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New England Journal of Medicine: SSRI's Don't Really Work

Today's reports about a study just completed and published in the New England Journal of Medicine. It's worth quoting the piece in full:
It’s official: the world has been fundamentally misled about the benefits and harms of extremely popular anti-depressant drugs, including Prozac, Zoloft and Aropax.

A study in this week’s New England Journal of Medicine found roughly one third of all the scientific trials of these antidepressants were never published. Why? Because the trial results did not show the drugs in a favourable light.

The study published this week examined data from the clinical trials of anti-depressants that drug companies had submitted to the United States Food and Drug Administration in recent decades.

They found that of 74 scientific trials of the anti-depressant medicines, 31% of them were never published in the medical literature. Some of the trials had positive, favourable results and some had negative, unfavourable results.

Almost all of the trials with positive results ended up being published in medical journals. Almost all of the trials with negative or questionable results were not published - or were published in a way that tried to portray the results in a positive light.

What this means is that doctors, patients and the public all over the world have been grossly mislead about the true value of these widely prescribed medicines. This is of course the class of anti-depressants that has been enthusiastically championed for more than a decade by psychiatrists closely tied to the drug makers, and widespread prescription of the drugs has cost the taxpayer hundreds of millions of dollars.

According to this week’s New England Journal of Medicine, if you look at what’s been published, 94% of the trials of these antidepressants that have been published were positive. But if you look at the real evidence, including the published and unpublished trials, as the authors of this week’s papers did, only 51% of the anti-depressant trials conducted were actually positive.

It's not clear exactly how negative trials were buried -- drug companies may have suppressed them, authors may not have submitted them, or journals may have decided not to publish them.

In recent years, concerns about buried trial data have led to the creation of new registers of all clinical trials, which the pharmaceutical industry is now actively involved in.

Given that I know several people who claim to have been "restored to themselves" because of healthy and regular doses of SSRIs, this report - like everything else in the world - needs to be taken with a dose of salts (preferrably lithium salts). Still, it should give everyone in the psychopharmocological community more than a moment's pause.
Posted By amazingdrx at 2008-01-17 21:59:03 permalink | comments
Tags: SSRI anti-depressant medicine hoax science peer-review
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benzyme : 2008-01-19 10:13:34
it's my proclivity to infer that this is nothing new.. it was a big scheme since the 1990 ban of tryptophan (which actually increases serotonin levels, rather than just preserving them) manufacturing due to a tainted batch in Japan, but all of a sudden, Prozac takes the nation by storm as the new "wonder pill". Serotonin was the first neurotransmitter to be studied in depth, and Eli Lilly spun this card, disregarding the notion that depression is not limited to a single neurotransmission pathway, and even worse, promoting the premise that blocking reuptake would "increase" said neurotransmitter levels. This is a fallacy, and a big sham of big pharma, that millions of americans believed like 2004 Bush campaign slogans. In actuallity, SSRIs do nothing to facilitate efficient neurotransmission and encourage neuroplasticity.. but serotonin reuptake enhancers like Tianeptine do.
omgoleus : 2008-01-18 16:57:04
Re taking with a grain of salt: In all clinical studies of antidepressants, the variable in question is "how much better than placebo is it". The dark secret is that placebo is really good at curing depression. So (addressing both amazingdrx and DaFuZzMaStA) "it doesn't work" doesn't mean people won't get better on it; it merely means there is no evidence that some unique mechanism specific to that chemical is involved in any way.

In contrast, with something like MDMA or THC, there is no question that "it DOES work" in the sense of getting you high better than placebo. :)

DaFuZzMaStA : 2008-01-18 01:07:18
whats with this"it does work it doesn't work" hibber jibbery i see all the time, does everyone spare the details?

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