Posted by doxogenic boy on October 18, 2013, at 18:22:39
In reply to Re: Irving Kirsch, placebos and antidepressants, posted by SLS on October 18, 2013, at 14:54:37
> > lots of patients in the studies weren't depressed in the first place.
>
> Exactly.
>
> > (I think they got money for participating in the studies.)
>
> Exactly.
>
> > Therefore the placebo response looks higher than it is.
>
> Exactly.
>
> What do you think about this?
>
> Perfect!
>
> https://www.google.com/search?q=sls+placebo+severe+mild&sitesearch=dr-bob.orgI didn't know you had discussed Kirsch's articles before. I have now read some of it, such as this post:
http://www.dr-bob.org/babble/20050728/msgs/536653.html(See this article: http://web.archive.org/web/20050212082903/http://www.journals.apa.org/prevention/volume5/pre0050024c.html )
I will read more of the earlier placebo debate tomorrow. Here is a critical comment to Kirsch's article in PLOS Medicine:
http://ebmh.bmj.com/content/11/3/66.full
Excerpt from the link above:
Evid Based Mental Health 2008;11:66-68 doi:10.1136/ebmh.11.3.66
EBMH Notebook
Do antidepressants work? A commentary on Initial severity and antidepressant benefits: a meta-analysis of data submitted to the Food and Drug Administration by Kirsch et al
R H McAllister-Williams
+ Author Affiliations
Institute of Neuroscience, Newcastle University
Dr H McAllister-Williams, Reader in Clinical Psychopharmacology and Honorary Consultant Psychiatrist, Psychiatry, Leazes Wing, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK; r.h.mcallister-williams@ncl.ac.uk
The publication of this meta-analysis1 received a vast amount of coverage in the UK. This is despite the bottom line that the review does not report any novel findingsantidepressants work and their effectiveness increases with baseline severity of depression. This was not the picture painted in the media. Rather the conclusions drawn by the authors took an extreme viewpoint and the reviews publication was sensationalised both by the journal editor and the media.
[...]
COMMENTS ON THE AUTHORS CONCLUSIONS
Undoubtedly the findings in this analysis are robust, as far as the studies included in the analysis are concerned. The choice of the data set was based on logical reasoning in trying to avoid publication bias. However it does not include all possible data from studies completed subsequent to FDA submissions. Nevertheless, in line with many previous analyses (including NICEs own), the meta-analysis demonstrates that antidepressants are significantly better than placebo. Further, in line with previous evidence, the drug-placebo difference increases with increasing severity of baseline illness.5 The conclusion that this is due to a decrease in response to placebo rather than an increase in effectiveness of the drug is entirely fallacious because the magnitude of the therapeutic effect is the difference between active drug and placebo, not the absolute response to active drug.
End quote.
------------- doxogenic
Earlier TRD/anxiety
300 mg tianeptine, 6 X 50 mg successfully since Oct 2009
20 mcg liothyronine
40 mg escitalopram
100 mg trimipramine
50 mg agomelatine
600 mg quetiapine
poster:doxogenic boy
thread:1052457
URL: http://www.dr-bob.org/babble/20130930/msgs/1052512.html