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Treating Depression: Is there a placebo effect? (PROZAC, OTHER SSRIs VIRTUALLY WORTHLESS)
CBS 60 Minutes ^ | Tonight | Lesley Stahl

Posted on 02/19/2012 6:07:06 PM PST by MindBender26

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To: MindBender26
Some 40% of women are on these anti-depressants, and increasing!

When (if the trend continues) a majority of women are diagnosed as “depressed” is that a clinical diagnosis of an actual affliction - or is it just being a woman in modern America where any complaint to a physician elicits a prescription?

101 posted on 02/20/2012 9:07:46 AM PST by allmendream (Tea Party did not send the GOP to D.C. to negotiate the terms of our surrender to socialism.)
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To: netmilsmom

Whenever I see a HARVARD STUDY, I am reminded of the Harvard Arsenic Study, which I read on-line before it was put together as a position paper.

They posted all the information and documentation, gathered from around the world, before the paper was written. The documentation didn’t match up with the conclusion. The simply dropped all the documentation that did not fit their stated premise, that arsenic in the water caused bladder cancer.


102 posted on 02/20/2012 9:34:39 AM PST by Eva
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To: ConorMacNessa

Me too. It works.


103 posted on 02/20/2012 9:45:41 AM PST by midnightcat
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To: E. Pluribus Unum

give me the years you think this complex started. And what useless medication they put on the market..


104 posted on 02/20/2012 9:52:30 AM PST by goat granny
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To: allmendream

We have entered the Age of Irresponsibility.

Nothing is anyone’s fault. There is no bad or sinful behaviour. Everything is a medical problem.

Back in my Crusading Reporter days, had a number of medical sources. A number of psychiatrists and psychologists, even then, said that many of their patients were “cringing whiners.”

Back then, they got guidance, encouragement, set goals and deadlines, etc.

Now, they get a pill that has proved ineffective!


105 posted on 02/20/2012 9:53:16 AM PST by MindBender26 (New Army SF and Ranger Slogan: Vengeance is Mine, sayeth the Lord.... but He subcontracts!)
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To: goat granny

After you address the corruption of the FDA that I asked you to.


106 posted on 02/20/2012 9:58:06 AM PST by E. Pluribus Unum (Government is the religion of the fascists.)
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To: MindBender26
This syndrome has managed to infect nearly every aspect of U.S. health care.

I had Strep throat. After an hour in the waiting room the Dr. gave me a scrip for penicillin. Absolutely NO mention of “rest and fluids” or ANYTHING - just pills. Pills were the only answer - making me thing - “It seems I needed the pharmacist a LOT MORE than the Dr..”

It is difficult to walk out of the Dr.’s office WITHOUT a prescription. I had elevated liver function as a result of rapid weight gain (15 lbs after I gave my dog to my brother and stopped walking daily, also taking a new GF out to dinner several nights a week, etc). Luckily that precluded me from being prescribed something for my (slightly) high cholesterol.

All I really needed was exercise and weight loss and to adjust my diet - but pills was the first answer - and he seemed rather disappointed he wasn't getting me on some form of pill or another!

Don't get me wrong - I develop life saving therapeutics for a living - but EVERY drug my company makes is for severe illness - not for any little thing that might not feel 100%!

Impotent? - the Dr. wont tell you to quit smoking and lose 20 lbs - he will prescribe you a blue pill.

Overweight? They got a pill for that!

Anxious? Depressed? They got a pill for that!

Child disruptive in class? They got a pill for that!

I see the regimen of pills my father is on. If I start now by the time I am his age I will be on pills to counteract the activity of the pill I am taking to treat the syndrome brought about by a different pill - all to treat a rather mild initial symptom that could probably be treated through non therapeutic intervention!

107 posted on 02/20/2012 10:21:11 AM PST by allmendream (Tea Party did not send the GOP to D.C. to negotiate the terms of our surrender to socialism.)
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To: E. Pluribus Unum
If you read my reply #88 I did not defend the costs of medications, and in fact thought many drugs are too expensive. The U S citizen is charged more for a medication then Canada who pays less for the same drug......Price gouging for new drugs is nasty, but it cannot be denied that they put out life saving medicines.

For decades there was only a few pharmacuticals....Parke Davis was one and it was in an area I use to drive by when shopping....Now it is highly competitive..with a multitude of pharmacutical business's..It is a cut throat business with a rush to be the first with a new medication..

It also cannot be denied that the FDA regulates the business so heavily, that the cost of R & D is unnecessarily high...

These business have to kiss the arse of government to get their products on the market. Blame government. They have *big pharma* by the short hairs and greasing the wheels of politicians with large amt. of money is a necessity evil of doing business in this country...The evil one here is regulations and regulators put in place by our great congress of mostly corrupt people...and the government is the one that lets them charge more to recupe money based on their having to charge less to other countries that won't pay the same price american's have to...it stinks but thats the game Washington plays. Its pay the price or go out of business...

In reguard to your wanting me to read something you find interesting, forget it. And I won't tell you to read something I think is interesting that might bore you to death...

108 posted on 02/20/2012 10:29:29 AM PST by goat granny
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To: goat granny
The FDA should be abolished.

People move from a company into the FDA to approve the drug they worked on.

The purpose of the FDA is to grant monopolies to LARGE drug companies.

The FDA is on record saying they will NEVER approve a drug not owned by a large drug company.

That is documented in my previous link.

109 posted on 02/20/2012 10:41:40 AM PST by E. Pluribus Unum (Government is the religion of the fascists.)
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To: Eva

>>Whenever I see a HARVARD STUDY, I am reminded of the Harvard Arsenic Study, which I read on-line before it was put together as a position paper.<<

Oh my goodness! Great find!


110 posted on 02/20/2012 10:58:11 AM PST by netmilsmom (Happiness is a choice)
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To: FourPeas

Exactly!


111 posted on 02/20/2012 11:01:13 AM PST by netmilsmom (Happiness is a choice)
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To: allmendream

>>Overweight? They got a pill for that!<<

What is it?
I want to go to your doctor.


112 posted on 02/20/2012 11:02:54 AM PST by netmilsmom (Happiness is a choice)
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To: MindBender26

You need to read Post 102.

And I don’t take a single pill (short of an ibuprofen for headache occasionally) so you can’t really define me as a “pill popper”. As for “too lazy to read the study”, it’s more of a “won’t waste her time with reading Obama propaganda”.

You can however count me as someone who worked with people who WERE helped with both chemicals and natural medicine. All I can tell you is, Harvard will find what it wants and it should give you pause when academia and CBS agree on anything.


113 posted on 02/20/2012 11:07:50 AM PST by netmilsmom (Happiness is a choice)
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To: MindBender26

There are more things in heaven and earth, Horatio, Than are dreamt of in your psychiatry.


114 posted on 02/20/2012 11:16:40 AM PST by St_Thomas_Aquinas (Viva Christo Rey!)
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To: E. Pluribus Unum
I addressed the FDA in #88 and you missed it completely. You should read what I wrote and not what you think I wrote.

FDA is not the only department that should be eleminated. EPA, ADA,BATFE, DEPT OF EDUCATION, DEPT.OF HOMELAND SECURITY, MOLESTERS THAT YOU HAVE TO SUBMIT TO SO YOU CAN FLY ON A PLANE DEPT. OF COMMERCE and that is just off the top of my head...with though could come up with lots more dept. we don't need and all czars to go. I am way ahead of you and the FDA. But probably have lived a few decades longer than you......

115 posted on 02/20/2012 11:19:04 AM PST by goat granny
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To: netmilsmom

What the Harvard Arsenic Study actually found was that the areas in the US with the highest % of arsenic in the water, had the LOWEST rate of bladder cancer.

The reason was that those same areas had a high % of selenium in the water and that selenium combines with the arsenic (and other potentially dangerous elements, like mercury) to flush it from the body.

Man would have died out a long time ago if arsenic was as dangerous as the Harvard arsenic study led people to believe. Arsenic is plentiful in areas of former volcanic activity.


116 posted on 02/20/2012 11:21:54 AM PST by Eva
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To: Eva

Amazing!
Thanks for sharing that Eva!


117 posted on 02/20/2012 12:13:52 PM PST by netmilsmom (Happiness is a choice)
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To: netmilsmom

Speed. Didn’t you know?

They regularly prescribe amphetamines for weight loss.

There are even over the counter products.

Unfortunately they have major side effects - and when you stop taking the speed the weight comes back.


118 posted on 02/20/2012 12:32:18 PM PST by allmendream (Tea Party did not send the GOP to D.C. to negotiate the terms of our surrender to socialism.)
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To: netmilsmom
Read the report. It's not magic. It is simply a compendium of the research done by Eli Lilly itself when testing Prozac before the FDA approval!

By FDA rules, clinical studies that show any drug is safe and effective is admissible, and a study that shows the drug is ineffective is ignored by the FDA.

A company could get 20 negative tests in a row, and as long as they get two positive trials, over any time period, the drug will be approved!

There is no debate that people with depression get well. Many of them took Prozac, Welbutrin or other such drugs. They also ate mashed potatoes.

The studies all confirmed that Prozac was more effective than a placebo in only 14 percent of the cases, and only when the patient was severely depressed.

In the moderately or minimally depressed, (often called “stinkin’ thinkin’”) Prozac had no effect than that created by the placebo sugar pill.

Yes the moderately and minimally depressed people got well, but it wasn't because of the Prozac, nor was it because of the mashed potatoes!

And in the severely depressed, only 14% got help from Prozac. The other 86% who got well did it through talk therapy and their own commitment to getting well.

Those are the facts, from Eli Lilly's own clinical trials!

119 posted on 02/20/2012 4:20:40 PM PST by MindBender26 (New Army SF and Ranger Slogan: Vengeance is Mine, sayeth the Lord.... but He subcontracts!)
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To: netmilsmom
Read the report. It's not magic. It is simply a compendium of the research done by Eli Lilly itself when testing Prozac before the FDA approval!

By FDA rules, clinical studies that show any drug is safe and effective is admissible, and a study that shows the drug is ineffective is ignored by the FDA.

A company could get 20 negative tests in a row, and as long as they get two positive trials, over any time period, the drug will be approved!

There is no debate that people with depression get well. Many of them took Prozac, Welbutrin or other such drugs. They also ate mashed potatoes.

The studies all confirmed that Prozac was more effective than a placebo in only 14 percent of the cases, and only when the patient was severely depressed.

In the moderately or minimally depressed, (often called “stinkin’ thinkin’”) Prozac had no greater effect than that created by the placebo sugar pill.

Yes the moderately and minimally depressed people got well, but it wasn't because of the Prozac, nor was it because of the mashed potatoes!

And in the severely depressed, only 14% got help from Prozac. The other 86% who got well did it through talk therapy and their own commitment to getting well.

Those are the facts, from Eli Lilly's own clinical trials!

120 posted on 02/20/2012 4:20:58 PM PST by MindBender26 (New Army SF and Ranger Slogan: Vengeance is Mine, sayeth the Lord.... but He subcontracts!)
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To: MindBender26

I read the transcript. I couldn’t find a link to the study.


121 posted on 02/20/2012 9:20:51 PM PST by FourPeas ("Maladjusted and wigging out is no way to go through life, son." -hg)
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To: FourPeas

http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0050045

Here is part of it:

INVESTIGATORS:

Irving Kirsch1*, Brett J. Deacon2, Tania B. Huedo-Medina3, Alan Scoboria4, Thomas J. Moore5, Blair T. Johnson3

1 Department of Psychology, University of Hull, Hull, United Kingdom, 2 University of Wyoming, Laramie, Wyoming, United States of America, 3 Center for Health, Intervention, and Prevention, University of Connecticut, Storrs, Connecticut, United States of America, 4 Department of Psychology, University of Windsor, Windsor, Ontario, Canada, 5 Institute for Safe Medication Practices, Huntingdon Valley, Pennsylvania, United States of America

Abstract

Meta-analyses of antidepressant medications have reported only modest benefits over placebo treatment, and when unpublished trial data are included, the benefit falls below accepted criteria for clinical significance. Yet, the efficacy of the antidepressants may also depend on the severity of initial depression scores. The purpose of this analysis is to establish the relation of baseline severity and antidepressant efficacy using a relevant dataset of published and unpublished clinical trials.

Methods and Findings

We obtained data on all clinical trials submitted to the US Food and Drug Administration (FDA) for the licensing of the four new-generation antidepressants for which full datasets were available. We then used meta-analytic techniques to assess linear and quadratic effects of initial severity on improvement scores for drug and placebo groups and on drug–placebo difference scores. Drug–placebo differences increased as a function of initial severity, rising from virtually no difference at moderate levels of initial depression to a relatively small difference for patients with very severe depression, reaching conventional criteria for clinical significance only for patients at the upper end of the very severely depressed category. Meta-regression analyses indicated that the relation of baseline severity and improvement was curvilinear in drug groups and showed a strong, negative linear component in placebo groups.

Conclusions

Drug–placebo differences in antidepressant efficacy increase as a function of baseline severity, but are relatively small even for severely depressed patients. The relationship between initial severity and antidepressant efficacy is attributable to decreased responsiveness to placebo among very severely depressed patients, rather than to increased responsiveness to medication.

Editors’ Summary Top
Background.

Everyone feels miserable occasionally. But for some people—those with depression—these sad feelings last for months or years and interfere with daily life. Depression is a serious medical illness caused by imbalances in the brain chemicals that regulate mood. It affects one in six people at some time during their life, making them feel hopeless, worthless, unmotivated, even suicidal. Doctors measure the severity of depression using the “Hamilton Rating Scale of Depression” (HRSD), a 17–21 item questionnaire. The answers to each question are given a score and a total score for the questionnaire of more than 18 indicates severe depression. Mild depression is often treated with psychotherapy or talk therapy (for example, cognitive–behavioral therapy helps people to change negative ways of thinking and behaving). For more severe depression, current treatment is usually a combination of psychotherapy and an antidepressant drug, which is hypothesized to normalize the brain chemicals that affect mood. Antidepressants include “tricyclics,” “monoamine oxidases,” and “selective serotonin reuptake inhibitors” (SSRIs). SSRIs are the newest antidepressants and include fluoxetine, venlafaxine, nefazodone, and paroxetine.

Why Was This Study Done?

Although the US Food and Drug Administration (FDA), the UK National Institute for Health and Clinical Excellence (NICE), and other licensing authorities have approved SSRIs for the treatment of depression, some doubts remain about their clinical efficacy. Before an antidepressant is approved for use in patients, it must undergo clinical trials that compare its ability to improve the HRSD scores of patients with that of a placebo, a dummy tablet that contains no drug. Each individual trial provides some information about the new drug’s effectiveness but additional information can be gained by combining the results of all the trials in a “meta-analysis,” a statistical method for combining the results of many studies. A previously published meta-analysis of the published and unpublished trials on SSRIs submitted to the FDA during licensing has indicated that these drugs have only a marginal clinical benefit. On average, the SSRIs improved the HRSD score of patients by 1.8 points more than the placebo, whereas NICE has defined a significant clinical benefit for antidepressants as a drug–placebo difference in the improvement of the HRSD score of 3 points. However, average improvement scores may obscure beneficial effects between different groups of patient, so in the meta-analysis in this paper, the researchers investigated whether the baseline severity of depression affects antidepressant efficacy.

What Did the Researchers Do and Find?

The researchers obtained data on all the clinical trials submitted to the FDA for the licensing of fluoxetine, venlafaxine, nefazodone, and paroxetine. They then used meta-analytic techniques to investigate whether the initial severity of depression affected the HRSD improvement scores for the drug and placebo groups in these trials. They confirmed first that the overall effect of these new generation of antidepressants was below the recommended criteria for clinical significance. Then they showed that there was virtually no difference in the improvement scores for drug and placebo in patients with moderate depression and only a small and clinically insignificant difference among patients with very severe depression. The difference in improvement between the antidepressant and placebo reached clinical significance, however, in patients with initial HRSD scores of more than 28—that is, in the most severely depressed patients. 1Additional analyses indicated that the apparent clinical effectiveness of the antidepressants among these most severely depressed patients reflected a decreased responsiveness to placebo rather than an increased responsiveness to antidepressants.

What Do These Findings Mean?

These findings suggest that, compared with placebo, the new-generation antidepressants do not produce clinically significant improvements in depression in patients who initially have moderate or even very severe depression, but show significant effects only in the most severely depressed patients. The findings also show that the effect for these patients seems to be due to decreased responsiveness to placebo, rather than increased responsiveness to medication. Given these results, the researchers conclude that there is little reason to prescribe new-generation antidepressant medications to any but the most severely depressed patients unless alternative treatments have been ineffective. In addition, the finding that extremely depressed patients are less responsive to placebo than less severely depressed patients but have similar responses to antidepressants is a potentially important insight into how patients with depression respond to antidepressants and placebos that should be investigated further.


122 posted on 02/21/2012 4:53:10 AM PST by MindBender26 (New Army SF and Ranger Slogan: Vengeance is Mine, sayeth the Lord.... but He subcontracts!)
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