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April 11, 2004
Anti-Depressants, The Continuing Saga
We've already engaged the debate over whether or not anti-depressants have a significant correlation with suicide. Now, Joseph over at The Corpus Callosum attempts to explain the paradox of why the drugs are so widely used yet show equivocal results vs. placebo in many controlled studies. Do they work? Joseph doesn't quite get into the answer to that, but does put perspective around how researchers stack the deck against the investigational drugs during testing. This could help account for the commonplace clinical use and success of an anti-depressant that may only show a slight advantage over sugarpill during the course of a controlled study. I would point out to suicide skeptics that this cuts both ways; clinical evidence of suicides may be more significant than study data indicate as well. If you are interested in medicine, or are taking or considering taking one of these drugs, make sure that you read this typically long, detailed and interesting CC post. For the rest of you that are not interested in explanations of medicine or scientific method, skip down to the DC protests or William Hung posts below! Posted by Bill at 05:27 AM
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I've been taking antidepressants for about two years now. (Wow. How's that for my first comment to your site? Nothing like making a big, dramatic entrance.) I've tried a variety of SSRI's, most recently sticking with one called Celexa. I can say, for me, they work. They have a noticeable effect on my emotional responses to everyday events. And each of them that I've tried has affected me differently. The worst was one called Serzone: it left me very paranoid, very irritable, and with blurred vision. I didn't stick to that one very long before calling my doctor. Posted by: Jeff Harrell at April 12, 2004 07:55 AMThanks for the comment. I believe that they work for a ton of people, but I also think that some of the people that very strongly believe that anti-depressants work are also a bit too dismissive of the incidence of people that have bad reactions and are driven towards suicidal ideation. All depends on the person, the dose, the drug, etc. But based on statistical results from studies, there seems to be murky evidence for the effectiveness AND suicide-risk of the drugs. Clinically however, there is some evidence that supports both the good and bad (with the suicidal ideation side-effect being much less common) Posted by: Bill from INDC at April 12, 2004 08:05 AMOh, absolutely. I agree completely. When you're talking about brain chemistry, it's much harder to generalize than when you're talking about, say, the body's reaction to aspirin. I just wanted to chime in with a vote for the "not just a placebo effect" side. Posted by: Jeff Harrell at April 12, 2004 08:22 AMBad reactions happen for some people, sure. Some of them are more dangerous than others, some can be avoided or mitigated by switching or combining antidepressants, all of them mean you need a knowledgeable prescriber. The thing is, though, that untreated depression kills people, and these stories (if not balanced) can cause people not to seek treatment, and does cause those around them to discourage treatment. The fact that depression tends to give you a hopeless outlook that this plays right into ("I'm never going to be well, there's no point in going to a shrink and trying an antidepressant, the news says they're bad for you anyway so what's the point?") only makes this more imperative. The customary habits of the news media in reporting science stories, of course, don't help here. Posted by: jaed at April 13, 2004 05:58 PMPost a comment
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