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Is Your Antidepressant A Big Crock Of Shit?

PaxilJpeg.jpgA dozen popular antidepressants don't work nearly as well as the "data" doctors cite to tell you they do, according to an FDA review. (The whole graph is after the jump.) The biggest grade inflators were Serzone, Zoloft, Remeron, Wellbutrin SR, Paxil and Cymbalta. Effexor, the drug that shame-ridden shrink confessed to shilling unethically in the New York Times Magazine last fall came in seventh. Which brings me back to an important part I was trying to make when I posted insensitively about fibromyalgia the other day. See, it is often times the people who think they're least susceptible to advertising — ahem, doctors — who turn us all into suckers.

No one likes to think we're prey to the shameless "Talk to your doctor!" come-ons of the advertising industry. We like to think we are too smart for that. We like to think we make rational purchasing decisions borne of a thorough survey of all the available options — or that at the very least, we are creatures of our own innate needs and desires. I can only assume that this is why a lot of you got so defensive when I joked that fibromyalgia was a "vague pharmaceutical industry invented malady." A few of you turn out to have fibromyalgia — and "restless leg syndrome", and whatever else I treated with my signature careless disdain. I'm sorry guys; I made my point less thoughtfully than I maybe should have. We all have health problems. But right now the most highly -capitalized, influential and consumer-savvy source of all that we know and learn about those problems — the developers of the drugs, the sponsors and publishers of their studies, the sources of continuing education to your doctors — is the pharmaceutical industry, and the pharmaceutical industry exists to convince us that our problems are "syndromes" necessitating a pill you take once a day. Ever wondered why the industry doesn't seem to develop anything you can take once and be done with it? Yeah, well. Ever wondered who that cute guy in the suit with the briefcase sitting outside your shrink's office at lunchtime was? Yeah, don't ask him out, he's definitely a player and he's probably a recreational Cialis user on top of that.

Anyway, apologies to everyone out there who is suffering from something. Just hatin' on the game, so to speak. If I spoke that way. Whatever.

Antidepressants Under Scrutiny Over Efficacy [WSJ]

12:00 PM on Thu Jan 17 2008
By Moe
6,071 views
236 comments

Comments

  • Image of wigglepuppy wigglepuppy at 12:16 PM on 01/17/08 *

    simple solution--just give me more! mmm...drugs....

  • Image of blackbirdfly blackbirdfly at 12:18 PM on 01/17/08 *

    Great. Mine's #3. Those fuckers.

  • Image of ineffable.me ineffable.me at 12:18 PM on 01/17/08 *

    No worries Moe, I think restless leg syndrome is just a white, first world disease... but besides that, I dont understand how a side effect of an anti-depressant can be suicide, especially on teens. To me, that means that the medication is NOT effective, yet they release it to the public like that wasnt a big deal and its just a "thing that can happen to you, maybe". Then again, I've never taken any anti-depressants but that's how I feel.

  • After just watching the Tom Cruise clips on the Gawker site......this worries me because it confirms his craziness.

  • That's why I only use leeches. 10% of the time, it works all the time.

  • Image of hortense hortense at 12:18 PM on 01/17/08 *

    Wasn't Serzone black boxed and taken off the US market?

    I've never had any luck at all with SSRI's. And the advertising for them is the worst. "Sad? Try some pills!" Whatever.

    I've had to go off-label for everything, and after 7 years and seriously 20 medications, I've finally got the right mix.

    The pharmaceutical companies are horrible.

  • I always hated in school when a teacher would abuse their knowledge of a student who was on meds for some reason. If that student was particularly chatty they'd say something like, "Did you forget to take your ____ today?" I just always hated that. If someone was taking something, it was none of my business.

  • I got into a discussion with a friend after the fibromyalgia debate: does it matter what the cause of the malady is if the medicine is treating it, even of it's only a placebo effect? I mean, if you think the anti-depressants are making you better, they are, even if your brain chemistry isn't being altered that much. But then again, that's what gets us hooked on the drugs so I don't really know.

  • Image of Pinkosaurus Pinkosaurus at 12:21 PM on 01/17/08 *

    The pharmaceutical industry is the devil and all those damn PHARMA lobbyists are it's minions. Seriously, those people are NIGHTMARE to deal with. I can only imagine what it's like for doctors dealing with the sales reps. Plus, all the reps are perky and attractive but perhaps not-so-scientifically inclined so I'm sure that makes the true effectiveness a harder to discern.
    [www.nytimes.com]


  • Image of nellicat nellicat at 12:21 PM on 01/17/08 *

    All I know is, in the depths of a horrible, horrible, post-partum depression, Celexa made it possible for me to love my child the way she deserves. I've been off of it for a while now, and yeah the sexual side effects sucked, but it came through for me when I needed it.

  • I think my sister is on two of the "top" ones there... hmm, maybe this is why she tried to punch me in the face the other day for not putting groceries away right?

  • Image of Archetype Archetype at 12:21 PM on 01/17/08 *

    I was just put on Prozac and, honestly, after 15 years of refusing meds, I am willing to give it a try.

    I've been on it a week and so far all the only thing that's changed is my appetite.

  • If it's the placebo effect stopping me from crying at my desk all day and having emotional breakdowns, then the placebo effect I shall take.

  • Image of hortense hortense at 12:21 PM on 01/17/08 *

    Drugs shouldn't be marketed on television. You should never "ask your doctor" about antipsychotics or antidepressants. You should schedule an appointment with a goddamn psychiatrist who is qualified to discuss possible medication options with you. It's not a pizza, you don't just go in and order it because it looked good on tv.

  • I tried Zoloft, Effexor, and Wellbutrin. They all made me either fatter or tired or both which is REALLY depressing. I think antidepressants are a total scam.

  • I've had a great experience on Effexor XR actually. I think the problem is the advertising. I didn't go from a poorly lit blue room to a sunny canoe picnic after taking it. I did some damn hard work and took care of myself. It won't all happen with a pill, but they can help keep you off of tall buildings in the meantime.
    If something doesn't work for you, take control of your health and do something about it.

  • Image of BeAgrestic BeAgrestic at 12:23 PM on 01/17/08 *

    @MissSamAdams: Teachers like that made my childhood hellish.

  • Mine is 4. For a long time, I've wondered why I keep having spells.
    Why?
    Well they lie. That and the fact I react badly to medications of all types.
    Sigh. gonna talk to my doc next time about weaning off. Thanks for publishing stuff like this. It makes me realize it might not all be my imagination when I don't feel "better".




  • Image of hortense hortense at 12:23 PM on 01/17/08 *

    And please, please, discuss possible side effects with your doctor, and keep regular appointments with your p-doc to monitor said side effects. Dealing with meds adjustment on your own is really scary and should be a guided process. If the medicine is really messing you up, you can change it with your doctor.

  • @blackbirdfly: mine's #4, but it works really well for me and that's what matters.

    Interestingly enough, Paxil and Effexor had horrible, horrible effects on me.

  • Image of Scoregasm Scoregasm at 12:24 PM on 01/17/08 *

    Of course, I think this assumes that doctors try to convince you of whether one drug or another is effective relative to your other choices. Having worked with way too many doctors over the years, I feel like a lot of them just hand their patient a prescription and say, "Try this and see if it works; call me if you still feel bad."
    I think this study does a good job of showing the way the drug companies have inflated their effectiveness to doctors or the people who go in specifically asking about a drug, but doesn't address the vast number of people who are just sort of handed a specific drug without any knowledge of the options.


  • I hope all the popular herpes medications are working as well as the "data" says.

  • Image of Archetype Archetype at 12:24 PM on 01/17/08 *

    @hortense: I agree wholeheartedly.

  • gilmore girls made fun of fibromyalgia so i will too.

    wtf are restless legs? those legs want to go west? i hate those commercials.

  • Image of hortense hortense at 12:24 PM on 01/17/08 *

    I have paradoxical reactions to meds. Uppers bring me down and downers bring me up. Everyone's brain chemistry is different. So that's why it's important to find a good doctor.

    I'm sorry. I just had shitty experiences with drug pushing doctors for years before I found a good one, and I don't want anybody else to deal with that.

  • Feeling all proud and mama bear and shit. Aw. Not just of Moe, but of myself as well. Despite all the fucking bullshit I've been through in my life, I've had an almost phobic aversion to drugs - prescription or not. (Alcohol notwithstanding, natch.)

    One day my gloating about this might come back and bite me in the ass, and hard, but for now, I feel really awesome about being a twenty-seven-year old mother who has no need for a bottle of wee happy pills.

    It seems like a beast of a world to navigate.

  • @ineffable.me: The anti-depressant changes your brain chemistry, to boost the serotonin that you're supposedly lacking when you're depressed (basic explanation of my understanding of it). And so sometimes that sort of backfires, because everyone's brain is different, and the drug actually hurts you rather than helps you. Prozac did that to my dad back in the early 90's.

    that said, I understand anti-depressants do help a lot of people. In general, I tend to feel that if you THINK it helps, then it does.

  • @hortense:
    In the town where I live, ALL psychiatrists had a waiting list of at least 4 months. I tried getting myself in once when I was feeling really "bad". I was shocked that you can't get in. I mean what do you do if you're in trouble? *which I pretty much almost was. It is a shame. A bad shame.


  • SAM-e and 5-HTP have got it goin' on. (Pssst...Available over the counter.)

    That is all.

  • Paxil made me an impotent zombie.

    I'd have to be crazy to go back on it.

  • I just remember how my college health services would offer antidepressants for almost any conceivable malady. I tried a couple of different antidepressants earlier this year, and they just made me ragingly unhappy, but I know a lot of people who wouldn't be able to function without them. The experience sucked for me, but served as a great reminder that there is no one-size fits all solution to mental health. One person's personal health is another's mental salvation.

  • Um, yeah, this isn't uncommon with other drugs, either. The whole industry is totally fucked up.

    That said, I would be unable to have a real life without Prozac. (I'll kick that shit some day, though!)

  • @hortense: Agree whole-heartedly. It's the stupidest fucking thing. I was reading a website for an injectable anti-coagulant that I might have to use soon, and it was all propaganda; this many people have a clot, this can happen to you, etc, etc--ask your doctor to give you a prescription today!

  • Image of ineffable.me ineffable.me at 12:28 PM on 01/17/08 *

    @Nicorette: Yeah, I understand that, I'm not saying there shouldn't be anti-depressants I just think its fucked up that with a side effet like suicide, they didnt think "this formula doesnt work as well, maybe we should keep trying" they were just like "ok release it to the public but let them know about this"... you know what i mean?

  • @skinnybonejones: I'm with you. I won't even take aspirin for a headache, then feel all proud of myself when it goes away. I know in a few years, it will all come back to bite me and I'll be screaming at my kids to "Get Momma her DAMN PILLS!"

  • Image of katastic katastic at 12:29 PM on 01/17/08 *

    When I was on Prozac, I just felt...okay. Not much better, not any worse. But the side effects- no ability/ desire to orgasm, an inability to hold my liquor, weird numbness- didn't seem worth it to me. It is not surprising in the least that their efficacy is overrated.

  • I had good results with Wellbutrin SR but it was also combined with therapy. I've taken antidepressants in the past with no therapy, and the results were not nearly as good.

  • @Pinkosaurus: Yep. All the women I see trotting around the hospital are the traditional idea of attractive, and most of the men are very dapper and buttoned-down. I want to ask them how it feels to work for the devil, but I'm never brave enough. Totally fucked up.

  • I think antidepressants do work and I am glad that we have access to them. My mom has been on them my whole life, and I always knew when she stopped taking them because those were the nights where she would talk about killing herself (once with a knife in the hand) and how life was pointless. Meds help my mom to be a happy wonderful person who likes life but she has to work at it with therapy and hard work too. I think the idea that drugs can make you happy is dangerous but not necessarily the drugs themselves especially if you are working with a good therapist and psychiatrist.

  • @hortense: Truth.

  • I've been taking #6 for about 14 years now (almost half my life!), and it's a lifesaver. Literally. I've experimented with going off of it, and it just isn't a good option for me... and not just because of the withdrawal effects, which GlaxoSmithKline thinks are all in patients' heads. That's what irritates me most about SSRIs. Even a tapered discontinuation makes me feel woozy.

  • Image of hortense hortense at 12:30 PM on 01/17/08 *

    @Muffyn: I know, it's terrible. There are always APRN's, too. I get my meds filled by an APRN who is brilliant and understands women and who is really, really honest about what she prescribes and what the benefits/drawbacks are.

  • The only time I took antidepressants it was supposed to boost my natural endorphins to treat chronic pain after a car accident. Well, it didn't work that way for me. It added to my symptom complex and I was MISERABLE. I felt like they had been thrown in my direction when I was vulnerable and other, healthier methods would have been a better alternative. The weaning off of that stuff was a nightmare of an experience I wouldn't wish on anybody. (Prozac) Never.again.

  • I love my cymbalta and my cymbalta loves me. I'm just glad I found something that works for me. Depression fucking sucks.

  • It's times like this that I realize how lucky I am. I can't imagine what it must be like to have to find the right drug cocktail that actually works. I'm not on anything, not even the Pill (I don't have sex, uh, EVER, but on the rare occastion I do, it's condoms all the way.) My sister has asthma and at one point she was on 13 seperate medications A DAY. All it did was stunt her growth and turn her off meds forever, which is probably why she's currently studying holistic healing.

  • Does that mean the OTHER Wellbutrins are fine? Or, at least, less inflated? I'm on XL.

  • @ineffable.me: As I understand it, they can pull people of their deepest depression, in which they can't muster up the energy for anything, only to give them the energy to attempt suicide. At least that's how a friend of mine described it. Thank God her roommate caught her, is all I can say.

    Incidentally, I take Effexor XR. Wonderful.

  • Image of blackbirdfly blackbirdfly at 12:31 PM on 01/17/08 *

    @summerwheatley: Mine actually seems to work pretty well, also, for two things: insomnia and anxiety. I had a terrible experience on Wellbutrin. Prozac made me stop eating (no appetite) and also made me sleep 24/7.

  • Image of Archetype Archetype at 12:31 PM on 01/17/08 *

    @Muffyn: That makes me sooooo angry. Navigating the system is hard enough, but when you're looking for a mental health doctor, I feel like there should some extra sensitivity and flexibility.

    A few weeks ago, I was trying to make an appointment with a GP for a check-up on some stitches I had gotten the day before. After calling about 5 hospitals with no luck, I started looking up doctors online. I called a number provided on a hospital website and was yelled at by a doctor because, apparently, it was his private line. My stitches were a result of self-injury and I was already incredibly wiped out and scared. I cried for an hour after he hung up on me.

    Asshole. No wonder he was accepting new patients. No one wants to see him.