Prozac, used by 40m people, does not work say scientists

[sharingwisdom]

February 26, 2008, The Guardian (One of the U.K.'s leading newspapers)
https://www.guardian.co.uk/society/2008/feb/26/mentalhealth.medicalresearch (https://www.guardian.co.uk/society/2008/feb/26/mentalhealth.medicalresearch)

Prozac, the bestselling antidepressant taken by 40 million people worldwide, does not work and nor do similar drugs in the same class, according to a major review released today. The study examined all available data on the drugs, including results from clinical trials that the manufacturers chose not to publish at the time. The trials compared the effect on patients taking the drugs with those given a placebo or sugar pill. When all the data was pulled together, it appeared that patients had improved - but those on placebo improved just as much as those on the drugs. The only exception is in the most severely depressed patients, according to the authors - Prof Irving Kirsch from the department of psychology at Hull University and colleagues in the US and Canada. But that is probably because the placebo stopped working so well, they say, rather than the drugs having worked better. "Given these results, there seems little reason to prescribe antidepressant medication to any but the most severely depressed patients, unless alternative treatments have failed," says Kirsch. "This study raises serious issues that need to be addressed surrounding drug licensing and how drug trial data is reported." The paper, published today in the journal PLoS (Public Library of Science) Medicine, is likely to have a significant impact on the prescribing of the drugs. The National Institute for Health and Clinical Excellence already recommends that counselling should be tried before doctors prescribe antidepressants.

[NudeTea]

I don't understand the purpose for posting this.

People not using prozac already aren't using prozac.
Those who are using prozac are now going to slip into a depression over the news.

[mickki]

i'm a user of prozac myself and was curious to know which scientists say it does not work the depressed ones or the happy ones no disrespect to sharingwisdom..mickki:):

[santarosie]

I'm bothered by this, and lean toward skepticism of the motivation and research behind this story.

Is Prozac over-prescribed? ...probably.
Has it helped only the most severely depressed people?
I don't think so. I'm just coming at this from personal experience with people I know who were helped by it. Helped enough to come out of the depression or black cloud in which they were mired, enough to resume life and start to feel like living again, return to some semblance of normality. Not saying it always cures a person fully or miraculously, but that it is like a helping hand out of the quicksand of depression. It may not be strong enough to pull the person clear out, but if it can help pull someone in the right direction, whose been stuck or going in the way wrong direction, it's useful. And I've personally seen enough of those cases to doubt that it is "just a placebo effect". This research is questionable in my opinion because it puts an all or nothing expectation to cure on such drug; and sometimes these types of drugs serve the purpose to aid or assist, to work in tandem with other avenues of treatment, and not necessarily "cure".

Bottom line is: I'd like take a poll and hear from others. Do you personally know people, other than the severely depressed who you believe were helped by Prozac?



February 26, 2008, The Guardian (One of the U.K.'s leading newspapers)
https://www.guardian.co.uk/society/2008/feb/26/mentalhealth.medicalresearch (https://www.guardian.co.uk/society/2008/feb/26/mentalhealth.medicalresearch)

Prozac, the bestselling antidepressant taken by 40 million people worldwide, does not work and nor do similar drugs in the same class, according to a major review released today. The study examined all available data on the drugs, including results from clinical trials that the manufacturers chose not to publish at the time. The trials compared the effect on patients taking the drugs with those given a placebo or sugar pill. When all the data was pulled together, it appeared that patients had improved - but those on placebo improved just as much as those on the drugs. The only exception is in the most severely depressed patients, according to the authors - Prof Irving Kirsch from the department of psychology at Hull University and colleagues in the US and Canada. But that is probably because the placebo stopped working so well, they say, rather than the drugs having worked better. "Given these results, there seems little reason to prescribe antidepressant medication to any but the most severely depressed patients, unless alternative treatments have failed," says Kirsch. "This study raises serious issues that need to be addressed surrounding drug licensing and how drug trial data is reported." The paper, published today in the journal PLoS (Public Library of Science) Medicine, is likely to have a significant impact on the prescribing of the drugs. The National Institute for Health and Clinical Excellence already recommends that counselling should be tried before doctors prescribe antidepressants.

[mickki]

to santarosie i'm with you on the prozac post. i am a prozac sucess story it helped me stop crying 20 hr of the day and do some other things in my life. I was reluctant to take it at first but i know that it worked for me. I left a short reply yesterday about the same thing but i guess it got lost. thanks for your post i appreciate it :): mickki

[Sylph]

This is a difficult issue. I, too, have known many people dramatically helped by Prozac, or other SSRIs. My cousin was very depressed. Her brother had been killed in a car accident some time before, and Steph was in a 'hole'. After starting Zoloft, it was like a light was switched on and she was almost a new person (or the same person she had been before). She was happy again, laughing again. She was able to carry on with her life and cultivate many rewarding friendships, pursue her hobbies and a new job. I don't know if she's still on Zoloft, but she continued it for several years, anyway.
The difficulty is that testimonials don't prove anything...or shouldn't. The reviews of studies do show some effect, but it's not as dramatic as I would wish, for a medication that does have a certain rate of side effects. The effect is better than placebo, but placebos do pretty well, too!
That said, everyone's brain chemistry and life experience is so different. If someone is feeling hopeless, and the counseling isn't working...they should not be afraid to try an antidepressant. Also, if one medication doesn't work, another may be a better fit.
Someone close to me was not helped by Prozac, but found huge relief with Effexor. (I wouldn't advise anyone to start taking Effexor unless all else fails. It's the devil to wean oneself off of).

Facts of Life Vol. 10 No. 3 (https://www.cfah.org/factsoflife/vol10no3.cfm)

Efficacy and Tolerability of Tricyclic Antidepressants and SSRIs Compared With Placebo for Treatment of Depression in Primary Care: A Meta-Analysis -- Arroll et al. 3 (5): 449 -- Annals of Family Medicine (https://www.annfammed.org/cgi/content/full/3/5/449)
Efficacy and Tolerability of Tricyclic Antidepressants and SSRIs Compared With Placebo for Treatment of Depression in Primary Care: A Meta-Analysis
We found evidence that both TCAs and SSRIs are more effective than placebo.
For most patients, 56% to 60%, responded well to active treatment compared with 42% to 47% for placebo.
This finding needs to be tempered with the knowledge that some publication bias may have occurred and that many studies in the review were small and of variable quality.



Is Prozac over-prescribed? ...probably.
Has it helped only the most severely depressed people?
I don't think so. I'm just coming at this from personal experience with people I know who were helped by it. Helped enough to come out of the depression or black cloud in which they were mired, enough to resume life and start to feel like living again, return to some semblance of normality. Not saying it always cures a person fully or miraculously, but that it is like a helping hand out of the quicksand of depression. It may not be strong enough to pull the person clear out, but if it can help pull someone in the right direction, whose been stuck or going in the way wrong direction, it's useful. And I've personally seen enough of those cases to doubt that it is "just a placebo effect". This research is questionable in my opinion because it puts an all or nothing expectation to cure on such drug; and sometimes these types of drugs serve the purpose to aid or assist, to work in tandem with other avenues of treatment, and not necessarily "cure".

[Yubajeff]

IF no two snowflakes are the same, what do think about the uniqueness of each human brain? There could be a unique neurochemical Qi to unlock every unique brain, and release the prana of life, and no further talk about this depression thing will be needed, maybe someday soon. When they put me in charge at NIH. Naw, too stressful at the top. I'd rather do it in the road, the Bohemian Highway probably.