Posted by Larry Hoover on February 10, 2009, at 16:51:21
In reply to Re: Good grief...NOT a pro ssri video, posted by Connor on February 10, 2009, at 16:22:45
> "New generation anti-depressants have little clinical benefit for most patients, research suggests."
>
> http://news.bbc.co.uk/1/hi/health/7263494.stmNot that hoary misrepresentation of reality again. Kirsch completely distorted reality to come to his conclusions. I urge you to read the following posts to understand why that is so.
http://www.dr-bob.org/babble/20080221/msgs/815551.html
https://www.dr-bob.org/babble/20080420/msgs/824891.html> It's great being prescribed medication that has ruined your life, when there's not even any science to back it up. SO you're saying I could have taken a sugar pill that wouldn't f*ck up my brain and would have gotten similar theraputic benefits? Fantastic.
No, placebo would not have offered similar results.
I like this quote from Dr. Arif Khan, from the April 2000 volume of Psychiatric Times, commenting about the same set of studies looked at by Kirsch (by the way):
"The less-than-impressive results in these and other studies also calls to mind the fact that patients assigned to placebo treatment in clinical trials are not "getting nothing." The capsule they receive is pharmacologically inert but hardly inert with respect to its symbolic value and its power as a conditioned stimulus. In addition, placebo-treated patients receive all of the commonly employed treatment techniques: a thorough evaluation; an explanation for their distress; an expert healer; a plausible treatment; expectation of improvement; a healer's commitment, enthusiasm and positive regard; and an opportunity to verbalize their distress. Jerome Frank, Ph.D., in his book Persuasion and Healing: A Comparative Study of Psychotherapy made a compelling case that these parts of treatment are the active ingredients of all the psychotherapies (1993)....
A cautionary note is indicated about the generalization of these data to the clinical management of depressed patients. The less-than-impressive difference between drug and placebo in this and other studies of clinical trials does not speak directly to the effectiveness of antidepressants in clinical practice. Participants in antidepressant clinical trials are a highly select group and are not representative of the general population of depressed patients. They are not actively suicidal, they are almost always outpatients who are moderately rather than severely or mildly depressed, and they are free of comorbid physical or psychiatric illness. They are likely to have a higher placebo response rate than more severely ill depressed patients.
Furthermore, the primary aim of these studies is not to assess the optimal effect of antidepressants, but rather to rapidly assess efficacy of new drugs so they can be brought to the market. Therefore, dose, duration and diagnosis in clinical trials are not necessarily ideally suited to identify the optimal effects of antidepressants. Accordingly, clinical trials may identify the lower bound of the effect size compared to placebo."
Lar
poster:Larry Hoover
thread:879096
URL: http://www.dr-bob.org/babble/20090203/msgs/879286.html