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Antidepressants Work No Better Than a Placebo

kdawson posted more than 6 years ago | from the sugar-pills-are-cheaper dept.

Medicine 674

Matthew Whalley writes "Researchers got hold of published and unpublished data from drug companies regarding the effectiveness of the most common antidepressant drugs. Previously, when meta-analyses have been conducted on only the published data, the drugs were shown to have a clinically significant effect. However, when the unpublished data is taken into account the difference between the effects of drug and placebo becomes clinically meaningless — just a 1 or 2 point difference on a 30-point depression rating scale — except for the most severely depressed patients. Doctors do not recommend that patients come off antidepressant drugs without support, but this study is likely to lead to a rethink regarding how the drugs are licensed and prescribed."

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674 comments

This just in! (3, Insightful)

n3tcat (664243) | more than 6 years ago | (#22556906)

Thinking that you're going to not be depressed anymore makes you less depressed!

Re:This just in! (5, Insightful)

Anonymous Coward | more than 6 years ago | (#22556996)

Spoken by someone who's obviously never suffered from depression.

Re:This just in! (-1, Flamebait)

CarpetShark (865376) | more than 6 years ago | (#22557116)

Spoken by someone who's obviously never sincerely tried it.

Re:This just in! (0, Redundant)

dbjh (980477) | more than 6 years ago | (#22557178)

Spoken by someone who has no clue how bad depression can be.

Re:This just in! (5, Insightful)

BobPaul (710574) | more than 6 years ago | (#22557712)

No, seriously, he's right. It's not so simply like you can just say, "I'm not going to be depressed" but just being depressed is itself a real downer than sucks you in deeper. Antidepressants, even if they only work through placebo affect, provide a patient with hope, which could help the roller coaster move gradually upward.

The best days are usually the days you've made a plan of action and convinced yourself it will change everything and you'll be better--you're thinking positively and not fixated on your depression. The worst days are when you realize you plan of action didn't do shit and everything still the same.

Re:This just in! (-1, Flamebait)

plague3106 (71849) | more than 6 years ago | (#22557728)

Well, I do, and I have to agree. Its a lot of self pity and focusing on what's wrong, and wanting to be depressed. Witness fat people that are depressed because they are fat.. so what do they do.. eat more. Ya, that's someone that wants to be happy.

Re:This just in! (-1, Flamebait)

Neo_piper (798916) | more than 6 years ago | (#22557224)

Spoken as a real and true "danger to himself and others" I think you should spend about 1 week in a room with me and no meds...

If you make it out you can tell the world if you still think that it's "all in your head"

Re:This just in! (3, Insightful)

dbjh (980477) | more than 6 years ago | (#22557268)

I happen to be close to someone with a serious depression. But I don't understand your last statement. In what way is depression *not* all in your head? I know how self-destructive a depressed person can be. I also know they drain energy from the people around them. That they can feel physical pain and get into panics. However, I don't see how that's not all something happening in the head of the depressed person.

Re:This just in! (2, Insightful)

qbzzt (11136) | more than 6 years ago | (#22557318)

He meant "in your head" as an idiom for "illusionary". Depression is not illusionary, it's a real disease.

Re:This just in! (4, Funny)

Brian Gordon (987471) | more than 6 years ago | (#22557356)

What? It's a placebo? AAH DON'T TELL ME!

*plugs fingers in ears*
la la la la la

Re:This just in! (-1, Troll)

plague3106 (71849) | more than 6 years ago | (#22557752)

Ya, its people deciding day after day they really don't want to be happy. That doesn't mean illusionary, but it does mean that you can decide not to be depressed.

Re:This just in! (-1, Troll)

module0000 (882745) | more than 6 years ago | (#22557666)

Go be crazy somewhere else; we're all full up here.

and the room for attention starved kids is down the hall [disney.com] .

P.S.: Depression is a catch all diagnosis for people that simply can't cope - why we put up with you all instead of gassing you in camps continues to elude the rest of us destined to "put up" with your little tantrums and cries for affection.

Re:This just in! (1)

Spetiam (671180) | more than 6 years ago | (#22557772)

No...spoken like someone who's recovered from depression. A big problem with being depressed is that you can't see a way out, you lose hope, and get even more depressed. If someone who's depressed sees a way out, they can have hope, which further improves their ability to recover. There are a lot of self-perpetuating cycles involved in depression.

Re:This just in! (5, Insightful)

DuncanE (35734) | more than 6 years ago | (#22557036)

As its been widely noted this study does not take into consideration as a variable those patients that talked about their depression with a psych or councilor and those that didn't.

Anti-dep medication allows you to handle your current situation enough so that you can go and talk to someone about your wider issues.

Its a band aid. The real fix is to find the thing making you depressed and fix that. And you need to talk to someone for that.

Re:This just in! (3, Informative)

dosius (230542) | more than 6 years ago | (#22557282)

And it depends on WHY you're depressed.

If you're depressed because of a neurological glitch - yeah, meds might help. But if like me you're depressed because of environmental issues (cabin fever compounded by social phobias) - they might just not work at all - Prozac didn't do shit for me, didn't even cause a reaction when I OD'd on it.

-uso.

Re:This just in! (1)

Shining Celebi (853093) | more than 6 years ago | (#22557410)

If you're depressed because of a neurological glitch - yeah, meds might help. But if like me you're depressed because of environmental issues (cabin fever compounded by social phobias) - they might just not work at all - Prozac didn't do shit for me, didn't even cause a reaction when I OD'd on it.

How do we know that those environmental issues aren't what causes the chemical imbalance?

Re:This just in! (1)

Lemmy Caution (8378) | more than 6 years ago | (#22557738)

The distinction between the neurological and the biographical is a bit artificial. Thoughts and patterns of thought can have long-term neurological and endocrinological consequences. One's brain chemistry is a result of experiences as much as of genes.

Re:This just in! (-1, Troll)

plague3106 (71849) | more than 6 years ago | (#22557768)

cabin fever

I take it you're "up North." Try moving South. Not everyone can handle many cloudy days.

compounded by social phobias

Um, get over it.

Re:This just in! (5, Interesting)

Aladrin (926209) | more than 6 years ago | (#22557316)

I have to agree. My sister and mother are both are anti-depression meds... And I used to feel I was depressed, but wouldn't do anything about it.

I no longer feel depressed and I know why: I have hobbies now.

My mother and sister don't have hobbies at all... They just sit around and play games or watch tv... They have nothing to look forward to each day, or even each week.

Me, I can't -wait- to get home and mess with one or more of my hobbies at any given time... I've got so many that it's actually a burden at times to decide what I want to mess with... And I want to add more.

It really was the difference between wondering what life's about and loving my life.

I'm not a doctor, and this isn't the solution for everyone... But I'd bet a -lot- of people would be better off if they had things to look forward to, instead of living life minute-by-minute and never looking forward. Having friends is not 'having a life'. Having a future is, and that -should- include friends to do those things with.

Re:This just in! (3, Insightful)

justthinkit (954982) | more than 6 years ago | (#22557698)

I strongly agree about hobbies. In addition, I think there is a benefit to limiting contact with the news. As Steve Chandler said, "It's not the news, it's the bad news". This is of course related to having a hobby. If you disappear into the basement for 4 hours, you probably didn't fire up CNN every 10 minutes during that time.

Another thought, perhaps controversial, is that women seem inclined to worry more than guys. I try to minimize potential worry-items -- opening up bills just before I plan to actually pay them, for example. My wife will open a bill the minute she sees it, even if we are just off for a walk with the dogs. Then while we are walking the dogs in the fresh air, she has to be thinking about that ridiculous Comcast bill.

Finally I would add that carrying too much stuff around in our head does us no favors. No one in our family has a cell phone, nor do we wish we did. That way when I'm driving from A to B, I am not so rudely interrupted that I almost drive off the road. Instead I can enjoy the beautiful bumper-to-bumper traffic in peace. But seriously, if I am fuming in traffic I would just as soon not share my headspace with someone else at that exact moment. I have also used a reminder program [xreminder.com] for eight or nine years now, and currently have 225 reminders in it. When my wife hits me with an event -- take the dog to the vet on Wed -- I create a reminder and then forget about it until the reminder goes off. I miss fewer events and carry a dozen times less event-related detail in my mind -- has to be a good thing.

Re:This just in! (1)

Shivetya (243324) | more than 6 years ago | (#22557726)

I think you missed the point, the drugs do nothing. Its the idea that they do something that is the fix.

I think that has always been the key to the ME generation. Its not my fault, therefor a drug will obviously fix it because its beyond my control otherwise.

We've become a society which feels entitled to not bear any self responsibility. Drugs or Government, either one makes you short feel good but does nothing in the end except make your poorer and more dependant

Re:This just in! (1)

afxgrin (208686) | more than 6 years ago | (#22557540)

whatever. Depression is just the result of life's bullshit. There's every reason to be depressed.

It's just important to enjoy the moments when you're not.

Re:This just in! (1)

popmaker (570147) | more than 6 years ago | (#22557680)

To the rest of the replies to this post:

Come on, guys, it's just a joke!

A Dose of Reality! (1)

SINternet (1194899) | more than 6 years ago | (#22557702)

Being depressed is a natural state of consciousness along with being happy or whatever emotions a person may have. People have to start listening to friends and understand what giving support is as opposed to giving advice on how to fix a problem. Being that our lives are so choatic now it allows the Mental Mongers (Psychiatrists, Drug Companies) as opposed to the Disease Mongers (Doctors, Drug Companies) the abilitiy to exploit us and drag out our problems and get paid for it! Take this example. Why is it mostly boys get prescribed ADD/ADHD medicine just for being boys because they can't sit still and have alot of energy or are bored by what they are being taught when the answer is as simple as boys learn differently than girls and maybe........just maybe need a different classroom environment. Maybe we need better teachers. Blah Blah Blah. My son has been on Antidepressants and ADD medicine all of which I was against but anytime his mother or the school said boo they went and push medicine and my hands are tied but now a Doctors order supercedes my wishes. What I know with Common sense is my son needed a change that these folks couldn't bring themselves to do. As long as you have an enabler "his mother" (variation of the enabler in the addictive sense) telling him he won't like something before it is presented or served to him, or says he's always been depressed then how can he get past it and see that at least as a child those matters for him pale to the issues he'll have as an adult if he can't learn how to let things go. Thats what is the major problem for those depressed. Letting go. Mind your comments in respect of "well you don't know what I've been through" because I'm sure most people have something buried in their Pysche. The aim is to see it for what it is and if you have the same problem after many years then maybe you need to move or get some new friends, change jobs.

Prozac changed my life (2, Interesting)

Anonymous Coward | more than 6 years ago | (#22556910)

I don't care if it is a placebo - and I doubt it is - but I'm glad I finally went on Prozac.I'm a much more functional human being than I was five years ago before I started.

Re:Prozac changed my life (2, Funny)

JustOK (667959) | more than 6 years ago | (#22556980)

no, you're not.

Re:Prozac changed my life (3, Insightful)

BeanThere (28381) | more than 6 years ago | (#22557146)

This summary doesn't mention it, but I saw another summary of this recently, and as I recall Prozac was not one of the drugs covered under this study (assuming it's the same one I read about).

While the results are interesting and worth keeping an eye on as a basis for further research, we should retain heavy skepticism here. It would be absurd and incredibly stupid to draw major conclusions already from this one small study (like the slashdot headline does). In ANY given field you'll find studies that disagree with most other studies. And for all we know this study could've been funded by a company whose main competition is anti-depressants, for example (e.g. many of the quack "cures") or some other group that ideologically disagrees with anti-depressants, and/or there could've been problems with the methodology --- I mean, we may know the drug companies have a financial reason to be biased, but that doesn't mean no drugs have value and doesn't mean that nobody other than drug companies have reasons to be biased.

Re:Prozac changed my life (4, Informative)

Muad'Dave (255648) | more than 6 years ago | (#22557416)

Prozac == fluoxetine, which is mentioned in the article.

Re:Prozac changed my life (1)

BeanThere (28381) | more than 6 years ago | (#22557554)

Sorry, if so, then my mistake - I saw a similar article only about a week ago where it was claimed Prozac was not covered and it seemed like too much of a coincidence that these would not be related, so I assumed they must be referring to the same study.

Re:Prozac changed my life (1)

jambox (1015589) | more than 6 years ago | (#22557418)

Sorry, do you work for Ely Lilly? http://news.bbc.co.uk/2/hi/health/7263494.stm [bbc.co.uk] Prozac was included, according to BBC. Also, the study was done by the University of Hull, so presumably it was not funded by someone selling quack cures. Lastly, the sample was rather large, given that it was an analysis of previous studies. The obvious (or so I had thought) implication is that the unpublished studies, obtained under the FOI act, were withheld because they were the less favourable ones and when that bias is removed, the resutls look a lot like a placebo effect. No, we shouldn't shut down all serotonin reuptake inhibitors, but we'd be crazy to just keep buying them in the light of this, very worrying, report. If it does indeed turn out that corporations have been hiding knowledge of this for profit, at the expense of the health of the general public, they should be fined back into the stone age.

Re:Prozac changed my life (1)

BeanThere (28381) | more than 6 years ago | (#22557696)

I may have been mistaken about the Prozac, as mentioned above.

You're crazy if you believe something just because it comes from a university, many biased studies are done 'through' universities *specifically* to lend credence and hide the sources of funding (it's so easy to almost completely hide the source of funding through one or two layers of university bureaucracy, but *someone* always funds *every* study), and even big-name ones aren't immune.

Re:Prozac changed my life (1)

jambox (1015589) | more than 6 years ago | (#22557784)

Perhaps Universities aren't as trustwhorty as I'd like to think, but I just can't see who would have selfish enough motives, as you suggest, to fund this. Surely, someone flogging quackery wouldn't have the means. My main concern, which you've not addressed, is the potential for corporations to warp scientific opinion by paying for, perhaps, 10 studies but then only publishing the 5 that are best for their product.

Re:Prozac changed my life (1)

BeanThere (28381) | more than 6 years ago | (#22557798)

do you work for Ely Lilly

Talk about over-reacting. I specifically even said it might not have been the same thing I read about, you respond with "do you work for Ely Lilly" - how ridiculous. Yet in the same breath you automatically assume everything in this study must be the absolute truth even if it contradicts so much existing literature. A wee bit biased, methinks.

Re:Prozac changed my life (1)

jambox (1015589) | more than 6 years ago | (#22557470)

Whether it's a placebo or not, you should care because whatever the effect is, it will eventually wear off. This is the sad truth about all anti-depressants - eventually you will star to feel as sad as you did before, only then - you're hooked. No anti-depressant in the world is going to address the root cause, most likely there was never anythiong wrong with your brain in the first place. It may give you the temporary lift you need to make the changes your life needs, but taking them for longer than a year is just crazy. Despite the claims of the manufacturers, there's no such thing as a non-addictive anti-depressant, because it makes you happier. You don't want that to stop.

On the other hand (1)

corrie (111769) | more than 6 years ago | (#22556914)

I have a tremendous amount of unpublished data that shows the exact opposite

Right (0)

Anonymous Coward | more than 6 years ago | (#22556916)

And now that I know they don't work, I'm even gunna be more depressed when i take them!

Sooo... (2, Interesting)

TubeSteak (669689) | more than 6 years ago | (#22556960)

I guess Tom Cruise was right?

Re:Sooo... (2, Insightful)

Thyamine (531612) | more than 6 years ago | (#22557072)

I think Mr. Cruise was ranting about post partum depression specifically. As I understand it, he actually had some details right (no one is certain why mothers get it), but you can't go busting on a new mom on national TV and come out as anything but an ass. And really, he was one.

Well that's depressing.... (2, Insightful)

Frostclaw (1006995) | more than 6 years ago | (#22556962)

I'm not really surprised that the drugs are overperscribed. However, I do find that the subject heading is misleading.

Re:Well that's depressing.... (1)

arivanov (12034) | more than 6 years ago | (#22557240)

The fact that they are overprescribed is very well known. In fact you are taking it even if you do not have it prescribed: http://news.bbc.co.uk/1/hi/health/3545684.stm [bbc.co.uk] . It hate to be cynical, but it is a healthy economy booster. After all what can be better than not getting depressed from the fact that you just about scrape for a living and balance your books at the end of the month. Joe Average consumer should go on, go out there, consume, enjoy buy and do not worry about bad thing.

On a side note I have found only one reliable method of dealing with depression - work you like. Regardless of what it is. It is the ultimate antidepressant. If you are depressed go and find something to do, change your job if necessary.

Should've listened to Tom Cruise (1, Redundant)

Spikeman56 (543509) | more than 6 years ago | (#22556982)

The Scientologists were right all along!

Intresting choice of words (2, Insightful)

DarthApoc (696826) | more than 6 years ago | (#22557012)

However, when the unpublished data is taken into account the difference between the effects of drug and placebo becomes clinically meaningless -- just a 1 or 2 point difference on a 30-point depression rating scale -- except for the most severely depressed patients.
I'd say that this part could be interpreted as "People resort to drugs against depression too lightly" That's what I thought when I read those words at least.

Re:Intresting choice of words (1)

gplus (985592) | more than 6 years ago | (#22557078)

I'd say that this part could be interpreted as "People resort to drugs against depression too lightly" That's what I thought when I read those words at least.
That's not surprising. After all GP's make money for themselves every time they write out a prescription.

Depression not natural? (2, Insightful)

Merritt.kr (1120467) | more than 6 years ago | (#22557024)

People seem to miss something that seems very obvious to me... They think "Oh! You're depressed.. there's something wrong with you, maybe these drugs can help it" ... but depression is a _natural_ state in most living beings. Just look at dogs, they can get severely depressed, just like their owners. Sometimes, yes, a chemical imbalance is to blame and drugs can help. But more often than not a human being is depressed for a reason... bad relationship, money problems, reading about too much pain in the world from the newspaper. You name it, there are plenty of very valid reason all around us to get depressed. Our society has changed very quicktly in the past few centuries, and the past few decades, and it seems that this new way of living does not agree with a lot of people. Rush, do this, do that, look like this, behave like this, own this, spend your money more, more, etc, etc. This is all extremely stressful, and none of it to the betterment of ourselves as people. "Okay, so, I bought myself a fancy new $600 sofa. It's pretty and soft and my guests will be impressed...... Hmmm.... So, where's my scotch?"

Re:Depression not natural? (5, Insightful)

adpe (805723) | more than 6 years ago | (#22557136)

I think you're confusing depression as in "Man, I'm pissed off today" and depression as in the medical condition. "Real" depression is a horrible thing and needs treatment. It's as if you're saying cancer neends no treatment, since the cells grow very naturally.

Re:Depression not natural? (3, Insightful)

Merritt.kr (1120467) | more than 6 years ago | (#22557168)

I agree with you, clinical depression is a very serious thing. I should know, I've been diagnosed as bipolar, manic-depressive, and, I quote "SEVERELY clinically depressed". To the point where I don't mention feelings to my doctors, cause they start asking me about razor blades and the like. I've tried the drugs -- believe me, I know what I'm talking about. I'm not talking about "Man, this is a crappy day" I'm talking about a never-ending, life long dysphoria with LIFE. You get occasional pick-me-ups in the form of the people you life, a funny cartoon, etc... but in general, life seems to kind of... suck. And even when those thoughts AREN'T going through your head (or mine), you still feel bogged down just by how you have to live in this society.

Re:Depression not natural? (1)

Grym (725290) | more than 6 years ago | (#22557284)

I agree with you, clinical depression is a very serious thing. I should know, I've been diagnosed as bipolar, manic-depressive, and, I quote "SEVERELY clinically depressed"... I'm talking about a never-ending, life long dysphoria with LIFE. You get occasional pick-me-ups in the form of the people you life, a funny cartoon, etc... but in general, life seems to kind of... suck.

So, going back to your original post, do you feel that this is a "natural" state of being? More specifically, do you think that your depression (since you brought it up) was the result of events in your life or your perception of these events?

Clinical depression is not normal. Being sad or upset because bad things have happened to you in life is not the same as being clinically depressed. Whether or not anti-depressants work, it would be dangerous to confuse this fact.

-Grym

Re:Depression not natural? (1)

Merritt.kr (1120467) | more than 6 years ago | (#22557422)

In general, I don't have a reason to point to and say "I feel depressed because of this". I usually just feel depressed, just.. because. It's not always so, and I can occasionally drag myself out of it, but most of the time I just feel sort of numb, no matter what's going on.

Re:Depression not natural? (-1, Flamebait)

HouseArrest420 (1105077) | more than 6 years ago | (#22557482)

I agree with you, clinical depression is a very serious thing. I should know, I've been diagnosed as bipolar, manic-depressive, and, I quote "SEVERELY clinically depressed". To the point where I don't mention feelings to my doctors, cause they start asking me about razor blades and the like. I've tried the drugs -- believe me, I know what I'm talking about. I'm not talking about "Man, this is a crappy day" I'm talking about a never-ending, life long dysphoria with LIFE. You get occasional pick-me-ups in the form of the people you life, a funny cartoon, etc... but in general, life seems to kind of... suck. And even when those thoughts AREN'T going through your head (or mine), you still feel bogged down just by how you have to live in this society.
I say you're either crying out for attention, which is sad in an of itself and you will need help to over come it, or you need to find better doctors because they're fillling your head with shit. It's either one of those two things, or you're trying to impress us by throwing out your disorder...with different names. Bi-polar=manic depressive=server clinical depression. Saying your bi polar AND manic depressive AND severly clincally depressed is like someone tleling you they've taken acid AND LSD. No shit....they're the same thing.

Re:Depression not natural? (1)

popmaker (570147) | more than 6 years ago | (#22557644)

The last equality symbol doesn't fit, though. Severe clinical depression is not bi-polar disorder... it might be a subset though. If you're severly clinically manic sometimes and severly clinically depressed other times, then you have manic-depression - which is the same as bipolar disorder as you pointed out.

Re:Depression not natural? (1)

Negatyfus (602326) | more than 6 years ago | (#22557164)

Your definition of depression is off.

Re:Depression not natural? (1)

QuantumG (50515) | more than 6 years ago | (#22557174)

You obviously don't know anyone with depression.

Re:Depression not natural? (1)

DrLang21 (900992) | more than 6 years ago | (#22557186)

There tends to be a public perception problem with Anti-depressants and other psychotropic drugs in general, and the blatent over prescribing of these drugs does nothing to help their image. By and large, from my unscientific observation, anti-depressants are widely over prescribed and abused (which may actually account for a skew in the data discussed in this article. However, this does not invalidate their usefullness and effectiveness for those with a severe chronic depression problem. My personal opinion is that anti-depressants should only be used in conjunction with regular visits to talk with a psychotherapist.

Re:Depression not natural? (1, Offtopic)

MrHanky (141717) | more than 6 years ago | (#22557194)

This comment exemplifies how broken the Slashdot moderation system is.

Re:Depression not natural? (0)

Anonymous Coward | more than 6 years ago | (#22557380)

What would really show that is if you got modded informative.

Heh, that's just a joke I tell.

No, but seriously, elaborate? I happen to agree with you (I think), but what if I didn't? It'd be like "uh, okay".

Re:Depression not natural? (1)

techstar25 (556988) | more than 6 years ago | (#22557210)

Yes, there is a clear distinction between feeling a little depressed because your team lost, and being Clinically Depressed, yet most people don't get the difference, and these drugs are then "abused".
I really hope more research is done using these findings, because there could be an unwanted side effect (pardon the pun). The last thing we need are more ignorant anti-psychology/psychiatry types screaming "See! I told you it was all a scam!". Clinical depression is as real as Cancer or AIDS, and it's just as difficult to treat.
However, those with clinical depression are always told to "pull yourself up by your bootstraps", and "get over it, it's normal". You never hear people saying that to Cancer patients.
For the doubters, let me put it in easy to understand terms: Saying depression is a normal part of being human is like saying the Earth is flat, or that nobody needs more than 640k of RAM. ;)

Re:Depression not natural? (1)

Merritt.kr (1120467) | more than 6 years ago | (#22557290)

That is just it, my friend. I am sorry if I was not clear in how I put things. Being depressed is not "a natural human state" to be in. It is, however, a natural _reaction_. My point was not that depressed people are simply down, I do believe it is a serious problem and needs addressing, and clinical depression sometimes is because of chemical imbalances that need to be corrected. My point was more that psychologists, and doctors tend to prescribe these medications to too many people, often people who do NOT suffer from chemical imbalances in the brain. My point was that many of the "depressed" people out there have very valid reason to be depressed, and all too often it is overlooked and they have drugs shoved at them. The drugs have helped me in the past, I know I have that problem. But I have also seen far too many people have drugs given to them to make them "Better", only to have it screw them up more because they didn't need them. Simply put: You can be SEVERELY, suicidally depressed, for a very long time, because our world right now, and how the majority of us live in it, is fucked up and does not agree with how we have evolved to live in the world.

Re:Depression not natural? (1)

dosius (230542) | more than 6 years ago | (#22557320)

It's because it literally is "all in the head" - just not the way they see it. From their perspective it's like, you know, "Cheer up emo kid", but hell, can we help it that we're always feeling down? I get depression in waves, you know what I do? I lock myself up in my room for days on end, and it gets worse, until I find something to pull me out of the doldrums, but depression's like a vortex...

-uso.

Re:Depression not natural? (1)

Cadallin (863437) | more than 6 years ago | (#22557348)

At the same time, if one is to suggest that they find the world a very disturbing and dystopian place, and that the current trends in society and its effects on the world at large are only likely to magnify these traits, and that as a result one has decided to kill to kill oneself, well, their feelings are immediately regarded as irrational and society hospitalizes them.

The possibility that those individuals have come to a rational decision about a course of action to take as a response to the world around them, and their vocalization of this attitude is merely seeking reassurance to proceed with an act that the irrational parts of the brain fight actively against, is dismissed on its face.

Now, let's admit that this percentage of Suicidal patients may be a small one, but it is there. Society really needs to re-evaluate how we respond to those people. I'm going to hazard a guess that the rising population in developed countries of http://en.wikipedia.org/wiki/NEET [wikipedia.org] , http://en.wikipedia.org/wiki/Hikikomori [wikipedia.org] , and http://en.wikipedia.org/wiki/Parasite_singles [wikipedia.org] is fed by this group. Hikikomoris in particular, (while the term is Japanese, the phenomena it refers is anything but unheard of in the west, the Highly educated young person who withdraws from society has a history here going back centuries) are probably highly symptomatic of a society that refuses to deal with (or stops doing so) suicides in a reasonable way. This is exacerbated by people who (very mistakenly) believe that Major Depression can be cured, when in reality it is Permanent, and can be both extremely debilitating and largely unresponsive to treatment.

While articles, such as http://en.wikipedia.org/wiki/Clinical_depression [wikipedia.org] , tend to gloss over just how bleak the prognosis often is, the acknowledgment of the proliferation of increasingly fringe treatments for depression, such as Vagus Nerve stimulation, Hypnotherapy (!), and transcranial magnetic and electroshock techniques is evidence of just how ineffective medicine often is at dealing with this condition.

Re:Depression not natural? (1)

HouseArrest420 (1105077) | more than 6 years ago | (#22557580)

At the same time, if one is to suggest that they find the world a very disturbing and dystopian place, and that the current trends in society and its effects on the world at large are only likely to magnify these traits, and that as a result one has decided to kill to kill oneself, well, their feelings are immediately regarded as irrational and society hospitalizes them. The possibility that those individuals have come to a rational decision about a course of action to take as a response to the world around them, and their vocalization of this attitude is merely seeking reassurance to proceed with an act that the irrational parts of the brain fight actively against, is dismissed on its face.
QFT. It's like I've said for the longest time. The ONLY people qualified to call someone else "normal", are people that are not "normal". Just look at our definition of the word insane to see that argument. That's why I can safely say without a doubt, disregarding the chemical inbalances in my brain, that I am the sanest person I know.

Re:Depression not natural? (2, Insightful)

erase (3048) | more than 6 years ago | (#22557440)

just because something is natural doesn't make it inherently desirable or even tolerable - there are plenty of natural diseases you would certainly choose to seek unnatural medical treatment for and there are plenty of natural things that will kill you outright (poisonous mushrooms, bears). you probably wrote this post on an unnatural computer in your unnatural living or working space, bathed in unnatural light from an artificial source, while wearing unnatural clothing and using the wholly unnatural slashdot. clearly some selective unnatural things are quite acceptable and desirable.

Re:Breaking your leg not natural? (0)

Anonymous Coward | more than 6 years ago | (#22557474)

Breaking your leg is pretty natural too. Do you not do anything against the symptoms either? Nor help the healing process?

Re:Depression not natural? (0)

Anonymous Coward | more than 6 years ago | (#22557578)

Here's how it works.

If you grew up in a good home and have a history of good things happening, and shit happens to hit the fan in your life and you begin to tilt down towards paranoid nitpicking (my hubby cheated on me once, he's going to do it again, fuckity fuck fuck, I hate him, yadda yadda yadda, and so on), then the best cure is a temporary antidepressant to help you get your head on straight.

If you grew up in a shit home and your concept of reality has been warped by the constant abuse of parents, teachers, and society in general, then the cause isn't "something is wrong with you". The solution is temporary isolation and work on learning to live with that pain and beyond that pain. If you can't find a way, and therapy by a trained professional doesn't help, then likely gunfire and lots of it is the only solution. Got raped as a kid every weekend by a preacher? Your useless father and worthless mother beat on you as a child for emotional support? Take them out; they deserve it, it leaves the world a better place, and it'll allow you to move on, because they're dead. So the next time the freak-out attack happens you know you've got a gun-in-hand and nobody is going to do that shit again. You may be in prison, you may even never get out, but you know, you can at least rest at night.

Think it's far fetched or extreme? What's extreme is allowing the abuse to continue. No amount of medication is going to fix a hannible-lector complex.

The problem is with society; the problem is with corporations, government, banks, and companies that constantly flambast the public with useless garbage to get them "on their side".

Re:Depression not natural? (2, Insightful)

ChrisMaple (607946) | more than 6 years ago | (#22557590)

Regardless of whether there is an external cause of depression, drugs can sometimes make a depressed person feel less depressed. This is true even of a weak herb like St. John's Wort. If someone feels too depressed to get out of bed, an antidepressant can give him the mental boost to get up and solve his problems.

Even if it has almost no effect... (0)

Anonymous Coward | more than 6 years ago | (#22557040)

Even if it has almost no effect, that shouldn't matter it does help some people even if it is all in their head. And the more people who learn that they can overcome depression the better. And even if it doesn't help much it can help in the long run as they slowly work their way off and realize that added self esteem stayed with them and that they are overall happier.

Re:Even if it has almost no effect... (0)

Anonymous Coward | more than 6 years ago | (#22557156)

Even if it has almost no effect, that shouldn't matter it does help some people even if it is all in their head.
Where else is depression going to be, other than in the head? Brain cancer is also "all in the head". People need to stop thinking of the mind as some immaterial thing that's somehow separate of our physical bodies.

Further evidence... (5, Interesting)

inviolet (797804) | more than 6 years ago | (#22557060)

A while ago somebody noticed that anti-depressant drugs don't work at all unless they have some side-effects. The side-effects remind the user that he or she is taking a wow-must-be-powerful drug, which increases its placebo effect. The upshot is that it is completely counterproductive to search for an anti-depressant drug that has no side-effects. In fact, the more side-effects the better.

I don't remember more details than this, though.

In any case, it reminds me of a similar effect in microeconomics, in which consumers would tend to evaluate a widget more favorably if they had paid more money for it.

Re:Further evidence... (1, Informative)

Anonymous Coward | more than 6 years ago | (#22557114)

The side-effects remind the user that he or she is taking a wow-must-be-powerful drug, which increases its placebo effect.
I have been taking Wellbutrin for almost a year and a half and I have yet to have any side effects, even with no side effects the drug worked perfectly and helped me get through my senior year of high school. While taking it someone told me about someone they knew whose pharmacist switched her over to the generic form of the drug with out her knowing it(thus no placebo effect) and the drug stopped working. So either she did know and was lying to get attention or she had no idea which shows that in some cases it can work or the third option that it was a bad batch of the drug that wasn't as powerful as the normal ones.

Re:Further evidence... (1)

mother_reincarnated (1099781) | more than 6 years ago | (#22557138)

A while ago somebody noticed that anti-depressant drugs don't work at all unless they have some side-effects.

In any case, it reminds me of a similar effect in microeconomics, in which consumers would tend to evaluate a widget more favorably if they had paid more money for it.

You're right this psychology crap is bullshit :) On a related note most of us don't pay for /. -- which might explain a lot!

Re:Further evidence... (1)

six025 (714064) | more than 6 years ago | (#22557198)

In my own personal experience with depression, the associated feeling is born out of an inability to believe in ones (higher) self. Please feel free to leave out "higher" if you don't agree with the weight that carries. It seems obvious now that happy people do not have this problem. The unhappy person is so UN-believing in their own self that they would prefer to put that belief in to a pharmaceutical product / company. With respect to people that have a real chemical imbalance, most people who suffer from "depression" are attached to a word that matches their feeling a little blue. Drugs are not the solution to this problem. It is relatively easy to fix through holistic treatments such as regular meditation, exercise and healthy eating, and maybe a little reading. Sorry if that is not be what you want to hear ... but if you fall in to the above category, you are doing it to yourself. YMMV? I am convinced otherwise .... Peace, Andy.

What about (1)

antifoidulus (807088) | more than 6 years ago | (#22557090)

Hairibo Gummy Fungus? Seemed to work for Amy Wong....

Depression is not all serotonin (5, Interesting)

zombie_striptease (966467) | more than 6 years ago | (#22557096)

I was on Zoloft for a couple of years way back when I was a teenager. It did fuckall to help my depression, I still hated life and still contemplated suicide, but I noticed something funny after I stopped taking it (due to severe gastrointestinal side effects). A few days after I'd quit the pills cold turkey, I was thinking of something I was stressed about, and along with the common wave of emotional despair, felt a physical sinking in my chest that I realized I hadn't felt for... about two years. I laughed when I realized that that was probably the chemical reaction that the SSRI had been halting, and laughed harder the longer I contemplated what a drop in the bucket it was in the scope of the depression I was struggling with. It made me understand the extent to which the Zoloft was just targeting a symptom of a larger problem, like any number of other medications do. There may be some people whose depression truly does stem from such a one-note imbalance, and I truly hope that the medication can help them, but it doesn't surprise me that antidepressants could be so insignificant to so many others.

Re:Depression is not all serotonin (0)

Anonymous Coward | more than 6 years ago | (#22557404)

That's exactly what I noticed with St. John's Wort, though it also stopped my occasional panic attacks. Alas, it also turns you into a vampire (sensitivity to sunlight).

Eli Lilly CEO (5, Informative)

ruinevil (852677) | more than 6 years ago | (#22557108)

I just listened to the CEO of Eli Lilly speak for an hour last night, and he said most prescription drugs work at best in 80% of patients who are diagnosed with the disease it's supposed to treat. Their least effective drugs only treat 20% of patients. Until effective genomics, proteinomics, and metabonomics testing systems come out, which will show exactly how people react differently to drugs, they have to train doctors in choosing criteria where the drug will work, and ensure that they don't prescibe drugs that don't work in that circumstance. Selling drugs that don't work is an unsustainable business policy.

He talked about Strattera, a nonstimulant ADHD drug, that works works best in people with ADHD combined with clinical anxiety. Otherwise, the patient should be prescribed a stimulant based ADHD drug, which works more often in other cases.

Anyways, a lot of drug trial data is needed to find the population where the drug works. In a lot of cases the drug might not work at all. Prescribing methicillin against methicillin-resistant Staphtacaccous aureus will probably an efficacy similar to placebo.

Re:Eli Lilly CEO (1)

ruinevil (852677) | more than 6 years ago | (#22557206)

Also, all the labs working on this are either in the psychology departments of their schools, or in consumer advocacy groups with a some kind of agenda. The psychoanalysts want you on their couch.

CHIP appears to primarily do research on AIDS in Africa. http://www.chip.uconn.edu/ [uconn.edu]

Consumer advocacy group: http://www.ismp.org/ [ismp.org]

Wait a minute... (0)

Anonymous Coward | more than 6 years ago | (#22557112)

Surely by publishing the unpublished data it's now published which means it's no longer unpublished, therefore contradicting itself?

(SIGH) that figures (4, Funny)

192939495969798999 (58312) | more than 6 years ago | (#22557124)

(SIGH) nothing ever works, its hopeless!

Re:(SIGH) that figures (1)

Thwomp (773873) | more than 6 years ago | (#22557344)

My anti-bear rock does!

Ha! (0)

Anonymous Coward | more than 6 years ago | (#22557128)

I could have told you that myself! Just came off antidepressants myself last month, after complaining that I cried as much with or without the pills. Only effect was that it *uhm* stopped the man-machinery to work completely, for as long as I was on the stuff. Now of course, my doctor is totally patronizing, postpones my appointments for months / doesn't provide much help because I don't obey and take the pills, and am generally left on my own when I need help the most...

Should have taken the sugar pills at least...

--the leprechaun / leprec

I have friends on anti-depressants (3, Informative)

QuantumG (50515) | more than 6 years ago | (#22557132)

When they're on them they are normal and healthy. They feel so normal and healthy that they often decide they don't need them anymore - so they go off them. Then they are not normal and healthy.. they are depressed. After one too many 2am phone calls one of their friends will recommend that they go back on the anti-depressants. Soon after they will be normal and healthy again.. until the cycle repeats itself.

Must all be the placebo effect though.

Anafranil (4, Interesting)

SharpFang (651121) | more than 6 years ago | (#22557200)

I don't know about deep depression, but with rather mild depression I took a 25mg pill of Anafranil and had some 2 days of pretty much silly euphoric high.

The effect wasn't mild or insignificant or anything you could consider effects of placebo. I was feeling like in very good mood, work that felt like dread before, could be finished at my standard efficiency and the effects were NOT negligible.

Of course there -were- side effects and they were quite strong (feeling of heat, including sweating and problems with sleep, lower max physical strength, getting physically tired faster, problems with urination), but first they felt like a total non-issue due to the great mood I was in, and second, the lower efficiency of my body at physical work was ballanced by increased enthusiasm and will to work more and mental efficiency was not affected (not just in subjective opinion) and no other factors of perception than general very good mood were affected (although feeling far too warm to fall asleep resulted in natural effects of insomnia).

No idea what drugs they talk about but Anafranil is THE shit :)

Re:Anafranil (1)

linux_geek_germany (1079711) | more than 6 years ago | (#22557390)

This sounds a lot like XTC to me... Sure you took the right pills? ;-)

Re:Anafranil (2, Interesting)

Dr_Barnowl (709838) | more than 6 years ago | (#22557520)

The pharmacological effects of clomipramine and MDMA are similar ; both of them futz with your serotonin metabolism, although clomipramine also futzes with noradrenaline.

The major difference is that while clomipramine just inhibits the re-uptake of these neurotransmitters in the synapse, MDMA also induces heavy release of serotonin, enough that your serotonin reserves are rapidly emptied on a "normal" dose.

I wouldn't touch MDMA with a mile long barge pole ; serotonin is the "happy" hormone, taking a drug that empties out your supply seems like a recipe for a suicidal Sunday morning, not to mention the long-term effects (like your brain getting so used to the high serotonin levels that it needs the drug just to be mildly cheerful).

Re:Anafranil (1)

SharpFang (651121) | more than 6 years ago | (#22557592)

Absolutely. Pharmacy-bought, state-refunded. Not for me but the person who was taking it on regular basis (heavy depression) gave me one.

Anafranil is good in that it has no 'down' phase, it just wears off without aftereffects (other than it remains in your organism for some 2-3 days after it stops working, meaning if you take second pill as soon as you feel the first stopped working, you get way more than you bargained for, personal experience.) It is also said to be non-addicting (likely is, the person changed drugs after 1.5 years of taking 2 pills a day) and not damaging to health (just the leaflet to support that).

The wrong med from the wrong dr. (4, Insightful)

ubrgeek (679399) | more than 6 years ago | (#22557204)

Sorry, I have a considerable amount of experience with family members who went the counseling route for years without seeing improvements. After finally deciding to try anti-depressants, anti-anxiety, etc., the problems they had most of their lives went away or were reduced to levels that made it easier for them to have a better life. The biggest problem I've seen is not whether they work or not, it's that GPs are the ones issuing the Rx. GPs are just that - GENERAL practitioners. The good ones admit that their knowledge of the nuances involved with the "low-level" chemical behavior of the brain is limited. A psychiatrist, someone with a medical understanding of the topic (not knocking psychologists, but their understanding is in a different area: the non-biochemical causes of issues) should be the person making the determination of just what a person should be on. They're aware of more of the potential "cocktails" of drugs (one particular drug is not enough) - both in terms of what works and what needs an additional medication to target secondary causes/effects of depression....

Missing the point (5, Insightful)

Hebbinator (1001954) | more than 6 years ago | (#22557208)

The point is not that antidepressants don't work - the point is that diagnosis criteria for depression has been to lax for too long. "Everybody gets depressed, not everyone needs antidepressants" It makes sense that the only people who respond to antidepressants designed to fix chemical imbalance are the ones with severe depression.... who are likely to have a real chemical imbalance. These are not "happy pills" they are formulated to fix an insufficiency. Normal, mild depression from events (death, divorce, etc) has always been treated best by cognitive behavioral therapy (aka psych visits), unless you just want to zonk someone out. But, in our society, if you have a problem you get a pill. No one wants to hear "go talk to someone and get over it," so doctors write the scripts and the generally malcontent get them filled.

Re:Missing the point (1)

Weh (219305) | more than 6 years ago | (#22557672)

I wouldn't be surprised if this study was funded by insurance companies seeking a way to lower the amount of money the pay for anti-depressant drugs.

well prozac works (1)

oliverthered (187439) | more than 6 years ago | (#22557306)

At least prozac worked for me, infact it worked too well and I've been take off of it and put onto something that doesn't work at all.

Sadly the doctors think my depression is because I smoke a couple of spliffs a week, it just shows how you can talk intimately to people and yet they never really know you, I was depressed long before I knew what a spliff was.

Don't forget (3, Informative)

Per Wigren (5315) | more than 6 years ago | (#22557308)

At least in Sweden, if you've had a deep depression and are on the way to getting good, they will stop helping you and force you to go back to work 100% immediately. If you've ever had a (real) depression you know that that is not an option. You need to start slowly before you can get up to speed or you will be back to where you started (when you got depressed/burned out). So what to do? You lie to the doctors for a while and pretend that it's still as bad as it used to be so you get a chance to recover. The doctors would understand and agree with you but they aren't allowed to sick-list you if you aren't so down that you rather starve than go outside to buy some food. So, I think this survey isn't telling the whole truth.

I always take (1)

Bromskloss (750445) | more than 6 years ago | (#22557386)

a placebo pill when I have a headache.

Well duh... (1)

LiENUS (207736) | more than 6 years ago | (#22557398)

That's because the scammer aliens sold the researchers a jar of gummy fungus instead of real antidepressants.

Depression is Cyclical (2, Insightful)

Eli_Courtwright (949563) | more than 6 years ago | (#22557424)

This fits with what some other studies have shown in the past... in the short run. Depression is often cyclical; people get more or less depressed over time and will often be fine for long periods of time. So simply by taking nothing and waiting, they'll often start to feel better soon. This is why taking anti-depression meds is almost indistinguishable from a placebo in the short run, except in the most severe cases.

The real test is how effective the meds are at preventing future episodes of depression, or at least limiting how bad they are. TFA doesn't go into enough detail on the length of time over which the data was collected, so I don't know what it has to say about this.

I'm glad I don't take em (1)

HouseArrest420 (1105077) | more than 6 years ago | (#22557436)

I never knew about this study. but I've been on every type of medication from a to z. From the time I was about 6 everyone knew I was a bit off. Yhey figured it was just my intelligence at the very start. Then they started seeing the issues with authority, the issues in large groups, the lack of focus, and the destructive behavior. So they started with ADD and went from there. I've been clinically diagnosed manic depressive with acute paranoia since about the age of 15/18 (read late teens). I've been on anti depressants, but they never really did anything for me. Currently I only take mood stabilizers like lithium (600mg 2x's a day) and seroquel (400mg 2x's a day). I guess seroquel can be considered an anti depressant, but because it helps with both the up's and downs I don't consider it soley an anti depressant.

author unknown (1)

FudRucker (866063) | more than 6 years ago | (#22557462)

"A man (or woman) is as happy as they make their mind up to be"

How was the data obtained? (1)

jambox (1015589) | more than 6 years ago | (#22557512)

Wasn't the unexpected result produced by including unpublished clinical data, released under FOI? If so, who was holding onto that data and why? It seems very fishy to me that anybody would be conducting studies, then deciding whether to publish them or not based on their conclusions. Clearly, by selecting which studies to publish, an interested party could present any result they wanted to - through medical journals.

I think the conclusion is clear (1)

JimboFBX (1097277) | more than 6 years ago | (#22557548)

Start prescribing Placebex for depression!

How was the data obtained? (1)

jambox (1015589) | more than 6 years ago | (#22557552)

Wasn't the unexpected result produced by including unpublished clinical data, released under FOI? If so, who was holding onto that data and why? It seems very fishy to me that anybody would be conducting studies, then deciding whether to publish them or not based on their conclusions. Clearly, by selecting which studies to publish, an interested party could, in theory, present any result they wanted to. I find this extremely worrying.

The One (1)

TheGreatOrangePeel (618581) | more than 6 years ago | (#22557610)

You read the label for a lot of Anti-depressants out there and a number of them will warn you that their particular anti-depressant may not work for you and, in fact, may have the opposite effect. I want to see the standard deviation of the two groups, and before/after numbers. My guess would be that the plecebo group has a low standard deviation and rated their depression very much the same as before, while the group who actually took the anti-depressant had a higher standard deviation and a significant number of people rated their depression very differently.

Not to mention that both myself and one of my college buddies took anti-deperssants while at college and the fact of the matter is that they helped us both. I wouldn't say they made me happy, but they certainly helped me cope which gave me the opportunity to do the rest.

Clearly, this comes from a depressed individual. (1)

Thanshin (1188877) | more than 6 years ago | (#22557616)

Antidepressants work no better than a placebo."
"He's delusional! Quick, give him some Thorazine! Or sugar! Whichever you can get faster."

Indictment of diagnosis, not drugs (1)

LotsOfPhil (982823) | more than 6 years ago | (#22557688)

This seems like people are being given the drugs who don't need them. The drugs work for severely depressed people. They don't do anything special for people who aren't depressed because... they treat depression.
The drugs' success is contingent on you having the ailment they treat. Big news? I think not.
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