Against Depression, a Sugar Pill Is Hard to Beat

Washington Post ^ | May 7, 2002 | Shankar Vedantam

[liberallarry]

After thousands of studies, hundreds of millions of prescriptions and tens of billions of dollars in sales, two things are certain about pills that treat depression: Antidepressants like Prozac, Paxil and Zoloft work. And so do sugar pills.

[DallasMike]

As for drugs for "something else", that's completely off the subject and irrelevant to the discussion at hand.

Do I take it that you're willing to admit that drugs can work for some diseases but somehow not for brain diseases? In the light of your worldview, how can you explain Alzheimer's, senile dementia, strokes, and Parkinson's? There are drugs that help those diseases, too. Do you think that they are just figments in people's imagination that a few verses from the Bible would somehow magically cure?

Yet you call me arrogant?

[Sam Cree]

"What makes you say that, there is not a word in the article to suggest that most of the numerous studies performed on drugs which have been licensed show the placebos outperform the drugs"

This is one of the words: "A new analysis has found that in the majority of trials conducted by drug companies in recent decades, sugar pills have done as well as or better than antidepressants."

I think the article certainly implies that they at least compete and sometimes outperform, at least in the case of depression drugs. Is it your experience that this is not so or that the above studies were mostly for drugs that didn't "pass the test"?

As an asthmatic, I do rely on drugs (Seravent and Albuterol) and don't know if I would survive without them, at least in the colder months. I am quite certain that they have a major and positive impact on my health.

[philman_36]

I highly resent either you or he thinking you know the first thing about me and think that you know better for me than I do.
All I have to "know you" by are your replies. You don't know better for me than I do for you either, yet you appear to think you do, and are willing to go to some length to persuade me to your line of thinking based upon your "personal experiences", blind clinical trials and personal research. Resentment? Who should be resenting whom?
Remember, for "mental health" to come to the rescue there first has to be "mental illness".

[philman_36]

...to persuade me to your line of thinking...
Maybe I should edit that to...to persuade myself and others to your line of thinking...
As you mentioned...I guess I shouldn't get so upset, just because a few people post nonsense on a message board.
This is a message board, by your way of thinking, and you're just putting out your message.

[philman_36]

Nope, no interactive forum here...

[Austin Willard Wright]

We agree though I must say that the pro-druggers (at least on this thread) usually rely on anecdotal cases or their own personal experiences. Speaking of statistics, if this stuff about sugar pills is true, it seems that the FDA may have been asleep at the wheel when approving these "medicines" as statistically beneficial doesn't it?

[Amore]

The only thing I'm really trying to say is that there is no one uniform answer on this issue. You and watchin both implied -- well, he called me a "sucker" and you implied basically that. I assure you I know what I am doing. I'm not trying to run anybody else's life or make their decision for them. I believe people are entitled to make their own decisions. This study can be helpful in encouraging people to be a little more skeptical and question how the drugs are really working for them. That's good. But putting out the message that anti-depressants are all bogus is wrong. It amazes me that people who have never experienced a severe depression think they know what it's like or think they could overcome it by sheer force of will. If you don't know what it's like, you should count yourself fortunate.

[philman_36]

It amazes me that people who have never experienced a severe depression think they know what it's like or think they could overcome it by sheer force of will. If you don't know what it's like, you should count yourself fortunate.
You're saying you know me when you don't, the very thing you chastised me for earlier. You have no idea if I have or haven't been through severe depression in my life, yet you make the presumption that I haven't. I have had very depressing periods in my life and I have overcome them through that "sheer force of will" you disparage so readily.
Yeah, I do know what severe depression is! Walk a mile in my shoes before you presume.
I'm sorry that your force of will isn't as strong as my force of will, but there isn't a thing I can do about that. Go take your psychotropic drugs, which you evidently believe help you. Just make sure it's not a sugar pill, you're buying and ingesting, which seem to be just as effective, as I wouldn't want anyone to be ripped off.
Some mental anguish and pain can lead to mental growth and inner strength.

[liberallarry]

In all these trials - whether cooked or not - some people benefit and some people don't. I was struck by Amore's earlier comments about the value of anectodal (personal) experience. One has to wonder whether statistics capture the essence of it all - or whether they miss crucial individual distinctions.

[Razz Barry]

Since both depression and the effect of the medicines are still not well understood, it's not clear what these changes mean. While they could be irrelevant effects, Mayberg said a better explanation is that the drugs affect areas deep within the brain and then work upward to affect parts of the brain that control mood. Placebos may work in the reverse direction. In part, this may explain why drug effects tend to be more reliable than placebos in the long run.

I wouldn't take something where the effect isn't understood. I'd be worried about liver, kidney...damage, down the road.

[Amore]

No, I didn't presume -- I said you were fortunate if you had not. My reference to others who didn't know what they were talking about was directed to many on this thread, not just to you.
As for you, congratulations on being such a wonderful, strong person. It must be great -- especially the part about getting to look down on others who aren't so strong.

[NukeMan]

Actually, no. The placebo effect has been increasing noticeably over the past 15 years or so, a very puzzling development. Drugs that passed muster in 1985 (superior to placebo and roughly equivalent to a tricyclic antidepressant (the 'gold standard' AD)) might not pass today. In fact, one large pharma company couldn't show effectiveness for a trial of an noradrenergic reuptake inhibitor, but also included in that trial was a control group that took Prozac (fluoxetine) and a control group that took a placebo. *Neither* Prozac nor the experimental drug proved superior to a placebo!!.

[Al B.]

The placebo effect has been increasing noticeably over the past 15 years or so, a very puzzling development.

Perceptive point. Maybe Eli Lilly salted the original trials. You can get some evidence of that just by looking at the exclusion criteria in the PDR. Others who have looked at FOIA'd clinical trial data and written about it say some pretty startling things about what went on in the clinical trials used for approving Prozac.

[Petronski]

In the meantime, we're robbing the sufferers and calling it compassion. Hypocrisy.

You don't know what you're talking about. Your lack of understanding on this issue is commonplace.

[liberallarry]

I don't like medications. I don't like operations. I'm not crazy about the diagnostic opinions of doctors. But I've overcome my resistance when I felt my body couldn't take care of itself. I'm pretty sure I would do the same if I felt I was losing my mind.

[Amore]

Just wanted to say, hang in there, there are people here who ARE supportive. I hope your son gets better.

[Petronski]

How does one smear Scientology?

[Al B.]

I doubt if that's possible and it's not what I meant.

Read on, maybe what I meant will become clearer.

[watchin]

I do not know if you are associated with these nut-cases, but you are fighting their battles.

I'm not associated with those nutcases, and your ad hominem argument is bogus.

[Petronski]

No, I think I understand now. You're referring to being smeared by an implication that you must be a Scieno for criticizing SSRIs, right? Such an implication would be quite a slur indeed!

My bad.