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It's generally found that between 50% and 65% of people on ADs will improve after three months, whereas between 25% and 30% of people on placebo will improve. Source. So it's hard to argue that they are no more effective than placebo, because they quite clearly are, but there is obviously a placebo effect at work in their usage. A 30% difference between taking placebo and taking AD is quite significant.
People suffering from depression do tend to have a lack of serotonin- whether this is a cause or reaction is still unclear. It's certainly not all about the chemicals, and there are few people who would argue that it is all about the chemicals, but there is a proven chemical problem at work. And ADs are proven to help alleviate it.
Skive, have you needed to take ADs? Have you taken ADs? I don't think it is your place to dismiss everyone who has taken ADs and has seen an improvement after taking them. They did a lot of good for me, as for many other people, but obviously without dealing with the mental issues as well as the hormonal and chemical you will relapse.
ADs should not be used as an alternative to therapy, but they do serve a purpose in stabilising people enough to undertake therapy.
It appears so.
I suppose there are no drug companies, or medical proffessionals that would benifit from studies showing that AD's work to treat depression to a significant degree?
Here's some intresting reading.
http://www.newscientist.com/article/dn4920-unpublished-data-reverses-riskbenefit-of-drugs.html
http://www.newscientist.com/channel/health/mg18825252.500.html
http://medicine.plosjournals.org/perlserv?request=get-document&doi=10.1371/journal.pmed.0020392
http://news.bbc.co.uk/1/hi/health/129048.stm
http://www.23nlpeople.com/clinical_depression.html
One of latest studies used the freedom of information act to gain access to all the clinical trials of AD's submitted to the FDA by big pharma companies. When all these published and unpublished trials were pulled together it showed that the placebo was as good as the AD's 80% of the time.
Exaclty, which is why adverts for anti depressants claiming that claim the drug sort out depression by controlling serotonin levels are bollocks. Adverts that people seem all too ready to believe.
SSRI's boost levels by hundreds of percent and no effect is felt for a fortnight.
I've seen a study (which I'm trying to source) that people born since 1945 are 10 times more likely to suffer from depression than those born before. And it cannot be explained away by people going to their doctor more, or depression being diagnosed more easily, as these were taken into account in the study.
Human biology doesn't change that quickly, which indicates that depression has more social causes than medical causes.
AD's have been found to be no more effective than the old style sedatives and downers but are constantly advertised as a miracle cure.
No, though I have suffered from depression after a series of illnesses when I was younger.
My sister however, had suffered from anxiety, panic attacks and bouts of depression for a number of years and was prescribed several different drugs at the drop of a hat from a number of different doctors. Nothing helped, they just made her feel worse. In the end she turned to hypontherepy, which was of an enormous benifit.
It's now almost 'cool' to be on anti depressants. How many patients seek help from their doctor because antidepressant advertisements have convinced them that they are suffering from a serotonin deficiency?
I get fed up with people who state as fact that they're depressed because of a chemical inbalance, and that depression is a physical disease when they simply don't know.
It's a pet hate "I'm depressed better take some pills to fix it" :mad:
That's what I mean when I say it depends who you believe.
There's no such thing as an independent survey, as someone has to pay for it, and its usually either the big pharmacos or the Christian right who have the money.
I'm not sure which adverts you refer to- you aren't allowed to advertise prescription drugs in this country.
What I think does happen is that GPs fob people off with ADs rather than sending for expensive and time-consuming talking therapy, but who's fault that is I'm not sure.
It's a tough one, I think depression is about both physical and social. Which is cause and which is effect I simply don't know. How much physical is due to genetical predisposition I don't know, but mental illness seems to run in families.
All I can say for certainty is what happened to me. I was disposed to depression because of what's happened in my life, and also depression has been noted several times in my extended family. I got physically ill and the depression set in, also at the same time I was stressed. ADs helped lift the worst of the mood, Prozac stabilised me, but I stopped taking it when I started therapy and it was the therapy that has helped me recover.
Curiously, my feelings get worse if I don't eat.
Taking pills perhaps has become "fashionable" amongst certain people, but I'm not so sure it isn't an overhyped phenomenon.
Yet the figure I gave - that placebo's were as good 80% of the time - was found by independant researchers (mental heath experts at Florida Uni), taken from trials by the big Pharma companies using the freedom of information act. I think pretty safe.
Other quotes from professionals
http://medicine.plosjournals.org/archive/1549-1676/2/12/table/10.1371_journal.pmed.0020392.t001-M.gif
They are in America, where it's become and absolute mainstay of popular culture that if your feeling doen AD's are the way to go. That's comes across through film and TV I think. It's certainly not as bad here, but I don't think it would take much for us to get there.
There is certainly a case for manic depression being genetic, apart from that I'm not really ready to belive the genetic theory either.
I can't see how being told that you were bound to get it because of genetics, is a particularly helpful statement to make to somebody suffering from depression. Not only that it's still speculation.
I think that a lot of behavior is learned from our familly - our parnets in particular - why should depresssion be any different. I think depression is to do with styels of thinking, behavior and relationships - there is so much scope for depression to be learned through the familly.
I'm not completely ruling out the fact that drugs (that obviously affect you physically) can affect your state of mind and attitude, just that this chemical inbalane that's often stated as a cause and that SSRI's are the cure is just mere theory. Ketamine whorks in a completey different way has been shown to be more effective than SSRI's for example.
The fact that placebo's are almost as effective as any drug out there, leads me to believe that depression is state of mind, a way of thinking, and attitude problem - and by saying that I don't mean to try and make depression seem trivial, I know it's not. It must be horrible.
Problems with a physical casue should really be treated with physical solutions, and problems caused psychologically should be treated with psychological solutions.
A pleasure inducing activity. I think if you you depressed your likely to be stuck in a loop of thought where don't really do anything pleasure giving, such as eating, excercise, proper sleep etc. That's why chemical changes occur I think - because your not using parts of your brain that would if you were content.
Everbody feels depressed at some point, but I think some people get caught in horrible circle of thought which leads to depression.
That's my take on it anyway.
The fact that I've been called 'ignorant little Skive' by MyName for not subscribing to the checmical inbalance theory, along with the numerous occasions where other posters have stated it as fact leads me to believe that it is overhyped, it's certainly believed by too many people.
I'm not completey ruling it out, but at the moment there simply isn't enogh evidence to make me believe it.
I don't think you are right to discount the opinions of those who say that ADs did work for them. I think you should be listening to that before saying that ADs never work. The fact of the matter is that for many people they do work, and they do make a difference, but they obviously can't and shouldn't replace therapy-based treatments.
How much is nature and how much is nurture is open to debate, because nobody really knows. Nobody really knows why serotonin level drop during depressive episodes, but they do. Levels of all mental illnesses have increased significantly, and I think better detection techniques play a big role in that.
I generally don't believe anything Klintock says, because he's very much a Walter Mitty sort of man.
The figure of 80% come from all drug trials carried out by these big Pharma companies, published and unpublised involving depression. I assume that includes all types of depression all across the board.
In mild and moderate depression the risks AD's carry outway the benifits ffs.
Just look at the sudies carried out by the Universtity professors and the read the links I've posted in this thread. Can you individually tell me why the sources I've linked to would have an agenda?
As hypnotist who deals with people suffering from depression on a regular basis, I think his opinions on this subject are definately worth considering. And what he said about inactivity in parts of the brain certainly makes sense.
He didn't think it was doing him any good anymore a few months ago and decided to gradually come off it with the help of his psych and Dr - after 8 weeks he had to go back on the full dose again, as his depression and OCD came back with a vengeance.
The only side effects he suffers are excessive sweating and some sexual dysfunction.
On the whole he feels it's totally worth being on it, as without it he can't function in the same way. The prozac, along with counselling and therapy have given him a new lease of life.
The 80% figure seems to have been pulled from thin air, it seems to be agreed (using your BBC link) that ADs are at least 25% more effective than placebo, which really does sink your argument that ADs are no more effective.
They're not as effective as Ely Lily would have, but of course they're not, Eli Lily make a lot of money out of Prozac.
Some of your source material seems to be neutral (ADs work, but not as well as the pharamcos would have you believe), and some of it seems to be spurious and agenda-ridden at best. A book called Prozac Backlash isn't likely to be a balanced look at fluoxetine, is it? And as for the "life coach" who uses his "scientific" essay to slag off the "appalling" Elizabeth Wurtzel, and then can't even be arsed to spell her name correctly, the less said the better.
If I thought for one second that he actually was one, they might have been worth considering.
The only thing he got right was saying that depressive people need help to learn how to deal with things that come into their path. Well, der.
I believe ADs work because I have seen them work and feel them work. I don't believe they are a long-term solution to depression, and I do think they are over-prescribed when a short course of counselling would be far more beneficial. I don't think they're a magic cure because they don't make you feel happy, they stop you feeling sad, and I don't think they're as good as their manufacturers make out, but I don't think they are deserving of the backlash that they receive.
Even critics of ADs are forced to concede they are 25% more effective than placebo, which means for every four people who go on a course, one will get better. For a science which is still in its infancy, that's not bad going.
Does it fuck!
If they're are 25% more effective doesn't that mean that a placebo is as effective as the AD 75% of the time? - A quite serious figure really. How many other drugs with that level of ineffectivness do you think you can get on script - would you take them? AD's supposedly work by correcting the THEORY that depression is a chemical inbalance in your brain, how many other drugs would you take which only work 'in theory'?
http://www.mcmanweb.com/FDA_suicide.htm
Not only are Anti depressants only midly more effective than a placebo they are twice as likely as a placebo to cause suicidal feelings in young people.
I havn't said that AD' arn't effective just that they're not significantly more effective than a placebo. That makes me me believe that depression is almost entirely psychological. And with the side effects and risks are AD's really a good way to go about things?
Well they're opinions shared by many proffesional therapists. So they are worth considering. Klintock had some strange ideas - but he wasn't stupid.
It's more likely to have been the placebo effect than the actual chemistry of the AD which helped.
That's not what it means at all. Think about it.
Saying that they are 25% more effective than a placebo is not the same as saying they work on one if four people?
British Medical Journal
AD's are just a big con.
Lots of cutting-edge drugs only have those figures, because they don't know what causes a lot of things.
The argument that placebo is as effective as ADs is a bit of a weird one anyway, as many use it to imply that people recover from depression because they think they're taking a super pill when they're not. What I think the figures really show is that ADs don't work for everyone- about half the people I know who've taken them saw an improvement, and half didn't.
I agree that many depressions are psychological, but the fact remains that serotonin does seem to drop in depressed brains. Whether it is cause or effect I don't know, but it does happen. Whether raising serotonin uptake would make a difference I don't know either, but it did for me.
What the figures quite clearly show is that if you take a AD and see an improvement it's more likely the placebo effect than the actual chemical effect of the drug, with many sudies and trials showing that the placebo is AS effective and even MORE effective in some cases.
The fact that AD's are also more likely to make people feel suicidal than a placebo is food for thought.
Those figures suggests to me that depression is almost always psycological, and if that's the case, I think it should be treated as such. For now, and from what I've seen, the negative aspects outway the benifits - I certainly don't think they're safe in the way they're being used at the moment. We don't exactly know what causes depression but we're treating it as though we do - with some potentially dangerous drugs. Just seems crazy.
As I said I'm willing to keep my mind open and would love to see really postive evidence that AD's work but at the moment it just doesn't exist.
Nobody knows yet, that's the point. But it's become a mainstay of popular culture that it's a cause. All I'm doing is pointing out that it's nothing more than an assumption.
How do you know it was the chemical and not the placebo. It's more than likely it was the placebo. I don't doubt taking a little pill helped, but I do doubt that it was the contents of the pill which helped.
I don't think it's for you to decide what medication you go on. The Doctor can advise you and help you more than the internet.
Because I didn't see the drug as a miracle cure and had an open mind about it.
I can't explain it, but lets just say I know what goes on in my own head.
People should make their own decisions about ADs, but as I say, much of the anti-AD literature is funded by Christain nutjobs who reckon the Bible is the only way to cure depression.
But you do believe AD's work. That's all you need for a placebo effect.
You don't think that the test subjects in these trials were skeptical, knowing theres a good chance the drug they'd been given was a placebo?
How come your so special that you knwo the in and outs of your mind?
I'm sure you saw an improvement after taking these pills, but I do find it hard to believe you know exactly why you saw an improvement. For that you'd need to understand why you were depressed, and be sure that it was because of a 'chemical inbalance'. And as you previously admitted, the fact is we don't know if depression is caused by a lack of seratonin.
The statistics show that in all likelyhood it was the belief that you were taking something that'll help you that made an improvement, the placebo effect - not the effect of the chemical.
People should make up their own minds but this chemical inbalance theory has become a mainstay of popular culture. You have people on here talking about it as though it were a prooven fact, when it's not. I think that's worrying.
The statistics I've shown wern't from trials funded by the Church, they're from trials funded by the drug companies themselves. No spin, just the freedom of information act, unless you'd care to proove otherwise?
I actually didn't expect them to work until I tried them, FYI.
But whatever. Most of the empirical evidence you have provided has been from biased sources (one couldn't even stop abusing Elizabeth Wurtzel long enough to spell her name right), and as the old saying goes, there's lies, damn lies and statistics.
Whatever. I used them and thought they worked; you didn't use them and don't think they work.
i dont wish to cure or help my depression by drugs, and i know i am still depressed but i have read books, researched the internet to get a better understanding of it which has helped me loads to start to "cure" myself
personally i prefer the cognitive behavior therapy. that helped so much more for me.
so now im off the drugs by my choice and just carrying on with life, i feel so much better for having my feelings whether they are negative or not because i am learning to deal with them a lot better
Again, it's amazing how you can be sure of this.
The trials conducted by the drug companies themselves show that AD's are often worse, no better, or not significantly better than placebo. To suggest that the MHRA has a religous agenda is a pretty hefty claim....
Instead of writing off my sources why not link to some your own showing how AD's and in particualr SSRI's, are of much higher benifit than I believe.
Without statistics what have we got?
To believe that SSRI's work you have to subscribe to the theory that depression is caused by a chemical inbalance in your brain. Your defending that as fact rather than the theory it really is.
There's no shame in admitting it may have been a placebo effect, placebo is the most effective drug in the world, it works for everything.
My mind is still open, and I havn't totally written of the effectiveness of AD's, but from the evidence I've seen so far I can't see any significant benifit from AD's especially when you take into account the unpleasant and potentially dangerous side effects. I'm willing to be prooven otherwise, though it'll have to be more than the argument that 'They worked for me' I'm afraid.
And for Fluoxetine both studies showed a greater success rate with the drug. Perhaps you see 20% as minimal, but I don't. Even your source states the testing was successful.
You don't have to believe that depression is caused by it, but I do believe that it is a factor in depression. I don't think it is necessarily causal, but that doesn't mean its not in play.
I also don't believe that drugs are a substitute for prolonged therapy, but they do serve a purpose.
Yes they did and I'll admit that an improvement is a improvement however large, but I still don't believe 20% is 'that' significant, especially when you consider the side effects that come with it.
For sure it's a factor though wether it's a cause or result of depression is still to be determined.
So, unless you know someone with a serious mental illness, or have one yourself. You should'n really comment on it.
Don't be so absurd.
The meds I am on are extremely strong, and they work!
Do I have to have suffered from Cancer to be able to comment on cancer treatments? Of course not.
I havn't been talking about schizophrenia.
I'm not going through this all again either. Read the thread from the start. I've supplied credible sources that show that in many cases SSRI's are no more effective than placebo's. If you want to link to a bit of evidence that shows otherwise feel free, but I'm not really intrested in the individual 'it works for me' argument.
I am not taking them.
You would also know that SSRI'S are a mainstay of treatment from schizophrenia.
which kind of blows your "'Im not really intrested in the individual 'it works for me' argument." out of the water.
along with your "I've supplied credible sources that show that in many cases SSRI's are no more effective than placebo's." comment.
Those sources do not take into account dosage strength. A very high dose of citalopram will have a much stronger effect than a low dose (obviously).
Whilst I agree that doctors prescribe medications too readily, frequently to people who would do better to eat three times a day, take a long walk in the morning, and GET OVER IT.
I think it is very dangerous to give the appearance of having some kind of solid knowledge of drug treatment for mental illness, when the way you are presenting your "evidence" is flawed, and does not take into account variables, like dosages for instance.
I'm with you on the spirit of what you are saying, but disagree with the method you have tried to use to say it.
My problem is that it's become a mainstay of popualr culture that depression is caused by a chemical inbalance of neuro transmitters in the brain, depsite the fact this still remains a theory. SSRI's work purely on the premise that this IS the cause of depression.
The evidence I've given which show that these AD's have been shown to be marginally more effect than a placebo at best, has been taken directly from trials completed by the large drug companies themsleves. I'm very sure that during these trials dosage was one of the many variables taken into account.
This is why I take a lot of peoples claims that SSRI's worked in their treatment for depression with a pinch of salt.
There are a lot of other drugs which are far more effective than SSRI's, I secretly think that doctors prescibe weak SSRI's to get whingers to go away, rather than for any real theraputic value.Strong SSRI's have to be prescribed in combination with drugs like tegratol for them to work well.