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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 74. This is the beginning of the thread.
Posted by bulldog2 on February 17, 2007, at 13:07:07
See link below
Posted by willyee on February 17, 2007, at 16:15:58
In reply to Why Most New Antidepressants Are Ineffective, posted by bulldog2 on February 17, 2007, at 13:07:07
Great article,and not the first time i have read about the hidings of the initial SSRI trials.
Posted by Quintal on February 17, 2007, at 19:35:46
In reply to Why Most New Antidepressants Are Ineffective, posted by bulldog2 on February 17, 2007, at 13:07:07
That's an excellent link bulldog. I particularly agree with him about Parnate being one of the most effective antidepressants, yet one of the most poorly researched. It was an interesting read and very encouraging for someone in my position.
__________________________________________________
The major remaining alternative drug treatment to remember is the old MAOIs, particularly tranylcypromine. Ironically, that is the one drug for which there is the very least amount of controlled trial evidence, yet the one drug that most experienced psychopharmacologists agree is indispensable for the treatment of severe illnesses. I would submit that this is yet another major example of the unhelpfulness of controlled trials of medication and the bias produced by pharmaceutical company sponsorship in the perceived relative effectiveness of treatments. In my opinion tranylcypromine is the most under-used antidepressant available. It is the one I would take, and the one I would give to my nearest and dearest, if any of us became ill. The supposed problems and ‘dangers’ of MAOIs are greatly exaggerated (see my information on MAOIs), In my opinion, to the point of hysteria.
Is there anything you can do if you want to learn about what antidepressant treatment strategies actually do work? I suggest my essay on dual action antidepressants is a good place to start.
__________________________________________________
Q
Posted by flmm on February 17, 2007, at 20:07:49
In reply to Re: Why Most New Antidepressants Are Ineffective » bulldog2, posted by Quintal on February 17, 2007, at 19:35:46
If they don't work for you, don't take them!
Posted by Quintal on February 17, 2007, at 20:23:06
In reply to Re: Why Most New Antidepressants Are Ineffective, posted by flmm on February 17, 2007, at 20:07:49
Thank you. I don't take them.
Q
Posted by Phillipa on February 17, 2007, at 21:26:41
In reply to Re: Why Most New Antidepressants Are Ineffective » flmm, posted by Quintal on February 17, 2007, at 20:23:06
Bye Bye luvox. Cutting down again tonight. Love Phillipa never thought I needed an ad only the anti anxiety benzos and that still stands.
Posted by willyee on February 17, 2007, at 21:28:30
In reply to Re: Why Most New Antidepressants Are Ineffective, posted by flmm on February 17, 2007, at 20:07:49
> If they don't work for you, don't take them!
Thats not the issue at hand,the discussion was how true the facts are that critical information was witheld about ssris,if this is true is extremly important in my eyes to know,and believe it fits this boards topic like a glove.
No one is suggesting anyone not take them or the like,i personaly wouldent advise anyone to stop something that worked,beit church,nutrients,ssris etc.
BUT i am intersted since ive heard this in numerous places that information was misleading,i wanna know if i was misinformed about taking a mind altering drug,this is extremly vital information whether a drug is helpful or not.
Posted by Declan on February 18, 2007, at 1:54:55
In reply to Re: Why Most New Antidepressants Are Ineffective, posted by willyee on February 17, 2007, at 16:15:58
‘why didn’t some bastard put me on this 30 years ago’.
Did you see that this bloke comes from North Queensland, Australia?
Posted by Quintal on February 18, 2007, at 2:11:14
In reply to Why Most New Antidepressants Are Inneffective, posted by Declan on February 18, 2007, at 1:54:55
Yes, I saw that he lives in Australia now, but didn't he work in the UK during the 70's? Where did you get that quote from?
Q
Posted by Declan on February 18, 2007, at 2:17:26
In reply to Re: Why Most New Antidepressants Are Inneffective » Declan, posted by Quintal on February 18, 2007, at 2:11:14
From Psychopharmacology updates (I think) and you follow that to MAOIs, about which he has stuff to say.
The quote was about Parnate.
Posted by blueberry1 on February 18, 2007, at 6:03:26
In reply to Why Most New Antidepressants Are Ineffective, posted by bulldog2 on February 17, 2007, at 13:07:07
The title is misleading. Forget the clinical studies. Go to remedyfind.com and askapatient.com to see real world people experiences with ssris. A good number of them do very well with ssris. The title is an inaccurate over-generalization.
I understand the manipulation of clinical data, ghost writers, big pharm influence, and behind the scenes scandals of facts. That stuff really disturbs me.
Regardless, judging from real world experiences with ssris, it appears maybe 35% - 45% of people really benefit from them. That is a far cry from saying they are ineffective.
I'm not sure why he praises parnate so much. There have been plenty of people here and other places that did poorly with. Side effects often require 2 or 3 other meds to deal with, when it works. I would guess in the real world the actual positive benefits of parnate compared to ssris are probably a little higher than ssris, but not enough to totally trash ssris and put parnate on a pedestal.
Anyway, bottom line, mileage varies. I totally respect the authors views, but feel the title is a bit inaccurate and overgeneralized.
Posted by cloudnine on February 18, 2007, at 6:41:31
In reply to Re: Why Most New Antidepressants Are Ineffective, posted by blueberry1 on February 18, 2007, at 6:03:26
I do not know, but Ive tried every single AD that is out there including Clomipramine and Parnate,and the only ADs thar really gave me a benefit were Imipramine,Fluoxetine and now the other great AD Venlafaxine (Duloxetine was useless).So I guess everyone is different and it what works for x may not work for another.Im grateful there are many types of medications,but I agree that some big pharmas produce nearly the same medications just to benefit like Mianserin/Mirtazapine , Trazodone/Nefaxodone, Citalopram/Escitalopram
Just an opinion
Posted by Squiggles on February 18, 2007, at 7:31:45
In reply to Why Most New Antidepressants Are Ineffective, posted by bulldog2 on February 17, 2007, at 13:07:07
How depressing! Whether true or false,
I'm glad I am on lithium. It's a relatively
difficult drug to adjust and monitor for the
physician, and very old (Carl Lange of 'Theory of Emotions' first used it),
but it works - no doubt.I don't know if everything that is said by
this camp is true. I read materials like Robert
Whitaker's book, and can't help but feel indignant about this medical area. But then, I never really know whether the problem is the drugs, or the sloppy treatment and lack of understanding in applying them.Squiggles
Posted by linkadge on February 18, 2007, at 8:38:18
In reply to Re: Why Most New Antidepressants Are Ineffective, posted by blueberry1 on February 18, 2007, at 6:03:26
>Regardless, judging from real world experiences >with ssris, it appears maybe 35% - 45% of people >really benefit from them. That is a far cry from >saying they are ineffective.
Yeah, and 35-45% of people benifit from placebo.
Linkadge
Posted by willyee on February 18, 2007, at 9:34:43
In reply to Re: Why Most New Antidepressants Are Ineffective, posted by blueberry1 on February 18, 2007, at 6:03:26
> The title is misleading. Forget the clinical studies. Go to remedyfind.com and askapatient.com to see real world people experiences with ssris. A good number of them do very well with ssris. The title is an inaccurate over-generalization.
>
> I understand the manipulation of clinical data, ghost writers, big pharm influence, and behind the scenes scandals of facts. That stuff really disturbs me.
>
> Regardless, judging from real world experiences with ssris, it appears maybe 35% - 45% of people really benefit from them. That is a far cry from saying they are ineffective.
>
> I'm not sure why he praises parnate so much. There have been plenty of people here and other places that did poorly with. Side effects often require 2 or 3 other meds to deal with, when it works. I would guess in the real world the actual positive benefits of parnate compared to ssris are probably a little higher than ssris, but not enough to totally trash ssris and put parnate on a pedestal.
>
> Anyway, bottom line, mileage varies. I totally respect the authors views, but feel the title is a bit inaccurate and overgeneralized.Actualy ive read and i wish i had the article/articles handy that documented studies did show parnate to be one of the most fast & effective drugs for depression,Nardil the old one as well,in fact the old Nardil used to be nick named the GOLD STANDERD.
Along with the parnate statistics however the drug prob holds the highest or close to addiction potential,so you always get some form of major con.
Your right however,studies from any source,PERIOD doesent overide actual experiance,and mileage varies,although i do agree with the findings i also agree if someone does well on any drug that is helpng all around then they have no reason to look else where just because of some documented study.
Remedyfind shows parnate less effective overall because u can see the users invovled are far far far less than a user of ssris,this is prob common since again maois are strayed by most docs as not to be used.
Also,like maois,most people on ssris will also have a adjunct med like a benzo or mood stablizer as most ssris,especaily when working well tend to cause some over excitement,im sure you know the term polypharmacy which is multiple drugs used,and with the complex way the brain works,during the lentgh of a day it actualy makes sense that more than a single drug would be best.
Sadest thing of all to me is that a drug "parnate" from the what..50`s is still even considered one of the better ones,it just shows to me the slow advancments were making,i truly believe as long as patients listen to docs about not going off on there own to research,sometimes scared into doing a thing without talking to them,etc,.....as long as these drugs and cousin drugs make such big money,im afraid and almost certain i wont see any serious new line treatments in my lifetime,and ill be either off or juggling drugs for a very long time.
All debates aside,everyone has a similiar goal,and if you feel better on any form of treatment,then recomend it as a option,and from there on dont worry what others say and enjoy it,we spend to much time defending what works i think,aim to live life as full as you can !
Posted by flmm on February 18, 2007, at 10:32:51
In reply to Re: Why Most New Antidepressants Are Ineffective, posted by willyee on February 18, 2007, at 9:34:43
Antidepressants help many people, period! Are they perfect? NO! They make a significant difference in my, and many other people I know, lives. Anxiety and depression is a complex and difficult disease. The drugs can only do so much! Maybe some of you complainers should look at other ways to help yourself, and be grateful for the help available to us!
Posted by linkadge on February 18, 2007, at 10:41:02
In reply to Re: Why Most New Antidepressants Are Ineffective, posted by flmm on February 18, 2007, at 10:32:51
I don't consider stating facts complaining.
Linkadge
Posted by Squiggles on February 18, 2007, at 11:13:13
In reply to Re: Why Most New Antidepressants Are Ineffective, posted by linkadge on February 18, 2007, at 10:41:02
> I don't consider stating facts complaining.
>
> LinkadgeI think it would be interesting to see how many
posters here aredoctors
medical students
patients
SSRI takers
AD takers
ATYPICAL AD takers
Benzo takers
Lurkers
Drug company reps
Naturo or herbal therapy takers
Addicts on hard drugs- and see how many are currently unhappy or
mentally distraught from their medical condition.I have noticed that many are very lucid in their writing (are they stable on the meds or not taking meds?) and some cannot spell or have trouble posting their complaints (are they non-medicated or perhaps over-medicated). And then there are the ones who are too sick to post or have left for some reason or another.
I think that would be revealing of how well this group is doing on medications.
Squiggles
Posted by madeline on February 18, 2007, at 11:51:06
In reply to Why Most New Antidepressants Are Ineffective, posted by bulldog2 on February 17, 2007, at 13:07:07
That big pharma has with intention misled the public, the medical community and all of the regulatory agencies.
Let's also assume that these new drugs are actually awful and any efficacy that has been noted has been disproportionally reported.
I would even go so far as to say, as the author quoted, that the for profit venture of making medicine has fueled every bit of this deceit. That a mere 10% of the operating budget devoted to R&D is a mere pittance of what it should be in these companies.
All that being true what, exactly, are we prepared to do about it?
10% R&D of the operating budget from big pharma is probably more than 1000X money than the best NIH funded laboratory in the US gets from the gov't.
If you combined all of the R&D budgets from big pharma it is probably more than the ENTIRE NIH budget, and the NIH funds everything from basic research on up and not just drug discovery.
If you took the for profits out of the game entirely, then you wouldn't have anything at all.
So regulate them? They already are. Expose them? Keep going. Demand better drugs and reporting? Absolutely, the market drives the product.
But nothing is going to change until people start putting their money where their mouth is.
Posted by Squiggles on February 18, 2007, at 11:54:40
In reply to So let's just assume that it's all true., posted by madeline on February 18, 2007, at 11:51:06
I think they should build clinics
and hire doctors, nurses and medical
technicians-- to help the present
stressed situation of dr. and hospital
overload.There should be economic and educational
collaboration between the drug companies
and the medical public sector.Squiggles
Posted by willyee on February 18, 2007, at 12:19:11
In reply to Re: Why Most New Antidepressants Are Ineffective, posted by flmm on February 18, 2007, at 10:32:51
> Antidepressants help many people, period! Are they perfect? NO! They make a significant difference in my, and many other people I know, lives. Anxiety and depression is a complex and difficult disease. The drugs can only do so much! Maybe some of you complainers should look at other ways to help yourself, and be grateful for the help available to us!
Perhaps re read the thread,no one is stating they are not grateful meds are available,but im not gonna sit down and never be concerned if there is misleading facts being presented,i WANNA KNOW.
Im not the guinia pig in the maze,i wanna know that what im told when i reasearch a drug is not half truths,im sorry if you feel this is complaning.
Is my concern to simply feel safe and that i can trust information any less important than yourself benfiting from it?
Posted by Quintal on February 18, 2007, at 13:39:54
In reply to Re: Why Most New Antidepressants Are Ineffective, posted by blueberry1 on February 18, 2007, at 6:03:26
Blueberry, haven't you yourself taken umpteen different meds over recent months and found not only were they ineffective, but they made your depression worse? It surprises me then, to hear you being so critical of this author's work. Have you ever taken Parnate or any other MAOI? From what I recall from your posts you have not. I suggest you actually try one and see if it helps your depression rather than relying on reports from RemedyFind, most of which don't seem to reflect your own experiences with newer antidepressants in any case.
Q
> The title is misleading. Forget the clinical studies. Go to remedyfind.com and askapatient.com to see real world people experiences with ssris. A good number of them do very well with ssris. The title is an inaccurate over-generalization.
>
> I understand the manipulation of clinical data, ghost writers, big pharm influence, and behind the scenes scandals of facts. That stuff really disturbs me.
>
> Regardless, judging from real world experiences with ssris, it appears maybe 35% - 45% of people really benefit from them. That is a far cry from saying they are ineffective.
>
> I'm not sure why he praises parnate so much. There have been plenty of people here and other places that did poorly with. Side effects often require 2 or 3 other meds to deal with, when it works. I would guess in the real world the actual positive benefits of parnate compared to ssris are probably a little higher than ssris, but not enough to totally trash ssris and put parnate on a pedestal.
>
> Anyway, bottom line, mileage varies. I totally respect the authors views, but feel the title is a bit inaccurate and overgeneralized.
Posted by Quintal on February 18, 2007, at 13:59:10
In reply to Re: Why Most New Antidepressants Are Ineffective, posted by Squiggles on February 18, 2007, at 11:13:13
Okay, I for one am not taking any prescribed psych meds at the moment. I am taking codeine in the form of OTC painkiller tablets, which I seem to be addicted to. I am in the process of weaning myself off them. I also take these herbs;
Rhodiola Rosea in the morning as a mild stimulant and mood elevator (think caffeine but without jitteriness).
Agnus Castus - as is often the case with naturals I'm not entirely sure why I'm taking it to be honest, but it does seem to have a positive effect on my mood and anxiety as I've found out from skipping doses for a few days and finding myself nervous and overwrought. I seem to find emotional balance again after a day or two of taking it again. Scientific studies have shown it is (among many other things) a mild D2 antagonist (like antipsychotics) and balances hormone levels (quite how I don't know).
Valerian, hops, passion flower, melissa, opium lettuce; a compound preparation of sedative/hypnotic herbs take at night to aid restful sleep. It does seem to be effective.
Melatonin; 3-9mg slow-release tablets as a sleep cycle regulator and hypnotic. It does seem to be effective.
I have a hard time convincing some people here that I'm not anti-med or anti-psychiatrist because of the above, but I can assure you I was once *very* anti-alternative and very pro-med and nobody is as surprised as myself to find me in this position after five years of taking nearly every psychoactive substance available in the BNF (that is not an exaggeration). I'm in the process of compiling a spreadsheet of all the drugs I've taken along with doses, side effects, tolerability etc. I may post it here after I'm finished if anyone would like to see it.
Q
> I think it would be interesting to see how many
> posters here are
>
> doctors
> medical students
> patients
> SSRI takers
> AD takers
> ATYPICAL AD takers
> Benzo takers
> Lurkers
> Drug company reps
> Naturo or herbal therapy takers
> Addicts on hard drugs
>
> - and see how many are currently unhappy or
> mentally distraught from their medical condition.
>
> I have noticed that many are very lucid in their writing (are they stable on the meds or not taking meds?) and some cannot spell or have trouble posting their complaints (are they non-medicated or perhaps over-medicated). And then there are the ones who are too sick to post or have left for some reason or another.
>
> I think that would be revealing of how well this group is doing on medications.
>
> Squiggles
Posted by Squiggles on February 18, 2007, at 14:22:12
In reply to Re: Why Most New Antidepressants Are Ineffective » Squiggles, posted by Quintal on February 18, 2007, at 13:59:10
Well, you sound lucid; and content with
your herbal meds. I'm not going to remark
on this... thanks for your response.Squiggles
Posted by linkadge on February 18, 2007, at 15:36:31
In reply to Re: Why Most New Antidepressants Are Ineffective » Squiggles, posted by Quintal on February 18, 2007, at 13:59:10
>Scientific studies have shown it is (among many >other things) a mild D2 antagonist (like >antipsychotics) and balances hormone levels >(quite how I don't know).
I was under the impression that agnus cascus was a d2 agonist not antagonist.
Linkadge
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