Posted by Larry Hoover on December 16, 2005, at 21:13:48
In reply to Re: Dr. Tracy on SSRIs.., posted by linkadge on December 16, 2005, at 20:06:15
> >Maybe. Placebo response is the bugbear of mood >disorder treatment. Placebo response in e.g. >positive symptom schizophrenia is estimated at < >3%. Here is an excellent article about the >difficulties in interpretation that arise >because of the clinical trial system for >medication being inappropiate for mood disorder >treatments.
> When you have a drug that is oftentimes performing no better than placebo, you'd better make sure it is safe. Thats what sparks this contoversy, the combination of questionable efficacy, and questionable safety.
Fine. Let's just keep using tricyclics, which on every measure, come up worse than SSRIs.
> I don't think you have bipolar disorder, do you ?No, I do not. Unless you accept other nosologies, where AD-induced mania is a form of bipolar.
>>That's why they did these studies. Healy's an author on the first one.>>A meta-analysis of 702 clinical trials....
>>http://bmj.bmjjournals.com/cgi/content/full/330/7>488/396>"Discussion Our systematic review, which included a total of 87 650 patients, documented an association between suicide > attempts and the use of SSRIs. We also observed several major methodological limitations in the published trials."
> >And, another, of 477 more....
>> http://bmj.bmjjournals.com/cgi/content/full/330/7>488/385> "Increased risks of suicide and self harm caused by SSRIs cannot be ruled out"
> Thanks, that saves me the trouble.What, of reading them?
From the first of those two:
"In comparing fatal suicide attempts, we did not detect any differences between SSRIs and placebo (0.95, 0.24 to 3.78). "From the second one:
"The pooled odds ratio (with 95% credible intervals) for all SSRIs compared with placebo treated subjects in relation to suicide was 0.85 (0.20 to 3.40)."Considering that a clinical trial seldom exceeds 10 weeks, and the critical danger period for suicidal act is most definitely within these ten weeks, the failure to discover any evidence for an increase in suicide would tend to fail to support your/Tracy's hypothesis. One could fairly argue that the SSRIs were modestly protective against suicide.
END
poster:Larry Hoover
thread:587690
URL: http://www.dr-bob.org/babble/20051211/msgs/589687.html