There are some confusing headlines in today’s papers which will send the manufacturers of Prozac and other antidepressants in a spin.
A clinical trial has concluded that placebos worked as effectively as anti-depressants. Researchers found that the drugs had no more effect than a placebo for mildly depressed patients, and for most people suffering severe depression.
So does this mean that thousands of patients are taking these drugs, which could have severe side effects, unnecessarily? Are you, like me, confused about what it means?
A group of experts, led by Prof Irving Kirsch, from the Department of Psychology at the University of Hull, analysed 47 clinical trials using data released under Freedom of Information rules by the US Food and Drug Administration. They found little evidence of benefit when analysing both unpublished and published data from the drug companies.
Does these findings mean that antidepressants do not work? I don’t think that is what they were saying, they found that the anti depressants did work, but then so “did” the dummy drugs.
More than 31 million prescriptions for drugs such as Prozac were issued in England in 2006 – a 6% rise on the year before – and a record high, despite national guidance advocating alternative treatments. I wonder how doctors will view these results, it must be confusing for them too.
So does Prozac and other depressants work? Or should doctors be prescribing counselling and alternative treatment instead, such as exercise?
The headlines today are sensationalist and irresponsible. Thousands of people are likely to chuck their pills away and be left feeling foolish and abandoned _ and their depression will worsen or recur in many cases. The message from this study as I see it, is that many cases of depression are ‘self-limiting’ and will resolve over time without the help of an active drug. However, many of these patients also derive benefit from being listened to and ‘given something’ _ if depressed people feel they are being taken seriously and their needs are being addressed, that in itself is likely to lift mood, even if they are receiving a placebo or a drug which is not doing much for them ‘chemically’. But the usual suspects, the peddlers of ‘talking cures’, the crank counsellors who encourage people to wallow in misery and blame everyone else for their problems will be rubbing their hands with glee over this, as they do over every bad news story about pharmaceutical products. Fortunately, as science progresses, we get ever more proof that these things are down to genes or other organic causes, not the fact that ‘your dad didn’t come to sports day’ or other nonsense!
Never tried Prozac but exercise definitely improves my energy levels and mood. I’m sure you’d advocate dancing.
The drug companies have not been as open about the research as we might hope for:
http://www.abc.net.au/pm/stories/s312381.htm
Not on anti depressants but interesting from a ‘how the drugs company market’ perspective:
http://www.abc.net.au/science/articles/2008/01/23/2144112.htm
and
http://www.guardian.co.uk/uk/2001/sep/10/medicalscience.businessofresearch
http://www.abc.net.au/news/stories/2004/09/09/1195109.htm
If you look at the dates they might appear old; but nothing has changed in the last 5 years…
Certain faiths don’t need Prozac. Happily married couples don’t either. Nor Viagra.
I excercise regularly and vigorously. I also have projects on the go most of the time and take exams, learn new things etc. I’ve become accomplished in classical guitar and karate. I do these things to remain positive and focussed but have experienced episodes of depression in the past.
These took the form of deep melancholy worse than my normal negativity.
I had many sessions of counselling with different practitioners and none of them were any good. I generally eschew medicine. My wife will testify that I will not take headache pills or painkillers unless things are really bad. I am not suggestible and am unable to be hypnotised (they tried) – so why should I be affected by placebo ?
I was once put on Escilotopram by my GP. There was no effect for a few weeks … and then WOW !
I had never experienced such peaceful mind or optimism.
I can assure you that I did everything holistically to change my fundamental mindset. It failed. I did not want to go on medication and saw it as a failure when I eventually did.
It was a chemical issue. How these people can say otherwise beggars belief. Anti depressants were the only thing that worked with me and the result was astonishing.
It’s got to depend on the individual. One can’t assume it will act the same for all.
Doctors already ‘prescribe’ exercise and generally keeping fit – for basically every ailment you turn up and tell them about. But it’s not as easy to do as swallowing a pill, so a lot of people don’t – and won’t – bother.
My own experience of anti-depressants is very positive. I was on Aropax for about six months about a decade ago, and they had a very identifiable beneficial effect. I’d fallen into a morbid ‘hole’ and they helped me climb out. And when I felt I didn’t need them anymore, I weened myself off them fairly easily.
Every few days there’s a sensational health-based headline doing the rounds – ‘The Drugs Don’t Work’ is merely this week’s model.
I’ve had a few periods of depression and have tried anti-depressants two or three times. The first and worst was when I was at university, and I think the pills did help to lift me. But I ditched them as soon as I could because I hated the idea of becoming reliant on them. On another occasion the doctor prescribed sleeping tablets instead and they made me feel so unutterably awful I packed them in straight away.
I have to endorse the comments about exercise. I find it much, much easier to stay “up” if I’m physically active. I’m willing to bet that exercise does as much good as any tablet.
Like many i think the answer lies with exercise…I am sure i would have gone under many times if i did not exercise…infact i would go as far as saying walking saved my life……
I don’t know. I have a friend who has really been helped by Prozac and another whose life was almost destroyed by it. I took anti-depressants twice , the first time after my Dad died and they helped me. But the second time I got even more depressed. It is easy to judge this from the “wagon loaded with hay” as Blake wrote. If you are on the empty wagon, you will clutch at anything that might help you.
Well it does seem to be a very thorough review but only of the clinical trials, not the actual patients. One also has to be very wary of the media write-up and look at the report itself and see how it was conducted.
Severe clinical depression cannot be cured by exercise or alternative forms of therapy, although no doubt they can help. These drugs are certainly very useful in keeping patients functioning in their daily lives. Don’t forget they are well studied in clinical trials for years before being released to the public.
I have had many clients suffering from mild to moderate depression who have been considerably helped by counselling. My counselling approach is integrative humanistic and I use Person Centred and Gestalt as appropriate to the individual client. It annoys me that the NHS generally focus only on CBT as other counselling approaches can be equally and often more helpful. CBT works well short-term but doesn’t address underlying issues, so when the client comes back 18 months later for more, he/she is counted as a new patient, which means that it appears that success criteria are being met and the NHS can tick their boxes.
I have been on seroxat for a number of years. It changed my life. I suffered with obsessive anxiety and nothing helped. I believe that it is a chemical inbalance that, in my case, needs correcting.
I think maybe I’ll write a post on this later on today. I don’t want to feel ashamed of a perceived weakness or failure.
My post is up now.
All of us have different DNA and different metabolisms. Some herbs and vitamins work better than others. The first thing that is needed is proper nutrition and a good physical exam. As the director of Novus Medical Detox, I often see patients who are on alcohol or opioids, central nervous system depressants, also taking antidepressants. When they detox they find they don’t need the antidepressants.
This is good news because a Swedish study showed that 52% of the 2006 suicides by women on antidepressants. Since antidepressants work no better than placebos and are less effective than exercise in dealing with depression.
There is a prescription drug epidemic and these are leaders in the list of terrible abuses.
Steve Hayes
http://novusdetox.com
MITCH said (apologies, it was accidentally deleted with my spam comments”:
“I’ve suffered depression twice in my life, both were at times when prolonged stress meant I could no longer function normally. I was an emotional wreck. The second episode of depression was only alleviated by use of the drug Escilotopram. I won’t normally take tablets and tried ‘over the counter’ herbal remedies first. My GP prescribed it and although I was sceptical and frightened at first, I’m pleased to say that it was useful for a short period of time. I weened myself off it easily and am thankful that life is ‘normal’ once again.”