---
In FairfieldLife@yahoogroups.com,
Peter Sutphen
<[EMAIL PROTECTED]>
wrote:
>
Antidepressants (specifically the SSRI's: Prozac,
> Paxil,
Zoloft, Lexapro) can be very effective in
>
reducing the symptoms of clinical depression in about
> 50% of
the people who take them. I work with patients
> who
have benefitted tremendously from
>
anti-depressants. However, while Bob overstates the
> point,
anti-depressants are not the panacea the drug
>
companies make them out to be.
It's not me
that is making the point, but a lot of careful
researchers
whose meticulous work has been published in the American
Psychological
Assn Journal this is one of the studies:
http://www.journals.apa.org/prevention/volume5/pre0050023a.html
> For
some people they
> just
don't work.
Placebo
effects, which is what anti-depressants are exhibiting, don't
work for
everybody.
>In my
experience, the more high
>
functioning the person is, the more effective the
>
anti-depressants are. Research has also shown (and
> I'll
find the reference if you want it), much to many
> peoples
surprise, that 1 year of cognitive-behavioral
> was as
effective as the SSRI's in reducing clinical
>
depression.
> -Peter
>
I already
posted the recent research from Univ of Pennsylvania and
Vanderbilt
on the lack of benefit from anti-depressants compared with
talk
therapy:
Cognitive
therapy as potent as antidepressants: study
Posted on :
2005-04-05| Author : Steve Walters
News
Category : Health
Cognitive
therapy can help as much as antidepressants
in
alleviating initial chronic depression and provide
longer
lasting effects, a study has found.
The study by
University of Pennsylvania and Vanderbilt
University researchers
raises doubts about the
guidelines
by American Psychiatric Association, which
stipulate
that antidepressant medicines are required
to treat
moderate to severe depression.
"On the
whole, these findings do not support the
current
American Psychiatric Association guidelines,
based on the
Treatment of Depression Collaborative
Research
Program (TDCRP), that most patients require
medication,"
the report said, while adding that
cognitive
therapy could be as `effective as
medications,
even among more severely depressed
outpatients,
at least when provided by experienced
cognitive
therapists'.
In a study
of 240 patients suffering from moderate to
severe
depression, researchers divided these patients
into three
groups. While 60 of them were administered
cognitive
therapy, 120 received antidepressant
medication,
and 60 others were given a placebo.
After being
given the treatment for eight weeks,
researchers
found that 50 per cent of those who were
given
medication responded positively as against 43
per cent of
those in the cognitive therapy group. The
response in
the placebo group was about 25 per cent.
Sixteen
weeks into the treatment, response rates of
those in the
cognitive therapy and the medication
group were
on par at 58 per cent. While those
receiving
medication showed a remission rate of 46 per
cent, only
40 per cent of those who underwent
cognitive
therapy lapsed back into depression.
Said Penn's
Department of Psychology's Robert
DeRubeis,
who authored the study, "We believe that
cognitive
therapy might have more lasting effects
because it
equips patients with the tools they need to
learn how to
manage their problems and emotions." He
added that
`pharmaceuticals, though effective, offer
no long-term
cure for the symptoms of depression'.
According to
DeRubeis, for many patients, cognitive
therapy
offers a better form of treatment.
However, the
effectiveness of cognitive therapy
depends
entirely on the experience and expertise of
the
therapists administering it. The findings of the
study have
been published in the latest issue of
Archives of
General Psychiatry.
-----------------
Here’s a possible explanation for
the curious conclusions, from:
http://skepdic.com/refuge/funk21.html
"The
high levels of placebo effect which have been repeatedly reported in many
articles, in our mind are the result of flawed research methodology," said
Dr. Hrobjartsson, professor of medical philosophy and research methodology at University of Copenhagen.*
Typical
of the kind of flawed research methodology Hrobjartsson is referring to would
be that of surgeon J. Bruce Moseley who performed fake
knee surgery on eight of ten patients. Six months after the surgery all the
patients were satisfied customers. Rather than conclude that the patients didn't
need surgery or that the surgery was useless because in time the patients would
have healed on their own, he and others concluded that the healing of the eight
who did not have surgery was due to the placebo effect, while the two who had
real surgery were better because of having had the operation. Irving
Kirsch and Guy Sapirstein made the same kind of methodological error in
their controversial meta-study which found that anti-depressants work by the
placebo effect, rather than that anti-depressants are unnecessary and useless.
Hrobjartsson would probably claim that the observed results of controlled
studies on anti-depressants were actually due to regression.
Many
researchers have avoided this kind of flaw by having a third group, who receive
no treatment at all, to compare to the other two. If the placebo group shows
better results than the group getting nothing, then surely the placebo is
effective. Hrobjartsson and Gotzsche think most of these studies, too, are
flawed, mainly due to having samples that were too small or due to patients who
make reports aimed at pleasing the researcher. Thus, to those researchers who
have found that depressed patients on a waiting list did not do as well as
those on a placebo,*
Hrobjartsson and Gotzsche might claim that the studies were too small or that
the improvement was due to subjective and biased evaluations of either the
would-be patients or the researchers.
