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.

[Dianna]

If diethylstilbestrol (DES) can cause cancer in the granddaughters of those who took it, what will we see in the offspring of the Ritalin and Prozac kids?

As the mother of a medicated child, I share your concern. I don't know how deeply this has been studied. But for me, there came a point where I was afraid of what would happen if we didn't intervene.

I'm a bad parent because I medicate my kid. But 5 years down the line if he's drug addict, commits suicide, or heaven forbid, pulls a Columbine, that would be my fault too.

[Dianna]

Having said that, I would never call these drugs "medicines" unless I had firm scientific basis for the view that they were treating an illness just like any other.

The problem is that the brain is simply not something we've been able to figure out yet. How many years will it be before we understand fully the role of brain chemicals vs experience? But people are killing themselves, they are killing others. Families are going through hell because "something" is not right. Do we make them wait when we CAN offer relief to some, as imperfect as our understanding is?

If you knew nothing about virus' and bacteria and yet had discovered penicillin would you do nothing?

[Al B.]

The question on this thread is not especially about the quality of Prozac,

Geez, what a waste of time this is.  You just MADE the quality of Prozac an issue with your statement:  "There has never been a scientifically valid study attacking prozac per se,....."   That's what I was responding to, along with your continuous tripe about Scientology.

Most of the researchers I was referring to have strongly criticized the safety of Prozac.  I'm not aware that these specific researchers have attacked the efficacy of Prozac, but others certainly have.  I'll look for the cites.

Any debate about the efficacy of Prozac vs. placebo goes far beyond the raw statistics you're so fond of.  Manipulating such things as inclusion/exclusion criteria, baseline HAM-D scores, and utilization of extremely dubious techniques such as placebo washout can bias ANY outcome for efficacy.  Lilly set the standard for setting these criteria by being first to the SSRI market with Prozac and most, if not all, of the RCT's touting Prozac were bought and paid for by Eli Lilly.

If you want to get into a serious discussion about SSRI efficacy vs placebo, we can start with the FDA database analysis this article references.  Believe it or not, I've actually read it.

I suspect, however, that you'll have a lot more fun calling everyone who disagrees with you a cultist.

[Lucius Cornelius Sulla]

you'll have a lot more fun calling everyone who disagrees with you a cultist.

As I pointed out in #134 above, the cultist opposition to psychiatric medication are a direct threat to the life of a member of my family. I will deal with it as such.

[philman_36]

Would you care to elaborate?
Simply stated...it probably cost you a pretty penny (a lot of money) for all of the "assistance" your son has been given with so little result. There is also the continuing cost of prtescriptions and "ongoing treatment" such as "adjusting medications" and "monitoring sessions".
You might ask for new testing too. After the your son gets fed up with all of it he may still come out of it on his own. Excuse my brevity and bluntness.

[philman_36]

Are you suggesting that mental illness didn't exist until meds came along?
Never said that nor suggested that, but determination and treatment of "mental illness" today is quite a different thing from days ago. A whole bunch of things are described as "mental illness" today that would seem laughable in the past.

[Arioch7]

Again, if you read my post, you will find that I did NOT say that mental illness should never be treated with drugs.

Also, if I am not mistaken, severe Bi-Polar disorders are not treated with prozac or ANY of the drugs mentioned here.

For such an analyst, you sure twist my words around. I said that most prozac is over prescribed to people that are really not sick, just suffering from lifes ups and downs.

So you respond by implying that my post had to due with people with full blown mental disease. It makes no sense and if that is indicative of your analytical skills then you need to try again, addressing the points I ACTUALLY MADE and not the way YOU interpreted my post.

[Dianna]

Simply stated...it probably cost you a pretty penny (a lot of money) for all of the "assistance" your son has been given with so little result.

Yes, it has. I suppose I should have simply told him to get over it? We worked it on our own for 4 years. Things were getting worse and worse.

I'd rather regret doing too much than not enough. You may feel differently.

[Al B.]

As I pointed out in #134 above, the cultist opposition to psychiatric medication are a direct threat to the life of a member of my family. I will deal with it as such.

Well you better get a suit of armor then, 'cause real opposition to these drugs is coming out of the woodwork. It's coming from places like Harvard, Yale and Columbia, from practitioners' offices everywhere, from book authors to psychiatric survivors' groups, and even from scientists who were involved with the development of Prozac.

BTW, you don't have a corner on the market for personal family tragedies involving mental illness. I suspect a lot of people participating in this discussion can make the same statement, including me.

[a history buff]

In that case, they would not be licensed for sale. Believe me, unless it can be statistically demonstrated that the drug outperformed the placebo the drug will never get on the market.

Why did Pharamcia & Upjohn's (I believe) Reboxetine get approved in the UK, but not here, where it couldn't outperform placebos? And why does Lilly's Prozac come with warnings in Germany that aren't required here? Is the cause genetic, or due to the modalities of the "stringent testing?"

[a history buff]

You seem to confuse psychiatrists (MD's) with psychologists (PhD's). This is roughly likely confusing a chiropractor with a neurosurgeon. Psychiatrists have NEVER done anything except treat with various medical treatments, including medications and electroshock, among other things. They are not trained in psychoanalysis, and do not practise it.

Nuts. Many American psychoanalytical assocations will not accept non MDs as full members.

[MarMema]

It's easy to see the drugs as overdone in this country.
But I have a child from an extremely awful third world situation who had severe behavioral problems until zoloft came into his life. So count me thankful for pharmaceutics.

[a history buff]

As I understand it, Lilly had a motion filed against them for practicing a "fraud on the court," after it emerged that they had, in regulatory filings, averred claims about Prozac that their expert had denied under oath, so words like "criminal profiteer" and "conmen" ought to be employed with great circumspection.

[MarMema]

But I think they have to be an option.

I think they are a Godsend. Sorry to disappoint all you other freepers. I have two children from horrible early beginnings, whom my husband and I naively adopted.

Setting fires, running away so often that the sheriff's deputy sees your child in the woods and recognizes him from the last runaway attempt( and brings him home), the agony of living with a child who screams for 4 hours at a time.
The neighbors calling CPS on you when they hear your child screaming nonstop - and who can blame them?
We adopted them and we stuck it out, and meanwhile THANK GOD for the psych drugs, and the wonderful child psychiatrist who helped us have a life again.

Our oldest is now medication free and doing well. The other child is still on meds and you can bet we want to keep it that way.
There is no chance in heck that sugar pills would have done what the meds we made use of did for our family. The people in this survey were having bad hair days or something.

[a history buff]

If diethylstilbestrol (DES) can cause cancer in the granddaughters of those who took it, what will we see in the offspring of the Ritalin and Prozac kids?

Tell me, as someone who is greatly interested by the DES story, where I could read more about your claims.

[hinckley buzzard]

First, most psychiatrists do little or no therapy. Second, any psychiatrist worth his salt can have a thriving practice in short order regardless of how many antidepressants are written by primary care physicians.

You want to be the big cynic, you're going to need to know a little more about the real world and entertain a few less half-formed theories.

[Lucius Cornelius Sulla]

real opposition to these drugs is coming out of the woodwork.

No problem, in Florida we know how to deal with carpenter ants.

[ladyinred]

I could have told them that sugar is a great bad mood killer for free! Give me chocolate and I am a happy camper!
Seriously, it is rather disgusting how the doctors and drug companies are trying to put every patient who walks in on some mood elevator!
Those who claim they are just miserable without them are made into fools by this study!

[Lucius Cornelius Sulla]

As I understand it, Lilly had a motion filed against them for practicing a "fraud on the court,"

There is no meaning to filing a motion, only some sort of adjudication would rise to the level of a datum. Since you do not mention it, that would tend to lead to the conclusion that there was no adjudication of this allegation. I could file a motion alleging that you are a Martian, but that would not mean that you are one.

[null and void]

I am also well aware that Prozac is a particular target of the Scientologists, who are the primary producer of anti-psychiatric drug propaganda. Their position is that psychiatric drugs do not work, that those who take them should instead pay thousands of dollars to Scientology, so that they may be 'cleared'.

BINGO!

(I'm a former member of that particular, ummm, organization)...