Study seeks to end antidepressant debate: the drugs do work

S.J.B.

S.J.B.

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Study seeks to end antidepressant debate: the drugs do work
Kate Kelland
Reuters
February 21st, 2018

LONDON (Reuters) - A vast research study that sought to settle a long-standing debate about whether or not anti-depressant drugs really work has found they are indeed effective in relieving acute depression in adults.

The international study - a meta-analysis pooling results of 522 trials covering 21 commonly-used antidepressants and almost 120,000 patients - uncovered a range of outcomes, with some drugs proving more effective than others and some having fewer side effects.

But all 21 drugs - including both off-patent generic and newer, patented drugs - were more effective than placebos, or dummy pills, the results showed.

"Antidepressants are routinely used worldwide yet there remains considerable debate about their effectiveness and tolerability," said John Ioannidis of Stanford University in the United States, who worked on a team of researchers led by Andrea Cipriani of Britain's Oxford University.

Cipriani said these findings now offered "the best available evidence to inform and guide doctors and patients" and should reassure people with depression that drugs can help.
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Read the full story here.

Read the study here.
 
so they mixed studies from ages ago with modern ones where the placebo being as effective has come from advertising?

but we live now not in 1983 so how old are many of the studies included in this meta analysis
my guess is they used older studies to water down effect of recent placebo is the same type studies
 
lol :)

I'm getting the feeling that the whole emphasis on cure as opposed to healing is a big part of what is fucking up the way modern Western medicine treats a lot of conditions, especially mental health and addiction related stuff.
 
100mg of Sertraline (Zoloft) for several months really helped me at a time in my life when I was on the brink of suicide on a daily basis.

I won't claim that it wasn't hard to adjust it. On the contrary, about two months, it took, for me to begin to feel any benefit whatsoever.

Stopping it wasn't exactly pleasant either. A month of weird 'brain zaps' and headaches - it was relentless. But in the end, I firmly believe that some brain chemistry was altered long-term by the SSRI, because several years later, it's as if I'm still living with the subtle pros of the aforementioned Rx med.

It's not for everyone, obviously. My point being: before I was put on it, I tried Venlafaxine (Effexor XR) and Fluoxetine (Prozac), and I had to stop both after a few days.

Nevertheless, I recommend that you at least look into it if you feel it MIGHT be right for you (and obviously talk to your doctor about it), good day.
 
but seriously

in recent years their efficacy vs placebo has gone down

so they stuck every study including the old ones together BUT we live now so the placebo effect is more relevant today


this is how you water down a trend that shows you drugs aren't that good

do meta analysis so you can blend all the old trials with the new ones

what about trials suppressed before the drugs got to market? did they include those ones? :\

this is all one big data trick
 
SSRI's, SNR's etc all trick your brain into thinking it has more happy neurotransmitters than it actually has. It is a fake chemically induced happy state. Argue with me all you want, this is true to be the case. Full stop. Stop the drug, stop the specific feeling/effect felt. Simple.
 
JK25 said:
It is a fake chemically induced happy state. Argue with me all you want, this is true to be the case. Full stop. Stop the drug, stop the specific feeling/effect felt. Simple.
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The goal is to be able to put depression into remission and then taper off the antidepressant in question, and this certainly does occur. There are some people who relapse upon cessation of the drug who must be maintained on it (sometimes for decades) but dependence on an antidepressant is little different in concept than dependence on insulin for a type one diabetic.

Many drugs can acutely improve scores on a depression inventory (e.g. amphetamine or opiates) but other drugs have a real shot at genuinely treating MDD pathology, and this can be evidenced by more than just how a person reports feeling - there are neurological differences in function that can be objectively detected after a person is successfully treated with an antidepressant. As an example, people with depression are hyper attentive to negative stimuli - this can be attenuated with successful antidepressant treatment.

SSRIs in particular seem to encourage synaptic remodeling and reverse atrophy of the hippocampi, these are effects that aren't going to immediately disappear the moment the drug is tapered. Its part of why there is a lag between antidepressant initiation and antidepressant response, the beneficial effects of SSRIs aren't just due to an increase in serotonin, there is a genuine change in the neurons. Just as the beneficial effects of antipsychotics for schizophrenics aren't just due to blocking dopamine receptors, as there is also a lag between antipsychotic initiation and symptomatic improvement in schizophrenia.

CY
 
I was on an MAOI prescribed the psych I was seeing at the time. It didn't do anything for my depression but it shut down my colon until I was forced to stop taking it. I only get the side effects & none of the benefits intended.
 
I was on Prozac for 2 weeks & felt nothing. The next day I was overcome by an intense feeling of sadness that I felt only could be remedied by killing myself. After calling the doctor I stopped taking it, took a Xanax & laid down for a while. The feeling passed. But I know that a lot of suicides are being caused by just this sort of reaction to these drugs.

In general, it is assumed that antidepressants are beneficial for all symptoms of depression, including suicidality. However, some evidence suggests that Selective Serotonin Reuptake Inhibitors [SSRIs] may cause worsening of suicidal ideas in vulnerable patients.

https://www.theguardian.com/science/2000/may/22/drugs.uknews

Happy drug Prozac can bring on impulse to suicide, study says


As best-selling pill is prescribed by GPs for ever more sufferers from mild depression, research brings disturbing evidence to light

Sarah Boseley, health correspondent
Sun 21 May 2000 20.09 EDT

Alarming evidence from a new British study shows that the Prozac class of antidepressants can make healthy men, women and children with no history of depression feel suicidal.

The research undermines the claims of Eli Lilly, makers of Prozac, that people who kill themselves while on the tablets do so because of their depression, and that the disease, not the drug, is to blame for their suicide.
 
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Biggest Analysis of Anti-depressant Efficacy in History Released

This is huge. In Britain they did the biggest meta-analysis of anti-depressants in history by looking at over 100,000 patients, covering 21 different drugs. All drugs were better than placebo, but most not by much. Only about 5 or 6 had "modest" results.

The ones that had "modest" effect (which was the best outcome in the study) were: escitalopram, mirtazapine, paroxetine, agomelatine, and sertraline. They go on to talk about the ones that did pretty crappy. Trazadone is one of them.

Here's the link to the Lancet: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32802-7/fulltext
 
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Oops, I posted a separate thread about this.

The OP article has misrepresented the results.

Only 5-6 of the antidepressants had "moderate" effect. The rest did only slightly better than placebo... as in, they caused only a slightly better improvement in depression than a sugar pill.
 
Foreigner said:
All drugs were better than placebo, but most not by much. Only about 5 or 6 had "modest" results. [/url]
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That all drugs are better than placebo is true. However, there is a VERY important element to state here. The degree that anti-depressants are better than placebo IS NOT STATISTICALLY SIGNIFICANT.
For the null hypothesis to be rejected (The hypothesis that placebo is the cause of more positive anti-depressant effects than anti-depressents themselves) the observed result have to be statistically significant. And this is not the case - at least in the recently publiched studies I have read.

I haven't read the link in details yet but I will.
What I would like to know in the future is what medicines (food, training, what ever) anti-depressant can be combined with in order to result in a bigger positive effect. At least this will be important to research until potentially new anti-depressants emerge that works different from SSRI's and SNRI's and works on something that actually have a significant effect.
 
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