RE: May be of interest......

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kittinSol -> RE: May be of interest...... (2/26/2008 6:02:33 PM)
quote: ORIGINAL: Sinergy quote: ORIGINAL: kittinSol It's true that pain and sorrow are part of life's rich tapestry... but if I could be happy all the time, I'd take it. If your emotional state was static and invariable, how would you know whether you were happy or not? DrPhilergy Say eternal happiness was available to me now, after having experienced pain and sorrow... I'd definitely appreciate it :-) .

dollparts85 -> RE: May be of interest...... (2/26/2008 6:04:19 PM)
I've never found psych meds to work but if I refuse to take them I'm being "non-compliant." At one point, in the hospital, I was taking Effexor, Wellbutrin, Cymbalta, Geodon, Trileptal, Ativan and Klonopin...everyday...they were worried about seritonin syndrome. I felt like shit but they made me take them. They made me so anxious and I was crying near constantly and felt sick. They were trying to take me off max doses of Effexor, Wellbutrin and Geodon and put me on Cymbalta and Trileptal...and then Ativan for my panic attacks (didn't do shit) and the Klonopin to help me sleep...

NorthernGent -> RE: May be of interest...... (2/26/2008 6:26:30 PM)
quote: ORIGINAL: Aileen1968 Ohhhhh...that's sooo sad. I know, should we have a cry together? Shed a little tear or two......

MissHarlet -> RE: May be of interest...... (2/26/2008 6:30:24 PM)
DollParts .. you seem to crave the attention you are getting with the poor me Im a victim of modern medicine ... You have received some great advice on 2 different threads .. its your choice to ignore it and remain the victim .. I for one am not interested in feeding your fetish for negative attention...its time to either Shit or get off the pot in my opinion !

NorthernGent -> RE: May be of interest...... (2/26/2008 6:38:44 PM)
quote: ORIGINAL: Termyn8or All forms of psychotherapy should be tried before drugs are administered. Agreed. As should exercise and talking issues through with friends. quote: ORIGINAL: Termyn8or Basically I think depression is at an all time high because life sucks. I'd say it's more to do with the consistent presentation of a particular view of what it means to be a human being - this view deems anxiety and unhappiness to be abnormal - so, people troop off to the doctors for some normal pills. quote: ORIGINAL: Termyn8or Actually I do not think the system is fixable. Drug company executives run the FDA, literally, they have two jobs. If that isn't a conflict of interest tell me what is. They also give grants to medical schools, on top of funding research. The best argument for government intervention: if you leave big-business to its own devices, it'll run amok. Assuming the government is accountable to the electorate.

dollparts85 -> RE: May be of interest...... (2/26/2008 6:39:38 PM)
sorry, I just don't think medication is going to "cure" me. I have to work on getting well...it's all me...there is no magic pill or med combo that is going to fix me.

NorthernGent -> RE: May be of interest...... (2/26/2008 6:44:09 PM)
quote: ORIGINAL: Alumbrado Exactly... and then maybe they would stop being surprised at the 'secret' that they don't always work as advertised. Nothing has prevented people who wanted to do their own homework from finding out about positive and negative aspects of Prozac and other drugs, including clinical trial history, efficacy, side effects, etc. years ago. You may have the capacity to obtain unpublished studies from the US Food and Drug Administration and the time to analyse them, but some of us don't. This comprehensive study is useful as it adds credence to a point of view that is gathering pace.

NorthernGent -> RE: May be of interest...... (2/27/2008 3:14:45 AM)
Interesting reading, Aswad. I have zero experience with anti-depressants - 'didn't realise there are so many out there.

NorthernGent -> RE: May be of interest...... (2/27/2008 3:23:55 AM)
quote: ORIGINAL: celticlord2112 What would be of interest would be requiring the drug companies to fully publish the results of ALL studies of medications, 'Certainly would. How can GPs make an effective prescription where they do not understand the true efficacy, or lack of it, of the drugs. Our government Health Secretary has just announced that 3,600 therapists are to be trained during the next three years to provide nationwide access through the GP service to talking treatments for depression, instead of drugs.

DaddyKeeper -> RE: May be of interest...... (2/27/2008 5:35:21 AM)
1. It was not a study of SSRI antidepressant drugs: neither nefazodone nor venlafaxine are SSRI drugs. 2. It did not look at all the trials ever done on these drugs: it looked only at the trials done before the drugs were licensed (none of them more than six weeks long), *** and specifically excluded all the trials done after they were licensed. It is common for quacks and journalists to think that the moment of licensing is some kind of definitive “it works” stamp of approval. It’s not, it’s just the beginning of the story of a drugs’ evidence, usually. 3. It did not show that these drugs have no benefit over placebo: it showed that they do have a statistically significant (”measurable”) benefit over placebo, but for mild and moderate depression that benefit was not big enough for most people to consider it clinically significant, ie there was an improvement, but not enough points improvement on a depression rating scale for anyone to get too excited over it. * How many quacks would expect quantifiable results after a mere 6 week course of a/d medication? (my comment & *) http://www.badscience.net/?p=619

Alumbrado -> RE: May be of interest...... (2/27/2008 5:52:12 AM)
quote: ORIGINAL: NorthernGent You may have the capacity to obtain unpublished studies from the US Food and Drug Administration and the time to analyse them, but some of us don't. This comprehensive study is useful as it adds credence to a point of view that is gathering pace. Ahhh yes... more evidence that you 'can't see'? When it comes to matters I consider significant, I'll dig up as much information as I can, and make time to evaluate it....instead of using the media or the manufacturers as my sole source. The information about the trials on Prozac et al. has been easily available for as long as 15 years now. Psychology Today, Jul/Aug 94 Article ID: 1471 "After weeding out the most badly flawed studies, the FDA found only four that were adequate enough to consider. One of these showed that Prozac was no better than placebo. Three others supposedly showed Prozac to be somewhat superior to the sugar pill, but not as good as older antidepressants. However, due to adverse drug effects and lack of drug effectiveness, the dropout rates in most of these studies was very high. While the gross number of patients receiving Prozac in all the trials was more than 5,000, the actual number finishing the trials used for approval was very small. When I counted the actual number of patients who completed the four- to six-week trials used for the approval of Prozac, it turned out to be a grand total of 286. It bears restating--only 286 patients finished the four- to six-week trials used to determine Prozac's efficacy." Psychiatric News July 16, 2004 Volume 39 Number 14 © 2004 American Psychiatric Association "In April the British Medical Journal published a paper by Jon Jureidini, M.D., head of the department of psychological medicine at Women's and Children's Hospital in North Adelaide, Australia, and colleagues. The article reviewed the evidence base for efficacy and safety of antidepressants in children and adolescents. The authors included in their review published clinical trials, as well as some unpublished data .... ....Two weeks after the BMJ article, Lancet published a systematic review of SSRIs for childhood depression that also compared published and unpublished data from the same clinical trials that Jureidini analyzed." THE BOSTON GLOBE MEDICINE: No prescription for happiness By Thomas J. Moore, 10/17/99 "Lilly had conducted 10 such clinical trials for Prozac, according to FDA records. However, in six of these trials no measurable overall difference could be detected between those treated with Prozac and those who got the placebo. Prozac was usually ahead slightly, but within a margin that often could be explained by chance. One trial deemed successful was based on such a small group of participants that only eight patients taking Prozac completed it. The FDA discarded another ''successful'' trial because no one could explain why one investigator got so much better results than others giving the same drug to similar patients. " Robert Temple, M.D. Director, Office of Medical Policy Center for Drug Evaluation and Research U.S. Food and Drug Administration on Hearing: FDA's review of the safety and efficacy concerns in anti-depressant drugs for use in pediatric populations before the Subcommittee on Oversight and INvestigations Committee on Energy and Commerece House of Representatives September 23, 2004 "However, it is also important to consider the efficacy data for these drugs because a risk-benefit assessment is important to clearly understand the benefit side of this equation. Of the seven products studied in pediatric MDD (Prozac, Zoloft, Paxil, Celexa, Effexor, Serzone and Remeron), FDA's reviews of the effectiveness data resulted in only one approval (Prozac) for pediatric MDD. (In January 2003, FDA approved Prozac for the treatment of children and adolescents ages 7 to 17 for depression and obsessive-compulsive disorder.) Overall, the efficacy results from 15 studies in pediatric MDD do not support the effectiveness of these drugs in pediatric populations."

Hippiekinkster -> RE: May be of interest...... (2/27/2008 6:42:07 AM)
quote: ORIGINAL: Aswad quote: ORIGINAL: slaveboyforyou We all get the blues, but who the hell wants to be happy all the time? Clinical depression isn't even remotely related to "having the blues." Health, al-Aswad. Indeed it isn't. All I have to say is, if Citalopram is no more effective than placebo, then that is one hell of a placebo effect I'm feelin'. [:D] I'd also like to say that it's not surprising that initial studies of the SSRIs showed marginal benefit. New research indicates that SSRIs promote new neuron growth in the brain, which is a slow process. http://cmbi.bjmu.edu.cn/news/0610/7.htm It appears that there is a gene mutation which may influence efficacy. Here's a great site about these meds: http://crazymeds.us/

SummerWind -> RE: May be of interest...... (2/28/2008 1:52:14 AM)
That really bum's me out.....

NorthernGent -> RE: May be of interest...... (2/28/2008 2:34:23 AM)
quote: ORIGINAL: DaddyKeeper It did not look at all the trials ever done on these drugs: it looked only at the trials done before the drugs were licensed but for mild and moderate depression that benefit was not big enough for most people to consider it clinically significant, ie there was an improvement, but not enough points improvement on a depression rating scale for anyone to get too excited over it. The study concludes no more than that which you mention above, i.e. drugs are being licensed to treat a wide-ranging section of the public when the evidence suggests they're only useful in extreme cases.

NorthernGent -> RE: May be of interest...... (2/28/2008 2:43:47 AM)
quote: ORIGINAL: Alumbrado Ahhh yes... more evidence that you 'can't see'? You're still ploughing this furrow, Alumbrado? That was 2 days ago on a different thread. quote: ORIGINAL: Alumbrado When it comes to matters I consider significant, I'll dig up as much information as I can, and make time to evaluate it....instead of using the media or the manufacturers as my sole source. The source is a study undertaken by researchers at a University. It's not a big issue for me, so I've had no past desire to spend my energy looking at the trials. As per the OP, I thought it may be of interest to some. Obviously, it's of little interest to you because you know all about this; this is fair enough. 'Hope this is all ok with you, Alumbrado. 'Wouldn't want to post anything that you find disagreeable........seeing as you're the enforcer 'round these parts. If it helps, I could send my posts to you in advance for a seal of approval? quote: ORIGINAL: Alumbrado Psychology Today, Jul/Aug 94 Article ID: 1471 "After weeding out the most badly flawed studies, the FDA found only four that were adequate enough to consider. One of these showed that Prozac was no better than placebo. Three others supposedly showed Prozac to be somewhat superior to the sugar pill, but not as good as older antidepressants. However, due to adverse drug effects and lack of drug effectiveness, the dropout rates in most of these studies was very high. While the gross number of patients receiving Prozac in all the trials was more than 5,000, the actual number finishing the trials used for approval was very small. When I counted the actual number of patients who completed the four- to six-week trials used for the approval of Prozac, it turned out to be a grand total of 286. It bears restating--only 286 patients finished the four- to six-week trials used to determine Prozac's efficacy." Psychiatric News July 16, 2004 Volume 39 Number 14 © 2004 American Psychiatric Association "In April the British Medical Journal published a paper by Jon Jureidini, M.D., head of the department of psychological medicine at Women's and Children's Hospital in North Adelaide, Australia, and colleagues. The article reviewed the evidence base for efficacy and safety of antidepressants in children and adolescents. The authors included in their review published clinical trials, as well as some unpublished data .... ....Two weeks after the BMJ article, Lancet published a systematic review of SSRIs for childhood depression that also compared published and unpublished data from the same clinical trials that Jureidini analyzed." THE BOSTON GLOBE MEDICINE: No prescription for happiness By Thomas J. Moore, 10/17/99 "Lilly had conducted 10 such clinical trials for Prozac, according to FDA records. However, in six of these trials no measurable overall difference could be detected between those treated with Prozac and those who got the placebo. Prozac was usually ahead slightly, but within a margin that often could be explained by chance. One trial deemed successful was based on such a small group of participants that only eight patients taking Prozac completed it. The FDA discarded another ''successful'' trial because no one could explain why one investigator got so much better results than others giving the same drug to similar patients. " Robert Temple, M.D. Director, Office of Medical Policy Center for Drug Evaluation and Research U.S. Food and Drug Administration on Hearing: FDA's review of the safety and efficacy concerns in anti-depressant drugs for use in pediatric populations before the Subcommittee on Oversight and INvestigations Committee on Energy and Commerece House of Representatives September 23, 2004 "However, it is also important to consider the efficacy data for these drugs because a risk-benefit assessment is important to clearly understand the benefit side of this equation. Of the seven products studied in pediatric MDD (Prozac, Zoloft, Paxil, Celexa, Effexor, Serzone and Remeron), FDA's reviews of the effectiveness data resulted in only one approval (Prozac) for pediatric MDD. (In January 2003, FDA approved Prozac for the treatment of children and adolescents ages 7 to 17 for depression and obsessive-compulsive disorder.) Overall, the efficacy results from 15 studies in pediatric MDD do not support the effectiveness of these drugs in pediatric populations." Yeah, it appears to be old hat. Well done. Edited to add: I'm sure some people will go away from this thread with more knowledge than they had previously (myself included), so it may prove useful to some. There's no accounting for a spot of knowledge sharing between countries and continents!

Aswad -> RE: May be of interest...... (2/28/2008 4:04:10 AM)
quote: ORIGINAL: dollparts85 At one point, in the hospital, I was taking Effexor, Wellbutrin, Cymbalta, Geodon, Trileptal, Ativan and Klonopin...everyday...they were worried about seritonin syndrome. IIRC, neither Efexor, nor Cymbalta, are potent enough to cause serotonin syndrome / serotonin poisoning. Health, al-Aswad.

Aswad -> RE: May be of interest...... (2/28/2008 4:19:12 AM)
quote: ORIGINAL: NorthernGent Agreed. As should exercise and talking issues through with friends. Strongly disagree. Most forms of psychotherapy are indistinguishable from talking to any listener with some expecience, in terms of efficacy. CBT is unusual in that regard, and bears trying, but it takes a lot of time and resources that could be spent elsewhere. As for drugs, it depends on a number of factors, including the severity and duration of the illness. Just like there's no quick fix for the depression, neither is there a quick rule for treatment. If you absolutely want one, then go with CBT for light depression, CBT plus a non-serotonergic drug for moderate depression, and one or more drugs for severe depression. quote: I'd say it's more to do with the consistent presentation of a particular view of what it means to be a human being - this view deems anxiety and unhappiness to be abnormal - so, people troop off to the doctors for some normal pills. Anxiety and unhappiness isn't the issue at hand, is it? Yes, misdiagnoses should be avoided, but that's a fairly different issue. quote: The best argument for government intervention: if you leave big-business to its own devices, it'll run amok. Assuming the government is accountable to the electorate. Moving the bottleneck, in other words. Elsewhere, one might use a system of checks and balances instead. For instance, let the drug companies make the drugs and run the approval process, then collect statistics from clinical practice after approval, and feed those back to the doctors through regular updates in a government controlled empirical evidence journal that doesn't do advertising. If the discrepancies are too large, fine the drug companies for it. That way, the gov't doesn't have to be nearly as reliable, and the drug companies have incentive to be. Health, al-Aswad.

Aswad -> RE: May be of interest...... (2/28/2008 4:21:12 AM)
quote: ORIGINAL: NorthernGent You may have the capacity to obtain unpublished studies from the US Food and Drug Administration and the time to analyse them, but some of us don't. I never needed unpublished studies to conclude that the efficacy of SSRIs was very low for depression. The only update in what was published here, is that it was even lower; specifically, that it was as low as I suspected, rather than merely as low as I could document. Health, al-Aswad.

Aswad -> RE: May be of interest...... (2/28/2008 4:31:45 AM)
quote: ORIGINAL: NorthernGent Interesting reading, Aswad. I have zero experience with anti-depressants - 'didn't realise there are so many out there. There are hundreds. Drug company advertisers would like you to think there are only a handful, and that theirs is best... until it becomes available as a generic, of course. In truth, what most people think of as depression, isn't. And the drugs pushed as antidepressants by big pharma, aren't. Actual clinical depression merits treatment with drugs in a significant percentage of the cases. Hell, we give painkillers to people with cancer, despite it doing little beyond alleviating suffering more quickly than waiting for death or remission. Why should one *not* use antidepressants to alleviate suffering in clinical depression? Therapy can frequently take years, where Parnate would typically take 4-8 weeks. Thus, socioeconomics and compassion both have the same things to say about the choice between the two. Health, al-Aswad.

Aswad -> RE: May be of interest...... (2/28/2008 4:41:22 AM)
quote: ORIGINAL: DaddyKeeper 1. It was not a study of SSRI antidepressant drugs: neither nefazodone nor venlafaxine are SSRI drugs. It was a study of non-TCA serotonergic drugs. Both nefazodone and venlafaxine are primarily serotonergic drugs. The former via 5HT2A-antagonism and a moderate reuptake inhibiting effect at 5HT and NE terminals, if memory serves. The latter via a significant reuptake inhibiting effect at 5HT ones, and a moderate one at NE terminals. My memory is somewhat fuzzy regarding the ratio, but I seem to recall 9:1 between 5HT and NE. quote: 3. It did not show that these drugs have no benefit over placebo: it showed that they do have a statistically significant (”measurable”) benefit over placebo, but for mild and moderate depression that benefit was not big enough for most people to consider it clinically significant, ie there was an improvement, but not enough points improvement on a depression rating scale for anyone to get too excited over it. In other words, that they aren't clinically useful antidepressants, except in cases where they shouldn't be used. quote: How many quacks would expect quantifiable results after a mere 6 week course of a/d medication? Parnate (tranylcypromine) gives quantifiable results after 2-3 weeks on average. If the dose is increased to 2.4mg/kg/day, it is comparable to ECT in terms of speed and efficacy. Health, al-Aswad.

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