AD=Placebo?

[hugugh]

I've been slightly obsessed and majorly confused with this article since I found it:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2253608/

 

I don't understand how drugs with such terrible side effects and with very little/no efficacy were approved for use and became so popular throughout the world.  I am not a conspiracy theorist so I'm having a hard time wrapping my head around the idea that anti-depressants might just be one giant scam between pharmaceutical companies, regulatory agencies and doctors.  How is this possible?  If this research is real (and it sure looks convincing) and antidepressants really are no better than placebo, then if the research was not muddled and hidden, my poor daughter would have been saved from years of torment that almost took her life.  It makes me want to tear my hair out thinking about this.

 

Has anyone seen this research?  Opinions? 

[ChessieCat]

What I would like to say is that at least you know now.  You did what you did at the time, with the knowledge you had at the time. 

 

• You did what you did because you care about your daughter and thought you were doing the right thing
• You have more information now
• You now know how to find information before deciding on what action to take
• You are now better able to make informed decisions
• You are doing the best you can

 

This is something that I think a lot of us have trouble getting our heads around.  And I think that the anger we have about it is warranted.  I, too, am not a conspiracy theorist, but from what I have learned since joining SA at the end of 2015, not just about psychiatric drugs but also about other drugs (statins, diabetic drugs) and the "research" results, I have become very cautious about everything that I read/hear.

 

It's a horrible way to be, not knowing what/who to trust but I have started questioning anything that a doctor suggests.  For example, I had a pain in my upper right quadrant and had an ultrasound that didn't show anything.  The blood test showed some markers for inflammation so she wanted me to take fluoroquinoline antibiotic.  I know about possible issues with this drug from what I had read here at SA so I did more research.  It turns out that there are 3 FDA warnings about this drug.  One of them is that older people (I was about 61 or 62 at the time) are at a higher risk of ruptured tendons.  When I gave this information to the doctor she said, oh but that is only x% (I think it was about 1%).  Things that I thought about:  I snapped an ankle ligament in my mid 30s and have issues with it ever since, I might be in that 1%, how many people get a ruptured tendon and it is not attributed to the drug (I had raised blood pressure after increasing my Pristiq from 50mg to 100mg and the doctor who prescribed it did not make the connection between that and the blood pressure; it wasn't until years later that I made the connection myself).

 

Anyway back to the pain.  I refused to take the fluoro and asked for a different antibiotic but she said that the fluoro was the one they give for what I had.  She said okay then we will wait and do another blood test in a few days.  At that time the inflammation markers had gone down.  My body had "done the job".

 

Another example.  I was diagnosed diabetic with high cholesterol in October 2021.  Doctor wanted to change diet (probably low FAT), start a statin (can increase risk/worsen diabetes) and also metformin (can increase obesity).  Three variables!  I said no and did my own research, thankfully finding out about low CARB diet.  After only 3 months my Hba1c is below 5.5 so my diabetes is in remission/reversed, my liver function tests are normal, my cholesterol has improved and my blood pressure reduced (I am only on a very low dose of perindopril now).  If I had taken the drugs and changed my diet to low carb I think that the drugs would have been "praised" as doing their job and I would have ended up on them long term with the side effects.

 

 

 

I saw a video just a couple of days ago.  I've highlighted the important parts in the transcript.  And I wonder why I am now cautiously cynical.

 

https://youtu.be/ladtvxTAYYw

 

from the transcript:

 

22:27

drug companies can distort the literature on statins so one of their favorite ways is to have what we call a

22:33

run-in period so i was just reading a study the other day on statins and what they did is that they gave

22:39

before the trials started they gave everybody a statin and 11 000 of them approximately had

22:46

significant side effects so they were withdrawn from the study before it even started

22:53

now do you think the side effect data was based on these 11 000 people who withdraw with side effects or do you

22:59

think it was based on the population that was remaining who had then proven

23:04

that they were tolerant to statins so this is abuse of a run-in period and there's multiple other ways that we can

23:10

actually get to the truth of it but in reality as you say peter it's at least one in four people have significant side

23:16

effects from statins

 

 

 

Please be aware that these videos might be triggering, so please make your own decision about whether you are in the right place mentally to listening to them.  For me, I find that knowledge is power.

 

Gwen Olsen was a pharmaceutical representative.  She has personal experience using psychiatric drugs as well as her niece.

 

Interview:  Confessions of an Rx Drug Pusher (51 minutes Gwen Olsen - ex pharmaceutical representative)
 

Video:  Ex-Big Pharma Rep:  We’re Trained To Misinform -The Drugs ARE Dangerous (6 minute video)
 

Video:  Ex-Big Pharma Rep:  Manipulating Doctors to Sell More Drugs (10 minute video)

[Ariel]

18 hours ago, hugugh said:

antidepressants really are no better than placebo

 

The problem is not so much that ADs are no better than placebo as it is that ADs are decidedly worse than placebo in terms of the harm they can do. A placebo doesn't do harm. 

I was skeptical about psych drugs pretty much from the beginning, but being ignorant of the potential risks, I just figured:

What is there to lose? If they're no better than placebo, then why not try? If they don't work, I'll be no worse off than when I started. If they work from a placebo effect, at least they're working. If they work from the chemicals, at least they're working. 

That was my reasoning for years and years. Meanwhile I had no clue that they were actually actively doing harm. Had the risks been known to me I would have opted out.  

 

18 hours ago, hugugh said:

I don't understand how drugs with such terrible side effects and with very little/no efficacy were approved for use and became so popular throughout the world.  I am not a conspiracy theorist so I'm having a hard time wrapping my head around the idea that anti-depressants might just be one giant scam between pharmaceutical companies, regulatory agencies and doctors.  How is this possible?  If this research is real (and it sure looks convincing) and antidepressants really are no better than placebo, then if the research was not muddled and hidden, my poor daughter would have been saved from years of torment that almost took her life.  It makes me want to tear my hair out thinking about this.

 

I hear you, @hugugh. It is shocking, appalling, maddening, unfathomable, scandalous, outrageous, etc. The mind balks. 

I'm so sorry that you and your daughter have been affected by this. I'm so sorry that we have all been so negatively impacted by this and that things are so messed up in the world. 

 

It would be really cool if parents such as yourself came together to advocate for other families and children in activist efforts to stop the prescribing of psych drugs to children! 

Have you considered forms of activism on this issue? I ask not only because the world needs action but because one of the best remedies for torment and shock and rage and trauma is taking action. One day when you feel ready, you may consider getting involved hands on. There may already be initiatives out there or maybe you could start something.

Anything and everything counts. Not everyone can be Altostrata, but if nothing else, we can donate to SA to help keep this place going. 

 

16 hours ago, ChessieCat said:

What I would like to say is that at least you know now.  You did what you did at the time, with the knowledge you had at the time. 

 

• You did what you did because you care about your daughter and thought you were doing the right thing
• You have more information now
• You now know how to find information before deciding on what action to take
• You are now better able to make informed decisions
• You are doing the best you can

 

This is something that I think a lot of us have trouble getting our heads around.  And I think that the anger we have about it is warranted. 

 

Well said, ChessieCat. 

 

Thanks for this topic, @hugugh

 

[HugHK]

On 6/9/2022 at 7:36 AM, hugugh said:

I've been slightly obsessed and majorly confused with this article since I found it:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2253608/

 

I don't understand how drugs with such terrible side effects and with very little/no efficacy were approved for use and became so popular throughout the world.  I am not a conspiracy theorist so I'm having a hard time wrapping my head around the idea that anti-depressants might just be one giant scam between pharmaceutical companies, regulatory agencies and doctors.  How is this possible?  If this research is real (and it sure looks convincing) and antidepressants really are no better than placebo, then if the research was not muddled and hidden, my poor daughter would have been saved from years of torment that almost took her life.  It makes me want to tear my hair out thinking about this.

 

Has anyone seen this research?  Opinions? 

 

there's also plenty of research that shows anti-depressants are decent at doing what they're supposed to do, ie relieving symptoms of depression. 

 

I do not have a single doubt in my mind that ADs are better than placebo, and an AD saved my bacon when I needed it. Before trying it, I had tried half a dozen meds, none of which had worked. 

 

It's like everything: if you look for science studies aiming at disproving climate change, you'll find quite a few of them, all written in ways that sound and look convincing to someone who isn't a scientist. It doesn't make them right. 

 

[Altostrata]

On 6/8/2022 at 4:36 PM, hugugh said:

I don't understand how drugs with such terrible side effects and with very little/no efficacy were approved for use and became so popular throughout the world. 

 

There is a vast amount of commentary on this, and the decline of the FDA and other regulatory agencies due to "regulatory capture" by the pharmaceutical industry. For what it's worth, European regulators tend to be a little more stringent. 

 

12 hours ago, HugHK said:

I do not have a single doubt in my mind that ADs are better than placebo, and an AD saved my bacon when I needed it. Before trying it, I had tried half a dozen meds, none of which had worked. 

 

That is just wonderful that the 7th drug you tried "worked". That is a success rate of 1/7, or about 14%. The estimated number needed to treat (NNT) for one person to benefit from antidepressant prescription is 7-9, meaning 6/7-8/9 people taking an antidepressant will see no benefit. (Some put the NNT for antidepressants to be an even more dismal 10-20.)

 

Among other drugs, these ratios are not considered to show a high rate of benefit or efficacy.

 

In addition, these drugs have drawbacks, which may be represented in NNH (number needed to harm). You are experiencing one of these yourself, in your own difficulty going off your miracle drug. Generally, regulators need to evaluate NNT with NNH, but both NNT and NNH have not been well studied with antidepressants. So your assertion "I do not have a single doubt" is based entirely on your own subjective belief, which may be a consolation for you now that you're paying the cost for your trust in the drugs.

[HugHK]

4 hours ago, Altostrata said:

 

There is a vast amount of commentary on this, and the decline of the FDA and other regulatory agencies due to "regulatory capture" by the pharmaceutical industry. For what it's worth, European regulators tend to be a little more stringent. 

 

 

That is just wonderful that the 7th drug you tried "worked". That is a success rate of 1/7, or about 14%. The estimated number needed to treat (NNT) for one person to benefit from antidepressant prescription is 7-9, meaning 6/7-8/9 people taking an antidepressant will see no benefit. (Some put the NNT for antidepressants to be an even more dismal 10-20.)

 

Among other drugs, these ratios are not considered to show a high rate of benefit or efficacy.

 

In addition, these drugs have drawbacks, which may be represented in NNH (number needed to harm). You are experiencing one of these yourself, in your own difficulty going off your miracle drug. Generally, regulators need to evaluate NNT with NNH, but both NNT and NNH have not been well studied with antidepressants. So your assertion "I do not have a single doubt" is based entirely on your own subjective belief, which may be a consolation for you now that you're paying the cost for your trust in the drugs.

you're right that other meds didn't work (although they included only two other ADs, as well as benzos, anti-psychotics and Lyrica for eg). 

 

But at the tend of the day, I did find one that works, whereas any 'natural' method gave me 0% relief... So as far as I am concerned, the AD I take got me out of the hole I was in back in 2019. (and put me back in another hole when doctors wrongly advised me on how to come off, but that's a different story). 

[Altostrata]

You'll have to allow that such difficulties do, indeed, cause other people to have more than a single doubt that taking an antidepressant would be a good idea for them.

[HugHK]

35 minutes ago, Altostrata said:

You'll have to allow that such difficulties do, indeed, cause other people to have more than a single doubt that taking an antidepressant would be a good idea for them.

 

Yeah I fully agree with that, but I feel like I take a more nuanced approach when it comes to why they are prescribed at all. for ADs to help some people is already better than not having them 9as far as I'm concerned. 

 

to be clear I' m not trying to anger anyone and I know my views don't reflect the consensus on the forum, but I do think it's important to try to look beyond personal experience and look at the wider benefits. 

[carefulprayerful]

On 6/9/2022 at 9:36 AM, hugugh said:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2253608/

 

The study got me thinking.  Under the subtitle "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."  

I wonder if this is based on the prognosis for the most severe depression.  AD's can cause suicide (according to the black box warning on the labels).  I did not read the whole article, but I tried using Ctrl + F for the word "suicide" and nothing came up.

 

"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...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." 

 

In the further investigation proposed here, maybe they should look into a special type of placebo that creates side effects (perhaps headaches, dehydration, etc.), so that the patient is convinced s/he is consuming a drug.  If I remember correctly, D. Healy mentions this type of placebo in Pharmageddon.  (I don't have the book on hand.)

 

"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." 

 

This is in line with my opinion.  Alternatives should be more readily available and tried with persistence first.  Also, in my opinion, the drug should be used for the shortest possible duration of time. 

 

Edited June 12, 2022 by ChessieCat
unbolded

[carefulprayerful]

To clarify what I am trying to say :

 

The outcomes for the most severely depressed patients looked better.  However, it is still possible based on what is known about ADs causing suicide, that if there were any deaths among the study participants, then the ADs could have been responsible.

 

 

Edited June 12, 2022 by ChessieCat
extracted post from quote

[hugugh]

On 6/11/2022 at 1:20 PM, carefulprayerful said:

Also, in my opinion, the drug should be used for the shortest possible duration of time. 

My daughter's doctor told me she should be on Zoloft for the rest of her life - she was 10 years old.  No psychiatrist ever suggested that she tried life without medications once she started - they just kept adding more and more meds.  It seems criminal to tell an 11 year old they should be on a prescription drug the rest of her life for what apparently was a temporary issue she had at age 10. 

[Ariel]

2 minutes ago, hugugh said:

My daughter's doctor told me she should be on Zoloft for the rest of her life - she was 10 years old.  No psychiatrist ever suggested that she tried life without medications once she started - they just kept adding more and more meds.  It seems criminal to tell an 11 year old they should be on a prescription drug the rest of her life for what apparently was a temporary issue she had at age 10. 

 

@hugugh I'm so sorry. This is truly awful and stupid and wrong. Unfortunately it's not surprising. 

Good on you for high-tailing it outta there! Your daughter is lucky to have you <3 

 

[Onmyway]

On 6/8/2022 at 7:36 PM, hugugh said:

I've been slightly obsessed and majorly confused with this article since I found it:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2253608/

 

I don't understand how drugs with such terrible side effects and with very little/no efficacy were approved for use and became so popular throughout the world.  I am not a conspiracy theorist so I'm having a hard time wrapping my head around the idea that anti-depressants might just be one giant scam between pharmaceutical companies, regulatory agencies and doctors.  How is this possible?  If this research is real (and it sure looks convincing) and antidepressants really are no better than placebo, then if the research was not muddled and hidden, my poor daughter would have been saved from years of torment that almost took her life.  It makes me want to tear my hair out thinking about this.

 

Has anyone seen this research?  Opinions? 

@hugughthat article is legit and there are many like it out there. 

Here Prof Kirsch explains his findings in a less academic way. And his journey to these findings. 
Antidepressants and the Placebo Effect - PMC (nih.gov)

[ChessieCat]

@hugugh

 

Here's a video about the same thing which I found easier to understand.  Prof Kirsch and his cohorts used Freedom of Information to get the unpublished clinical trials. 

 

Excerpt from the paper that Onmyway linked above:

How Did These Drugs Get Approved?
....
The FDA requires two adequately conducted clinical trials showing a significant difference between drug and placebo.  But there is a loophole:  there is no limit to the number of trials that can be conducted in search of these two significant trials.  Trials showing negative results simply do not count.  Furthermore, the clinical significance of the findings is not considered.  All that matters is that the results are statistically significant.
....
(NB:  emphasis in abstract and excerpt are mine)