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Re: SSRIs worsening Social Phobia?

Posted by SLS on July 19, 2005, at 10:14:09

In reply to Re: SSRIs worsening Social Phobia? » SLS, posted by Kon on July 18, 2005, at 11:12:25

Hi.

Have you ever experienced a robust antidepressant response from a medication?

I have. These drugs work. That's my bias.

I can't review the citations you provided, but I think it is great that you were able to find them. The Internet is a great place to find differences of opinion.

I am not a statistician, but I think biases are probably seen on both sides of a debate over the efficacy of antidepressants.

Approximately 30% of people will "respond" to placebo. Of course, they are not really responding to nothing, they are simply recovering spontaneously, whether it be the natural course of their illness or a psychological effect from belief that they will get well. I don't have the energy to get into a discussion of the selection criteria used for most antidepressant trials, but 30% is too high for these studies to have much meaning. I don't think many of these people belong in these studies to begin with. If you exclude the placebo responders, things look different. Most antidepressant studies report rates of response close to 65-70%. That is an excellent rate of response no matter how you look at it. Many "failed" and "weak" studies report placebo responses significantly higher than 30%. Something is wrong here. Placebo controls don't work when evaluating depression when using the current inclusion criteria.

> Given such weak evidence,

I don't agree that the evidence is weak, as I have indicated above.

why are these drugs so popular with prescribers?

They work.


- Scott

 

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