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Re: We need placebo Kon

Posted by SLS on August 2, 2005, at 9:53:55

In reply to Re: We need placebo SLS, posted by Kon on August 2, 2005, at 0:25:39

Hi Kon.

> Thus there seems to be little support for the suggestion that recent failure to find marked differences between antidepressants and placebo is due to recruitment of patients with mild depression that is less responsive to antidepressants

My conjecture is not that people with mild depression are less responsive to antidepressants. It is that they are far more apt to respond to placebo.

Kirsch et al. has stimulated debate. His reviews post-hoc are not the only ones that exist, though. It has been several years since he reached a conclusion for which he seems to now search out affirmation. This is, of course, part of the process, but it seems to me that his search is resulting in his reaching a bit to far for coroboration.

Regarding Kuhn, old ideas are not invalid simply because of their age.

In his conclusion, Kirsch writes:

"The NICE review data suggest that selective serotonin reuptake inhibitors do not have a clinically meaningful advantage over placebo"

It is his interpretation of the data that suggests to him affirmation of his thesis, not the data itself.

These drugs work. Many of us who have experienced the profound therapeutic effects that these drugs exert would consider there to be something profoundly wrong with the conclusions of Kirsch and others who are still reluctant to acknowledge that a relatively smaller statistical separation of drug versus placebo in our current investigations is significant and sufficient when it comes to evaluating antidepressants as efficacious.

One comment about Kirsch's work can be found here:

http://www.journals.apa.org/prevention/volume5/pre0050024c.html


- Scott

 

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