How am I stretching anything?
He wrote the article-
Quote:
“Why Antidepressants Don’t Work for Treating Depression”
HERE’S SOME DEPRESSING RECENT medical news: Antidepressants don’t work. What’s even more depressing is that the pharmaceutical industry and Food and Drug Administration (FDA) have deliberately deceived us into believing that they DO work. As a physician, this is frightening to me. Depression is among the most common problems seen in primary-care medicine and soon will be the second leading cause of disability in this country.
The study I’m talking about was published in The New England Journal of Medicine. It found that drug companies selectively publish studies on antidepressants. They have published nearly all the studies that show benefit — but almost none of the studies that show these drugs are ineffective. (1)
|
I read the study in The New England Journal of Medicine and it didn't say a word about "why" they don't work and it didn't say they don't work. I also quoted the lead author of the study in two separate articles.
Here is the main conclusion of the study-
Quote:
|
We wish to clarify that nonsignificance in a single trial does not necessarily indicate lack of efficacy. Each drug, when subjected to meta-analysis, was shown to be superior to placebo. On the other hand, the true magnitude of each drug's superiority to placebo was less than a diligent literature review would indicate.
|
Go back and read what the lead author wrote.
Quote:
|
And that’s what we found, that each of the 12 drugs, overall, was statistically superior to placebo.The other caveat would be that the results of these trials get reported as means, but each mean value is based upon thousands of individuals, some with very good responses and others with lousy responses. So when you think about how an individual patient in your practice might respond, remember the old saying, “Your mileage may vary.”
|
That statement seems to match real world experience. For some people they work really well and for others not at all.
All of this is based on the initial 6 to 8 week clinical trials. I contend that these trials don't tell us much in the first place since these drugs take 6 to 8 weeks to work in many cases and the early clinical trials are always small. We need to look at the body of evidence since the drugs have been on the market.
To flat out state they do not work is not true based on what is currently known. I do not see it as responsible for a doctor to make that statement is a widely publicized article. That's my opinion but I don't see how you get around it.
Here is a very balanced article that talks about the problems with clinical trials and with real world practice and how the same is true for just about all drugs that have ever hit the market.
Do Antidepressants Really Work? - BrainFacts.org
Quote:
William Z. Potter, M.D., Ph.D., Foundation of the National Institutes of Health, and Steven M. Paul, M.D., Weill Cornell Medical College, examine the effectiveness of antidepressants in treating severe depression.
Given the relative safety of SSRIs it is now common for someone with the symptoms of depression to be prescribed one by their physician, generally a primary care doctor, even though the clinical trial data tell us that only about 1 in 5 such patients will respond better to the drug than placebo over the ensuing four to six weeks. The doctor, however, has no way of selecting only those patients who will benefit from these SSRIs and, therefore, given the extremely low risk of serious side effects, prescribes the drug and follows the patient to see if he or she is among the 60 to 70 percent who will improve. It is almost impossible however to know in such a real-life setting how many patients would have responded to just placebo.
|
I have read 40 to 70% in the real world in a whole bunch of different articles.