January 21, 2008

A Study Finds Antidepressants Don't Work, And Suddenly It's October 25



ABC News, and others, report that the NEJM study found that antidepressants "may be duds." 

Climb on the bandwagon, my bolsheviks, no brakes, no driver, let us see where it takes us.

Amidst the nearly unanimous "I told you so!  Pharma has been lying to us!" the most important question of all goes unasked: why was this article written?  Did no one think about the consequences?

An article like this has consequences, widespread social consequences.  They are massive, you just don't see it.

Let's say antidepressants really don't work, and this could/should have been known.  Have the last 10 years of psychiatry been a lie? It was all a shell game?  If so, is anyone going to step up and apologize, take responsibility?  "We were wrong, we've been pushing sham treatments-- sorry?" I don't want to hear, "we suspected this..."  I want someone to stand up and announce, "you know, I've been prescribing these for years, and I now realize I was duped."

If it's true, then what were we doing to all those patients all those years?

These guys write this as if to say, "I told you so."  It's all so clear to them.  And to read the interviews, you'd think they were sipping on a Diet Coke-- poured into a glass, with a lime-- smugly announcing what they've known all along.

These guys are hailed as some sort of heroes, exposing the lies of Big Pharma.  But they aren't, they are the worst possible self-promoters; they should be ashamed, they should be ashamed to show their faces in public, let alone practice medicine.  They are worse than hypocrites, they are unconscious hypocrites.

Before you email me saying, "what-- you didn't want this published?   You want them to simply pretend everything is ok, that the data for the meds really isn't weak?  That data isn't really being suppressed?" let me state my point as clearly as possible:

THE PROBLEM ISN'T THE STUDY WAS PUBLISHED, THE PROBLEM IS IT SHOULD HAVE BEEN PUBLISHED 10 YEARS AGO.

It's the exact same data they had 10 years ago, the exact same data.  This isn't a discovery, this isn't Woodward and Bernstein, this is a bunch of academics who are no longer on Pharma payrolls who have now decided that they have nothing further to gain from pushing antidepressants.

Now they can pretend to be on the side of science.   We reviewed the data, and found some of it was not published.

You knew that already.  You were the ones who didn't publish it-- it's your journal.  Turner worked for 3 years as an NIH reviewer.  He just notices this now?

Is no one wondering how it is that this study comes out now, when all antidepressants but two are generic?

As suspicious of Pharma as everyone is, no one seems to see that they are no longer getting Pharma money, they are now getting government money-- NIH-- so they're going to push the government line.  No one finds it at all suspicious that the two biggest NIH studies in the past two years both found the generic to be the best?

You think that in 2000 those studies would have been published?  But now-- 2007, 2008, if they'd found Cymbalta to be the best on the NIH's dime, you think that they'd get re-funded?  What's the difference?  Same authors, same studies, same data.  All that's changed is the climate.

People want a direct financial link to show bias, not realizing that bias is much more prevalent and more powerful elsewhere.

And oh boy, there is going to be hell to pay.

This study isn't just about antidepressants, it is a call to arms-- and I'm sure these guys had no idea they were playing with revolution-- it's the rally cry of the disenfranchised, the powerless, who will say, "look, see! Big Business!  Everyone leeching off the poor public!"   Do you think ABC News picks this story up because they care about antidepressants?

Again, I'm not saying hide the study-- but publishing this 10 years ago, with the same  fanfare and media attention, would have prevented the coming storm, the storm caused by them-- and others-- and others-- the building anger and resentment-- not to mention maybe altered psychiatric practice in the first place.  All of this could have been prevented.   IT'S THE SAME DATA.  But no one cared then.  Times are different, I guess-- because the people are not.

Huckabee wins Iowa; recession looms under the direction of an insecure but resentful, spiteful, Fed Chairman-- even as oil goes to $100 and no one cares; China rises, Pakistan falls, and Russia is a viable solar energy plan away from collapse; pointless obsession about NSA eavesdropping, while Google and others shuffle along archiving your DNA, voice, and existence, all for future governments to decide what to do with; a public anger and distrust of the "system" that rivals the 60s coupled with an apathy and narcissism that rivals, well, any time, ever.

We are doomed. Look on my works, ye mighty, and despair.  Nothing besides remains.

The Cold War ending had the reverse effect of making socialism ok to consider.  And socialism combined with public apathy and near total control over the existence of information is...

You want to salvage your kids futures?  Forget about bonds, forget about gold.  Buy Google.   You'll get your chance tomorrow, when we collapse.





Comments

There was a study reporting... (Below threshold)

January 21, 2008 4:59 PM | Posted by Cheryl Fuller, Ph.D.: | Reply

There was a study reporting on a meta-analysis of studies on Prozac in one of the psychology journals in 1998 reporting that the placebo effect accounted for most of the variance in the studies. Hardly anyone read it. I have been citing it for years. Do I feel vindicated? Yeah, some. But I think you hit the nail on the head.

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This is not really news in ... (Below threshold)

January 21, 2008 5:20 PM | Posted by Parapraxis: | Reply

This is not really news in terms of published studies showing the ineffectiveness of antidepressants. It does make them look even more ineffective than before. I've been crowing about this for the last 10 years. However, I wouldn't call antidepressants duds, they're just a good placebo. A lot of people really did feel better on them, because they believed that they would. I suppose I'm guilty of bias as well because I'm a psychologist and prefer to use psychotherapy as the first line treatment for most emotional problems.

But, the evidence has been around since 1998.

Kirsch & Sapperstein (1998)-Listening to Prozac but Hearing Placebo
http://content.apa.org/journals/pre/1/2/2

Yes, it's not just big pharma that's the problem as you note. It's the money trail and biases throughout the entire system. If you could show me one study that was truly unbiased, I'd be impressed. And everyone has an agenda, except for me. ;) It'll probably blow over just like the previous research on the ineffectiveness of antidepressants did. Or, it'll increase the use of atypical antipsychotics for depression...I'll be looking for the studies to be published real soon now...

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Some points: 1. "H... (Below threshold)

January 22, 2008 9:15 AM | Posted by Steve: | Reply

Some points:

1. "Huckabee wins Iowa; recession looms under the direction of an insecure but resentful, spiteful, Fed Chairman-- even as oil goes to $100 and no one cares; China rises, Pakistan falls, and Russia is a viable solar energy plan away from collapse; pointless obsession about NSA eavesdropping, while Google and others shuffle along archiving your DNA, voice, and existence, all for future governments to decide what to do with; a public anger and distrust of the "system" that rivals the 60s coupled with an apathy and narcissism that rivals, well, any time, ever."

I was with you until that. One of the biggest fallacies in life is to see today's bad news as indicative of "the end times" or as George Carlin put it" every generation things the country is going down the tubes.

2. Ever notice that most of the folks who rally against antidepressants are psychologists (disclosure: I am a psychologist). Yet these are the same folks who happily declare that psychotherapy is equivalent to antidepressants. Wasn't there a study a few years back using brain scans which compared meds v. CBT for OCD and found both equivalent? And the psychologists use this as their trump card all the time, right?

3. Perhaps, just perhaps, what these studies really indicate is the weaknesses of the studies themselves not the drugs. You know, the 6 week university studies using the god awful HAM-D...

4. You're right to point out that no one criticizes the bias of NIH investigators... and their bias is enormous but politically favorable these days

5. And the same folks who criticize Pharma for giving us these "duds" are the same folks who criticize Pharma for not having more drugs in the pipeline. It's just enough to make you want to vomit in despair... luckily I have some prozac around here...

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And I for one welcome our n... (Below threshold)

January 23, 2008 2:15 AM | Posted by bryon: | Reply

And I for one welcome our new Google sponsored overlords [sic].

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I am sure psychiatrists wil... (Below threshold)

January 23, 2008 10:28 AM | Posted by Anonymous: | Reply

I am sure psychiatrists will be sharing this latest finding with their patients, right?

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Yes I know if you look at t... (Below threshold)

January 23, 2008 12:59 PM | Posted by Rich Hudson: | Reply

Yes I know if you look at the average American medicine cabinet today and compare it to one from 20 years ago you'll see that people now are taking a sh*tload of pills, antidepressants included. Even little kids are taking Ritalin and whatnot, for Christ's sake! And all those pharmaceuticals are a little-discussed factor in the rise of health care costs.

Having said that...

I know people around me who sing Prozac's praises; they say it's changed their lives, and I've really noticed the changes in a couple of cases. It seems too much to chalk up to the placebo effect.

I think the reality may be that antidepressants help *some* people, but not all of the ones currently taking them, but that once a doctor prescribes a medication like that to someone, and that person *thinks* it helps, then it's nearly impossible to take that person's pills away ... who knows how many docs have been threatened with bodily harm after trying to take away a patient's Prozac.

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My simple GP knew this more... (Below threshold)

January 23, 2008 2:56 PM | Posted by Whatever: | Reply

My simple GP knew this more than 10 years ago. God bless him, he saved my brain from getting fried by this stuff.

Good call on Google selloff. Everything peachy otherwise, or so they'd like us to think.

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Yes, please, buy Google! B... (Below threshold)

January 23, 2008 5:22 PM | Posted by Common Reader: | Reply

Yes, please, buy Google! Buy lots and lots of Google!

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<a href="http://www.radaron... (Below threshold)

January 23, 2008 6:11 PM | Posted by Anonymous: | Reply

if google were evil...

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I think this is complete an... (Below threshold)

January 24, 2008 10:04 PM | Posted by Assrot: | Reply

I think this is complete and utter bullshit. Due to some uncontrollable circumstances in my life about 4 years ago, I fell into a deep depression.

To make a long story short anti-depressants helped me quite a bit. They do seem to be like any other mood altering drug however. You get used to them and need more and then one day you can't take enough so you try another one.

After about 1-1/2 years of this along with counseling I got off the meds and I have been fine and medicine free for a little over 2 years.

My point is, as a patient, I think they helped me but you do become tolerant of them and they are difficult to wean off of. I had a very hard physical withdrawal from them. I believe the pharmaceutical companies made a nice word for addiction withdrawals that the call "discontinuation syndrome". That's where the hogshit is. Withdrawal is withdrawal and its no easier just because they call it something else.

The only difference betwen these drugs and narcotics addiction in my experience is that there is no drug seeking behavior because anti-depressants don't have any euphoric effect that I can see. They are still just as addictive if not more so and very hard to get off of once you don't need them any more.

So yes, I think they work. I'm not so sure I'd take them again given what I know now.

I went from Prozac to Paxil to Lexapro to 3 weeks of hellish withdrawal. Once that was over, I was my old normal self again.

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As a future psych resident ... (Below threshold)

January 29, 2008 2:51 PM | Posted by DJT: | Reply

As a future psych resident and trained hypnotist, i am well aware of the power of the unconscious mind and all the things we harbor there to profoundly affect and even create our life experience. I have mixed feelings about this. Since I have been interested in psych I have advocated that these drugs are placebo pills with side effects and I think it is good that the truth comes out. However there are a lot of people in our culture who ARE NEVER EVER EVER going to work on themselves and pry into the causes of their suffering. As such a culturally established placebo is really powerful to these people. If they lose that, they will have no choice but to work on themselves, which many will never do. So while it is good that the truth came out, losing the placebo benefit is unfortunate.

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Is it a foregone ten-year-o... (Below threshold)

February 26, 2008 4:26 PM | Posted by cburke: | Reply

Is it a foregone ten-year-old (or ten-year late) conclusion then that these antidepressants do nothing, and are nothing more than placebos with side effects? Because the study said that they did have an effect above the placebo in the most severe cases. As a layman, this suggests to me not that antidepressants are ineffective, it suggests that they're vastly over-prescribed to people mis-diagnosed with clinical depression. If you don't have a serotonin deficiency, then an SSRI isn't going to help.

So the basic question is -- is this a failure of pharmacology, or of diagnosis?

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Seems to me that drug does ... (Below threshold)

February 26, 2008 10:17 PM | Posted by Anonymous: | Reply

Seems to me that drug does indeed work when prescribed to people that actually have clinical depression and the underlying physical cause.

The problem is that big pharma managed to convince doctors that it will help anyone with depression, and doctors happily went along with them instead of doing their own research.

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As an addiction therapist, ... (Below threshold)

March 30, 2008 9:14 AM | Posted by BRC: | Reply

As an addiction therapist, I see many people who are 'addicted' to the SSRIs. I find it quite interesting that psychiatry is the only field that NEVER uses scientific/medical evidence to support the claim of lower levels of serotonin in the brain. The psychiatrist makes this decision after the first session with a client. In fact, evidence (2007) states that the average time a psychiatrist prescribes an anti-depressant medication is 8 minutes in the doctor's office. This is ridiculous! Obviously, they don't have the time to provide good clinical counseling as they once had in the past. A good book to read is by psychiatrist William Glasser titled "Warning: Psychiatry can be Hazardous to your Mental Health" that discusses how bias the DSM IV is and how making subjective decisions in the medical field is preposterous. Question: if a doctor tells you that you you have a chemical imbalance in your brain, yet does no medical test to support the claim, why then are people so quick just to take medication? Answer: people blindly trust the psychiatrist and don't want to work on their problems but simply take drugs to solve whatever the problem is (maladaptive coping). To me, there is no difference then when you see a drug addict come for therapy. Statement: Ritalin is synthetic cocaine. Don't be surprised when your young son or daughter will graduate to taking cocaine when they get into their adult years because they were cut-off from ritalin. This is a shame. Statement: more thatn 51% of the people who wrote the DSMIV have ties to pharmaceutical companies (hmmmmmmm!)

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Oh, thank goodness for the ... (Below threshold)

June 27, 2008 12:23 PM | Posted by Barbara Young: | Reply

Oh, thank goodness for the common sense we have been without for so long.

Through plenty of serious thick-and-thin, mentally speaking, overlaid with 40 years of agonizing cluster attacks twice a year, I have stuck with psychotherapy and no pills.

It's now about 17 years since I started the therapy and my goodness! I have a life! I am content! And the cluster sieges are gone! I write, play the piano and have an enormous sense of gratitude for the fine therapist who saw me through like no pills could ever do.

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chemical imbalance is a lie... (Below threshold)

December 4, 2008 3:56 AM | Posted by nik : | Reply

chemical imbalance is a lie.it's genetic that's a lie too.psychiatrist are the biggest liers on the planet.antidepressants do not work they just put a mask over the problem that's all they do.i was in major depression for 2 years there were no solutions givin because psychiatrist don't have soulutions.i found a solution it was 900 mg magnesium glycinate and 500 mg of taurine for one week then the dose was reduced.i experienced rapid recovery from my major depression, migranes, heart paltipations,anxiety,and my sex drive returned IQ went up,energy level sky rocketed,all of these improvments happened in less than 7 days. i was able to go down from 15 mg lexapro to 5mg lexapro in less than 3weeks.why didn't the psychiatrist know that nearly 70% of all americans are mag deficient.why did she let me suffer.maybe she just in it for the money.

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Zoloft is a party in a litt... (Below threshold)

April 16, 2012 2:16 PM | Posted by lauren: | Reply

Zoloft is a party in a little green pill. I really enjoyed its effects. No, it's not placebo. Unfortunately most drugs are prescribed at too high a dose, without really knowing the problem, or caring to solve the problem. Stop blaming the poor little pills.

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Not about antidepressants, ... (Below threshold)

November 12, 2014 8:57 PM | Posted, in reply to Anonymous's comment, by : | Reply

Not about antidepressants, is it?

A study finds X don't work, and suddenly its time.

"An article like this has consequences, widespread social consequences. They are massive, you just don't see it."

"have the last 10 years of psychiatry been a lie?"

It's something about 2008, financial crisis.
Was it about real estate? Missing regulations?

In 1998, Scientific American (?) printed an article about future global oil supply which I assume was noted by many. Problem with long term supply, consumption keep rising.

Problems with oil supply have been predicted for a long time, actually since day one, but still, rational minds have frequently pointed out that if you make a graph over regular conventional oil discoveries, it peaked around 1960, which may not be all there is to say about it, but it suggest something. Main point: foreknowledge. Planning.

X = nuclear fusion or some other fancy technology?

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