Brainiac Five posted:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172306/


Antidepressants are supposed to work by fixing a chemical imbalance, specifically, a lack of serotonin in the brain. Indeed, their supposed effectiveness is the primary evidence for the chemical imbalance theory. But analyses of the published data and the unpublished data that were hidden by drug companies reveals that most (if not all) of the benefits are due to the placebo effect. Some antidepressants increase serotonin levels, some decrease it, and some have no effect at all on serotonin. Nevertheless, they all show the same therapeutic benefit. Even the small statistical difference between antidepressants and placebos may be an enhanced placebo effect, due to the fact that most patients and doctors in clinical trials successfully break blind. The serotonin theory is as close as any theory in the history of science to having been proved wrong. Instead of curing depression, popular antidepressants may induce a biological vulnerability making people more likely to become depressed in the future.

AARO posted:

I've been reading about some studies and meta-analysis on anti depressant medications. There have been many studies over the years that prove that modern anti-depressant medications preform no better than placebo with mild to moderate depression and only slightly better than placebo with severe depression. Yet they give these drugs out like candy to anyone who comes to them feeling sad about life, despite all the harmful side effects. It has been proven time and time again that SSRI's can cause suicidal idealization in patients, along with a host of other more common unpleasant side effects. And even the patients taking the placebo can experience unpleasant side effects called the "nocebo effect" (although this is rare and largely misunderstood.) The people who are receiving relief from SSRI or other drugs are largely just psychosomatically "curing themselves." This is not science. It needs to change.

It seems to me that we should stop proscribing these anti-depressant drugs, except for maybe in the most extreme cases. I feel that psychiatry is in its infancy and many of the treatments of today will be looked upon as absolute quackery by future generations.

AARO posted:

Brainiac Five posted:

However,

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4804177/

Brainiac Five posted:

However,

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4804177/

AARO posted:

I admitted in the OP that the actual drugs do work better than placebo in severe depression. But severe depression accounts for a very small number of the patients prescribed these drugs.

AARO posted:

You lazy research vampires can go ahead and find the studies I'm talking about yourselves that prove these contentions. What I'm saying seems to be totally non-controversial. It's only the application of the studies which are not presently being taking into account.

AARO posted:

You lazy research vampires can go ahead and find the studies I'm talking about yourselves that prove these contentions. What I'm saying seems to be totally non-controversial. It's only the application of the studies which are not presently being taking into account.

Angepain posted:

are you telling me i've got to do more than find an abstract that I agree with in order to determine the truth of an assertion? this is bogus i'm going back to hardline religious doctrine to solve my problems

Brainiac Five posted:

This doesn't refer to severe depression, it refers to analyzing studies conducted of first-generation SSRIs and using reported changes in depressive mood as the yardstick instead of the 57-point scale. It includes patients with moderate and severe depression. Essentially, the conclusion as found in the study is that SSRI antidepressants do have a statistically significant effect when it comes to improving depressive mood over placebo, which in turn suggests that the 57-point scale may be ineffective. Neither is actually conclusive and final when it comes to determining the effectiveness of the treatments, though the meta-analysis does perforate the serotonin reuptake model of depression.

Mister Adequate posted:

I used to want to kill myself and now I don't thanks SSRIs

AARO posted:

So what to make of the meta-analysises which prove the opposite?

AARO posted:

Gald you're feeling ok today but it's proven that they may eventually increase your desire to kill yourself at some later point.

AARO posted:

I've read more than the abstract of these studies. Nowadays, all studies are easily available on the internet.

AARO posted:

lazy research vampires

quote:

http://jama.jamanetwork.com/article.aspx?articleid=185157

Antidepressant medications represent the best established treatment for major depressive disorder, but there is little evidence that they have a specific pharmacological effect relative to pill placebo for patients with less severe depression.

Objective To estimate the relative benefit of medication vs placebo across a wide range of initial symptom severity in patients diagnosed with depression.

Data Sources PubMed, PsycINFO, and the Cochrane Library databases were searched from January 1980 through March 2009, along with references from meta-analyses and reviews.

Study Selection Randomized placebo-controlled trials of antidepressants approved by the Food and Drug Administration in the treatment of major or minor depressive disorder were selected. Studies were included if their authors provided the requisite original data, they comprised adult outpatients, they included a medication vs placebo comparison for at least 6 weeks, they did not exclude patients on the basis of a placebo washout period, and they used the Hamilton Depression Rating Scale (HDRS). Data from 6 studies (718 patients) were included.

Data Extraction Individual patient-level data were obtained from study authors.

Results Medication vs placebo differences varied substantially as a function of baseline severity. Among patients with HDRS scores below 23, Cohen d effect sizes for the difference between medication and placebo were estimated to be less than 0.20 (a standard definition of a small effect). Estimates of the magnitude of the superiority of medication over placebo increased with increases in baseline depression severity and crossed the threshold defined by the National Institute for Clinical Excellence for a clinically significant difference at a baseline HDRS score of 25.

Conclusions The magnitude of benefit of antidepressant medication compared with placebo increases with severity of depression symptoms and may be minimal or nonexistent, on average, in patients with mild or moderate symptoms. For patients with very severe depression, the benefit of medications over placebo is substantial.

Popular Thug Drink posted:

it's true that SSRIs aren't great but it's not like big pharma is sitting on a better solution, a not great treatment for a disease is better than no treatment at all

afaik SSRIs are often perscribed in conjunction with CBT and other forms of therapy

Business Gorillas posted:

i was diagnosed with mild depression and i cured myself of it with working out and doing sex, ymmv

foot posted:

Have you tried cocaine or ecstacy?

AARO posted:

You know the problem with rec drugs is they eventually gently caress up your life and cause psychosis. Otherwise this would be the ultimate cure all.

OwlFancier posted:

To an extent, so does breathing.

Peven Stan posted:

More like $$RIs.

AARO posted:

Gald you're feeling ok today but it's proven that they may eventually increase your desire to kill yourself at some later point.