Monday, August 11, 2008

Anti-Depressants for the Region

I seem to be meeting a lot of people lately who are on anti-depressants. Only the funny thing is, these people all seem to be depressed! I mean, what is the point of taking them if they don't work? Is the Region all that bad that everyone needs to be medicated to cope with our politics? I found a great blog discussing this at The Behavioral Medicine Report.

"The placebo effect is very common in most forms of health care. When people who are ill (mentally or physically) believe that they will get better - guess what - they get better. These are real changes too, though the placebo effect wears off over time for some people. The placebo effect is so powerful that the new gold standard in psychological & medical research is to have a placebo group instead of having a simple control group that does not receive the treatment. For example, if a manufacture is testing a new anxiety drug, they give the real drug to one group (called the “experimental group”) and, for example, give a sugar pill to another group (”placebo group”). Believe or not the placebo group often reports meaningful improvements despite getting a sugar pill. The same concept applies to psychology. In fact, simply going to psychotherapy, even if no real therapy is conducted, will likely result in a treatment gains. Belief is a powerful force!"

"The Food & Drug Administration regulates and approves medications that are available to the public. Anti-depressants are group of psychotropic drugs used to treat, as the name implies, depression. This is next statement is strictly an opinion: I have been skeptical of the benefits of anti-depressants. I cannot tell you how many people I know or have worked with in a clinical setting that are on anti-depressants and are still depressed - go figure. Aside from this bias, anti-depressants come with side effects, physiological dependence (your body physically relies on them and will through withdrawal symptoms without them), and tolerance (you need more of the same drug to get the same effect). Pharmaceutical companies must submit a certain number of studies to the FDA that demonstrate that their drug actually works and does so in a reasonably safe manner. But there’s a catch…. while pharmaceutical companies must submit all studies for a particular drug including the studies that demonstrate that it does NOT work - but get this - the FDA only counts the studies that show positive results.

Researchers in the article* we are discussing today were resourceful… they used the Freedom of Information Act to obtain all studies submitted to the FDA for 4 new generation (”SSRIs”) anti-depressants. A statistical technique called a meta-analysis was used to analyze the data. A meta-analysis combines data from all studies to increase its ability to determine something called an “effect size.” The results were astounding: the anti-depressant medications used in the analysis were no better than placebo effect, except for the most extremely depressed patients. Keep in mind that a meta-analysis is not a “cause and effect” experiment so you cannot say that “this causes that.” Nevertheless, this a very important finding. You can read the full article here...."

Since most people probably know someone using antidepressants, this might be interesting to all of you readers in NWI. Enjoy!

References:
*Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration. Kirsch I, Deacon BJ, Huedo-Medina TB, Scoboria A, Moore TJ, et al. PLoS Medicine Vol. 5, No. 2, e45 doi:10.1371/journal.pmed.0050045

3 comments:

briefs said...

I have to agree, far too many people on anti-depressants in NW Indiana

Chris Hedges said...

Just think what everyone would be like if they weren't on anti-depressants.

However, if anti-depressants are needed, they are invaluable.

I wasn't able to quit smoking for more than a short period of time before going on a low dose of anti-depressants. Since starting those up, I have been able to be smoke free for more than three years.

prayeramedic said...

That's great, Chris! Glad to hear you've been able to quit, too many people never can get to that point. They are definitely useful for solving legitimate chemical issues in the brain, but in many cases they are prescribed in instances where they may be contraindicated, and only psychotherapy can help that individual. The interesting part is that the placebo effect of taking them is just as strong as the chemical's actual effects in many cases.

Also, it doesn't help that the FDA is in bed with the pharmaceutical companies, which is an entirely different issue. They should publish all the results, positive and negative to come to an empirical conclusion. Thanks for sharing Chris!