Posted by Jlx on October 12, 2006, at 19:28:54
In reply to Lack of research behind herbs legitimate complaint, posted by psychobot5000 on October 12, 2006, at 11:08:10
>And indeed, even better-known remedies like hypericum certainly do not have enough evidence (in terms of study-size, results, double-blind quality, and research into toxicity at the very least) to compare with approved pharmaceutical remedies. As a drug, even hypericum would be kicked back for another 200 million dollars of research before it were approved. There is legitimacy to the point of view suggesting that many herbal uses are not supported, or not supported adequately, by science.
Are you sure?
"St. John's Wort Versus Placebo
Double-blind, placebo-controlled trials involving a total of more than fifteen hundred participants with major depression of mild to moderate severity have generally found that use of St. John's wort can significantly reduce HAM-D scores as compared to placebo.21–28,89,105,123
For example, in a 6-week trial, 375 individuals with average 17-item HAM-D scores of about 22 (indicating major depression of moderate severity) were given either St. John's wort or placebo.89 Individuals taking St. John's wort showed significantly greater improvement than those taking placebo. ...
St. John's Wort Versus Medications
At least eight double-blind trials enrolling a total of over twelve hundred people have compared St. John’s wort to fluoxetine (Prozac), citalopram (Celexa), paroxetine (Paxil) or sertraline (Zoloft).3132,33,90,91,107,108, 117-118 In all of these studies, the herb proved as effective as the drug, and generally caused fewer side effects.
In the largest of these trials, a six week study of 388 people with major depression of mild-to-moderate severity, St. John's wort proved equally effective as the drug Celexa (citalopram) and more effective than placebo. 118Additionally, Celexa caused a significantly higher rate of side effects than St. John's wort. There were also significantly more side effects in the placebo group than in the St. John's wort group -- presumably because treatment of depression reduces physical symptoms of psychological origin.
St. John’s wort has also been compared to older antidepressants, with generally favorable results. 34 -38"
Refer to the link for the footnotes: http://healthlibrary.epnet.com/GetContent.aspx?token=e0498803-7f62-4563-8d47-5fe33da65dd4&chunkiid=31050#ref21
Now to say that SJW is as effective as some ADs is saying what exactly?
2002: "Through a Freedom of Information Act request, two psychologists obtained 47 studies used by the FDA for approval of the six antidepressants prescribed most widely between 1987-99.
Overall, antidepressant pills worked 18% better than placebos, a statistically significant difference, "but not meaningful for people in clinical settings," says University of Connecticut psychologist Irving Kirsch. He and co-author Thomas Moore will release their findings July 15 in Prevention and Treatment, an e-journal of the American Psychological Association.
More than half of the 47 studies found that patients on antidepressants improved no more than those on placebos, Kirsch says." http://www.usatoday.com/news/health/drugs/2002-07-08-antidepressants.htm
And just who is in these clinical trials?
"Trials to determine the effectiveness of antidepressants have historically evaluated only a small subset of depressed individuals with a very specific clinical profile. People diagnosed with other psychiatric problems and people with mild depression are among those excluded, says the study, which appears in the March 2002 American Journal of Psychiatry.
“When you take any medicine you assume it’s been found to be effective for your condition,” said Mark Zimmerman, associate professor of psychiatry and human behavior, director of outpatient psychiatry at Rhode Island Hospital, and the study’s lead researcher. “No one knows for sure whether antidepressants are effective for most of the patients we treat.”...
To determine whether the clinic patients would qualify for the drug studies, the researchers reviewed inclusion and exclusion criteria used in 31 antidepressant trials published from 1994 to 1998 in five leading psychiatric journals. Many of the studies excluded patients who had psychotic features, a history of manic episodes, suicide risk, unstable medical illnesses, or a history of drug or alcohol abuse. Several also excluded subjects with eating disorders, obsessive-compulsive disorder or panic disorder.
Nearly all of the studies excluded patients who fell below a cutoff score on a measure of symptom severity, even though they were diagnosed with major depression. “We are not aware of any other medical condition in which individuals with the disorder are routinely excluded because they are not sick enough,” said Zimmerman.
“Drug companies are concerned that individuals with mild depression will respond just as well to a placebo as they will to antidepressant medication,” said Zimmerman. “However, this represents a sizable number of individuals who are prescribed these medicines, especially by primary care physicians.”...
“Drug companies have been correct in assuming that if they show their medicine works for a highly select group of depressed patients, physicians will use it for all patients,” said Zimmerman."
http://www.brown.edu/Administration/News_Bureau/2001-02/01-091.html
The National Institutes of Mental Health is funding a "real world" study that has been reported on throughout the year.
"First Antidepressant Fails 70% of Time" http://aolsvc.health.webmd.aol.com/content/Article/116/112381.htm?pagenumber=1
30% remission rate is the same as the expected placebo rate.
In the subsequent trials of further drugs for those for whom the first drug didn't work, the remission rates went down.
"Subsequent Treatment Strategies for Persistent Depression Yield Modest Results" http://www.nimh.nih.gov/press/stardphase3and4.cfm
>Herbalists are also rash and ill-informed.
Are they? How many people actually consult trained herbalists? Clerks in health stores are generally not trained herbalists.
>Sigh...it's not an easy issue, I guess. I don't mean to offend, but I feel people exaggerate the benefits of herbs as much as those of drugs, disregard irresponsible practices by herbalists, and forget that alternative medicine is also an industry. A balanced view is necessary.
I agree, it's not an easy issue. I think people have to be well informed, or find people who are about alternatives.
I also believe that the whole point of alernative therapies is to be holistic in using them.
Expecting to substitute "something" alternative for a drug "something" is not realistic, imo.I was suicidally depressed while on various meds, on disability for years, and now I'm working again and feel pretty good these days from being my own alternative practitioner. :)
JL
poster:Jlx
thread:691467
URL: http://www.dr-bob.org/babble/alter/20060817/msgs/694260.html