Anti-depressant pills give most users little benefit

[~lostgurl~]

Counselling funding call as anti-depressants questioned

Wednesday, 27 February
Stuff News (NZ)

The Government should bolster counselling services in light of research suggesting popular anti-depressant pills give most users little benefit, the Green Party says.

The Government's drug buying agency Pharmac today said it was looking into the effectiveness of the pills after a major international study found they were of no "clinical" significance.

The study, by British and American researchers, analysed 47 clinical trials - some of them previously unpublished by the drug companies who commissioned them.

The researchers, led by Professor Irving Kirsch, from the Department of Psychology at the University of Hull, looked at four commonly-used antidepressants - including fluoxetine (was Prozac, now Fluox), venlafaxine (Efexor) and paroxetine (was Aropax, now Loxamine).

They found little evidence of benefit for most users when comparing the pills to a placebo. There was some benefit for those who were severely depressed.

Green Party health spokeswoman Sue Kedgley today said the research showed doctors should halt the practice of prescribing anti-depressants to children and teenagers.

Previous studies had shown an increased risk of suicidal thoughts in these age groups with some antidepressants.

"The new study raises serious questions about the costs and benefits of the widespread use of these drugs and demonstrates that treating anti-depressants as a 'one stop shop' to treat this illness would be seriously misguided."

Instead the Government should boost funding to counselling services to ensure they were readily available.

In some cases GPs were giving out anti-depressants because of a lack of available services, Ms Kedgley said.

"It is essential that young people are offered the best possible counselling services and that antidepressants are not the only help available. "We should not be putting our kids at risk simply due to a lack of investment in this key part of primary health care and relying entirely on anti-depressants with significant side effects."

Pharmac medical director Peter Moodie said Pharmac would take a "measured" look at the issue and people should not stop taking their medication without consulting their doctor.

Researched Medicines Industry Association chairwoman and Christchurch general practitioner Dr Pippa MacKay today said anti-depressants could have a transforming effect. "Yes, they certainly do work and I guess that the trick is prescribing them to the right people."

- NZPA
http://www.stuff.co.nz/4418096a20475.html

[Jatelka]

And for those that are interested: The Meta-Analysis this story is based on has been uploaded to the archive by ThirdEyeFloond.

It's here...

http://www.drugs-forum.com/forum/loc...=4600&catid=47

[lulz]

The Last Psychiatrist had an interesting (as usual) commentary on this study.

Yet Another Study On Antidepressants, And No One Notices The Timing

Are we on this again?

"Study doubts the effectiveness of antidepressant drugs." Or, even better, as per The Independent: "Antidepressant drugs don't work-- official study."

I don't know what passes for official nowadays. The data is the exact same data that has existed for 30 years. Yes, these authors are acting like they FOIA-ed the second Zapruder film, but let me assure you it's the same old data. These authors did the exact same study in 2002. So have twenty other groups. This is not new.

But it is news. The question is why.

1. I have a side question. Why is it that when an article says something works, people are suspicious of bias, but when an article says something doesn't work, everyone thinks it's objective science? IT'S ALL BIAS.

2. People are completely missing the point of this paper and all the other recent re-investigations, the true social and clinical consequences of them. For example: they're saying antidepressants are no good. Ok. What do you think doctors are going to use instead? Psychoanalysis? Nothing? They're going to prescribe antipsychotics. Are you listening to me? I'm not even saying this is clinically wrong to do, but do you not see the setup? Abre los ojos, man.

3. Previously, when SSRIs were being shown to be super effective, people suspected Pharma bias. Now they are being shown to be ineffective, and people fail to see the bias. IT'S THE EXACT SAME BIAS- Pharma. That's why there are popular press stories on this now, as opposed to five years ago. GSK doesn't care that Paxil is ineffective. Do you know why? Because they want you on Lamictal. (Again, this isn't to diminish Lamictal's or antipsychotics' usefulness. I'm just talking politics.)

4. And the handmaiden of Pharma is the academic. You can't make a career studying generic medicines, because no one but the NIH will fund you to do it. And nowhere save Hollywood is there more cronyism and prejudice than at the NIH, so just forget it. You're an academic looking to cover your salary? Get promoted? The address on your grant application better read "Bristol Myers, Makers Of Awesome Abilify." If it says "Bethesda Maryland," slit your wrists now.

5. The study does not say that antidepressants don't work; it says that they don't work better than placebo. Placebo is not nothing. The question someone should be asking is how the hell placebo generates 35% improvement in all but the most severely depressed.

5b. ...And why the placebo works worse in the severely depressed. Before you jump to the obvious answer, note that antidepressants had similar efficacy, independent of severity.

6. If the drug had been no better than placebo, but placebo had only 2% efficacy, then yes, the drug would be worthless. See the difference?

6b. But that isn't true, either. If any of the structural classists over at The Independent would care to explain how failure in Major Depressive Disorder can be extrapolated to OCD, panic, multiple myeloma, etc, I'm listening. "Mexicans don't work-- official study."

6c. "Why did you add multiple myeloma? How's that? It's an antidepressant, a psych drug." No, it's called an antidepressant, it's used by psychiatrists. You have no way of knowing what it actually is. Look at the history of thalidomide. "Girls named Candi are sluts-- official study." While I'll agree that any parents who name their kid Candi are probably at risk for having a brass pole set up in the basement, you can't make any judgments about Candi herself based on her name. Do you know why? Because she didn't get to name herself.

There's a lot we can learn from the recent controversies surrounding antidepressants, and by a lot I mean only one thing, best articulated by Lewis Black: "Doctors don't know. They pretend to know. Because they have a rectal thermometer in their pocket. As if it was an appeal to a higher authority."

http://thelastpsychiatrist.com/2008/...antidepre.html


Just to clarify his point about how this study is probably intended to promote the use of antipsychotics instead of antidepressants: the patents on most SSRIs have either run out already, or will run out soon. Most atypical antipsychotics on the other hand have only been introduced in the last decade.

Believe it or not, benzodiazepines were once prescribed for depression. Fast forward a little while, and not only have SSRIs completely replaced benzos for depression, but they were introduced for treating anxiety.

I believe atypical antipsychotics are starting to be used for anxiety too, I know that Zyprexa is being used in this way for example.

Reputation Comments on this post:

Nice find, thank you!

[silentghost]

Benzos are more abusable, but at least they take the edge off. And while counseling is always viewed as good and clean, I think the fact is your just paying someone to be your friend for an hour, which isn't much good in the long run.

SWIM doesn't know about everyone. He saw one once for addiction when he was young (below 18) and all the shrink ever did was repeat everything SWIM said. SWIM left $100 bucks shorter and nowhere closer to a solution. Of course SWIM smiled and said how he was "cured", but thats just so they don't make you go back.