Psycho-Babble Medication | about biological treatments | Framed
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Posted by Elizabeth on August 16, 1999, at 20:08:20

In reply to Re: weight gain on SSRIs - continued, posted by Adam on August 15, 1999, at 16:20:11

First, my thanks to Racer for the flattery .

Second, to Adam....

> Accusations of naivite or unethical behavior are ones I certainly never wanted to make or insinuate.

No...I didn't mean to imply that you were. Annie had called me "naive" and seemed to be saying that we should assume unethical behavior since we can't prove there wasn't any.

One of the authors of the study under discussion, Frederic Quitkin, has actually put a great deal of effort into what one might call "meta-research" - researching ways to make research more reliable (for example, by studying the "placebo effect"). I've always been very impressed by the innovative work of Quitkin and his colleagues, and also by their apparent devotion to making clinical research more accurate.

> Having seen grant money in action, all I can say is that where it comes from can have an influence.

Oh, c'mon, you can say more than that. Tell us some scandalous stories. :-)

> A healthy dose of skepticism is always warranted, which does not mean one should be paranoid or dismiss everything that a party with a certain vested interest has to say.

This is something that I think people do in regard to Lilly-funded studies. Not that it's totally unwarranted (as I noted before, *nobody* trusts Lilly!), but I do think people should look at who's doing the actual research. The chief author listed here is a Lilly researcher, but others are affiliates of respected teaching hospitals (such as Mass. General).

> I've seen brilliant competitors in academia hurl various ideological and philosophical spitwads at one another, produce totally contradictory results in attempts to repeat the other's experiments, accuse one another of being idiots, shitheads, what have you.

Yeah, isn't it great? Makes me feel better about occasionally losing my temper.

> My assumption is that SSRI-induced weight gain is real and could be teased out as a bona fide side effect in some individuals, including me.

Yes. I think you and I are 100% in agreement on this one. Reading on...

> Tegretol use has been associated with agranulocytosis and aplastic anaemia. If I were to conduct a tegretol study and monitor 1000 individuals for a year I might never see these terrible side effects and conclude they do not occur. Of course, these conditions are exceedingly rare and can't be equated with something as mundane as putting on weight.

No, they can't be equated with it, but perhaps weight gain is also rare..."below the statistical radar," I like to say. Another example of this is the controversy over whether SSRIs cause increased aggressive-impulsive behavior in some individuals: if they do, it's very rare, but it should be watched for because it is serious.

Indeed, I think physicians don't take weight gain seriously enough, perhaps because they write it off as "just" a self-image issue. Actually, though, it's a serious health risk...young people who gain weight are at increased risk for cardiovascular problems and diabetes mellitus later in life.

> I think because of the severity of such side effects few physicians would be prepared to dismiss the Tegretol connection. There is certainly a higher incidence of, say, agranulocytosis among Tegretol users than among the general population. For good resons, the association is considered real despite the fact that there might be little justification for such a conclusion on the grounds of certain statistical tests. This is a hypothetical situation, I know, but I think a plausible one.

I agree, and at present I think it is the most likely one. I don't mean to say that there aren't people who gain weight as a result of some specific effect of an SSRI, but when people claim that an SSRI "caused" weight gain for them, I'm always tem




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