Saturday, January 30, 2010

Anti- depressants vs. placebo

In a striking coincidence, the same week that I wrote a blog post about using psychiatric medications, Newsweek put out an article on the subject. Maybe they read here, who knows. There are several followers who have no avatar on their following icons (just kidding).



Their article is called The Depressing News About Antidepressants. It discusses the efficacy of chemical pills versus placebo pills. They included that way cool picture of all those pills representing different parts of the brain.

It is a very interesting and informative article which takes the position that antidepressants have almost no effect on depression. It states that the results people report are due to the "placebo effect" instead, basically that people think they will get better and so they do.

The article is specific to antidepressants. It does not address other forms of medication used for psychiatric disruptions.

If you actually have time to read all four pages of the article, try to squeeze in another few minutes for the comments. It was interesting to me that the comments were so bland, and noncommittal. At least the ones I read. I thought the comment writers would be all fired up for sure!

15 comments:

  1. Perhaps you read the comments too soon or, as I would like to believe, everyone popped over to your blog and got fired up to make a comment. LOL.

    What most angers me about studies like this is that they diminish a person's chances for getting proper treatment. Why should a doctor prescribe an antidepressant when a sugar pill would be just as good. Or,in our case, why have my daughter undergo a CT with angiography for a followup to make sure her aneurysm is still properly blocked by titanium coils when just doing a CT scan with contrast is "equivalent"... well, because the report states that the reading physician couldn't make out much because of the scatter caused by that titanium coil. Now, she's had an MRI, a CT scan AND STILL needs the CT with angio. Three expensive tests instead of one. Wow...that's cost savings!

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  2. It is a way cool picture of the brain. In studies, before a drug is released, they almost always do a double blind study, which is the golden standard in research. One group gets the drug, the other gets the placebo, and the doctors treating the patients and the patients themselves do not know who is in which group. If I was truly interested in"the placebo effect", I don't think I would read Newsweek.
    Hopefully, people with children who need psychotropic medications will do further research before letting Newsweek influence their decisions.

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  3. Maybe the comments were bland an non-committal because of the placebo effect from the antidepressants the commenters are on. Hahaahahaha. Oh. Maybe it's too early for this.

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  4. Thank you Newsweek. All these years of working with doctors to try to come up with the right meds for my kids and now you tell me all they need to do is think they are better and then they will be! Whew! What a relief! I wonder if this trick works on Cancer or Diabetes?

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  5. They will have to pry my anti-depressants from my cold dead hands before I will stop taking them. Because that's what I would be if I *didn't* take them.

    So many people do not seek treatment for depression because they feel like there is something wrong with them.. if they could just "get it together" or "man up" or "pull themselves up by their bootstraps" they would be fine. I refuse to feel guilty or deficient for something that is nothing more than chemical imbalance.. and I think it's shameful that people are still trying to convince us that it's "all in our head." (Well. It is. But not like they are implying.)

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  6. I didn't read this article. Instead I thought back. I thought back to the NEWSWEEK that had the cover article about how AA has it all wrong, and the "realistic" and far "better" approach to alcoholism is for problem drinkers to drink in moderation, because they CAN.

    I will never, ever forget seeing that magazine in my parents' house the week I was there for my brother's funeral. My only brother who had finally, after years of grief and struggle and trouble, gotten into AA and quit drinking about a year previous. The brother who, for some mysterious reason, suddenly started drinking again - started drinking again the month that article graced the cover of that magazine. The brother who shortly thereafter died of hemochromotosis, caused by alcohol consumption.

    Only to say, these light and interesting little articles can have more power than one might think. Surely more than the authors bother to consider.

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  7. Annie that's an excellent point. Audrey Kishline, founder of moderate drinking management, killed a man and his 12 year old daughter some years ago, driving with a .26 alcohol level on the highway, going the wrong direction. She now says she was wrong.
    So sorry about your brother.

    I really worry that a lot of people will think this makes all psych meds useless. People who were already hesitent to get help will now say, why bother.

    Erika, sounds like someone is padding their bill. Good crap.

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  8. I have an adult family member with OCD and depression, trust me it is not a placebo effect.

    I agree with Corey.

    I have a friend who was very anti-depressant meds or any kind of psychiatric medication. His son in his early 20's blew his brains out. We have never discussed the matter but I have never heard him speak negatively regarding meds since.

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  9. This may be one of the only times I agree w/ what the drug companies are saying over what the analyists say. Unless you test each person's best antidepressant against placebo, you aren't getting a good comparison.

    And this bit bothered me: "The extra effect of real drugs wasn't much to celebrate, either. It amounted to 1.8 points on the 54-point scale doctors use to gauge the severity of depression, through questions about mood, sleep habits, and the like. Sleeping better counts as six points. Being less fidgety during the assessment is worth two points. In other words, the clinical significance of the 1.8 extra points from real drugs was underwhelming"

    Sleeping better counts as 6 points? I sleep tons when I am depressed. SSRIs gave me nightmares, but I was less depressed. And I fidget less when I'm depressed. Where on earth are these guys getting their rating criteria from?

    But alas, I am one who can no longer take antidepressants as they caused my latent bipolar to emerge. I'm also one for whom the idea of becomming more suicidal on SSRIs is only a risk in the first few weeks was proven false.

    The same drug that saved my life almost killed me. Pretty hard to equate that to a sugar pill.

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  10. well newsweek is full of crap

    as a sufferer of ppd when my ob/gyn prescribed antidep i thought - these aren't going to do anything

    and so i stopped taking them

    and returned to crazyland

    and then realized - hmm i guess they did work

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  11. I was on Paxil in college and it made me feel totally weird. And one time I ran out over the weekend and couldn't get to the doc till Monday and I was SO sick from withdrawal!

    Definitely not so sure about those things...

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  12. Paxil can cause massive withdrawl symptoms- I have heard that it feels like your brain is exploding fireworks underwater. Awful.

    Yeah, that rating scale threw me off too. Strange how much weight was given to such odd things!

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  13. I have always had horrible, horrible withdrawal no matter which antidepressant I have tried to come off of. (You're not supposed to stop taking any of them abruptly, but even with a doctor weaning me off of the, I have to wean twice as slowly as they always recommend, and even then I have awful dizziness, etc). That being said, being on the right med (and I'm happy with the one I'm on right now, the least side effects EVER, YAY!) is awesome because being alive is G-O-O-D!

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  14. I have lived with depression and panic disorder both on meds and off. I COULDN'T take meds in the military so I tried to learn ways to deal - the happy place, etc. After 6 years, I finally gave up and knew I couldn't handle it on my own. Thank goodness! I ended up getting medically discharged because of that decision but that was nothing compared to the years of misery I put myself through. I had to try several meds before finding the right one. If I miss one day...OH the brain shivers!!! So worth it though - so worth it! I am a functioning person that only wants to climb in a hole about once a year now. Huge improvement!

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  15. Wow. Just wow. Articles like this make me SO UPSET, because I already run into a lot of people who have the, "If you just tried harder you'd be fine," or "I get sad sometimes, too, but you'll learn how to pull yourself out of it" attitude. They're both the same fundamentally: there's nothing really wrong with you, if you were stronger you could deal.

    I'm with Corey. I was close to suicide before pills. I got on them, and the difference was incredible. I got sad, but I COULD pull myself out of it. It was SADNESS not depression. Huge difference. I had to go off and thought, oh, whatever, I don't think they were doing that much. Yeah right. I was pretty much slapped in the face by that assumption when all of my symptoms returned in force.

    See, when people deal with mental illness successfully, others assume the illness can't be that bad. What they don't understand is how much more effort it takes for someone with a mental illness to negotiate everyday life. Meds make it closer to normal. It's still harder.

    Sorry for the long reply. Sensitive topic. I also loved your psych meds post.

    PS I totally replied a few times before, but then started a new blog. Was CompanionsWA. You are awesome :-)

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