Posted by linkadge on April 19, 2008, at 10:30:17
In reply to Re: OOOOOOOOOOOOooooooooo » Betula, posted by SLS on April 19, 2008, at 7:20:02
Hi, I know I said I quit psychobabble and for the most part I have, but I was passing by and can't resist a good argument of this nature.
I have to completely agree with Betula (no surprise) and cannot let him go on this solo mission.
It reminds me of some good Simon and Garfunkle lyrics, domething along the lines of "a man hears what he wants to hear and disregards the rest", I think it was "The Boxer".
Anyhow, the point is with these drugs, is that it doesn't matter how much you talk to people about their lack of established efficacy, you are still going to get people who refuse to look at good science like this.
Then you get those babblers who are resorting to the very devices they condemn. The very babblers that suggest that single case reports are weak seem return to the logic that "they work for me, and that's all that matters". To some extend they're right, this is all that matters.
I think the study that Betula brought up is very important, becase it is infact *not* just one study. It is a meta analysis of 47 other studies and the largest one of its kind to date. As mentioned it includes data that the drug companies conveniently left out which increases its validity beyond any one single study or any previous subgroup of *more positive* released trial data.
Saying that Kirsh is biased only goes so far. If you are going to make a substantial argument that he has somehow biased this data than do so. I have not seen one person pose a good reason why his methodology is flawed in some way. He was using standard methods of statistical analysis as far as I know, can you or anyone point to his flaws?
Even those of you who publicly dismiss this study are probably saying to themselves "man, this really sucks".
The clinical trial is unfortunately the only real way to scientifically establish the efficacy of antidepressants. Other forms of persuasion are not scientific and therefore don't mean a whole lot. People poked holes in sick patients heads to let the "evil spirits" out for years and it was hard to convince them that their practice was flawed. You see, when you believe there is an association between two things, there is a tendency to only see information that favors that association and to dismiss contradictory information as being flawed. I am young enough that I can get out of the "antidepressant cult" but there are others that have been in it too long and it is unlikely that they will be able to ever get out. Its called "belief perseverance" I think. When people make certain faulty conclusions, it tends to stick even in the face of contradictory information.
Another thing to consider is this: Most people are here because their antidepressant is not working the way they would like it to. That's why I take their proclamations with a grain of salt. Many of the people here arguing may just be doing so to re-establish their faith in the drugs. It's like...it seems like you're more trying to convince yourself. Its just like my brother at Bible college. Even he admits that arguing for Christianity bolsters his faith when even he is doubting it. After all, arguing a particular point of view is the first step to believing it.
The idea that it is hard to distinguish antidepressants from placebos is not new and has long preceded this study.
What always surprises me though is that if this kind of meta analysis occurred for a cholesteral lowering drug ie. you found out that you were taking a certain cholesterol lowering drug that was generally no better than placebo, most people would note get all defensive. Probably because there isn't the same kind of surge in introspection upon initiation of a cholesterol drug.
The argument for endogenous depression is a valid one. But, provide me any data anywhere that the current line of antidepressants addresses any one proven chemical imbalance. For instance, the majority of the findings suggest that SERT activity is in fact low in depression. You're not targeting any imbalance by giving SERT inhibitors to these individuals. Other studyies suggest that NET is low and even MAO is decreased.
People can, and often do feel better off drugs. This is in no way a sign that their depression is not due to some biochemical abnormality. Like mentioned above, it would seem reasonable to me that an individual with an already abnormally low level of the serotonin transporter takes a drug that lowers it further, they may just feel worse. I know severely depressed individuals who simply feel worse on drugs period. Psychiatry does not have all the tools and all the answers.
If anything I would hope that some of the current studies could help liberate certain individuals. You see people on this board who have never (or rarely) helped by an antidepressant, yet they somehow feel that the drugs work and there is something wrong with them when they don't. I would hope that data like this would be liberating. I.e. perhaps by seeing that they don't work for others too, they might stop beating themselves up about the issue and go look for answers somewhere else.
So, I digress. The establishment of a solid logical arugument does not depend on the ability to convince of any one individual. The more I am away from babble the more I realize how much "GroupThink" goes on here. One person talks about a drug then all of a sudden another person needs it. Also, the more time you spend on a board discussing drugs, the more you don't see the other ways that you can address your problems. Petting a dog will raise your serotonin you know.
Its just like some of the issues brought up by Bulldog. Many people are just at their wits end in terms of who to believe about who has the answers for their problems. Believing that prescription antidepressants are the only ways to solve your problems is seductively convenient. It allows you to narrow your focus and disregard other useful information. It makes life easy, or does it?
If the drugs work for you, then great: live happily ever after. For the rest of us, don't be so surprised and upset when you're not getting prozac.com type results. Trust yourselves for a change, and reflect critically upon data like this. It may be more liberating than you know.
Anyhow, I just thought I'd stop by and say hi.
To somebody who was on lithium, zoloft, depakote, zyprexa, clonazepam and ritalin, (all at once) and told by top psychiatrists that I will never be able to live medication free, diet, exercise, and certain supplements have gone a long way.
Obviously not all cases are like this, but the point I am trying to make is to never stop rethinking and reasessing exactly what the meds are and are not doing for you.
Linkadge
poster:linkadge
thread:823248
URL: http://www.dr-bob.org/babble/20080412/msgs/824231.html