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60-Minutes Segment on Anti-Depressants Efficacy vs. Placebo

Discussion in 'Other Health News and Research' started by Wayne, Feb 20, 2012.

  1. Wayne

    Wayne Senior Member

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    I just watched this segment and found it quite interesting. Starting at about the 6:00 minute mark, a pharmaceutical industry consultant acknowledges that the antidepressant treatment success rate for people with moderate depression is around 14%, and that the success rate for those taking placebo is up to twice as high. This segment also highlights how a pharmaceutical company only has to submit two studies demonstrating the efficacy of a drug vs. placebo to obtain FDA approval, but is allowed to not submit studies that don't support this. Anyway, I found the politics involved in the $11.3B dollar industry to be quite revealing.

    I've long thought the depression many pwCFS deal with is primarily a result of an unchecked infection(s) going on in our bodies, and generally unrelated to chemical imbalances in the brain (which I believe is what antidepressants are supposed to be able to correct). It seems that for many of us, various ABX or anti-viral medications and/or herbs could easily have a higher success rate for treating depression than powerful antidepressants based on the unproved hypothesis that a lack of serotonin is usually the underlying cause.

    Best, Wayne

    Treating Depression: Is there a placebo effect?


    [video=youtube;Zihdr36WVi4]http://www.youtube.com/watch?v=Zihdr36WVi4[/video]
  2. Wayne

    Wayne Senior Member

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  3. Esther12

    Esther12 Senior Member

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    Yeah - some of the more recent data on anti-depressent efficacy is interesting.

    A lot of the problems with quackery and psychological CFS research can also be found in other areas... but CFS psychiatrists can easily hide behind the 'their stigmatising mental health issues' response to their critics.
  4. Dreambirdie

    Dreambirdie work in progress

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    I saw that report too. It didn't surprise me. Big Pharma has been pushing these drugs for several decades now. It has been padding their pockets very well. "Every year, 230 million prescriptions for antidepressants are filled."

    On the other hand, there is tryptophan, which can be safely used by many to eliminate depression. I use it a lot for sleep. The history of the banning of tryptophan and the arrival on the scene of Prozac are very connected, as I read in the following article. http://healthwyze.org/index.php/com...lly-treating-depression-the-holistic-way.html

    "In the fall of 1989, the F.D.A. banned L-tryptophan sales, claiming that it caused a rare and deadly flu-like condition known as Eosinophilia-Myalgia Syndrome. Of course, the F.D.A. allegation was not true, which follows the usual pattern regarding herbs and supplements. L-tryptophan is a naturally occurring amino acid that is already found in foods, after all. In other words, all of us would be in serious trouble if the F.D.A. cronies had been telling the truth, unless we could find a way to survive without eating food. Food wasn't banned, by the way. The illnesses were actually caused by toxic impurities in L-tryptophan products, which were imported by a Japanese manufacturer. The manufacturer was found to have been secretly experimenting with a genetically engineered bacteria, in an attempt to speed the production process and efficacy of its tryptophan products."

    "Just four days after the F.D.A. ban on L-tryptophan, on March 26, 1990, Newsweek magazine featured a cover article praising the anti-depressant drug Prozac. Four days later. Its multi-color cover payed homage to a floating, gigantic green and white capsule of Prozac with the bold caption: "Prozac: A Breakthrough Drug for Depression".
  5. Nielk

    Nielk

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    I watched this episode of 60 minutes last night. It was pretty shocking. The fact that a placebo is just as effective as an anti-depressant - and with no adverse side effects that most anti-depressants present, is a real eye opener.
    I was confused though when he said that it's not the chemicals that are in the pill that is helping, it's just the fact that they are told this is a pill that will help your depression is what works. How do theu scientifically know that?
    What he is really saying is that the brain/body connection is huge. Just the suggestion that you will get better, works. That is a very strong statement to make and if it's true, it should work with other medications as well.
    Is it just with anti-depressants that this "placebo effect" applies? Is it because they have no idea HOW these chemicals really affect our brains?
    To me, this is a very thought provoking subject.
    How far can a placebo effect go?
    If one of us were to receive a package of 18 GcMaf injections from a CFS doctor and he would tell us that from his experience other patients who took 18 shots of Gcmaf felt better - some even went into remissions. Instead of Gcmaf, he would put saline water in there but, it would be marked as Gcmaf. What do you think would happen to that patient?
  6. madietodd

    madietodd Senior Member

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    Nielk, don't tell the doctors who gets the saline and who gets the GcMaf, and you've got yourself an excellent double-blind study!

    I'm also fascinated by the placebo effect. How can we use that? Well, I use it by throwing myself completely into whatever treatment I'm currently trying. No confusing self-talk - I totally go for it. Because if those positive beliefs can help at all, I'm using them. And when I get better, I don't care exactly what did it.
    Wayne likes this.
  7. Nielk

    Nielk

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    I noticed from my own experience that whenever I try a new, alternative approach/practitioner, for about the first three weeks I seem to have a slight improvement and then I fall back to my old severity scale. My husband says that there must be a psychological component that in the beginning I have hope that this new treatment might help and that I'm actively doing something to try to get better but after a short time. I realize that this is not it so I slide back.
  8. Wayne

    Wayne Senior Member

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    Reverse Placebo Effect ?

    Hi Nielk,

    Well, I'm glad I'm not the only one who has a number of questions for our esteemed scientific elite and governmental agencies regarding their supposed "gold standards" on how to prove causality. It certainly seems to me that widely accepted gold standard procedures and governmental approval guidelines were designed primarily for the purpose of supporting pharmaceuticals and excluding other safe and low cost therapies.

    I myself wonder why I never hear about anything that reflects some sort of "reverse placebo effect". I mean, if a large number of people are taking a trial drug that often has some very strong side effects, aren't some of the people going to know with a high degree of certainty that they are not getting the placebo, but are in fact getting a real drug instead? And couldn't this belief they're receiving the real drug influence a positive outcome, a reverse placebo effect if you will?

    Oh, oh, I just realized I'm getting a little annoyed. :angel: From my own experience, I've done many things that I felt quite certain would be very helpful to me, and weren't. And I've done things that I didn't think would help, and did. Who knows, perhaps after we've tried a thousand things, we're beyond the influence of placebo. We've become "detached" if you will, a state I think the Buddha speaks very highly of. ;)
  9. Wayne

    Wayne Senior Member

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    Hi Madie,

    I'm with you totally on this. I personally think the placebo effect is largely due to the principle of things always changing. I've often wondered why when they measure those doing a drug (or other treatment modality), and those taking a placebo, and then comparing the two, why don't they have a third group who don't take anything? It certainly wouldn't surprise me if this group did just as well as the other two.

    But I've often felt that if my own belief about whether something is going to work ends up working, I don't give a hoot whether it was placebo or not. I'll take it; and get on with preparing for my upcoming career! :Retro smile:
  10. ukxmrv

    ukxmrv Senior Member

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    We can't use saline as a control in clinical trials because of it's good effects on blood volume and therefore improvements based soley on that.

    I've had very few good effects to any medication and when I try a new treatment I wait for 3 months before looking at any effects. Also keep a diary of symptoms and use a scale to try and determine any changes. If subjects are needed for research projects I am sure that there are plenty of patients who have tried many things, had little response and they could be used. We don't want to keep getting the horrible hurt and disappointment from the repeated failures (thanks Wayne for the thoughts above).

    There was a study on CFS and placebos but it's been a while now and I can't remember how they determined the results. The reported spin was the placebo response was low in CFS.

    We need objective measures of outcome of course. It's hard without them. Also the use of patients who don't normally go into any sort of remission or have severe unpredictable monthly or seasonal changes in symptims.
    ahimsa likes this.
  11. Sushi

    Sushi Moderator and Senior Member Albuquerque

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  12. ukxmrv

    ukxmrv Senior Member

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    Antidepressants are also supposed to act on the serotonin produced by the gut. When I tried AD's my gut symptoms became much worse and even years later have not resolved. So many symptoms were made worse by AD's - POTS/OI / morning grogginess etc. I don't know if these awful long lasting side effects were due to an actual change in gut produced gut serotonin or other bad effects of the AD's on my stomach.

    When I was at uni we were taught that the mode of action of AD's was on the serotonin receptors and therefore a raise in the availability of serotonin. My serotonin levels were normal on a test. I was encouraged to try them a couple of times by doctors who claims that they would help me with sleep (they didn't) and with pain (no again).

    The last doctor I spoke to said that the serotonin levels theory was discredited now so I'll have to watch the 60 minutes report and see what they say.

    With PWME I've often wondered if the AD's act as a chemical cosh and suppress emotions. Many of us are sad, upset, angry and other quite understandable things because of the limitations of the disease. Add on top of that possible changes (as Sushi said) to neurotransmitters due to infections. I've seen people with ME on antidepressants report that they dampen down the emotions that they feel generally. It's up to the individual of course if this is a good thing.

    Having seen PWME become quite passive on AD's I started to wonder about their clinical and social use for us (and this is on top of the severe side effects some of us have from their use anyway)
  13. Sushi

    Sushi Moderator and Senior Member Albuquerque

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    We cross posted!

    Sushi
  14. ixchelkali

    ixchelkali Senior Member

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    All I can say is that if someone comes up with a pill that will alleviate my symptoms of ME/CFS, and then someone shows that it's only due to a placebo effect, DON'T TELL ME. I really don't care if it's due to a placebo effect if I get better.
    ukxmrv and madietodd like this.
  15. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    What i dont understand is that docs dont believe in cfs, mainly because there is no measurable test. How the hell do they measure depression, a questionaire like they do for cfs. They dont measure serotonin or noradrenaline levels, so how do they really know if someone needs these meds. I wouldnt disguard them althogether, but i really think they need to be able to measure neurotransmitters before they give meds that effect them. Maybe they dont measure them because there would be a great reduction in the amount that would be prescribed, maybe the serotonin theory of depression is a crock. 99.9% of the time depression isnt an illness but a symptom of something else, maybe people can get depressed with cfs as there lives have been taken away and they are in pain and constant fatigue, not dam depression causing these symptoms to occur. I think depression is a symptom and they really need to look for a cause. Adrenal fatigue is a measurable condition but for some reason the standard medical community ignore this, if u could knock someones dhea and cortisol down a few notches i bet they would feel like crap or maybe even a symptom like depression, not the illness of depression as prozac would do nothing for dhea or cortisol levels, maybe make u feel better about feeling like s--t.
    SaraM and Googsta like this.
  16. Esther12

    Esther12 Senior Member

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    I think that at least some of the reason why ADs are so widely prescribed is that doctors like the affect they have upon patients. I hope it's not a deliberate thing, but for doctors who want a quiet life 'managing' their patients, zonking them out on drugs must seem rather an effective strategy.

    I think that much of the placebo affect can be explained by reporting bias, or transitory self-delusion based driven by wish-thinking, rather than placebos generating real and dramatic positive changes themselves through psychosocial means. I could be wrong though, and one of the problems is that it's very difficult to be sure what's going on with these things. Re-wiring the way the brain interprets signals could well be helpful for some conditions.
  17. heapsreal

    heapsreal iherb 10% discount code OPA989,

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    I just think they dish them out to frequently and easily, they have their place??
  18. Esther12

    Esther12 Senior Member

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    Yeah - I don't want to act as if AD's should never be used. I do think that there more casual use, and the disinterest in the political nature of such widespread use of psychoactive medication, is deeply worrying.
  19. markmc20001

    markmc20001 Guest

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    There is a specialized questionaire called "battery for health improvement" (or something to that affect) I took with a psyhcologist who is a master of CBT. Almost all the questions they ask on the questionaire for depression fit ME/CFS experiences exactly.

    They ask stuff like:

    1) Do you think your doctors understand you health concerns?

    2) Do you think your doctors have done a good job of treating you?

    3) Do you avoid leaving the house often?

    4) Do you avoid social situations?

    it just goes on and on. Every question for a CFS'er might agree with those, but would qualify them.
  20. Wayne

    Wayne Senior Member

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    The drug ketamine was profiled in this 2 1/2-minute ABC News segment a couple weeks ago.

    Party Drug to Treat Depression ?

    Some highlights:

    1) The person profiled in the report mentions that the effect was almost immediate. Upon taking just one dose, he said he felt "clear" for the first time in months.

    2) A doctor mentions this has the potential to be the biggest change in the treatment of depression in the past 50 years.

    3) Most anti-depressant drugs target serotonin, which act on just 5% of the connections in the brain; ketamine targets glutamate, which acts on 50% of the connections in the brain.

    This last fact caught my interest. Isn't there some kind of connection between glutamate receptors and ME and/or CFS? I know very little about this topic, so would appreciate whatever information anybody could pass along. -- Thanks.

    Wayne

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