Psycho-Babble Medication Thread 16263

Shown: posts 1 to 15 of 15. This is the beginning of the thread.

 

Medscape article

Posted by Noa on December 5, 1999, at 20:32:51

I am on a Medscape "mailing list" and this week's articles included this one, that I thought I would pass on to you. I haven't read the article yet. Also, apparently a generic buproprion has been ok'ed.

MOST DEPRESSED PATIENTS REPORT ADVERSE EFFECTS, LIMITED EFFICACY WITH
ANTIDEPRESSANTS
Findings from an online survey of 2,370 patients treated for depression
within the past 5 years show that a majority report significant side
effects.
http://psychiatry.medscape.com/14543.rhtml

 

Re: Medscape article

Posted by Phil on December 5, 1999, at 20:49:19

In reply to Medscape article, posted by Noa on December 5, 1999, at 20:32:51

Hey Noa, I just read that. Heck, they could have just come to psycho-babble land and figured that out!

Phil

 

aCk! 8*P

Posted by Bob on December 5, 1999, at 21:31:45

In reply to Re: Medscape article, posted by Phil on December 5, 1999, at 20:49:19

more fuel for the anti-psychiatrists ... blech.

b

 

Re: aCk! 8*P

Posted by Cindy on December 5, 1999, at 21:37:04

In reply to aCk! 8*P, posted by Bob on December 5, 1999, at 21:31:45

> more fuel for the anti-psychiatrists ... blech.
>
> b
Not necessarily fuel for the anti-psychiatrists...real stats for the drug companies, to encourage them to come up with new AD's that don't have so many bad side-effects (including the infamous SSRI-induced sexual dysfunction that the drug companies pretend doesn't happen and doesn't matter)!--Cindy

 

Re: aCk! 8*P

Posted by dj on December 6, 1999, at 0:50:45

In reply to Re: aCk! 8*P, posted by Cindy on December 5, 1999, at 21:37:04

And the anti-psychs. are correct in that the drug companies cook the books, perhaps not to the degree that they sometimes insinuate BUT there is a basis in fact for the insinuations which are based on sloppy and distorted research methodolgy. The latter was noted in a meta-review of pharmaceutical studies which I heard cited recently, on CBC-Radio, I believe...PT Barnum lives!

> > more fuel for the anti-psychiatrists ... blech.
> >
> > b
> Not necessarily fuel for the anti-psychiatrists...real stats for the drug companies, to encourage them to come up with new AD's that don't have so many bad side-effects (including the infamous SSRI-induced sexual dysfunction that the drug companies pretend doesn't happen and doesn't matter)!--Cindy

 

Re: aCk! 8*P

Posted by Adam on December 6, 1999, at 9:27:47

In reply to Re: aCk! 8*P, posted by dj on December 6, 1999, at 0:50:45


I wouldn't say they "cook the books". It is in no one's interest to ignore or grossly distort evidence of
serious adverse effects. Drug companies, after all, don't want to get sued. I think it is fair to say, though,
that where data can be massaged to paint an optimistic picture, it will be massaged. It's not lying, its
selling. Drug companies aren't in the business for purely altruistic reasons. They're making money. If a
respectible publication gives evidence, say, that SSRI-induced sexual dysfunction occurs in 10% of patients
and another says 40%, which study will they report at conferences and in advertisements, etc.? Nobody makes
a profit by vaunting the worst-case scenerio. However, it's not like parmaceutical companies make up false
claims about adverse side effects. I've never seen anyone lie.

I see reports of the kind Noa cited as a positive rather than a negative. Supply is driven by demand. If the
depressed consumer wants something better, and a pharmaceutical company can provide it, they get the business.
The more aware of consumer dissatisfaction they become, the greater the threat that their enourmous investment
in drug discovery and development and threatened by the anti-psychiatrist camp, alternative medicince, and the
like, the harder they will work to get your money. None of this would appeal to the idealist, I would imagine.
But we must dispense with idealism when it comes to drug development: It's a long, arduous, and incredibly
expensive process. Until we feel like spending more of our tax dollars on basic research than ballistic
missiles, you can bet than only potent economic incentives will drive the drug discovery process forward.

> And the anti-psychs. are correct in that the drug companies cook the books, perhaps not to the degree that they sometimes insinuate BUT there is a basis in fact for the insinuations which are based on sloppy and distorted research methodolgy. The latter was noted in a meta-review of pharmaceutical studies which I heard cited recently, on CBC-Radio, I believe...PT Barnum lives!
>
> > > more fuel for the anti-psychiatrists ... blech.
> > >
> > > b
> > Not necessarily fuel for the anti-psychiatrists...real stats for the drug companies, to encourage them to come up with new AD's that don't have so many bad side-effects (including the infamous SSRI-induced sexual dysfunction that the drug companies pretend doesn't happen and doesn't matter)!--Cindy

 

Never seen lies, let me open your eyes!

Posted by Zeke on December 6, 1999, at 10:46:46

In reply to Re: aCk! 8*P, posted by Adam on December 6, 1999, at 9:27:47

Never seen anyone lie...

Well consider the Synthroid saga. The company sponsered research that thier branded drug was better than the generics. And they threw in a "hush" clause to the researchers who were forced to remain silent. Many of the studies came back showing no advantage to Synthroid, but the company hushed those up and presented only the studies showing an advantage to their product. Consequently, the company misled physicians into believing the generics were not bioequivalent, and thus to keep prwscribing the brand-only drug. This resulted in a major lawsuit. It is clearly an example of market driven deception.

Don't get me wrong -- I believe in psychopharmacology. Indeed the anti medical people are also open to deception -- intentional and unintentional. Take for example what Peter Breggin does -- tout only what supports his position and dismisses anything else.

A different and longer writeup about the AD side effects can be found here:
http://biz.yahoo.com/prnews/991130/il_nationa_1.html

I think the info from the survey is real, but I have some concern about the objectivity of the sample -- it was conducted via their website. Anyone else see any problems here?

 

Re: aCk-chung...

Posted by dj on December 6, 1999, at 11:23:24

In reply to Re: aCk! 8*P, posted by Adam on December 6, 1999, at 9:27:47

Adam,

As ever you are a voice of balance and reasonableness. However, idealism does have it's place, though it can too go to unreasonable extremes as we recently saw in Seattle. However, that is often how change happens...by drama...

In Canada in the past year there were a # of national reports about drug companies pressuring researchers and government staffers to approve drugs they had doubts about or which were not fully tested. Industry also has pressured govt. here and internationally to downsize so they have less ability to police such abuse, which the system often ignores until the media and media-savvy turn up the heat. Witness all the noise and efforts that have been make around AIDs drug development because the affected population is politically savvy and has a foothold in the mass media and entertainment industry. Whereas, cancers are much more prevalent in society and many more people are dying internationally from inadequate water and sewage treatment. People who don't have the $ or clout to affect drug and other treatment research or simple implementations.
Back to depression, the efficacy of the positive impacts of anti-depressants is often overstated and the negative impacts understated. The latter because many participants drop out during trials. The NY Times had a story titled: Some Still Despair in a Prozac Nation on July 27. In it the author notes:

"Psychiatrists estimate that 60 to 70 percent of people who can tolerate the side effects of antidepressants get better with the first drug they take. But 10 percent do not respond -- even after trials on many different drugs. And still others -- the estimates of how many vary -- get better but do not recover completely."

How many others and how correct are those estimates? I've seen various figures quoted one place or another that indicate that the impact of therapy and/or drugs only impact about 1/3 of people and about 1/3 recuperate on their own or something along those lines, though I can't recall the source. Anyone know anything about this?

And on and on and on it goes, where the debate stops, nobody knows...

dj


>Nobody makes a profit by vaunting the worst-case scenerio. However, it's not like parmaceutical companies make up false claims about adverse side effects. I've never seen anyone lie.
>
... But we must dispense with idealism when it comes to drug development: It's a long, arduous, and incredibly expensive process. Until we feel like spending more of our tax dollars on basic research than ballistic missiles, you can bet than only potent economic incentives will drive >the drug discovery process forward.
>

 

Re: aCk-chung...

Posted by Adam on December 6, 1999, at 12:35:58

In reply to Re: aCk-chung..., posted by dj on December 6, 1999, at 11:23:24


>idealism does have it's place, though it can too go to unreasonable extremes as we recently saw in Seattle. However, that is often how change happens...by drama...

If you are referring to the protests and rioting surrounding the WTO conference, I would say this is at best an example of idealism gone completely
amuck, and at worse an excuse for a variety of troublemakers to bang some heads while assuming the guise of activists. When in a particularly cynical
mood, I lump Peter Breggin and some media types into this catagory.

I do agree, though, that idealism has its place. I suppose it has to live alongside a healthy dose of cynicism. I've said over an over that I think
ADs, especially Prozac, have been overhyped and often don't live up to the expectations that advertising generates. The cynic in me says be skeptical
about the promises made by pharmiceutical companies; take drugs, but research them before you do, if you can. The idealist in me says, give money to
independant entities funding basic research of mood disorders (Any suggestions? Good topic for another thread?). That way people with fewer vested
interests can do more investigation that may be less equivocable. Oh, and vote for people who support such research and the rights of people like us
to adequate treatment.

 

Re: aCk-chung...

Posted by Kev on December 6, 1999, at 13:28:12

In reply to Re: aCk-chung..., posted by Adam on December 6, 1999, at 12:35:58

Well, then...given that the motives of big drug companies are not altruistic, but bearing in mind that non-altruistic motives are the engine of progress (cf. Adam Smith), why can't the State simply require that the evaluation studies be carried out by an independent third party in order to neutralize the blatant conflict-of-interest inherent in letting the drug co.'s do the initial research on their own meds????

-Kev

 

Seattle is not AMOK...

Posted by Sean on December 6, 1999, at 13:48:59

In reply to Re: aCk-chung..., posted by Adam on December 6, 1999, at 12:35:58

>
> >idealism does have it's place, though it can too go to unreasonable extremes as we recently saw in Seattle. However, that is often how change happens...by drama...
>
> If you are referring to the protests and rioting surrounding the WTO conference, I would say this is at best an example of idealism gone completely
> amuck, and at worse an excuse for a variety of troublemakers to bang some heads while assuming the guise of activists. When in a particularly cynical
> mood, I lump Peter Breggin and some media types into this catagory.
>
> I do agree, though, that idealism has its place. I suppose it has to live alongside a healthy dose of cynicism. I've said over an over that I think
> ADs, especially Prozac, have been overhyped and often don't live up to the expectations that advertising generates. The cynic in me says be skeptical
> about the promises made by pharmiceutical companies; take drugs, but research them before you do, if you can. The idealist in me says, give money to
> independant entities funding basic research of mood disorders (Any suggestions? Good topic for another thread?). That way people with fewer vested
> interests can do more investigation that may be less equivocable. Oh, and vote for people who support such research and the rights of people like us
> to adequate treatment.

The Seattle protests are to be celebrated as the
first time in two decades the worker bees finally
got the target right. If the WTO is allowed to \
run rampant, the world will be run exclusively by
multinational corps capable of pitting labor and
supply markets around the globe against eachother.
That a group with de-facto government power should
be allowed to formulate policies like NAFTA and
GATT without public representation is a big
mistake.

I'm all for the free market, but it must have some
sort of constraints which recognize the environmental,
cultural, and developmental needs of different
nations.

99.9% of the people protesting did not engage in
violence. As usual, a few thugs ruined everything
and the media, lusting for ratings, focused on
these events. On the whole, however, the WTO got
the message and is forever changerd.

 

Re: Never seen lies, let me open your eyes!

Posted by dj on December 6, 1999, at 13:53:21

In reply to Never seen lies, let me open your eyes!, posted by Zeke on December 6, 1999, at 10:46:46

> A different and longer writeup about the AD side effects can be found here:
> http://biz.yahoo.com/prnews/991130/il_nationa_1.html
>
> I think the info from the survey is real, but I have some concern about the objectivity of the sample -- it was conducted via their website. >Anyone else see any problems here?

Depends on the methdology used for screening as they did indicate that they had screened candidates: "The survey, conducted online through the National DMDA website this summer, screened for participants who had been treated for depression. Seventy-eight percent (78%) of respondents were being treated for symptoms of depression at the time of the survey. Members of all adult age ranges were represented, and three out of four respondents were female."

However, the very fact that it was web-based would screen out a lot of folks. Regardless, the results look pretty convincing and certainly reflect much of what is written on this board and elsewhere.

 

Re: aCk-chung...

Posted by Adam on December 6, 1999, at 15:26:48

In reply to Re: aCk-chung..., posted by Kev on December 6, 1999, at 13:28:12

> Well, then...given that the motives of big drug companies are not altruistic, but bearing in mind that non-altruistic motives are the engine of progress (cf. Adam Smith), why can't the State simply require that the evaluation studies be carried out by an independent third party in order to neutralize the blatant conflict-of-interest inherent in letting the drug co.'s do the initial research on their own meds????
>
> -Kev

I don't think altruism is ever completely the motivating force behind discovery, nor is it ever
completely absent. For instance, drug companies give a lot of medicine away to people who can't
afford to buy it. Part of this is due to an honest desire to help people. Part of the motivation
is great PR. It's all very grey.

The only independant third party I can think of capable of doing such studies is academia. No
scientist I ever knew would take kindly to being forced into a consumer watchdog position. At
any rate, all clinical trials are carried out by independant entities. And very few companies
have all of the necessary brain power, expertise, and resources in-house to fully investigate
candidate therapies. They rely heavily on academia and give loads of money away to fund the needed
research. There are plenty of checks and balances. The FDA does a pretty good job policing.
One of the biggest reasons it costs so much to get a drug from the bench to the clinic is the
daunting amount of work that must be done to get a drug to clear all the regulatory hurdles.
One investigator I know paraphrased _The Usual Suspects_: "I BELIVE in God, and the only thing
that scares me is the FDA."

 

Re: aCk-chung...

Posted by Noa on December 6, 1999, at 21:13:52

In reply to Re: aCk-chung..., posted by Adam on December 6, 1999, at 15:26:48

Recently heard from a relative in the international trade policy "biz": The ratio of drugs developed to drugs actually brought to market by the drug companies is something like 100:1, because of safety regs, etc.

 

Re: aCk-chung...

Posted by dj on December 7, 1999, at 2:08:55

In reply to Re: aCk-chung..., posted by Noa on December 6, 1999, at 21:13:52

> Recently heard from a relative in the international trade policy "biz": The ratio of drugs developed to drugs actually brought to market by the drug companies is something like >100:1, because of safety regs, etc.

And some of the ones developed have to be taken off the market after their negative side-effects become too prevalent, though that usually takes time. I don't know about any particular ADs but I do recall reading in a book on dangerous prescritpion and non-prescription meds. that a couple of anit-allergy meds. (I think Hisminal and Seledane but it's been awhile...) were eventually taken off the market after they caused some heart problems that resulted in at least one death. So keep ther pharm co.s, testing those puppies and if anything make the bar higher, rather than lower...because once the drugs are out there, they don't come back off the shelves quickly or without lots of outcry.


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