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Peter Gøtzsche discusses the various ways in which psychiatry may be harming rather than helping

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3,263
Thanks for sharing, @A.B. Gotzsche is half of the Hrobjartsson & Gotzsche team who argued that most of the placebo effect is largely due to artifacts - that is, biased self-reporting in those "expecting" to see improvement.

Click on their names for link to the paper.

They are very strong on the point that self-report measures are inadequate to measure treatment improvements. You need objective measures.

Obviously, the big point of this talk is that there's little justification for the use of antidepressants in anyone but the chronically severely depressed. And even then, take care not to misinterpret withdrawal effects as a sign that you are still depressed and have to stay on the drug. You want to get off them is soon as is possible, and do it slowly to reduce withdrawal effects.
 

IreneF

Senior Member
Messages
1,552
Location
San Francisco
I could watch only about half of this. It did something bad to my iPad.

I'm one of the chronically severely depressed. I've been on Cymbalta for ten years and I have no plans to stop. It works great.

I took a lot of meds. The only one that provided me with the delights of withdrawal was Effexor, and it was nothing like the description in the video, so I feel somewhat skeptical about some of his other claims.
 

IreneF

Senior Member
Messages
1,552
Location
San Francisco
And another thing--plenty of depressed people refuse to take meds because "that would mean I'm crazy". Or they give up after one or two tries. Lots of times it takes many trials to find a med that's effective.

There's another problem called tachyphylaxis, which is when a drug decreases in effectiveness over time, or simply stops working. Stopping and re-starting your antidepressant can cause it to stop working.

Gotzshe may be correct in certain cases, but I don't think he's presenting the entire picture.
 

Snowdrop

Rebel without a biscuit
Messages
2,933
And another thing--plenty of depressed people refuse to take meds because "that would mean I'm crazy". Or they give up after one or two tries. Lots of times it takes many trials to find a med that's effective.

There's another problem called tachyphylaxis, which is when a drug decreases in effectiveness over time, or simply stops working. Stopping and re-starting your antidepressant can cause it to stop working.

Gotzshe may be correct in certain cases, but I don't think he's presenting the entire picture.

I'm not disagreeing with your perspective on using AD drugs but do you have any thoughts then on how one might determine if they are no longer needed?
 

alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
From the video, when a trial is unblinded there is a big bias effect (maybe 36%), and what you are measuring (especially using subjective measures) is bias. When you correct for this, even if you ignore unpublished negative studies, the effect of antidepressants is zero.
 

Snow Leopard

Hibernating
Messages
5,902
Location
South Australia
If AD were prescribed more scientifically (eg an actual defect of serotonin or some other abnormality was measured before prescription) then it wouldn't be anywhere near as much of a problem.
 

A.B.

Senior Member
Messages
3,780
No. My personal perspective is that of a person with a real, permanent need for meds.

One of the big points made by Gøtzsche is that certain antidepressants are some of the most addictive drugs ever devised, and trying to come off them rapidly triggers symptoms that are similar to depression. He argues that this is why depression was once an illness that typically lasted for six months or so, while today it tends to last much longer, even decades.
 

IreneF

Senior Member
Messages
1,552
Location
San Francisco
One of the big points made by Gøtzsche is that certain antidepressants are some of the most addictive drugs ever devised, and trying to come off them rapidly triggers symptoms that are similar to depression.
Nonsense. I've come off quite a few, and had problems with only one, and my symptoms were not at all similar to depression. It's recognized that withdrawal can be a problem for some drugs in some people, but it is far from universal.

If you need to come off rapidly you should be hospitalized.

They are not addictive. They may cause dependency but no high or cravings. OTOH, someone told me that coming off Effexor is worse than coming off heroin.