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Showing posts with label Antidepressant. Show all posts
Showing posts with label Antidepressant. Show all posts

Wednesday, December 2, 2020

Do antidepressants work?

Jacob Stegenga
aeon.co
Originally published 5 Mar 19

Here is an excerpt:

To see this, consider an analogy. Imagine we are testing a drug for weight loss. For every 100 subjects in the drug group, three subjects lose one kilogramme and 97 subjects gain five kilos. For every 100 subjects in the placebo group, two lose four kilos and 98 subjects do not gain or lose any weight. How effective is the drug for weight loss? The odds ratio of weight loss is 1.5, and yet this number tells us nothing about how much weight people on average gain or lose – indeed, the number entirely conceals the real effects of the drug. Though this is an extreme analogy, it shows how cautious we must be when interpreting this celebrated meta-analysis. Unfortunately, however, in response to this work, many leading psychiatrists celebrated, and news headlines misleadingly claimed ‘The drugs do work.’ On the winding route from the hard work of these researchers to the news reports where you were most likely to hear about that study, a simple number became a lie.

When analysed properly, the best evidence indicates that antidepressants are not clinically beneficial. The meta-analyses worth considering, such as the one above, involve attempts to gather evidence from all trials on antidepressants, including those that remain unpublished. Of course it is impossible to know that a meta-analysis includes all unpublished evidence, because publication bias is characterised by deception, either inadvertent or wilful. Nevertheless, these meta-analyses are serious attempts to address publication bias by finding as much data as possible. What, then, do they show?

In meta-analyses that include as much of the evidence as possible, the severity of depression among subjects who receive antidepressants goes down by approximately two points compared with subjects who receive a placebo. Two points. Remember, a depression score can go down by double that amount simply if a subject stops fidgeting. This result, found by both champions and critics of antidepressants, has been replicated year after year for more than a decade (see, for example, the meta-analyses led by Irving Kirsch in 2008, by J C Fournier in 2010, and by Janus Christian Jakobsen in 2017). The phenomena of blind-breaking, the placebo effect and unresolved publication bias could easily account for this trivial two-point reduction in severity scores.

Tuesday, May 8, 2018

Many People Taking Antidepressants Discover They Cannot Quit

Benedict Carey & Robert Gebeloff
The New York Times
Originally posted April 7, 2018

Here is an excerpt:

Dr. Peter Kramer, a psychiatrist and author of several books about antidepressants, said that while he generally works to wean patients with mild-to-moderate depression off medication, some report that they do better on it.

“There is a cultural question here, which is how much depression should people have to live with when we have these treatments that give so many a better quality of life,” Dr. Kramer said. “I don’t think that’s a question that should be decided in advance.”

Antidepressants are not harmless; they commonly cause emotional numbing, sexual problems like a lack of desire or erectile dysfunction and weight gain. Long-term users report in interviews a creeping unease that is hard to measure: Daily pill-popping leaves them doubting their own resilience, they say.

“We’ve come to a place, at least in the West, where it seems every other person is depressed and on medication,” said Edward Shorter, a historian of psychiatry at the University of Toronto. “You do have to wonder what that says about our culture.”

Patients who try to stop taking the drugs often say they cannot. In a recent survey of 250 long-term users of psychiatric drugs — most commonly antidepressants — about half who wound down their prescriptions rated the withdrawal as severe. Nearly half who tried to quit could not do so because of these symptoms.

In another study of 180 longtime antidepressant users, withdrawal symptoms were reported by more than 130. Almost half said they felt addicted to antidepressants.

The information is here.

Sunday, November 19, 2017

Rigorous Study Finds Antidepressants Worsen Long-Term Outcomes

Peter Simons
madinamerica.com
Originally posted

Here is an excerpt:

These results add to a body of research that indicates that antidepressants worsen long-term outcomes. In an article published in 1994, the psychiatrist Giovanni Fava wrote that “Psychotropic drugs actually worsen, at least in some cases, the progression of the illness which they are supposed to treat.” In a 2003 article, he wrote: “A statistical trend suggested that the longer the drug treatment, the higher the likelihood of relapse.”

Previous research has also found that antidepressants are no more effective than placebo for mild-to-moderate depression, and other studies have questioned whether such medications are effective even for severe depression. Concerns have also been raised about the health risks of taking antidepressants—such as a recent study which found that taking antidepressants increases one’s risk of death by 33% (see MIA report).

In fact, studies have demonstrated that as many as 85% of people recover spontaneously from depression. In a recent example, researchers found that only 35% of people who experienced depression had a second episode within 15 years. That means that 65% of people who have a bout of depression are likely never to experience it again.

Critics of previous findings have argued that it is not fair to compare those receiving antidepressants with those who do not. They argue that initial depression severity confounds the results—those with more severe symptoms may be more likely to be treated with antidepressants. Thus, according to some researchers, even if antidepressants worked as well as psychotherapy or receiving no treatment, those treated with antidepressants would still show worse outcomes—because they had more severe symptoms in the first place.

The article is here.

The target article is here.

Wednesday, September 2, 2015

Antidepressants Make it Harder to Empathize, Harder to Climax, and Harder to Cry

Big Think
Published on Apr 7, 2015

Dr. Julie Holland argues that women are designed by nature to be dynamic and sensitive – women are moody and that is a good thing. Yet millions of women are medicating away their emotions because we are out of sync with our own bodies and we are told that moodiness is a problem to be fixed. One in four women takes a psychiatric drug. If you add sleeping pills to the mix the statistics become higher. Overprescribed medications can have far-reaching consequences for women in many areas of our lives: sex, relationships, sleep, eating, focus, balance, and aging. Dr. Holland's newest book is titled Moody Bitches: The Truth About the Drugs You’re Taking, the Sleep You’re Missing, the Sex You’re Not Having and What’s Really Making You Crazy.

Thursday, July 23, 2015

Common medications sway moral judgment

By Kelly Servick
Science Magazine
Originally published July 2, 2015

Here is an excerpt:

The researchers could then calculate the “exchange rate between money and pain”—how much extra cash a person must be paid to accept one additional shock. In previous research, Crockett’s team learned that the exchange rate varies depending on who gets hurt. On average, people are more reluctant to profit from someone else’s pain than their own—a phenomenon the researchers call “hyperaltruism.”

In the new study, the scientists tested whether drugs can shift that pain-to-money exchange rate. A few hours before the test, they gave the subjects either a placebo pill or one of two drugs: the serotonin-enhancing antidepressant drug citalopram or the Parkinson’s treatment levodopa, which increases dopamine levels.

On average, people receiving the placebo were willing to forfeit about 55 cents per shock to avoid harming themselves, and 69 cents to avoid harming others. Those amounts nearly doubled in people who took citalopram: They were generally more averse to causing harm, but still preferred profiting from their own pain over another’s, Crockett’s team reports online today in Current Biology. Levodopa had a different effect: It seemed to make people just as willing to shock others as themselves for profit.

The entire article is here.

Saturday, July 18, 2015

Are You Morally Modified?: The Moral Effects of Widely Used Pharmaceuticals.

Levy N, Douglas T, Kahane G, Terbeck S, Cowen PJ, Hewstone M, Savulescu J.
Philos Psychiatr Psychol. 2014 Jun 1;21(2):111-125.

Abstract

A number of concerns have been raised about the possible future use of pharmaceuticals designed to enhance cognitive, affective, and motivational processes, particularly where the aim is to produce morally better decisions or behavior. In this article, we draw attention to what is arguably a more worrying possibility: that pharmaceuticals currently in widespread therapeutic use are already having unintended effects on these processes, and thus on moral decision making and morally significant behavior. We review current evidence on the moral effects of three widely used drugs or drug types: (i) propranolol, (ii) selective serotonin reuptake inhibitors, and (iii) drugs that effect oxytocin physiology. This evidence suggests that the alterations to moral decision making and behavior caused by these agents may have important and difficult-to-evaluate consequences, at least at the population level. We argue that the moral effects of these and other widely used pharmaceuticals warrant further empirical research and ethical analysis.

The entire article is here.

Thursday, January 29, 2015

Brief depression questionnaires could lead to unnecessary antidepressant prescriptions

University of California School of Medicine - Davis
Press Release
Originally released September 2, 3014

Short questionnaires used to identify patients at risk for depression are linked with antidepressant medications being prescribed when they may not be needed, according to new research from UC Davis Health System published in the September-October issue of the Journal of the American Board of Family Medicine.

Known as “brief depression symptom measures,” the self-administered questionnaires are used in primary care settings to determine the frequency and severity of depression symptoms among patients. Several questionnaires have been developed to help reduce untreated depression, a serious mental illness that can jeopardize relationships, employment and quality of life and increase the risks of heart disease, drug abuse and suicide.

The UC Davis team was concerned that the questionnaires might lead to prescriptions for antidepressant medication being given to those who aren’t depressed. Antidepressants are effective in treating moderate-to-severe depression but can have significant side effects, including sexual dysfunction, sedation and anxiety. They also have to be taken over several months to be effective.


“It is important to treat depression, but equally important to make sure those who get treatment actually need it,” said Anthony Jerant, professor of family and community medicine at UC Davis and lead author of the study.

The entire pressor is here.

The link to the study is in a blue hyperlink above.  The conclusion of the research is as follows:

Conclusions: These exploratory findings suggest administration of brief depression symptom measures, particularly the PHQ-9, may be associated with depression diagnosis and antidepressant recommendation and prescription among patients unlikely to have major depression. If these findings are confirmed, researchers should investigate the balance of benefits and risks (eg, overdiagnosis of depression and overtreatment with antidepressants) associated with use of a brief symptom measure.

Tuesday, October 14, 2014

Is It Possible to Create an Anti-Love Drug?

By Maia Szalavitz
New York Magazine - Science of Us
Originally posted May 19, 2014

Here is an excerpt:

A drug that precisely targets only one specific relationship for destruction may be decades away, but drugs that interfere with specific aspects of love like sexual desire are already here. And as scientists begin to tease out the chemical chronology and specific brain systems involved in love, they are already investigating how existing medications taken in carefully timed ways could, for example, prevent the "bonding hormone" oxytocin from initiating or sustaining a relationship.

This could forever change what it means to sever romantic ties. And the ramifications go beyond “Please let me forget”–type situations à la Eternal Sunshine. Anti-love drugs could also provide an intriguing new “treatment” for those trapped in abusive relationships.

The entire article is here.

Tuesday, May 6, 2014

Record numbers on 'happy pills'

Psychiatrists warning over soaring use of pills in 'depressed Britain'

By Laura Donnelley
The Telegraph
Originally posted April 20, 2014

Britons are taking anti-depressants in greater quantities than ever before, new figures have disclosed, with a near 25 per cent rise in prescriptions in the last three years alone.

According to official NHS data, more than 53 million prescriptions were handed out for drugs such as Prozac and Seroxat in England last year - a record high, and a rise of 24.6 per cent since 2010.

The entire story is here.

Tuesday, September 17, 2013

The Psychiatric Drug Crisis

BY GARY GREENBERG
The New Yorker
Originally posted on September 3, 2013

It’s been just over twenty-five years since Prozac came to market, and more than twenty per cent of Americans now regularly take mind-altering drugs prescribed by their doctors. Almost as familiar as brands like Zoloft and Lexapro is the worry about what it means that the daily routine in many households, for parents and children alike, includes a dose of medications that are poorly understood and whose long-term effects on the body are unknown. Despite our ambivalence, sales of psychiatric drugs amounted to more than seventy billion dollars in 2010. They have become yet another commodity that consumers have learned to live with or even enjoy, like S.U.V.s or Cheetos.

Yet the psychiatric-drug industry is in trouble. “We are facing a crisis,” the Cornell psychiatrist and New York Times contributor Richard Friedman warned last week. In the past few years, one pharmaceutical giant after another—GlaxoSmithKline, AstraZeneca, Novartis, Pfizer, Merck, Sanofi—has shrunk or shuttered its neuroscience research facilities. Clinical trials have been halted, lines of research abandoned, and the new drug pipeline has been allowed to run dry.

The entire story is here.

Thanks to Tom Fink for this story.

Thursday, September 5, 2013

A Dry Pipeline for Psychiatric Drugs

By RICHARD A. FRIEDMAN, M.D.
The New York Times
Published: August 19, 2013

Fully 1 in 5 Americans take at least one psychiatric medication. Yet when it comes to mental health, we are facing a crisis in drug innovation.

Sure, we have many antidepressants, antipsychotics, hypnotic medications and the like. But their popularity masks two serious problems.

First, each of these drug classes is filled with “me too” drugs, which are essentially just copies of one another; we have six S.S.R.I. antidepressants that essentially do the same thing, and likewise for the 10 new atypical antipsychotic drugs.

Second, the available drugs leave a lot to be desired: patients with illnesses like schizophrenia, major depression and bipolar disorder often fail to respond adequately to these medications or cannot tolerate their side effects.

The entire story is here.

Wednesday, August 28, 2013

A Glut of Antidepressants

By RONI CARYN RABIN
The New York Times
Originally published August 12, 2013

Over the past two decades, the use of antidepressants has skyrocketed. One in 10 Americans now takes an antidepressant medication; among women in their 40s and 50s, the figure is one in four.

Experts have offered numerous reasons. Depression is common, and economic struggles have added to our stress and anxiety. Television ads promote antidepressants, and insurance plans usually cover them, even while limiting talk therapy. But a recent study suggests another explanation: that the condition is being overdiagnosed on a remarkable scale.

(cut)

Elderly patients were most likely to be misdiagnosed, the latest study found. Six out of seven patients age 65 and older who had been given a diagnosis of depression did not fit the criteria. More educated patients and those in poor health were less likely to receive an inaccurate diagnosis.

The entire article is here.

Wednesday, February 20, 2013

The Op-Ed: Antidepressants & Controversial Studies

By Ed Silverman
Pharmalot.com
Originally published February 11th, 2013

Several years ago, the Black Box warnings that were added to antidepressants over suicidal thoughts and behaviors for youngsters caused a backlash, as some suggested the language had pushed physicians and parents to avoid usage when the medications could have done some good. The debate may have slipped from view, but never really ended. A pair of papers published last year, in fact, renewed the controversy, and Glen Spielmans, an associate professor of psychology at Metropolitan State University, recounts why the issue remains fraught with challenges and a recent spat that erupted when an effort was made to critique the papers.

Antidepressants can cause suicidality – suicidal thoughts and behaviors – in children and adolescents. This message has been widely disseminated since October 2004, when the FDA placed a Black Box warning on such medications. The warning was based on findings from placebo-controlled trials, in which kids taking antidepressants had an elevated rate of suicidal thoughts and behaviors (see this). But research led by Dr. Robert Gibbons, professor of biostatistics at the University of Chicago, suggests that this warning is counterproductive, scaring parents and kids away from getting safe and effective antidepressant treatment.

Gibbons was the main author on two papers published in 2012 in psychiatry’s premier journal, Archives of General Psychiatry (which was changed to JAMA Psychiatry last month). One paper examined the potential association between antidepressants and suicidality and the other focused on the efficacy of antidepressants.

The entire op-ed is here.

Friday, October 21, 2011

Judge says Prozac factor in teen murder


Winnipeg Free Press
Sympatico.ca News

WINNIPEG - A Manitoba judge says a Winnipeg teen was driven to fatally stab another teen due to the adverse effects of an anti-depressant drug.

Provincial court Judge Robert Heinrichs agreed to keep the case in youth court, where the male youth now faces a maximum sentence of just four more years behind bars on the charge of second-degree murder.

Heinrichs said Friday the use of Prozac resulted in “unique circumstances” which he was forced to consider.

He described how the youth, who was 16 at the time of the stabbing in 2009, went from a loving, happy-go-lucky kid to a dark, depressed drug abuser who began to act out violently and even tried to harm himself on several occasions.

Heinrichs said it’s clear the youth's parents did the right thing in bringing their concerns to his various doctors, but they were largely ignored and the drug's dosage was increased.

Since his arrest, the youth is now clean of all drugs, has expressed remorse for his actions and greatly reduced his risk to the public.

“His basic normalcy now further confirms he no longer poses a risk of violence to anyone and that his mental deterioration and resulting violence would not have taken place without exposure to Prozac,” Heinrichs said in a written decision.

The entire story can be read here.