Prozac, used by 40m people, does not work say scientists

[mr blur]

Prozac, the bestselling antidepressant taken by 40 million people worldwide, does not work and nor do similar drugs in the same class, according to a major review released today.

The study examined all available data on the drugs, including results from clinical trials that the manufacturers chose not to publish at the time. The trials compared the effect on patients taking the drugs with those given a placebo or sugar pill.

When all the data was pulled together, it appeared that patients had improved - but those on placebo improved just as much as those on the drugs.

<snip>

Should go down well in the Health forum.

http://www.guardian.co.uk/society/2008/feb/26/mentalhealth.medicalresearch

[TZ]

1. Well I would like this study to explain

Why teen suicide rates increased after warnings about the drugs in teens and therefore were stopped prescribing them.
I have to say, having been on them and having severely depressed relatives on these drugs, I wonder how they measured how depressed someone is? It isn't just feeling sad, there are physical things that change with anti-depressents.
This study smells funny. There is plenty of data, including I think, brain scans, that show these drugs DO work.
I also am suspicious when they say they "left out data". Uh huh. They couldn't get all the data? Perhaps they couldn't get all the data they wanted to fit their theory.

[Random_Australian]

2. True, it seems odd and all. However, there have been ways to test how depressed a person

is for a long time. Basically, they go through an inventory of the thinking patterns that are the hallmark of depression, IIRC.

Furthermore, the study says that people improve on them - teens included - so taking them away would logically increase the teen suicide rate.

However, that is only consistency; it doesn't make it right, just not obviously wrong.

[TZ]

4. Oh yes, I have taken the test myself

But I would like to see the study broken down into mildly depressed, moderately depressed and severely depressed because that would be much more handy. Perhaps in the study it is, but it won't be reported this way. You know that this is gonna be *proof* of the evul Big Pharma making shit up...
And knowing Prozac saved my Uncle's life, I'm gonna have a hard time dealing with that shit.:banghead: :banghead:

[LeftishBrit]

3. I suspect that the problem isn't that they don't work...

but that they've been prescribed too indiscriminately. All medicines need to be targeted to people's specific needs and illnesses. Antibiotics don't work for an ordinary cold, or for a broken leg, but that doesn't mean they don't *work*.

I also think some doctors and patients were inclined at first to assume that because it's less easy to overdose dangerously on SSRIs than older antidepressants, they are perfectly safe and have no side-effects. Any drug can be unsuitable for some people. I know someone who had to stop taking Prozac because she was getting hallucinations (mind you, she also got severe hallucinations the one time she used cannabis in her youth - and yet has NEVER had any psychotic symptoms unrelated to a drug).

[chicagomd]

6. Accuracy of diagnosis is

very important, especially in mental health cases. We had a similar issue in pediatrics where something like 80% of middle ear infections would improve irrespective of antibiotics. Now we have stronger clinical guidelines and most expect those numbers to get better.

There is similar research going on in adult sinus infections, which seem to get better with or without antibiotics. What the doctor calls a "sinus infection" may not be a true bacterial infection that requires medication.

[Anarcho-Socialist]

5. The Guardian title is rather misleading

since the article does go on to say that the medicine helps those with severe depression.

[Warpy]

7. They're certainly miserable drugs to get off

I was able to switch from Paxil to Effexor, but it took me a whole six months to taper off the lowest dose tablet of Effexor, a quarter of a tablet at a time. Even then, I can't say I was particularly stable for another 6 months.

My rheumatologist keeps trying to get me on an SSRI and they've all been disasters, raising my blood pressure when I take them and dumping it into the toilet when I miss a dose. He's just going to have to be content with the weak SSRI action of Ultram. That's the only drug that has worked.

Funny, when I have adequate pain control, I'm not depressed. Odd how that works.

[salvorhardin]

9. My girlfriend has a wicked reaction to Paxil

Actually, she's tried a couple of SSRI's when she was depressed in the past and was prescribed Paxil for PMS. I've never seen someone react to a SSRI as fast as she does. Frankly if I hadn't seen it myself I'd be skeptical if anyone else told me they have such a strong and fast reaction to any SSRI. They're not supposed to work that way. As it is, she's decided that the anxiety she gets during and other symptoms she gets during her period are much easier to take than the sudden mood swings the Paxil induces.

Anyhow, this is all anecdotal I know, and not meant to imply anything in particular about SSRIs.

[lizerdbits]

10. Paxil was given to me for PMS

it was mainly sleeping problems that only when away with a period so that was the assumption. It didn't work and actually made things worse because I was so fidgety and anxious I could almost not function. I was frequently nauseous, especially when exercising, to the point I was close to stopping and going to the bathroom thinking I was going to throw up. The first week coming off sucked because of the brain zaps, I almost didn't want to drive anywhere. I was nervous about work too since I work with infectious stuff. Glad it worked for your GF, it was a nightmare for me. I had good luck with a tricyclic though, aside from the 35 lbs that never went away.

What's interesting to me about someone mentioning prescribing the right drugs is that the guy who gave me the tricyclic would prescribe based on specific symptoms. So not everyone with depression would be given the same drug by him, I remember about 10 pages of questions I answered on my first appointment. Just a note, he required you to be in talk therapy when beginning medication and for at least a year.

[salvorhardin]

11. Sorry if I wasn't clear

Paxil was absolutely a nightmare for my GF. Yes, it helped with the PMS symptoms but the side effects were so severe she decided to stick with the PMS. What I don't understand though is how fast the Paxil had effects on her behavior. It was literally only a couple of hours after taking a very low dose that she began to feel as if she was stoned (to use her description) and she acted like it. A couple of more hours and she couldn't make decisions, couldn't sit still, all the classic symptoms of mania. And then she crashed and became despondent. I've never seen SSRIs act this fast, and in fact, I didn't think they could. Yet she reports similar fast acting effects with Zoloft and Celexa (both of which she was prescribed for depression at different times in her life).

For what it's worth I took Celexa for a couple of months for severe depression but also stopped because while it alleviated the feelings of depression it also gave me this odd feeling of reckless carelessness. What convinced me to stop was when I cut my finger in the kitchen and just sort of stood there watching the blood stream out and all the while thinking to myself, "This isn't right. I should be putting a bandage on the finger, not just watching it bleed." After a few minutes I did bandage the finger and then stopped taking the Celexa the next day.

[TZ]

12. about your gf's reaction

It may have been an allergic reaction to something else with the meds? Something used to coat it?
Allergic reactions can cause weird behavior, not just physical reactions....

[salvorhardin]

14. Certainly possible.

Hard to know. Since she hasn't had any such reaction to anything other than SSRIs I would tend to think not though, especially since lizerdbits description of her problems with Paxil sound rather similar.

[lizerdbits]

13. It would affect me after an hour or so

The fidgetyness and near panic. I had to take it 3 hours before bed or sleeping wasn't even remotely possible.

[salvorhardin]

15. That does sound remarkably similar to what she was experiencing

Did you tend to then "crash" (i.e. go into a deep depression) the next day?

[Deep13]

8. I experienced a dramatic and sustained reduction in anxiety...

...with one of those products. I doubt I'm the only one, too.