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Re: Are ADs As Advertised?

Posted by bleauberry on March 29, 2009, at 8:31:05

In reply to Are ADs As Advertised?, posted by rradarr on March 29, 2009, at 1:18:24

As far as I can tell in the real world, the only three antidepressants that are true antidepressants worth being advertised are Parnate, Nardil, and Clomipramine. No one is going to do that with these 50 year old meds. Other ones worth advertising would be combinations of serotonin/norepinephrine meds such as Zoloft+Nortriptyline. No one is going to do that.

Clinicians can be puzzled why they do not get the same results in their practice that the clinical studies did. Clinical study patients are cherry-picked. Previous suicide attempts? Forget it, you're out. You've been depressed before? Forget it, you're out. Other medical problems? Forget it, you're out. Stuff like that, varying from study to study. In other words, the patients in the studies are often not a representative sample of the patients in a doctor's office.

Drug companies do not have to report their failed studies to the FDA when trying to get a drug approved. They only need to show the ones that succeeded. A drug can do worse than a placebo in 3 studies, better than a placebo in 2 studies, and be approved by the FDA as a blockbuster drug.

Most ADs are judged by a 50% improvement as being the threshold for "success". Well, a 50% improvement means you are still 50% sick. A more accurate way to look at it is that roughly maybe 15% to 25% of a sample of patients will reach remission.

If mental hospitals were emptied, it wasn't because of great antidepressants. None have been invented that are better than the real ones invented 50 years ago. They only appear to be better because of flaws in the clinical studies, flaws in the FDA process, and...key word from your original question...advertising. Companies spend millions of dollars to promote their products. Even more than they spend on the actual research and production. Ya know, if I go out and spend millions of dollars saying how great the pine tree is to this world, and you see the ads all over TV and on the radio and in magazines, well, the next time you see a pine tree you can't help but think what a great tree that is.

For taking some of the burden off of mental hospitals, I would give some credit to Zyprexa, Seroquel, Abilify, and Lamictal, as well as the use of polypharmacy. But not any of the antidepressants, with the exception of the 50 years olds which are still the best and totally unadvertised. Outside of the drugs, society has changed in a way that allows many of those people previously locked up to find alternative places in the world.




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