Prozac and other SSRIs; or, oh, for fuck's sake.

[jang]

http://www.guardian.co.uk/society/2008/feb/26/mentalhealth.medicalresearch

So, Prozac in the usual light doses it's prescribed in is indistinguishable from a placebo. But that's not what this is about. What this is about is the following gem:

[[[
The only exception is in the most severely depressed patients, according to the authors - Prof Irving Kirsch from the department of psychology at Hull University and colleagues in the US and Canada. But that is probably because the placebo stopped working so well, they say, rather than the drugs having worked better.
]]]

Let's have that once again.

But that is probably because the placebo stopped working so well, they say, rather than the drugs having worked better.

This kind of crap is enough to put one in a mood that is as likely to be affected by placebos as SSRIs :-/

Comments

[jonnycowbells.livejournal.com]

It makes me feel better about my usual advice of "Get a grip and buy some new clothes or something."

Most of us need crutches for mental health, it's just that some seem to be endorsed by doctors whilst others are made by Nintendo or sold by Top Shop.

*add flame here*

[sciolist.livejournal.com]

So... for severely depressed people, the drugs do have a greater beneficial effect than the placebo. Seems an unremarkable conclusion to draw.

Of course, I still favour the 'Eat better, get some fresh air and exercise' philosophy. If only there were regularly scheduled PT sessions on the NHS, you could prescribe them for depression -and- obesity!

[gedhrel.livejournal.com]

What irritates me is the reporting, which appears to say, "Prozac is so bad that it doesn't even work particularly for severely depressed people, it's just that the placebo has a reduced affect, so the conclusion that it's no good can be taken across the board."

[jonnycowbells.livejournal.com]

Reminds me of a certain report that went along the lines of "These children haven't got autism, but they've all had the MMR vaccine, so we'll stick them in that group anyway because they're bound to get it."

I'd hope it's ambiguous reporting because things like that can get one's licence to practise medicine taken away.

[gedhrel.livejournal.com]

Disappointingly, that particular phrasing occurs in the abstract too; presumably they were after the exposure that headlines can bring.

[fox-uk.livejournal.com]

Analysis, sir. Analysis!

I say this because I am still not sure I undertsand wtf he is talking about. Possibly that severely depressed patients do not react to a placebo at all, and so the actual effect of the drugs are measurably greater than that of a placebo effect in these patients only?

[gedhrel.livejournal.com]

Exactly, but to read it the way it's written you'd be forgiven for thinking that Prozac is uniformly ineffective.

[fox-uk.livejournal.com]

You mean the way they start the article with "Prozac...does not work and nor do similar drugs in the same class, according to a major review released today." Yeah, I can see how you could think that. ;)

[keziath.livejournal.com]

Grr.

I really, really hate reporting like this.

If they'd titled it "Prozac ineffective except in severe depression" or something similar I wouldn't have a problem with it (apart from the total failure to comprehend what a placebo is). As it is, please excuse me while I go and bang my head against a wall for a while...

[gedhrel.livejournal.com]

Time for a missive to the good Dr. Goldacre, I think.

[alanwrotethis.livejournal.com]

Grr!
If I'd written a psychology paper with a line like that in the conclusion or abstract I would:
a. do it to be drunk and ironic.
b. expect to switch course soon.
The tragedy is that the reports are interesting once you get over how monktarded the review of them is >.