of shit!
This is definitely a big factor. There are several classes of antidepressant, and they do different things - some cause one or two specific neurotransmitters to linger more in synapses, some slow the breakdown of the neurotransmitters, etc. There are also different kinds of receptor for doing essentially the same thing, and specific drugs affect the different kinds of receptor to different degrees (This is a bit of an oversimplification actually; they’re reuptake channels rather than receptors per se.)
For me personally, when I was put on an antidepressant (Prozac) it made me feel worse. I have bipolar, and apparently it’s common among us for the SSRI meds to worsen our moods. The doc switched me to a different med that does something to ion channels and that works so much better, though nobody really understands why.
As far as not being better than placebo, I don’t buy that anyway because the whole reason antidepressants were discovered was because the first few were being used to treat something else and some patients reported that they were in a better mood and seemed livelier. A psych professional tried the meds on his clinically depressed patients and for some they worked. Thus was born depression medication.
When I started taking Prozac there was this one night I had a very beautiful vivid dream about floating around in a biosphere where everyone lived on a strand full of blue disks, and when you were near the strand you could see stars up in the sky. The whole dream was bright blue and violet. With my current med my dreams are indistinct and mildly unpleasant. I really miss having awesome dreams and in fact going off Prozac was a disappointment because even while awake, everything was more vivid - colors, flavors, the mental imagery one gets while listening to music. Take that away and the world becomes slightly more dull.
Faked? Maybe. Cherry-picked results? Definitely.
As Ninjachick has pointed out, drug trials are not run by independent labs as you might expect, they’re funded by pharmaceutical companies.
lol, seriously? The US public are duped pretty much daily one way or another.
It’s a handsome cash-cow.
It’s worth noting that safe is usually defined in proportion to the drug’s potential benefits, and effective most often means it works significantly better than a placebo, which may not work all that well. So there’s some wiggle room there.
Could the U.S. public be duped? Let’s put it this way: most people aren’t reading medical journals, they’re watching TV commercials for the products. Whether that constitutes duping or not, it’s getting information that presents the drugs in a rosy light, even if the commercials do end with long lists of side effects. I’m unclear on the meaning of “the medical establishment.” We’ve discussed how the FDA works, and a great deal of effort is made to woo doctors.