Comments: Medical Group Releases Anti-Depressant Guidelines, Admits Little Differences Between Drugs
The other thing that's omitted is a discussion of rebound. Let's not assume that the "relapse" they speak of here is really anything other than another drug-induced or withdrawal-induced reaction (because of dosage tolerance and thus lost "efficacy"). Many clinical trials (like STAR*D for instance) have actually demonstrated that the longer you stay on antidepressants and the more different ones you try, the smaller your chances of lasting remission really are. This smacks of rebound to me. Depression will actually get worse and there's less chance of healing the longer you are on antidepressants and the more different ones you try. And this is precisely because of chemical dependency and the withdrawal issues that will come back to bite you in some way or other even if you stay on "for life" - the withdrawal that is being ignored by the medical profession. This failure to evaluate long term outcomes of people who take antidepressants vs. those who don't is a serious omission in the study of these treatments. If outcomes were seriously looked at, the withdrawal issue couldn't be ignored.
Posted by Sara at November 18, 2008 08:02 AM
Maybe if these researchers didn't have ties to the drug makers, they would have said these drugs do in fact cause people to kill themselves. It is getting harder and harder for pharma to deny this. But they still manage to do so. And as long as they continue to do so many more lives will be lost and many more lives will be turned upside down with these medications. When will Psychiatrist understand that while depression is a bitch, they make it much worse with the medications?
Posted by Jane at November 18, 2008 08:59 AM
I don't see anything new.
There are 100 References and two of them:
21. Nemeroff CB, Thase ME, EPIC 014 Study Group. A double-blind, placebo-controlled comparison of venlafaxine and fluoxetine treatment in depressed outpatients. J Psychiatr Res. 2007;41:351-9. [PMID: 16165158].[Medline]
25. Versiani M, Moreno R, Ramakers-van Moorsel CJ, Schutte AJ, Comparative Efficacy Antidepressants Study Group. Comparison of the effects of mirtazapine and fluoxetine in severely depressed patients. CNS Drugs. 2005;19:137-46. [PMID: 15697327].[Medline]
Mr. Versiani, he's Brazilian, and his colleagues have just came up with this finding:
Do SSRIs or antidepressants in general increase suicidality? WPA Section on Pharmacopsychiatry: consensus statement.
Möller HJ, Baldwin DS, Goodwin G, Kasper S, Okasha A, Stein DJ, Tandon R, Versiani M; WPA Section on Pharmacopsychiatry.
Collaborators (42)
Department of Psychiatry, Ludwig-Maximilians-University München, Nussbaumstrasse 7, 80336 Munich, Germany. hans-juergen.moeller@med.uni-muenchen.de
In the past few years several papers have reported critically on the risk of suicidal thoughts and behaviour associated with antidepressants, primarily SSRIs. The risk-benefit ratio of antidepressant (AD) treatment has been questioned especially in children and adolescents. The critical publications led to warnings being issued by regulatory authorities such as the FDA, MHRA and EMEA and stimulated new research activity in this field. However, potential harmful effects of antidepressants on suicidality are difficult to investigate in empirical studies because these have several methodological limitations. Randomised controlled trials (RCTs) are the most reliable way to test the hypothesis that AD have such side effects. In addition to meta-analyses of RCTs, complementary research methods should be applied to obtain the most comprehensive information. We undertook a comprehensive review of publications related to the topics ADs, suicide, suicidality, suicidal behaviour and aggression. Based on this comprehensive review we conclude that ADs, including SSRIs, carry a small risk of inducing suicidal thoughts and suicide attempts, in age groups below 25 years, the risk reducing further at the age of about 30-40 years. This risk has to be balanced against the well-known beneficial effects of ADs on depressive and other symptoms (anxiety, panic, obsessive-compulsive symptoms), including suicidality and suicidal behaviour. According to the principles of good clinical practice, decision making should consider carefully the beneficial effects of AD treatment as well as potentially harmful effects and attempt to keep the potential risks of AD treatment to a minimum. It is the major problem facing efforts to identify the possible 'suicidal effects' of antidepressants.
http://www.ncbi.nlm.nih.gov/pubmed/18668279?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
All I see is are more and more reviews, studies, clinical trials and all underestimating side effects.
The risks are potential nothing we should care about.
I believe that even if all people who are taking ADs committed suicide they would say:
"Oops! These suicides might be related to ADs. However we still need more evidences."
Posted by Ana at November 18, 2008 09:02 AM
Yes, there is little difference among the SSRIs and SNRIs. While studying www.SSRIstories.com, I realized that all the SSRIs & SNRIs, without exception, cause suicides, murders and mayhem. They are all equal in this regard.
Since we know that "homicidal ideation" is listed as an adverse reaction in the insert to Effexor and that the Zoloft study in children showed "homicidal ideation" as a Frequent side effect, then we can assume all of the SSRIs & SNRIs cause "homicidal ideation".
A mother who had an 18 year old daughter on Prozac kill her boyfriend and herself in front of a tanning salon on Coit Road in Dallas, Texas in the mid-1990's said: "I can accept the fact that my daughter committed suicide even though this is killing me, but I can never accept the fact that she murdered someone".
So all these SSRIs & SNRIs equally cause pain and suffering to the survivors of these murders, suicides and murder-suicides.
Posted by Rosie at November 18, 2008 10:47 AM
the study has a lot of points worth discussing. main pt being: no acknowledgement that psychotherapy has superior efficay than 40% metioned for ssris with none of these nasty "adverse events."
but here is another curious point:
their conflict of interest statement. now keep in mind: Ann Int Med is supported by pharma advertising. Ann Int Med supported the research. Lead author has been supported by Endo, who is working to get SSRIs approvd for tx of pain - yes, pain is mentioned in this ssri article.
The authors note the ONLY COI is for Author Snow. And then they declare that ANY possible conflicts have been considered and "resolved." Resolved? What does that mean?
Posted by MedsVsTherapy at November 19, 2008 09:14 AM