Study Doubts Effectiveness of Antidepressants? Imagine That.

[Athena]

Study doubts effectiveness of antidepressant drugs

WASHINGTON (Reuters) - Antidepressant medications appear to help only very severely depressed people and work no better than placebos in many patients, British researchers said.

Researchers led by Irving Kirsch of the University of Hull reviewed a series of studies, both published and unpublished, on four antidepressants, examining the question of whether a person's response to these drugs hinged on how depressed they were before getting treatment.

They were Eli Lilly and Co's Prozac, also known as fluoxetine, Wyeth's Effexor, also called venlafaxine; GlaxoSmithKline's Paxil, also called Seroxat or paroxetine, and Bristol-Myers Squibb Co's drug Serzone, also called nefazodone, which it no longer markets in the United States.

They are all so-called selective serotonin reuptake inhibitors, or SSRIs.

The researchers found that compared with placebo, these new-generation antidepressant medications did not yield clinically significant improvements in depression in patients who initially had moderate or even very severe depression. The study found that significant benefits occurred only in the most severely depressed patients.

"Drug-placebo differences in antidepressant efficacy increase as a function of baseline severity, but are relatively small even for severely depressed patients. The relationship between initial severity and antidepressant efficacy is attributable to decreased responsiveness to placebo among very severely depressed patients, rather than to increased responsiveness to medication," the researchers wrote.

The researchers obtained data on all the clinical trials submitted to the U.S. Food and Drug Administration for the licensing of the four drugs.

"Although patients get better when they take antidepressants, they also get better when they take a placebo, and the difference in improvement is not very great. This means that depressed people can improve without chemical treatments," Kirsch said in a statement.

But Mary Ann Rhyne, a spokeswoman for Paxil maker GSK, said the study only looked at data submitted prior to the drug's U.S. approval.

"The authors have failed to acknowledge the very positive benefit these treatments have provided to patients and their families who are dealing with depression and they are at odds with what has been seen in actual clinical practice," Rhyne said.

"This analysis has only examined a small subset of the total data available, while regulatory bodies around the world have conducted extensive reviews and evaluations of all of the data available," she said.

Doug Petkus, a spokesman for Wyeth, maker of Effexor, said he had not seen the study and could not comment.

------------------

Frankly, this doesn't surprise me one bit. While I absolutely believe that clinical depression exists, I would argue that the fast majority of people seek chemical therapy to cure a bad week and their unwillingness to take the steps necessary to curb their depression, like adjusting their diet and getting more exercise. Is it any coincidence that depression appears to be at its highest rates in countries more prone to obesity? Not likely, in my opinion.

[ells9824]

I don't really see this as new news,or maybe my doctor is ahead of his time.

I had my children very close together, and had a pretty big case of the baby blues. We had just moved half way across the country, hadn't closed on our house yet and were bouncing from in-laws to in-laws with 2 young babies until we did.

EVERY THING made me cry. The Princess Di version of Candle in the Wind, Fred being mean to Barny, thinking of my mom who'd been dead 8 years already.

My doctor wanted me to take Prozac for awhile to "regulate" my seratonin levels. I was very against any psych meds, but he said, "It will not hurt you,
and will only help you if you need it!"

In the end, I cleaned alot,rarely slept and lost all my baby weight...but most everything still made me cry. After one month he said quit taking it unless I wanted the energy boost, as thats all it was going to do for me.

Meh... I think they're looking for things to bitch about.

[TXChris]

I agree with you on depression. But, hey, it's much easier putting the blame elsewhere and attempting a quick fix that you don't have to really work at. And, if that doesn't work, then you have the healthcare field's assertion that it is so terrible and that you can't do it on your own (you need their psych fees and medication) to fall back on to give you a larger crutch to continue not doing what you should be doing in the first place to get out of the funk. What I want to know is what other problems were created by these drugs. After all, they are an attempt at messing with the biological function of the human body and since they really aren't doing what they were expected to do WHAT exactly are they doing?

[swivel]

Idiots! What are they doing?!

Around 30% of the general population are susceptible to the placebo effect. Announcing this crap means we are going to go from helping 1 in 3 to helping none!


Argh... now I have to figure out how to delete this thread...

[ells9824]

What I want to know is what other problems were created by these drugs?

I know Prozac replaced the fen in the phen-fen diet. That one caused heart valve problems. I do not recall off the top of my head of phen-pro diet regimen has caused any other health problems.

[TXChris]

I know Prozac replaced the fen in the phen-fen diet. That one caused heart valve problems. I do not recall off the top of my head of phen-pro diet regimen has caused any other health problems.

According to the study on phen-pro (http://www.hsph.harvard.edu/Organizations/DDIL/phen-pro.html) they say that 10-30% of patients reported, as side effects, decreased sex drive and orgasmic delay. :eek: That right there is reason enough NOT to take it, in my opinion.

[Athena]

Idiots! What are they doing?!

Around 30% of the general population are susceptible to the placebo effect. Announcing this crap means we are going to go from helping 1 in 3 to helping none!


Argh... now I have to figure out how to delete this thread...

LMAO...These people don't care, they just want to take something.

[Athena]

According to the study on phen-pro (http://www.hsph.harvard.edu/Organizations/DDIL/phen-pro.html) they say that 10-30% of patients reported, as side effects, decreased sex drive and orgasmic delay. :eek: That right there is reason enough NOT to take it, in my opinion.

I don't know...Orgasmic delay might not always be a bad thing. :p

[ells9824]

According to the study on phen-pro (http://www.hsph.harvard.edu/Organizations/DDIL/phen-pro.html) they say that 10-30% of patients reported, as side effects, decreased sex drive and orgasmic delay. :eek: That right there is reason enough NOT to take it, in my opinion.

So the equivalent of Viagra, but women can take it and you lose weight-sounds like a win/win to me ;)

[TXChris]

LOL Athena and ells. First of all there was the decreased sex drive. NEVER a good thing in my book. I am biased. What can I say? :D As far as the orgasmic delay goes, I guess I was looking at the possibility of always getting just to the edge and not being able to go over the falls, so to speak. THAT would suck.

[ells9824]

Thats fair.... but a woman on the edge of an orgasm for hours, again,can't complain LOL

[swivel]

The way we treat depression is 180 degrees from what we should be doing. Almost no psychologist on the entire planet understands what depression is, which is why we are seeing more and more people with depression, the more we try to treat it.

A hint on what depression is: The rate of depression in a country is positively correlated with the standard of living in that country, as compared to other countries.

[Rotten Apple]

Thats fair.... but a woman on the edge of an orgasm for hours, again,can't complain LOL

It's not like you think Ells.

It's no fun at all. Take my word for it.

[CPL CHUD]

Is it any coincidence that depression appears to be at its highest rates in countries more prone to obesity? Not likely, in my opinion.I think the opposite. Eating generally releases chemicals in the brain that makes people happy. I personally get stoked on some meatloaf. What really is the case is that most people spend equal amounts of time depressed and happy, but don't want to cope with the emotional lull, so they seek out things to comfort them, like food, but with or without obesity people are still going to go though the sad times. It's that we can afford these comfort items that make us obese to begin with but it isn't the initial cause.

[Athena]

I think the opposite. Eating generally releases chemicals in the brain that makes people happy. I personally get stoked on some meatloaf. What really is the case is that most people spend equal amounts of time depressed and happy, but don't want to cope with the emotional lull, so they seek out things to comfort them, like food, but with or without obesity people are still going to go though the sad times. It's that we can afford these comfort items that make us obese to begin with but it isn't the initial cause.

Different focus. I'm not talking about being fat. The prevalence of obesity is simply a bi-product of the root of depression in many cases.

Various studies have linked depression to nutritional deficiencies. (http://news.bbc.co.uk/2/hi/health/4610070.stm) The correlation is not entirely clear, at this point, but an increasing amount of funding is being funneled into such research. In many cases, a person's mental health may be a result of a poor diet and lack of exercise. This person may not be fat - you certainly don't have to be fat to be unhealthy.

I'm talking about the non-severe levels of depression and anxiety, by the way. That being said, nutritional deficiency has been linked to more severe mental illness.

[LadyValkyrie37]

Study doubts effectiveness of antidepressant drugs

WASHINGTON (Reuters) - Antidepressant medications appear to help only very severely depressed people and work no better than placebos in many patients, British researchers said.

Frankly, this doesn't surprise me one bit. While I absolutely believe that clinical depression exists, I would argue that the fast majority of people seek chemical therapy to cure a bad week and their unwillingness to take the steps necessary to curb their depression, like adjusting their diet and getting more exercise. Is it any coincidence that depression appears to be at its highest rates in countries more prone to obesity? Not likely, in my opinion.


I agree with you. Also these are not magic pills. Hasn't it been proven that with people who do have depression that meds plus psychotherapy works better than meds alone? One must be willing to work on the root of the depression in order to truely get better.

[CPL CHUD]

I'm talking about the non-severe levels of depression and anxiety, by the way. That being said, nutritional deficiency has been linked to more severe mental illness.It's still too inconclusive for me to plant my flag on.

If I had to take a guess I'd say like most things it'd have to be related in a big way to genes. You inherit different genes with different triggers that cause clinical depression. Since it's genetic it can never truly be cured, only hampered. I suggest meatloaf.

This also explains why the pharmacuetical(sp?) companies are so heavy handed with trying to sell their magic pills. They know it's temporary, reoccuring, and not permanently curable.

I can also understand why it's embued in so many people's genes. Why it survived. It's a reality check trigger. It kept us from overestimating our chances in the wild. From attacking that group of sabertooth tigers all by our lonesome. Realists, the ones that overevaluate the least, are usually the most depressed.

[Athena]

It's still too inconclusive for me to plant my flag on.

If I had to take a guess I'd say like most things it'd have to be related in a big way to genes. You inherit different genes with different triggers that cause clinical depression. Since it's genetic it can never truly be cured, only hampered. I suggest meatloaf.

This also explains why the pharmacuetical(sp?) companies are so heavy handed with trying to sell their magic pills. They know it's temporary, reoccuring, and not permanently curable.

I can also understand why it's embued in so many people's genes. Why it survived. It's a reality check trigger. It kept us from overestimating our chances in the wild. From attacking that group of sabertooth tigers all by our lonesome. Realists, the ones that overevaluate the least, are usually the most depressed.

Let me take a moment to clarify my position.

I am not asserting that clinical depression or other more severe mental illnesses are caused by nutritional deficiency. I merely note that a link has been discovered. I also believe that genetics is the determining factor with more severe illness.

What I am asserting is that not all, or even most people prescribed antidepressants are clinically depressed. This explains why chemical treatment does not affect them much if any more significantly than placebo. I do believe that, in these cases, lifestyle and nutrients play the major role in their mental health.

Unfortunately, it seems that the two "brands" of depression - that which is genetic and severe and that which is lifestyle based and more mild - are lumped into the same category. I think it's so hard for psychologists to pinpoint the cause of depression because there is no single cause when you look at all depression.

And, while I am no conspiracy theorists, Big Pharm wields some powerful lobbyists and such. I think they have a hand in depression being researched less than honestly. After all, what would it do to their bottom line if, suddenly, a large number of cases could be accurately treated without drugs? This also explains why a number of these studies critical of chemical therapy come out of countries like Canada and Britain, rather than the U.S., where the Big Pharm strangle-hold is most oppressive.

[TXChris]

Oh, damn, that almost sounds like a commercial espousing the greatness of socialized medicine. ;)

I'm just giving you a hard time. The free market can definitley best take care of the populace, but big pharma, here in the U.S., is most assuredly NOT based on the free market system. It's based on lobbying and anti-competition laws.

[CPL CHUD]

And, while I am no conspiracy theorists, Big Pharm wields some powerful lobbyists and such. I think they have a hand in depression being researched less than honestly. After all, what would it do to their bottom line if, suddenly, a large number of cases could be accurately treated without drugs? This also explains why a number of these studies critical of chemical therapy come out of countries like Canada and Britain, rather than the U.S., where the Big Pharm strangle-hold is most oppressive.
Don't forget all the bullshit psychologists involved with "relieving" mild depression.

And I agree, depression is linked to the decline or excess to pizza intake, but what do you think about the connection between being realistic and being depressed? Do you think this is an inherited biological trait geared towards creating a lack of confidence for the sake of making individuals less likely to take chances; the fear of doing wrong? I'm just musing around with this idea here. I think people who are overconfident take more risks, but yield a greater chance at reproducing their carrion. On the other hand, they run a bigger risk meeting disasterous outcomes. Depressed people take less risks, therefore venture to gain less, but are more likely to survive in the wild.

Sometimes the biggest step towards solving a problem is underlining where it came from and why it's here.

[Athena]

Depression as a hardwired safety, huh? To increase ones chances for survival...Interesting concept. It almost mirrors my opinion on the origin and purpose of religion.

I'm not sure, though. If we're talking the more severe, clinical depression that I feel is genetically oriented, that comes with a significantly increased risk of suicide and self-injury. The depression could very well outweigh the benefit of decreased tendency to take risk.

[skeptical]

I agree that Paxil doesn't work. My bipolar cousin is on it and it doesn't help her at all. Her bipolar daughter however is on Wellbutrin and Abilify and without those two drugs you can't stand to be around her. It's a severe roller coaster ride without them. I know cause she lives with me!

[swivel]

Here is my theory on the evolutionay advantages of clinical depression:

First, it has to have evolutionary benefits. Any complex chemically-induced behavior that affects such a large percentage of the population (possibly the ENTIRE population if conditions are right) must exist because it confers an advantage to the depressed.

Also, any chemically-induced state that we have in common with our mammalian neighbors can not be blamed on societal influences alone. Nor can they be the product of any processes in our frontal lobes, which strikes out almost all generally-accepted theories for the origin of clinical depression.

The first thing we have to do is ask, "How does depression HELP us?". At first, this seems like an unusual question. But here is something to keep in mind when searching for evolved benefits: Our happiness is not the goal. Happiness is a tool that evolution uses to reward beneficial behaviors. It is NOT the end-result that our behaviors are meant to lead to. All our genes "care" about is their perpetuation. They don't really concern themselves with our well-being except for how this furthers their own goals.

(forgive the anthropomorphizing, it is really the simplest way to discuss these pressures)

Another point: Death is a good thing for our genes, even though it doesn't suit us. The only way DNA can change, adapt, and survive in a non-static environment is through a process of renewal. (sexual selection, cross-pollination, genetic drift) If we lived forever, we would consume resources that need to go to the next generation of genetic information, which is more-suited for the current environment.

OK, so our adaptations are not concerned with our happiness, that means we are free to explore depression as useful, not as a harmful thing. Let's keep it simple... what does depression make us want to do? It makes us want to curl up in a ball and go to sleep. To do as little as possible. To "zone out".

Here is my theory: Depression is a form of alert hibernation. I think the most important drive in evolutionary competition is caloric intake, NOT sexual selection. I may be alone in this, but I think that I am correct. We spend more time worrying about our energy intake than we do about any other thing. And that is ALL animals, plants, and bacteria. It is such a common drive that we don't even notice it, and tend to focus on secondary concerns (from an evolutionary perspective) like reproduction and offspring-care. But the ATP cycle, the constant need for energy, is what moves us the most.

My theory is that when an organism has its immediate needs met, it is designed to shut itself down, to conserve ATP. This would explain a number of confusing facts about depression: The numbers of people with depression have gone up over the past 100 years, as a percentage of population. This coincides with a massive increase in our "standard of living", which can be equated as having our basic needs met. Second, we see higher rates of depression in the most industrialized societies. Luddites have tried to relate this to our "disconnect with nature", but no causal agent is shown. This is just agenda-driven nonsense. My theory not only explains this, but predicted it.

This theory also explains why attempts to treat depression do not work well. We are doing the opposite of what we should be doing. According to my theory, we should add stress to the life of someone who is clinically depressed. Give them tasks which must be performed. I have seen anecdotal evidence which supports this idea.

Lewis, of "Lewis and Clark" fame was depressed. And like many depressed people, he was only "himself" when he had challenges placed before him. He blew his brains out after returning to the East. Katherine Graham's husband (Washington Post, fame) led the same life of ups and downs corresponding to mental and physical challenges.

The problem is, we treat the inactivity and laziness as a SYMPTOM of depression, rather than the desired product of depression.

I think these ideas should be tested, but I think it is important to note that evolutionary tools have a tendency to be used for multiple purposes. That is why I think that this theory would only hold true for clinical depression, and not for similar depressions. It would be absolutely necessary to make sure that the type of depression was known before applying this theory to the depressed.

[ThreeOnAMeathook]

Another win for Tom Cruise.

[swivel]

Goddamn, Chud, did you actually read that post?

Sometimes you are the only thing that keeps me going...

[CPL CHUD]

Here is my theory: Depression is a form of alert hibernation. I think the most important drive in evolutionary competition is caloric intake, NOT sexual selection. I may be alone in this, but I think that I am correct. We spend more time worrying about our energy intake than we do about any other thing. And that is ALL animals, plants, and bacteria. It is such a common drive that we don't even notice it, and tend to focus on secondary concerns (from an evolutionary perspective) like reproduction and offspring-care. But the ATP cycle, the constant need for energy, is what moves us the most.

I like this. It ties my suspicions into the ongoing statistical trend and even explains the link between depression and eating, although I think this theory would be very hard to test. There are just so many reasons people say they feel depressed. It'll take a while to cut to the bone of the issue. You really expounded what I was trying to get at. And again it leads us to the conclusion that it can't really be cured. It can be natural and useful tool to survival, if we were still in the wild, but since we are barely out of the trees we've just begun to understand how our psyche clashe with modern living.

[Athena]

*Sigh*...

I'm going to have to bow out, here. So not qualified.

I'm going to college come fall, so I won't be retarded for TOO much longer. :p

[swivel]

*Sigh*...

I'm going to have to bow out, here. So not qualified.

I'm going to college come fall, so I won't be retarded for TOO much longer. :p

I'd say you are ahead of the curve, dear friend. Just wait until you see how dumb most college students are. It is going to scare the fuck out of you.

Oh, and your professors are going to LOVE you. You are almost TOO good a thinker to be in college!

[CPL CHUD]

I'd say you are ahead of the curve, dear friend. Just wait until you see how dumb most college students are. It is going to scare the fuck out of you.

Oh, and your professors are going to LOVE you. You are almost TOO good a thinker to be in college!

I was thinking the same thing. You are going to be the rare nerd that isn't forced to go to college by her parents and actually likes learning and being engaged in the discussion. Some professors will hate you for having your own opinion, some will love you, all will admire you.

It should be a breeze.

[swivel]

I like this. It ties my suspicions into the ongoing statistical trend and even explains the link between depression and eating, although I think this theory would be very hard to test. There are just so many reasons people say they feel depressed. It'll take a while to cut to the bone of the issue. You really expounded what I was trying to get at. And again it leads us to the conclusion that it can't really be cured. It can be natural and useful tool to survival, if we were still in the wild, but since we are barely out of the trees we've just begun to understand how our psyche clashe with modern living.

Not hard to test at all. I actually test it on myself all the time, we just need a bigger sample size.

When I feel unmotivated (that is what I call my depressive episodes, since it describes my theory perfectly), I force myself to get up and do something, and my lack of motivation goes away. And yes, I could be diagnosed with clinical depression. Suicidal ideation. The whole works. It was in my quest to overcome these chemical states that led to my deep thought on the issue, my examination of my circumstances when these chemical states were and were not present, and the random trials and experiments I conducted with myself to see if they lessened or increased the states.

All you would have to do is present challenges to people with depression. Perhaps taxing challenges that consumed a lot of ATP, with food for reward, and see if the depression goes up or down.

[Athena]

You gents are far too kind.

Unfortunately, I'm still way undecided. I don't know whether to go for the lucrative degree or the one I'm passionate about. I need to start talking to people in biotech. Find out if what I'm passionate about might actually make me decent money. :p