One of the authors of a controversial study which reveals that antidepressants are no better than placebos is interviewed on the CBS program 60 Minutes. Please enjoy the video below.
(CBS News) Do antidepressants work? Since the introduction of Prozac in the 1980s, prescriptions for antidepressants have soared 400 percent, with 17 million Americans currently taking some form of the drug. But how much good is the medication itself doing? “The difference between the effect of a placebo and the effect of an antidepressant is minimal for most people,” says Harvard scientist Irving Kirsch. Will Kirsch's research, and the work of others, change the $11.3 billion antidepressant industry? Lesley Stahl investigates. You can read the transcript of the episode by clicking here.
From the University of Hull press release. February 26, 2008:
“There is little reason to prescribe antidepressants to the majority
of depressed patients, according to a group of experts, led by Professor
Kirsch at the University of Hull.”
From the Editor's summary of the research article in the peer reviewed
“The researchers obtained data on all the clinical trials submitted to the FDA for the licensing of fluoxetine, venlafaxine, nefazodone, and paroxetine. They then used meta-analytic techniques to investigate whether the initial severity of depression affected the HRSD improvement scores for the drug and placebo groups in these trials. They confirmed first that the overall effect of these new generation of antidepressants was below the recommended criteria for clinical significance. Then they showed that there was virtually no difference in the improvement scores for drug and placebo in patients with moderate depression and only a small and clinically insignificant difference among patients with very severe depression. The difference in improvement between the antidepressant and placebo reached clinical significance, however, in patients with initial HRSD scores of more than 28—that is, in the most severely depressed patients. Additional analyses indicated that the apparent clinical effectiveness of the antidepressants among these most severely depressed patients reflected a decreased responsiveness to placebo rather than an increased responsiveness to antidepressants.
These findings suggest that, compared with placebo, the new-generation antidepressants do not produce clinically significant improvements in depression in patients who initially have moderate or even very severe depression, but show significant effects only in the most severely depressed patients. The findings also show that the effect for these patients seems to be due to decreased responsiveness to placebo, rather than increased responsiveness to medication. Given these results, the researchers conclude that there is little reason to prescribe new-generation antidepressant medications to any but the most severely depressed patients unless alternative treatments have been ineffective. In addition, the finding that extremely depressed patients are less responsive to placebo than less severely depressed patients but have similar responses to antidepressants is a potentially important insight into how patients with depression respond to antidepressants and placebos that should be investigated further.”
The Side Effects of Common Psychiatric Drugs
Talking Therapy Is More Effective
Talking therapy is more effective than pills in treating social anxiety disorder, a study has found. Social phobia - one of the most common anxiety disorders - is a persistent fear of social situations.
A review of 101 clinical trials found talking therapies were more effective and more long lasting than medication. Medication should be used only when psychological treatments are turned down, said the UK/US team behind the study in The Lancet Psychiatry.
“Social anxiety is more than just shyness,” said Dr Evan Mayo-Wilson, of the Department of Epidemiology at the Johns Hopkins Bloomberg School of Public Health, a co-researcher on the study. “The good news from our study is that social anxiety is treatable. Now that we know what works best, we need to improve access to psychotherapy for those who are suffering.”
The study, involving more than 13,000 participants, compared different types of psychological therapy with medications such as antidepressants and benzodiazepines. It found cognitive behaviour therapy (CBT) on a one-to-one basis was the most effective. CBT is a talking therapy that can help people manage their problems by changing the way they think and behave.
The research was carried out in collaboration with Oxford University and University College London.
(BBC item located at http://www.bbc.com/news/health-29367062 )
>> Question to consider: Why was this research not done in the US or Canada?
Copyright 2018 Dr. Peter B. Raabe