Are they gone? Are all the millions of people who take Prozac, Effexor, Paxil and Serzone-who-are-not-severely-depressed gone? Good. Now we can talk. The rest of you have probably already read the news that:
Antidepressant medications appear to help only very severely depressed people and the drugs work no better than placebos in many patients, British researchers said Tuesday.
Why would the news media ever report the truth regarding these wildly-hyped antidepressants? After all, scientists have long known that most of the power of these drugs is in the placebo effect. Or, at least, scientists should have suspected this, because the FDA was refusing to release the full data sets regarding these drugs trial, at least until the good scientists who work on this new report (Prof Irving Kirsch and colleagues) requested “the full data under freedom of information rules from the Food and Drug Administration, which licenses medicines in the US and requires all data when it makes a decision.” Gosh, it appears that some of the relevant data wasn’t available to the forty million people taking these drugs, until long after the release of these drugs through massive corporate guerilla marketing.
In its advertisements, the manufacturer of Prozac, Lilly, doesn’t say anything about the drug not working well for large numbers of the patients for whom it was being prescribed. In fact, Lilly makes this claim:
The safety and effectiveness of PROZAC have been thoroughly studied in clinical trials with more than 11,000 patients. There have been more than 3,500 publications on PROZAC in medical/scientific journals.
It’s that three thousand five hundred and EIGHTEENTH publication (or whatever) that gets you every time, especially when the full data set is finally made available.
But enough attacking of soul-less pharmaceutical companies. Well, almost enough. Forty million people paying good money to use this stuff? Egads! Kirsh and colleagues sum it up for me when they say: “This study raises serious issues that need to be addressed surrounding drug licensing and how drug trial data is reported.” Ouch. I could sum up this quote in my own way, using richly deserved expletives aimed at Big Pharma, but this is a family site, so I’ll refrain. Instead, I’ll simply disclose a new creative spelling for Lilly: L-A-W-S-U-I-T.
But now, the irresponsible news media has blown it too, and the news about these depressingly ineffective drugs is now available to the public at large. Because the media has reported that the effect of Prozac, Effexor, Paxil and Serzone is mostly due to the placebo effect, there won’t be any more placebo effect, at least for those people who saw the news and who understand the placebo effect.
Therefore, please keep your non-severely depressed friends away from the news media for the next several days. If they accidently see that the placebo effect is the main effect of Prozac, Effexor, Paxil and Serzone, they won’t be able to take those drugs any more to counter their mild depressions.
Even worse, all the people who work for the companies that manufacture Prozac, Effexor, Paxil or Serzone might lose their jobs, because patients might now switch to cheaper placebos, such as homeopathic drugs. BTW, here’s how you make some very cheap homeopathic drugs: Drink a teaspoon of tap water. The water in that spoonful contains (or used to contain) at least one molecule of something capable of causing the symptom that ails you. No, you didn’t miss anything; that’s homeopathic theory all in one sentence.
Don’t tell anyone about this cheap source of homeopathic drugs, though, or else the pharmaceutical companies that make Prozac, Effexor, Paxil and Serzone might double their prices for new antidepressant drug capsules filled with tap water.
Also consider this. Those workers who manufactured Prozac, Effexor, Paxil or Serzone might lose their jobs, because the pills they make don’t actually work (other than inducing the placebo effect). Sales will likely plummet. If those workers lose their jobs, they won’t be able to take these drugs to counteract the depression brought on by their loss of jobs either, because they certainly know (thanks to our irresponsible media) that Prozac, Effexor, Paxil and Serzone rely mostly on the placebo effect. Unless, perhaps, they take some sort of drug falsely touted to wipe out memories of this recent pharmaceutical news regarding the antidepressants. If those workers use a placebo to wipe out their knowledge that so many antidepressants are essentially placebos, they might be able to once again believe in the efficacy of Prozac, Effexor, Paxil or Serzone! Ignorance is bliss, all around.
BTW, here’s a serious article about the placebo effect which, to the surprise of many people, can be impressively strong. I understand that placebos, properly prescribed and used, can be so strong that they can even cure obsessive bloggers of their insatiable cravings for increased Internet traffic through their repeated use of brand names of antidepressants in their posts.
Unfortunately, those poor misled patients on SSRIs like Prozac aren't just getting duped and losing money. For all their uselessness, Prozac and drugs like it have pretty serious side effects. For instance, let's say you have occasional panic attacks and a doctor (probably a general practitioner, not even a psychiatrist or psychopharmacologist) gives you a prescription for Celexa. Your panic attack may subside, but if you ever forget a pill or attempt to even wean yourself off the drug, you could easily experience "breakthrough panic attacks" just as disturbing as what put you on the drug in the first place. Oh, and don't eat grapefruit at the same time you pop your pill. It can kill you. Yikes.
I know countless people my age who went through a minor-to-severe bout of adolescent depression and ended up on a bevy of antidepressants or antianxiety medications that they continued taking for years and years. The side effects of getting off the drug usually scare people enough to keep taking the pills indefinitely. And many, I suspect, would never have truly needed these drugs at all. It must really feel like an additional slap in the face for these people to hear that the expensive drugs that give them strange dreams, panic attacks, brain shocks, and gained weight also probably didn't ever work in the first place.
I know a lot about the biochemistry of Prozac and similar meds. I studied them a bit when my son was prescribed them as a treatment for his autism. They are a class of drugs called SSRI's (Selective Serotonin Reuptake Inhibitors.)
Without getting into the details, a very small group of people may benefit from taking SSRI meds. A normal healty person may experience a mild addiction, and a malnourished but otherwise normal person may actuall experience suicidal depression from taking an SSRI.
A large part of the pharma business come from the "co-op" ads on tv and in magazines. The ones that advertise a prescription med and end with "ask your doctor about". This encourages peolpe to self diagnose, and then find a doctor that will prescribe the med even if they don't need it. But as long as the Pharma companies make wads of money, and throw a bit to the politicians and regulators to look the other way, everything is hunky-dory.
Well, I'm glad I happen to be one of the people that antidepressants actually helped. I have no doubt that they are medications that are overprescribed by doctors who aren't psychiatrists, but I went through the gamut of AD's trying to find one that would make me able to even function. I can tell you how differently one acted vs. another, some of the side effects and withdrawal symptoms that were unique to each medication, etc. This news is going to be just one more thing to make life more difficult for people who really need help.
It's hard enough having people tell you that what's ailing you is imaginary when you're doing everything you can to fix yourself. When you find a treatment that works, finally, the last thing you need is someone waving a study under your nose telling you that now there's proof there was nothing wrong with you in the first place.
Putting the brakes on the overprescription of needless pharmaceuticals is all well and good, but a study like this doesn't prove that the medications are completely ineffective in all the people who use them. If it's used at some point by insurance companies to deny coverage for people who will really be in a dangerous mental or emotional situation without them, it's going to do an incredible amount of harm.
My friends in Scientology are overjoyed to have this mainstream vindication of part of what they've been saying for decades. But an actual study like this trumps their article of faith, whichever way it goes.
Can we say that if it confirms a belief of Scientologists, that automatically makes it questionable?
Don't statins reduce the risk of heart attack? Well, only for 40 to 50% of people taking them–the others incur increased health risks:
http://alternet.org/healthwellness/77916/?page=1
I know a few people who've had no trouble with statins, but my mother's life has been horribly impacted by them thanks to an insurance company that decided it knew better than her doctor what was good for her.
Blanket statements about the benefits, side effects, or actions of any medication (or its generic version) are so frequently wrong, yet disseminated to the public so quickly. I wish it were easier to go back to when medicine was practiced by doctors (who had time to get to know their patients. . .)
For most people, Prozac is about as effective as aromatherapy. http://www.msnbc.msn.com/id/23452343/
According to a recent study by the Journal of the American Medical Association, a $2.50 placebo works better than a 10 cent placebo:
http://www.nytimes.com/2008/03/05/health/research…
As the article states, "In marketing as in medicine, perception can be everything." Beware of perceptions!