Posted by MattDDS on September 24, 2002, at 13:27:59
In reply to Re: Antidepressants versus placebo smackdown!, posted by Eddie Sylvano on September 24, 2002, at 10:30:42
This is an interesting article. It has mirrored my experience with antidepressants,
namely, that I get ZERO response (other than annoying side effects).I don't understand why this is such an emotional issue for many people who are advocates
of antidepressants. It is almost like people defend the virtues of AD's with a religious
zeal! Personally, I am for whatever works. I really look forward to the day that we
do have an effective chemical (or other biological) treatment for depression.
Unfortunately, I do not believe that day has arrived. I definitely do not believe that the
answer lies in increasing brain serotonin (or monoamines, for that matter). We already
have a plethora of drugs that do this, and yet people are still depressed.Placebos consistently yield a 30-50% response! Antidepressants give maybe a 65-70% response
on average. In clinical trials, it has been shown that clinicians, as well as subjects, can
usually determine who is getting what treatment (the side effects give it away), and this
could potentially "unblind" the study. Why don't drug companies use active placebos, like
an antihistamine or something? Would you, if you were the CEO of a drug company, and your
livelihood depended on your drug working? I bet not. Anyway, I think this "unblinding"
effect could account for the (minute) difference between placebo and antidepressant.
Eddie says that effective placebo treatment is better than nothing. I politely disagree for
a number of reasons. I believe science is our ally. If we as consumers continue to take
medications that are not much more effective than placebos, then the drug companies will
have no reason to research out better treatments. Also, if placebos are as effective as
current antidepressants, why not just take a placebo with zero side effects: SUGAR!
Likewise, if antidepressants exert their action through "wishful thinking", why not just
work directly on the wishful thinking through the better researched forms of psychotherapy
(e.g. CBT)? The prices of these "effective placebos" are also outrageous! I have better
things to do with my money than spend it on drugs that are only marginally, ifat all,
better than placebo.Please don't interpret this as being "anti-meds". I am a huge advocate of brain and pharm
research. I am just not personally convinced that current AD's are that effective. I think
we as consumers should make informed decisions. If not, then we will see "more of the same",
as we have recently seen with Lexapro. Does anyone else think we really need another SSRI?Matt
poster:MattDDS
thread:120924
URL: http://www.dr-bob.org/babble/20020922/msgs/120951.html