just want to comment on "One Nation, indivisible". IMO this phrase should be a mantra for those of us who value the separation of church and state and who think the insertion of "under God" into the Pledge was wrong. I like the "one Nation, indivisible" phrase because it's positive and patriotic. With that said I value all approaches, from ridicule, using the courts, the pleasantries. I just don't like silent tacit consent.

Re: Prozak

Another Study

One Nation, indivisible.

hum... subtle but I like it. Simple use of a period.

Also, re: Prozak,

If you read the actual study, you'll see they studied patients who had been taking SSRI for 3,4,5,6,8 weeks. You'll find this under the Study Characteristics heading about half way down the page. If you are at all familiar with SSRIs, you'd know they do not even begin to work until at least the fourth week, and usually do not reach full effect until the eighth week. To include 3,4 or 5 week studies seems like an effort to skew the results to fit the researcher's desired result.

Textbook Confirmation Bias

I'm sure Tom Cruise would be proud of this 'study'.

asshat, you did an excellent job at hiding your bias.

Jim Jones,

I'll have to stick up for Syngas here. It is absolutely true that it takes at least four weeks for anti depressants to work. They are generally not all that effective for those suffering from mild depression though, and are only recommended in extreme cases.

It is also true that they have side effects that are very difficult to deal with and one suffers withdrawal symptoms if one decides to stop taking them. (I'm aware that the use of the term 'withdrawal symptom' can be debated by anyone familiar with this topic, but the general idea still holds)

Asshat (and other Prozac defenders). The article you cite is from 2006. Since then, it has been discovered that drug companies withheld 1/3 of the trial results from publication. As you might have guessed, the reason they were withheld is because they disconfirmed the claimed benefits of the drug. It is using the full data said, which, as the article that Norm posted explains, accounts for the new results.

http://query.nytimes.com/gst/fullpage.html?res=9B0CEFDA163CF934A25752C0A96E9C8B63&scp=2&sq=antidepressants&st=nyt

The makers of antidepressants like Prozac and Paxil never published the results of about a third of the drug trials that they conducted to win government approval, misleading doctors and consumers about the drugs' true effectiveness, a new analysis has found.

Although I am not a pharmacologist, my own view is that we don't have decisive evidence one way or the other on SSRI because drug companies have deliberate distorted their findings and withheld results that would disconfirm their claims. However things turn out with SSRI's, we need much strictly guidelines at the FDA--which have in part been stripped or not applied under the Bush Administration--and better enforcement mechanisms to protect us against junk pharmaceuticals with unproven results.

Ah! sorry for all the typos.

the full data said

Should be "full data set"

Prozac = SCAM.

Pfizer = CRIMINALS.

See also: http://www.google.com/search?q=prozac+is+a+scam&ie=utf-8&oe=utf-8&aq=t&rls=org.mozilla:en-US:official&client=firefox-a

Speaking as a genuine lunatic, there is no shortage of legitimate mental health concerns.

However, messing with brain chemistry with some VERY dubious approvals by the FDA is a recipe for disaster.

Fun fact: almost every "lone gunman", from the VA tech massacre, to the recent shooting in Chicago, have been on prescribed psychotropics.

If you need help, Gestaltian therapy was a great help to me. If you need a chemical solution, try some pot. Less dangerous, less addictive.

See also: http://en.wikipedia.org/wiki/Gestaltpsychology#Gestaltviewsinpsychology

In the immortal words of the fat construction worker from Total Recall:

"Don't fuck with your brain pal, it ain't worth it!"

oops, wrong link:

http://en.wikipedia.org/wiki/Gestalt_therapy

Sorry to keep dwelling on this, but I get the feeling I'm not the only lunatic around here. From the link:

"In what has now become a "classic" of gestalt therapy literature, Arnold Beisser (1970) described gestalt's paradoxical theory of change. The paradox is that the more one attempts to be who one is not, the more one remains the same (Yontef, 2005). Conversely, when people identify with their current experience, the conditions of wholeness and growth support change. Put another way, change comes about as a result of "full acceptance of what is, rather than a striving to be different" (Houston, 2003)."

Adam,

Thanks for telling me the date of the study that showed suicide has dropped significantly since SSRIs became widely used. Unless you have data that shows otherwise, it is an important correlation even if it is 2 years old.

I'm not sure I agree with the notion that drug companies kept these studies secret. Having known several people who started taking SSRIs, every one of them was made aware that they should not expect any results for the first 3-5 weeks. I guess it's possible their doctors just knew this from experience, but I'm betting the drug rep informed the doc of this and was told to tell the docs this from the drug companies themselves as a result of their own research.

That is precisely why drug companies research their own drugs - to find out if they work, and how they work best. Not for the sake of publishing their study.

Zap,

Fun Fact: Most 'heart attack victim' were taking taking heart meds.

Did the heart medication cause the heart attack?

can only offer anecdotal here. i tried some version of prozac for about 3 months. the doctor was honest with me, telling me that there are zillions of versions of these things, usually differing only by a molecule or two here or there, and the one she prescribed just happened to be the one she and her "doctors social circle" were currently favoring. my sypmtoms were basically depression- the can't-get-out-of-bed, i'd-definitely-kill-myself-if-i-didn't-have-kids kind of depression.

i was told it would take 2 weeks to build to an effective level in my system (not 4) and this turned out to be the case. that is, insofar as it had noticable effects they started after about 2 weeks and remained the same for the rest of the 3 months.

when i stopped taking them, on my own, i didn't notice any "withdrawal symptoms", but i cut down carefully over about a week in order to avoid this, as i had been warned.

i stopped taking them when i realized that, as well as being incapable of being depressed (in this sense they "worked") i was incapable of almost any other emotion as well, including those that actually defined me as a person. i mean, i couldn't cry at movies. i couldn't feel sorry for myself, but i couldn't feel sorry for anyone else either.

i decided it wasn't worth it.

JoAnn,

Thanks for your input, it's good to see you posting again ;-)

i mean, i don't want any drug coming between me and, say, jumping on oprahs' couch if i should feel so inclined. :)

Jon,

Do you still feel like killing yourself? If not, what did you do to change it?

Asshat, I don't know why I'm citing another article, as it is pretty apparent you didn't read the last I cited, but in any case:

Scientific studies work like this. Unlike your anecdotal evidence, they do an exhaustive study that applies the same experimental protocols to all subjects: that is a standard for getting reliable results. If you exclude evidence that disconfirms your findings without a principled reason, then you are cherry picking.

That is precisely why drug companies research their own drugs - to find out if they work, and how they work best. Not for the sake of publishing their study.

Drug companies need to confirm that the drugs they sell have the effects they claim, and provide scientific evidence of this. These studies must meet with FDA approval. Doctors typically read the experimental studies on the effects and possible side effects of new drugs, which are published in professional journals, before prescribing them. They cannot magically appeal to their experience because they do not have experience with new drugs, and even if they did this is not the same as a controlled study with explicit protocols and standards for assessing the effects of a drug on different people. Drug companies have also been known to pay doctors to write these articles in professional journals for them, as the last link I posted explains. The reason they do this is because they know most doctors do not prescribe drugs which have not met with scientific scrutiny.

You have a remarkable view of the relationship between drug companies and doctors. Here is an insider account from a doctor that worked as a drug rep. He reports withholding information on both disconfirming evidence and potential side effects.

http://www.nytimes.com/2007/11/25/magazine/25memoir-t.html?scp=2&sq=drug+rep&st=nyt

Getting doctors to prescribe drugs is hella big business.

honestly, since you asked, cory, i still struggle with it. as, i think, camus said, it's the only real question.

i didn't "do" anything. whatever moral code i had developed up to that point asserted itself and, like i said, the potential effects on my kids became a bigger issue than all the other ones. i don't take any credit for having made some brave "decision", i just couldn't justify being so selfish.

i'm better now, thanks.

Imagine a student tearing copies of Charles Darwin’s On the Origin of Species and calling evolutionists “simple-minded ignoramuses.”

maybe i'm wrong but i don't think even the most benighted, brainwashed, hate-filled, confrontational evangelistic creationist ignoramuses don't behave like this.

i think it should be legal to tear up things considered "holy" in front of those who consider it so (as long as the thing in question is one's own property) but i also think it's reasonable to expect a violent reaction. and i think that anyone who does something EXPECTING a violent reaction for reasons of ego or self expression is bringing evil into the world, not good.

sorry, that was re:"ripping into the bible".

if that wasn't clear.

Adam,

All I'm saying is that to include data from patients who have only been taking SSRIs for 3 or 5 weeks, when it is pretty widely known in the field that SSRIs don't usually start to work for at least 4 weeks seems like an attempt to skew the numbers. Why didn't they include patients who have been taking SSRIs for 3,6,12 months? If it is so ineffecive, it should be just as ineffective at six months as it was at three weeks right?

Heh all, i am a psychiatrist and this issue is much more complex than any of you bloggers seem to get fully. There are significant issues with studies on SSRI's. This issues are multifaceted and complex.

The bottom line is that some recent studies suggest there are issues with the efficacy of SSRI's in mild depression, and therapy may actually work better and be safer. There is pretty good evidence that in moderate to severe depression that medications are effective. Almost all studies suggest that a combination of meds and psychotherapy provides better results than either placebo or meds alone. So yes their is a real concern about the efficacy of these meds in mild depression. Frankly mild depressions are over-treated with medications, mainly as there is no other option. Psychotherapy is expensive, time consuming, and many medical insurance plans do not cover it at all, or do not cover it adequately. So get your senators to make sure insurance companies are required to cover mental illnesses and to cover them adequately.

Re the issues with the studies. One, all data in studies need to be published and be available. This is really essential. It is shameful that negative studies were withheld in the past, it needs to be enforced internationally as well. But if you really want good data on mental health treatments you should lobby the government to sponsor more research into mental health. There is a massive amount of money going to research on AIDS and cancer. But schizophrenia, which hits 1 percent of the population, and hits them as young adults before they have had a chance to get insurance, gets very little research money.

Two, there are many issues with studies on depression, one is that the criteria for mild depression is way too easy to achieve and likely many folks getting these drugs are basically not clinically depressed. Evidence for this is the huge placebo response in the mildly depressed group. Most studies (particularly the drug company sponsored studies) on depression have excluded all the severely depressed patients, patients with suicidal thoughts, patients with psychosis, patients who require hospitalization, patients with difficulties managing daily tasks. This is one of the biggest issues in studies on depression.

Finally re the violence issue, those people the poster was going on about were NOT on medications, both were not in psychiatric treatment. the VA shooter was not, nor was the recent incident, he was OFF his medications. Untreated mental illness is the primary cause of violence in the mentally ill. If you want to stop violence with this population argue for decent funding of mental health care.

There goes my rant... i gather both obama and hillary are pro mental health legislation..... not sure how pro however, anyone know?

Anyway i could give a lot more information here but I suspect that i have bored all of you to a depressed stupor.

Thanks k,

Good stuff!

Zaphod, Prozac isn't Pfizer's drug. That's Eli Lilly. Please provide evidence for Pfizer being criminals.

Also, your fun fact isn't complete. Most "lone gunmen" stopped taking their prescribed medications (NIU, Columbine) and/or were no longer receiving any sort of court-required counseling (VT).

Asshat is raising some very good points, and I'd suggest you all read past the sensationalist headline and actually read the study itself, in addition to the countless other independent studies that have concluded the opposite of what this ONE study says.

I'd also suggest you all take a basic neurology course and stop listening to Bill Maher claim he understands science.

Yes. Antidepressants are very overprescribed. But it's much better that than underprescribed.

If you don't want to medicate yourself even after your doctor recommends it, I would advise that you sit down and figure out that a doctor is a lot more educated on the subject than you and journalists.

What economic sense would it make for a drug company to cover something up when they know people will notice?

k, I found your comment to be neither a "rant" nor "boring" at all. Being a psychiatrist, you actually know the issue well. So I agree with asshat, a very much appreciated and informative contribution!