July 14, 2009

Placebo Outperforms Seroquel In Teen Bipolar Depression Study

A study out recently in Bipolar Disorders shows that Seroquel failed to beat, and was in fact beaten by, placebo in treating depression in 32 adolescents aged 12 to 18 and diagnosed with bipolar disorder type 1 who were given Seroquel for eight weeks or were given placebo:

"Results: There was no statistically significant treatment group difference in change in CDRS-R scores from baseline to endpoint (p = 0.89, effect size =−0.05, 95% confidence interval: −0.77–0.68), nor in the average rate of change over the eight weeks of the study (p = 0.95). Additionally, there were no statistically significant differences in response (placebo =67% versus quetiapine = 71%) or remission (placebo = 40% versus quetiapine = 35%) rates, or change in HAM-A, YMRS, or CGI-BP-S scores (all p > 0.7) between treatment groups. Dizziness was more commonly reported in the quetiapine (41%) than in the placebo (7%) group (Fisher's exact test, p = 0.04)."

Sixty-seven percent is a high placebo response rate, and the study group is a small one, but then again we keep running across studies of treating teen depression where placebo responses are very high. It's something researchers have tried to explain away with little success.

I wonder how many teens in this country are being given Seroquel off-label (it's currently only approved for adult use) for depression and bipolar depression and having a huge placebo response while taking a fat-producing, diabetes-inducing drug.

Oh, yes. The study authors included the University of Cincinnati's Melissa DelBello (subject of an investigation by Sen. Charles Grassley for undisclosed pharma ties) and Stanford's Kiki Chang. I don't think I've ever seen either of the pair produce a study that was negative for the study drug, so this is news.

Posted by Philip Dawdy at July 14, 2009 12:05 AM
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Comments

If the suggestion is indeed true that antidepressants are no better than placebo for people that ill then it begs the question ~ how on earth did antidepressants ever get on the market place to begin with..?

Posted by: Gledwood at July 14, 2009 02:31 AM

... having said all that I know they do something; they've made me a bit "hypomanic" more than once...

Posted by: Gledwood at July 14, 2009 02:33 AM

yes, wisner has been on the payroll for a long time. The way the story is portrayed, it appears that M B-S committed suicide despite treatment. A totally plausible, and possibly more believable, account is that the SSRIs had their aggressive/impulsive effect and drove a woman with a loving family, including hubby and baby, as well as extended family, to suicide. The only thing bad abt systematically screening newborn moms for depression is that our health care system is geared to Rx, but not well-designed to get people to psychotherapy.

Posted by: medsvstherapy at July 14, 2009 08:03 AM

When did antipsychotics become a treatment for depression?

Posted by: Francesca Allan at July 14, 2009 10:26 AM

DelBello and Chang are on the CABF advisory board (bp kids) and DelBello took 60,000$ from AstraZeneca for a personal business venture where the address is listed the place she works....she's been scrutinized for her AstraZeneca connection and un-reported pharma money from them, this is not surprising, they are corrupt and support the studies the company pays them to research.

of course Seroquel loses against a placebo; it's an antipsychotic for God's sake!

I'm so sick of AstraZeneca pimping out this drug for every possible way just to market the hell out of it before the drug goes generic! It's not about patients or depression, it's about money, marketing and at over 4 billion earned from Seroquel despite the diabetes lawsuits, they will milk it for all it's worth.

Posted by: Stephany at July 14, 2009 11:41 AM

We know from the New England Journal of Medicine article that antidepressants don't help bipolar depression. Now we are finding out that atypical antipsychotics such as Seroquel don't help either - I guess we know about this, at least, in children. The atypicals are half antipsychotic and half antidepressant.

Her is the NEJM article

http://www.ssristories.com/show.php?item=2279

First paragraph reads: "Antidepressants, which are widely prescribed with mood stabilizers to treat
patients with bipolar disorder, do not work in relieving the depressive symptoms of the illness, a large federal study reported Wednesday."

http://www.latimes.com/features/health/medicine/la-sci-bipolar29mar29,1,3436
931.story?coll=la-health-

THE Los Angeles Times

Antidepressants Don't Help Bipolar Patients, Study Finds
Combined With A Mood Stabilizer, As Many Doctors Prescribe, The Drugs Are
Found To Have No Effect On Depressive Symptoms.

By Denise Gellene
March 29, 2007

Posted by: Rosie at July 14, 2009 01:31 PM

Woah now, hope - which is what a placebo really is, minus side effects that cause physical distress, cure emotional distress bogusly labeled biological. Sort of weakens the biopsych argument further. I wonder how placebos fare against insulin when treating diabetes?

Posted by: Sally at July 14, 2009 02:10 PM

Let's get one thing clear: Seroquel is not an anti-depressant. It's an atypical antipsychotic -- meaning it is useful for things like paranoia, hallucinations, etc. It sounds to me like the manufacturers were out to grab as big a piece of the market as they can with this drug and reached too far.

Posted by: Joel Sax at July 14, 2009 07:49 PM

Look: DelBello and Chang published this article to cover their collective ass with Grassley. They will be out soon on the lecture tour pimping this drug for Astra. Just watch.

Posted by: Tom at July 14, 2009 08:42 PM

given I think the rate of "teen bipolarity" is mostly bullshit, I wonder if the kids in the study, got better knowing they were being cared for.

Posted by: Lee at July 19, 2009 12:42 PM

"If the suggestion is indeed true that antidepressants are no better than placebo for people that ill then it begs the question ~ how on earth did antidepressants ever get on the market place to begin with..?"

The same as how all psychiatric drugs have. Lies and marketing for the sake of social and political control (neuroleptics aka anti-psychotics are chemical lobotomies) and money (Since teaming up with psychiatry, Big Pharma has grown to be the third largest financial enterprise in the world. Trailing only the worlds energy and military industries)

Posted by: Mithotyn at August 15, 2009 03:14 PM

"Let's get one thing clear: Seroquel is not an anti-depressant. It's an atypical antipsychotic -- meaning it is useful for things like paranoia, hallucinations, etc. It sounds to me like the manufacturers were out to grab as big a piece of the market as they can with this drug and reached too far."
As Denise pointed out, if you believe in the chemical imbalance hypothesis than most atypicals are both "anti-psychotics" AND "anti-depressants" as they increase serotonin as they decrease dopamine. Tragically, "anti-psychotics" are not anti-psychotics, either. It's been well established in scientific circles that they do not treat psychosis, they merely hind natural and healthy brain functions that serve as an outlet of expression for psychotic behaviors, as well as many other normal, natural behaviors. This is why when you see people who are taking them they are usually weak, tired and with little to no personality. Their thinking skills are greatly dulled, their ability to feel themselves and realize their life is often affected as well. The pioneers of the neuroleptics (technically correct word for "anti-psychotic)who used them to quiet crowded mental hospitals openly referred to them in their literature as "Chemical straight jackets.", "Chemical lobotomies", "Therapeutic Parkinsons."

Here are some external links that should interest you.

http://www.madinamerica.com/Mad%20In%20America/Home.html - "Schizophrenics" in the U.S. and other developed countries fare worse today than in the early part of the 19th century and full, 100% recovery rates without use of drugs has reached as high as 82% in research studies performed in Finland and Switzerland using social interventions in place of medical ones.

http://www.bonkersinstitute.org/medicineshow.html - A history of drug advertisements sent to doctors and found in magazines.

Posted by: Mithotyn at August 15, 2009 03:25 PM
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