Posted by noa on May 8, 2002, at 17:55:18
In reply to lacebo as effective - probably not... I would hope, posted by Uppendown on May 7, 2002, at 17:46:23
When I first heard this news story on the radio, it was hyped with a rather sensationalist tone. Later, reading the newspaper article, it also had a provocative tone to it. After reading the whole article, I think the finding was actually that brain scans of subjects given placebo in AD trial studies showed similar changes in the frontal lobe to the scans of subjects given the ADs in the trials. The researchers guess that some combination of placebo effect and the kind of attention subjects are given in these trials, is what is behind the findings. The conclusion hyped in the headlines, that sugar pills are as effective as ADs, is, imho, a major jump from the actual findings. Here's why:
First of all, the review only accounts for the first 8 weeks of treatment, with no mention in the news story about what happens in the longer term. Secondly, it is a big assumption to make to assume that these particular frontal lobe changes, detected in these brain imaging scans, are the be all and end all of effectively improving symptoms of depression! These changes are simply what was observed. Buried deep in the news article is mention of the likelihood that other, more significant brain changes are involved in remitting depression through AD treatment, such as changes in the hippocampus, for example. Looking at imaging of frontal lobe changes is simply one view of what effects the placebo and ADs have on the brain! And we don't even know how significant these changes are.
Consider the extraterrestrial who comes to earth to observe the driving behavior of humans. After careful observation, he reports back to his superiors many findings, including those about the traffic signaling systems that humans use. He tells them, Red means "stop". Green means "go". And yellow means "go very very fast."
OK, not exactly analogous here, but you get the point about drawing conclusions based on observing a single factor. It could be spurious, or only parially causative. I doubt it is the whole story in how the brain changes in depression treatment.
So, in other words, IF these frontal lobe changes, and only in the first 8 weeks of treatment, are the be all and end all of desired brain effects to alleviate depression, well, then, simply noting the similarity in frontal lobe changes between ADs and placebos might be logical. But the scannable frontal lobe changes is only one measure of brain effect, and there is no proof that it is these changes that are what is responsible for remitting depression.What bothers me is how this story was handled. I do wonder who sponsored the review, and whether it was their press release that set the sensationalist tone, or was that set by the news media picking up on the release? I'd sure like to see the original release, and find out what agenda is behind it.
On a personal note, I have tried a number of medications, and am absolutely certain that my depression would not have responded to a sugar pill.
poster:noa
thread:105430
URL: http://www.dr-bob.org/babble/20020503/msgs/105634.html