Pill-popping Waccolites stick to their placebo-induced prejudices

[Zeno Swijtink]

Summary: Pill-popping Waccolites stick to their placebo-induced prejudices and are dismissive in the face of new meta-study evidence to the contrary.

The metastudy is at https://medicine.plosjournals.org/pe...l.pmed.0050045

*********

https://www.independent.co.uk/opinio...it-787825.html

Leading article: The nation should kick this expensive drug habit
Wednesday, 27 February 2008

The title of a recent paper submitted to the Public Library of Science Medicine journal – "Initial severity and antidepressant benefits: a meta-analysis of data submitted to the FDA" – does not sound like the sort of document likely to inspire a revolution. But a revolution is precisely what this paper by researchers from the University of Hull promises to effect in the world of clinical depression.

Since they emerged two decades ago as a new, safe, chemical remedy for depression and anxiety, Selective Serotonin Reuptake Inhibitors (SSRIs) have been a staggering commercial success story. These drugs are now taken by some 40 million depression sufferers worldwide. Their names – Prozac and Seroxat – have become emblems of 21st century popular culture.

But the so-called "Prozac Nation" is now under unprecedented threat. The Hull study, which analyses 47 separate clinical trials, concludes that SSRIs provide little clinical benefit for most people with mild and moderate depression and actively help only a small group of the most severely depressed.

The manufacturers of Prozac and Seroxat are questioning the study's conclusions. But the drug companies have a strong commercial incentive in protecting a market that generates considerable revenue. And their history of keeping secret the results of their own drug trials into the effectiveness of SSRIs does not support their position. The Hull researchers had to use the US freedom of information laws to gain access to this unpublished data.

The implications of this study should be clear to policymakers here in Britain, where some 30m prescriptions for antidepressants are being written every year: we need to prescribe vastly fewer of these drugs. Thankfully, the NHS has already been moving in this direction in recent years. The National Institute for Health and Clinical Excellence guidelines state that "talking therapies", rather than drugs, should be offered by GPs as a first response to cases of depression. And Alan Johnson, the Health Secretary, has announced that 3,600 therapists are to be trained during the next three years in England to this end.

This is the right road. Cognitive behavioural therapy has been shown to deliver genuine clinical benefits to depression sufferers. No overall cost savings should be expected from this treatment shift. Fewer Seroxat prescriptions will bring down the NHS drugs bill, but it will cost considerably more to train therapists. Yet, we will end up with a more efficient NHS in the end.

The other major implication of this report is that we need more transparency from the pharmaceutical industry over its drug trials to prevent a similar situation occurring again. Can they be prevailed upon to be more open? The record is not encouraging. Up until now the drug companies have only been willing to publish research that shows their products in a good light.

Is legislation necessary? This is a problematic area. Badly-drafted legislation could jeopardise research. It is not in our interests for drug companies to be prevented from developing and profiting from new products. There is also a question over when exactly to demand the disclosure of trial results from a public safety perspective. A single successful trial for a drug could lead to a spike in demand. But later trials might highlight dangerous side effects. Decisions over disclosure would have to be taken sensitively and on a case by case basis.

Yet some form of compulsion clearly needs to be brought to bear on the drug companies. The overwhelming lesson of the Prozac years is that secrecy is no good for our health.

****
https://www.independent.co.uk/life-s...es-787907.html
Drug giants warned: Tell the truth on medicines

After antidepressant treatments are discredited, fears grow that other products may be ineffective

By Jeremy Laurance, Health Editor
Wednesday, 27 February 2008

The pharmaceutical industry came under assault from senior figures in medical research yesterday over its practice of withholding information to protect profits, exposing patients to drugs which could be useless or harmful.

Experts criticised the stranglehold exerted by multinational companies over clinical trials, which has led to biased results, under-reporting of negative findings and selective publication driven by the market, which was worth £10.1bn in the UK in 2006, amounting to 11 per cent of total NHS costs.

The latest attack was triggered yesterday by an analysis of published and unpublished trials of modern antidepressants, including Prozac and Seroxat, showing they offer no clinically significant improvement over placebos (dummy pills) in most patients. But doctors said patients on the drugs should not stop taking them without consulting their GPs.

It was the first time researchers – from the UK, Canada and the US – had successfully used freedom of information legislation to obtain all the data presented to regulators when the companies applied to license their drugs. In some cases it had not been made public for 20 years. Over the past two decades the drugs, known as selective serotonin re-uptake inhibitors (SSRIs), have been among the biggest selling of all time, earning billions of pounds for their makers. Yesterday's finding suggests that the money may have been misspent. Drug companies are required by law to provide all data on a drug, published and unpublished, to the regulatory authorities when applying for a licence. But this requirement does not apply to the National Institute for Health and Clinical Excellence (Nice), which assesses cost effectiveness and recommends which drugs should be used by the NHS.

Peter Littlejohns, the clinical and public health director of Nice, said: "The regulatory authorities have access to everything. Obviously we have access to the published data and we do ask the industry for unpublished data, but it is up to the companies whether to deliver it or not. We have no power to demand it. The issue is that it relies on the good will of the industry."

Professor Mike Clarke, the director of the UK Cochrane Centre, an international collaboration between researchers in 100 countries which has published more than 3,000 systematic reviews of published trials to establish best medical practice, said lack of co-operation from the drug industry was damaging medical care.

"When we ask for details of a trial the company might tell us nothing. We have even less power than Nice. Researchers trying to make sense of trials for decision-makers need to have access to this data. If we have only got access to half of the data, when we see evidence that a drug works we don't know whether to believe it or not.

"It makes us doubtful – that's the big worry. The companies are in the business of making profits – but they are also in the business of providing safe, effective health care."

Legislation to compel the drug industry to publish its results was included in Labour's manifesto at the 2005 election and last month the Commons Health Select Committee demanded that Nice be given unfettered access to all clinical trial results.

Yesterday, the Government said it had been told that compelling the industry to publish trial data would not be allowed and it was instead pursuing a voluntary approach, developing a "searchable register" of all trials that have taken place in the UK and pressing the EU to make its own confidential register public.

A spokesman for the Department of Health said: "The Government has consistently supported open access to information about research when the findings could affect decisions about treatment or health outcomes. We planned to support the principle of mandatory registration of clinical trials in the UK, but legal advice stated this would be illegal under EU law." A World Health Organisation working group is examining how to improve reporting of clinical trials and is expected to announce a consultation shortly.

The pharmaceutical industry was unrepentant about its strategy yesterday. Richard Tiner, the head of medicines at the Association of the British Pharmaceutical Industries, said: "The regulatory authorities have access to all the data – absolutely everything. Nice is not a regulatory authority – it is making decisions on whether medicines should be available on the NHS... There is no reason why the companies would restrict access – it depends what they are asked for. The industry is very much more transparent than it was 10 years ago."

GlaxoSmithKline, maker of Seroxat, said yesterday it "fully endorsed public disclosure of all clinical trial results" and had published all data relating to Seroxat on its website "regardless of study outcome".

The antidepressant debate

Paul Bough, 41: 'You name it, I've tried it: none of them worked'

"The findings of this latest report don't surprise me in the slightest. In fact, they confirm what I already knew.

"I've been a depressive for most of my life, and all of my adult life. After the umpteenth failed suicide attempt seven years ago my doctor said I should try taking antidepressant drugs. You name it, I've tried it. Diazepam, Citalopram, Prozac, Seroxat, Atenolol [a beta-blocker], Efexor: none worked. They turned me into a zombie, totally incapable of motivation or movement and forced to vegetate on a sofa.

"I'd say to anyone on these drugs, you're better off going cold turkey. Talk to people, have therapy, be sociable: but don't rely on these little happy pills. Having tried the lot, I'm coming off – and staying off."

Sylvia Genge, 59: 'Without these drugs I would lose hope altogether'

"The findings go against several decades of experience. I have suffered three major traumas in my life – my father leaving home when I was 11, my husband having an affair, and now an unpleasant divorce – and I'm convinced these drugs helped me survive them. I've been close to suicide myself, but now, in my 60th year, I'm feeling positive and able to survive all the terrifying experiences each day throws at me. I take 20mg of Fluoxetine each day, and it makes me feel I can cope. I simply don't buy the idea that it's just a placebo – but then I suppose the point is even if it were I wouldn't care. These drugs are my crutch and my comfort; without them I would lose hope altogether. I'm staying on."
****
https://www.independent.co.uk/life-s...cy-787908.html

The drug industry's long and ignoble history of secrecy
By Jeremy Laurance, Health Editor
Wednesday, 27 February 2008

Discovering, testing and bringing a new drug to market can take more than a decade and cost as much as £500m. Over the past 30 years, as the costs have mounted, so have the pressures to protect new chemical agents which could become potential blockbusters.

Secrecy became the pharmaceutical industry's watchword as it sought to control publication of trials and even manipulate results. Cancer drugs introduced in the 1990s claimed to offer major benefits which later turned out to be more apparent than real. Evidence published in The Journal of the American Medical Association showed that 38 per cent of independent studies of the drugs reached unfavourable conclusions about them, compared with just 5 per cent of studies funded by the pharmaceutical industry.

In 2004, UK researchers commissioned by Nice to develop guidelines for prescribing antidepressant drugs to children tried to obtain unpublished trials from the drug companies. They were refused. They then contacted the individual researchers who had worked on the trials. Only then did a picture emerge of increased risk of attempted suicide, and a lack of efficacy. Nice concluded by banning the drugs for under-18s with the exception of Prozac.

Yesterday's report suggesting that modern antidepressants offer no significant clinical benefit over placebo has been dismissed by the drug industry as "just one study" which should not be allowed to undermine the wealth of research showing that the selective serotonin reuptake inhibitor (SSRI) antidepressants are effective.

But that is to miss the point. The Hull University researchers have demonstrated how partial access to research can give a distorted view of a drug. The non-disclosure of data on the SSRIs has raised doubts about the trustworthiness of all research on antidepressants.

We should be relieved that the licensing authorities have an absolute right to see all trial data, positive and negative, before approving a drug. But, bizarrely, Nice, with the responsibility for deciding which drugs should be used by the NHS, only gets what the drug companies agree to give it. The Health Select Committee has called for action to remedy this omission. Ministers must respond.

[shellebelle]

I see a lot of cut and paste and can't find your actual thoughts. But by the act of cutting and pasting it appears you agree that perscriptions that help the mentally ill are not required.

Note the quote below from your own link

"Yet, the efficacy of the antidepressants may also depend on the severity of initial depression scores."

Sonoma's only mental hospital closed leaving 150 people without jobs and many more patients without care. Police, fire and hospital staff are not equipped to care for or even skilled in working with these special patients.

I have more to say but just couldn't find my nice voice so I am stopping here.

Summary: Pill-popping Waccolites stick to their placebo-induced prejudices and are dismissive in the face of new meta-study evidence to the contrary.

The metastudy is at https://medicine.plosjournals.org/pe...l.pmed.0050045

[Braggi]

...

Sonoma's only mental hospital closed leaving 150 people without jobs and many more patients without care. ...

Yeah, my wife used to work there.
Now she works at the jail.
A lot of the same patients ...

-Jeff

[Braggi]

I though for sure this thread would be about all the useless vitamins and "supplements" we take. Some of them quite dangerous. Most of them just a harmless waste of money and time unless you consider water pollution a problem.

That's a far more expensive drug habit than anti-depressants.

-Jeff

[shellebelle]

I bet

Hey Zeno - since you apparently think these doctors are so wrong I challenge you "Hang up your shingle!" "Answer that call to give the mentally ill alternatives!" I'm sure many here locally would love to come by and spend time just stick out that "The Doctor Is In Sign". Dedicate your lifetime to these special people as so many doctors, nurses and families have. They'd love tohave an extra hand!

Yeah, my wife used to work there.
Now she works at the jail.
A lot of the same patients ...

-Jeff

[decterlove]

Eeeeyaaay, guess I have to weigh in here reluctantly. I think we're slamming into another Waccobbian Paradigm War here based on personal held biases and real experiences.

I have to favor Zeno's efforts from the standpoint of my own personal bias but I respect Braggi's intelligence and practical, skeptical, but IMHO also close-minded point of view. And let me say very clearly this up front...WHATEVER WORKS CONVENTIONAL OR ALTERNATIVELY BASED, FOR YOU AND THE PEOPLE YOU CARE ABOUT....GREAT....I TOTALLY SUPPORT IT. IF IT WORKS, USE IT.

I have relied on supplements my entire adult life to deal with every mild to moderate health concern that I have experienced. I've had excellent results overall. Two simple examples are asthma/allergies and severe digestive problems.

As a teenager I had such severe allergies that I used to bring 5 hankerchiefs to school with me during a period when they were adding a wing to the school I attended. The combination a food awareness and the use of supplements like Planetary Formulas 3 Spice and Dr Shens Allergy pills and occasionally Quercetin and other herbs over the past three and a half decades has virtually given me an adulthood entirely free of anything more than the mildest allergy and asthma discomforts.

Digestive wise, I was severely bulemic during my 20s, an effect in part caused by overeating to gain weight for sports as a teenager combined with the use of marijuana which of course is a very strong appetite stimulant often not in a healthy way. I also had a lot of stomach pain as a kid often caused by gas, and the use of antibiotics for acne combined with the general ignorance of probiotics in the 1960s.

The combination of digestive enzymes, some chinese formulas, pain/gas relieving herbs like peppermint, etc has given me a post 20s adult life with a vastly more comfortable and healthy functioning digestive system and a lot more energy as well.

A third tragic example of the pharmaceutical and medical communities inability and failure to be able to elegantly address the simplest of health problems is the epidemic of ear aches and ear infections these day in children. All sort of useless drugs and pointless operations are throw in the direction of this problem. I found in my twenties I suffered from chronic ear infections whenever my diet included high fat items like dairy, avocados and peanut butter. By controlling these items I greatly reduced the incidents of ear pain and whenever I suffered an ear ache in the middle of the night, a simple application of french green clay behind the ear, about 1/2 inch thick and covered with cheesecloth, or just tissue paper, completely relieved the pain in 5 TO 10 MINUTES EVERY TIME!

So while I sympathize with anyone who suffers from mild to moderate depression and totally support them if they seem to get relief from pharmacueticals, my feeling is that holistic remedies should always be the first line of defense in both physical and mental/emotional illness, at least those of a simple and milder nature.

The drug companies as well as most of the medical community offer complex and inefficient solutions to MOST, NOT ALL of the common ailments people suffer in the course of their lives. And our overall lifestyles create and greatly exascerbate these illness. Most lifestyles and values are essentially illness factories..........the connection between vanity and the epidemic of eating disorders is simple example of this.

There are many, many supplements and dietary adjustments, in my experience, that can be helpful for mood disorders. For a starting point of investigating alternatives for mood and mental enhancement, please check www.life-enhancement.com

They are a company I worked at for several years and although I hate them for their extraordinary inept management practices, their products are excellent and the back up the selection of their ingredients with strong evidence based scientific research providing sources at the end of each articles. Cheers.

[alanora]

What about teaching cognitive behavioral training beginning in kindergarten if not sooner? It is actually very simple to learn and simply involves assessing the validity of own held beliefs when exposed to the light of reason. me Some folks may need medication in order to attend....or to slow the thinking processes enough for new data to enter.

I bet

Hey Zeno - since you apparently think these doctors are so wrong I challenge you "Hang up your shingle!" "Answer that call to give the mentally ill alternatives!" I'm sure many here locally would love to come by and spend time just stick out that "The Doctor Is In Sign". Dedicate your lifetime to these special people as so many doctors, nurses and families have. They'd love tohave an extra hand!

[decterlove]

I bet

Hey Zeno - since you apparently think these doctors are so wrong I challenge you "Hang up your shingle!" "Answer that call to give the mentally ill alternatives!"

The problem here is Shellebelle, that you can't "hang up a shingle" without getting your ass throw in jail. Which is probably a good thing considering the kinds of ideas that can float freely around these days in our all to eager to believe anything culture.

But it also points the the central issue in our culture...if you don't fit yourself in to the prevailing toxic paradigm, you don't get to participate or play in the game. You basically have to stuff yourself into a tiny little box of ideas to work in the mainstream workplace in most professions.

This is also why it is so hard for any real intelligence to penetrate the highest political spheres. You can't "hang out a shingle" in that arena either....you have to raise a half a billion dollars!

[MsTerry]

Are you suggesting we go back to Quacks and Quicksilver?

The problem here is Shellebelle, that you can't "hang up a shingle" without getting your ass throw in jail. Which is probably a good thing considering the kinds of ideas that can float freely around these days in our all to eager to believe anything culture.

But it also points the the central issue in our culture...if you don't fit yourself in to the prevailing toxic paradigm, you don't get to participate or play in the game. You basically have to stuff yourself into a tiny little box of ideas to work in the mainstream workplace in most professions.

This is also why it is so hard for any real intelligence to penetrate the highest political spheres. You can't "hang out a shingle" in that arena either....you have to raise a half a billion dollars!

[decterlove]

It's not an either/or situation. And let me add another example of the complexity of it. Yes, nurses and doctors, and mental health professionals wherever they are still actually funded, work the noble butts off everyday to help other people.

But this is like acknowledging the military forces in Iraq for the excellent dedicated efforts they make. Yes, they are terrific young men and women for the most part, and like the medical community, have at their disposal all this incredibly expensive and advanced technological equipment, and their efforts should be respected and honored, but THEY ARE FIGHTING THE WRONG WAR!!!!

Are you suggesting we go back to Quacks and Quicksilver?

[MsTerry]

But my question is should anybody be able to proclaim that they can cure or heal?

It's not an either/or situation. And let me add another example of the complexity of it. Yes, nurses and doctors, and mental health professions wherever they are still actually funded, work the noble butts off everyday to help other people.

But this is like acknowledging the military forces in Iraq for the excellent dedicated efforts they make. Yes, they are terrific young men and women for the most part, and like the medical community, have at their disposal all this incredibly expensive and advanced technological equipment, and their efforts should be respected and honored, but THEY ARE FIGHTING THE WRONG WAR!!!!

[Hummingbear]

But it also points the the central issue in our culture...if you don't fit yourself in to the prevailing toxic paradigm, you don't get to participate or play in the game. You basically have to stuff yourself into a tiny little box of ideas to work in the mainstream workplace in most professions.

I think Decterlove has hit on the heart of the issue here.
More and more people are diagnosed as "depressed", as if it were a defect to be treated by drugs. Remember Brave New World? Huxley saw this coming, 70 years ago! With the right drugs, everyone can be fit neatly into their socially-appropriate boxes.

Another view was expressed by some 15 years ago in We've Had a Hundred Years of Psychotherapy--And the World's Getting Worse. If individuals keep trying to fix themselves to fit in better with society, there's no energy left to fix social problems. Conversely, if we stop blaming ourselves, there's more motivation to team up and join social movements to change the things that make us feel bad. Okay, that's an over-simplification, but it's still food for thought.

On another point--Braggi says that the cost is trivial compared to vitamins. First, I'd quibble with the analogy. We who regularly eat fresh whole foods may not need supplements, but the average American likely gets some benefits from them, if they are used judiciously (which admittedly if often not the case).
But even if we are just comparing costs, and not benefits: the typical anti-depressant retails for about $1 per dose--probably less for large buyers like insurance companies, but that's still a lot more than most people ever spend on supplements. It's not an out-of-pocket expense if you have insurance, but it still gets paid for with higher insurance premiums and co-pays. Plus, the whole game is a cover-up for our failure to deal with the root sources of depression, whether these are interpreted as personal or social. And that's a cost that will only keep growing until we find a way to really deal with the issues. The tendency of SSRI-addicts to break down and commit suicide or mass murder is just one facet of this problem.

That said, I've personally found various herbal treatments can go a long way toward improving my mood, provided I'm taking care of myself in other respects as well.

Hummingbear

[shellebelle]

No

And that was my point!

Zeno appears to not be a doctor but he says crap like "Pill-popping Waccolites stick to their placebo-induced prejudices"! So I was curious what made him qualified to make that judgement call as far as I can see he's all cut and paste and doesn't really have the knowledge or education to back it up.

Then of course I have to ask "Is this a reflection? Zeno have you had your meds checked lately?"


GOD/GODDESS/UNIVERSE forbid someone decide to remove themselves from their meds based on his irresponsible postings! They or someone else could be hurt!


Zeno appears to be posting this stuff without being an answer or a soluton. He's just posting it. No responsibility for it. My call was one to action - not talk - Zeno apparently you have a problem with how the depressed are being medicated and medically treated so get away from that computer - stop the cut and paste and act! Volunteer places - start small - try a suicide help line, a crisis intervention line, domestic abuse line, even just a hospital or nursing home. Be part of the solution don't aggrivate the issue.



I'm not saying their aren't alternatives or that they shouldn't be explored. I am saying though all choices should be explored responsibly with a medical professional who is dedicated to ones personal journey.


Don't follow the touts of a philosophy teacher at the local college seek a medical professional's opinion!

But my question is should anybody be able to proclaim that they can cure or heal?

[Karl Frederick]

It seems to me, some of the commentary has been based on personal assumptions about the article's intent, rather than on what the article actually said. It didn't for example say that the meds had no effect . . . it referred to " an analysis of published and unpublished trials of modern antidepressants, including Prozac and Seroxat, showing they offer no clinically significant improvement over placebos (dummy pills) in most patients." (italics mine)

Placebos do work. Not with 100% effectiveness all the time for everyone, but well enough to be a standard part of the conventional medical pharmacopeia. Try an internet search on the phrase "placebo effectiveness" for some interesting highlights.

To me, the study, based on what the story said about it, lends further support to a large body of evidence for a strong, causal, relationship between mind and body. Some would say (and I would agree) the relationship is so close that the mind and body must be considered as inseparable aspects of "bodymind," a term Kenneth Dychtwald popularized in his 1977 book by that title.

[Lenny]

If the magic works, use it.