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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by LostBoyinNCBecksDark on October 23, 2007, at 19:31:54
The STAR*D study done by NIMH discovered something I already knew for years...the present crop of antidepressants dont work well for most depressives. If you define "working well" as treating clinical depression to FULL REMISSION and not just a 50% improvement, most antidepressants fail in the majority of depressives who try them.
Only ECT or shock treatment, has a good reputation at treating clinical depression to full remission.
If you want to read about STAR*D, go to your nearest University library or nearest medical library. And pull archived copies of The American Journal of Psychiatry.
http://www.webmd.com/depression/news/20060104/first-antidepressant-fails-70-of-time
Eric
Posted by sunnydays on October 23, 2007, at 20:27:39
In reply to NIMH study...antidepressants work only 30% of time, posted by LostBoyinNCBecksDark on October 23, 2007, at 19:31:54
Yes, this is true. But even a 50% improvement can be enough to get someone to a point where they can make positive lifestyle changes that can get them the rest of the way. 50% improvement in depression could save someone's life. I just wanted to state that explicitly in case anyone got the impression that they shouldn't try antidepressants if they are depressed. And you might even be one of the lucky 30%! That's still 300 people out of 1000.
sunnydays
Posted by LostBoyinNCBecksDark on October 23, 2007, at 20:32:48
In reply to Re: NIMH study...antidepressants work only 30% of time » LostBoyinNCBecksDark, posted by sunnydays on October 23, 2007, at 20:27:39
> Yes, this is true. But even a 50% improvement can be enough to get someone to a point where they can make positive lifestyle changes that can get them the rest of the way. 50% improvement in depression could save someone's life. I just wanted to state that explicitly in case anyone got the impression that they shouldn't try antidepressants if they are depressed. And you might even be one of the lucky 30%! That's still 300 people out of 1000.
>It leaves huge room for improvement though. psychiatry needs to be more forthright about the results it can provide through psychopharmacology and psychotherapy. By not being forthright, they are basically lying to their patients and to the public. Its basically a form of negligence and malpractice.
Eric
> sunnydays
Posted by Phillipa on October 23, 2007, at 22:14:51
In reply to Re: NIMH study...antidepressants work only 30% of time » LostBoyinNCBecksDark, posted by sunnydays on October 23, 2007, at 20:27:39
Sunnydays good point you said it in a way that sunk in for the first time. Thanks makes perfect sense to me. Phillipa
Posted by Questionmark on October 24, 2007, at 2:14:36
In reply to Re: NIMH study...antidepressants work only 30% of, posted by LostBoyinNCBecksDark on October 23, 2007, at 20:32:48
Great study to show, thank you.
And good point that psychiatry needs to be more open and honest about its... limitations. AND THEY NEED TO ACKNOWLEDGE IT THEMSELVES FOR CRYAINSDG;H SAKE.
They need to understand and be aware of their own limitations-- and these drugs' limitations.
Posted by alan2102 on October 29, 2007, at 21:39:31
In reply to NIMH study...antidepressants work only 30% of time, posted by LostBoyinNCBecksDark on October 23, 2007, at 19:31:54
> The STAR*D study done by NIMH discovered something I already knew for years...the present crop of antidepressants dont work well for most depressives. If you define "working well" as treating clinical depression to FULL REMISSION and not just a 50% improvement, most antidepressants fail in the majority of depressives who try them.
50% improvement is pretty good, especially
when you're in hell at 0%.
Posted by Larry Hoover on October 30, 2007, at 8:08:14
In reply to Re: NIMH study...antidepressants work only 30% of, posted by LostBoyinNCBecksDark on October 23, 2007, at 20:32:48
> It leaves huge room for improvement though.
Nobody yet claims a cure.
> psychiatry needs to be more forthright about the results it can provide through psychopharmacology and psychotherapy.
More forthright? Their findings are all over Pubmed, for example, where you found this study.
> By not being forthright, they are basically lying to their patients and to the public.
That is an overly broad generalization.
> Its basically a form of negligence and malpractice.
No it's not. It's the state of the art.
This argument is a classic non sequitur. Start with a premise that is plausible, then proceed via broader and broader generalizations to a conclusion that is not supported by the evidence.
Lar
Posted by FredPotter on October 30, 2007, at 14:59:53
In reply to Re: NIMH study...antidepressants work only 30% of » LostBoyinNCBecksDark, posted by Larry Hoover on October 30, 2007, at 8:08:14
I think total remission in 30% is very good actually. About in line with most drugs I would have thought
Posted by yxibow on October 31, 2007, at 0:06:21
In reply to Re: NIMH study...antidepressants work only 30% of, posted by FredPotter on October 30, 2007, at 14:59:53
> I think total remission in 30% is very good actually. About in line with most drugs I would have thought
I would agree too. There is no such thing as perfect as I've learned with a rare psychiatric disorder I've been fighting for 6 years. I hope to have remission but its very discouraging at times.
An improved quality of life would be fantastic. One has to remember that there are psychiatrists who will try even the most unorthodox and dangerous treatments in the book -- do you want your provider to lose their medical license so you cant get any care ? Its a fine line. Its one worth debating but not overgeneralizing.
And while I'm at it, psychiatry without psychodynamic / psychological support is selling things half short. There's a lot to be said for therapy and medication both.
At any rate.
Posted by FredPotter on November 1, 2007, at 14:45:40
In reply to Re: NIMH study...antidepressants work only 30% of » FredPotter, posted by yxibow on October 31, 2007, at 0:06:21
but I've found talk therapy useless. It's just as good to talk to a close friend IMO. Nardil did the trick for me. Is it included in that 30%?
Posted by LostBoyinNCBecksDark on November 8, 2007, at 23:17:27
In reply to Re: NIMH study...antidepressants work only 30% of, posted by FredPotter on October 30, 2007, at 14:59:53
> I think total remission in 30% is very good actually. About in line with most drugs I would have thought
If drug success rates for high blood pressure was only 30%, it wouldn't be tolerated by society. A 30% remission rate for a debilitating illness like major depression is a poor remission rate that leaves huge room for improvement.
I remember years ago, right before Lexapro was marketed, there was a Forest drug rep that posted here. His name was "Pharmrep." You can do a searc for him here on this site and see the stuff he said about Lexapro. He came here bragging how great Lexapro was, blah blah blah. I and a few others on here knew he was FOS and called him on it. Of course, Dr. Bob doesnt tolerated opinions on this site and I along with several others, were booted.
Several years after "Pharmrep" posted here, NIMH conducted the STAR*D clinical trial and it was quickly found out that Celexa...a drug basically identical to Lexapro...had a remission rate of only 1/3. Only 1 out of 3 people who took Celexa for major depression remitted.
That Forest Lexapro drug rep was FOS and these drug companies way overstate the effectiveness of most of these psychiatry meds.
Eric
Posted by Dr. Bob on November 8, 2007, at 23:39:15
In reply to Re: NIMH study...antidepressants work only 30% of, posted by LostBoyinNCBecksDark on November 8, 2007, at 23:17:27
> I and a few others on here knew he was FOS
Please don't post anything that could lead others to feel put down.
But please don't take this personally, either, this doesn't mean I don't like you or think you're a bad person.
If you or others have questions about this or about posting policies in general, or are interested in alternative ways of expressing yourself, please first see the FAQ:
http://www.dr-bob.org/babble/faq.html#civil
http://www.dr-bob.org/babble/faq.html#enforceYou might want to consider asking another poster to be your "civility buddy" and to preview your posts before you submit them.
Follow-ups regarding these issues should be redirected to Psycho-Babble Administration. They, as well as replies to the above post, should of course themselves be civil.
Thanks,
Bob
PS: According to the new formula:
duration of previous block: 2 weeks
period of time since previous block: 0 weeks
severity: 2 (default) + 1 (uncivil toward particular individual) = 3
block length = 5.96 rounded = 6 weeks
Posted by KayeBaby on November 12, 2007, at 22:29:51
In reply to Re: NIMH study...antidepressants work only 30% of, posted by LostBoyinNCBecksDark on November 8, 2007, at 23:17:27
They only have to beat a placebo to be considered for approval. The way the laws are they can do their own studies (or fund those that do)and they can keep at it till they get the results they want while never revealing the failed studies.
Are you sure the blood pressure meds are any better than 30%. Most I know with true high BP require more than one drug to do the trick.
Kaye
This is the end of the thread.
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