5 ms·

The pharma trials are a joke. There is pressure on researchers to obtain positive results. Then, pharma companies select which results they want to share. Negat

by avgDev 8y ago

The pharma trials are a joke. There is pressure on researchers to obtain positive results. Then, pharma companies select which results they want to share. Negative results often go unpublished leaving the doctors and the public uninformed. https://www.scientificamerican.com/article/trial-sans-error-how-pharma-funded-research-cherry-picks-positive-results/ https://www.scientificamerican.com/article/trial-sans-error-... I have done plenty of research on this. I have friends who are pharmacists. Doctors don't like speaking up as it can ruin them. Many of these people have really high debt and simply cannot afford not making $100k+.

lhuser123 8y ago
This is the real problem. And the consequences are more devastating that most people think. Families and lives destroyed because they don’t understand what they are getting into, and doctors are not much help.
refurb 8y ago
I think you're under estimating just how hard it is to prove that an anti-depressant works. The placebo effect is massive. The tools to measure depression are more qualitative than quantitative. That's why a number of pharma companies have abandoned neuroscience entirely. Yes, you only need 2 positive phase 3 trials to get your drug approved. Yes, you could have done 10 others and had them fail. Yes, the FDA already knows this. The FDA is willing to approve drugs for depression with much weaker data than say, cancer, because if they held them to the same standard, no drugs would be approved at all.
- dorchadas 8y ago
  > The FDA is willing to approve drugs for depression with much weaker data than say, cancer, because if they held them to the same standard, no drugs would be approved at all. Then maybe we don't need drugs approved?
  - refurb 8y ago
    A drug that has some evidence it works for some people is better than no drugs at all.
    - maxerickson 8y ago
      I don't think that's obvious at all. It will be true some of the time, but there's lots of room for a drug to do more harm than good in that situation.
  - deleted 8y ago
    [deleted]
  - akiselev 8y ago
    The problem isn't their effectiveness versus a placebo but patient selection. Each drug helps a small subset of all people due to natural variations in brain chemistry but does nothing or hurts everyone else. Until we have the technology to properly identify which patients qualify for a clinical trial, the option is between letting people suffer without recourse or dealing with follow on problems like overprescribing and addiction. The FDA knows how much more complex neuroscience is to develop drugs for and has chosen the latter option as an ethical necessity.
    - narwally 8y ago
      I had to try at least a dozen antidepressants to find out that Lexapro was the only one that noticeably worked well enough to be worth the side effects. When my sister started suffering from depression as well, her doctor actually had her ask me about the medications that worked best for my depression. Lexapro ended up being effective for her as well, and she avoided the same process I went through because they were able to use the genetic clues to at least find a good starting point.
  - zdragnar 8y ago
    I can say with absolute certainty that I would be in a far, far worse position in life without lexapro. Others were far less effective, but it absolutely turned me around.
- leekyle333 8y ago
  I'm not totally familiar with the placebo process. Are there anyways you could throw off the process like having the placebo doctors be really mean and the drug doctors be really nice? Is everything completely randomized in terms of people that are taking the drugs? IE if there was a magic formula for determining that an individual is more likely to respond positively to placebos could they pick those people?
  - taejo 8y ago
    Double blinding is supposed to prevent this. Nobody who sees the patient should know which patients are taking the placebo (person A puts either placebos or treatments in bottle X, person B gives patient X the bottle).
  - fsloth 8y ago
    Yes, it seems that other people are more susceptible to placebo than others. It is likely there are portions of the population, who have a better response to a placebo than to the actual drug - but! - the reverse is also a likely scenario. I.e. there are people who don't respond to a placebo and show a strong therapeutic response to an actual drug. Hence, if one is capable, one should always have an active attitude to ones treatment - what works for someone else, may not work for you, and vice versa. I hope someone can dig out the reference to this... I read this from a reputable source, but damn if I can remember from where anymore.

by avgDev 8y ago

lhuser123 8y ago

This is the real problem. And the consequences are more devastating that most people think. Families and lives destroyed because they don’t understand what they are getting into, and doctors are not much help.

refurb 8y ago

I think you're under estimating just how hard it is to prove that an anti-depressant works. The placebo effect is massive. The tools to measure depression are more qualitative than quantitative. That's why a number of pharma companies have abandoned neuroscience entirely. Yes, you only need 2 positive phase 3 trials to get your drug approved. Yes, you could have done 10 others and had them fail. Yes, the FDA already knows this. The FDA is willing to approve drugs for depression with much weaker data than say, cancer, because if they held them to the same standard, no drugs would be approved at all.

dorchadas 8y ago
> The FDA is willing to approve drugs for depression with much weaker data than say, cancer, because if they held them to the same standard, no drugs would be approved at all. Then maybe we don't need drugs approved?
- refurb 8y ago
  A drug that has some evidence it works for some people is better than no drugs at all.
  - maxerickson 8y ago
    I don't think that's obvious at all. It will be true some of the time, but there's lots of room for a drug to do more harm than good in that situation.
- deleted 8y ago
  [deleted]
- akiselev 8y ago
  The problem isn't their effectiveness versus a placebo but patient selection. Each drug helps a small subset of all people due to natural variations in brain chemistry but does nothing or hurts everyone else. Until we have the technology to properly identify which patients qualify for a clinical trial, the option is between letting people suffer without recourse or dealing with follow on problems like overprescribing and addiction. The FDA knows how much more complex neuroscience is to develop drugs for and has chosen the latter option as an ethical necessity.
  - narwally 8y ago
    I had to try at least a dozen antidepressants to find out that Lexapro was the only one that noticeably worked well enough to be worth the side effects. When my sister started suffering from depression as well, her doctor actually had her ask me about the medications that worked best for my depression. Lexapro ended up being effective for her as well, and she avoided the same process I went through because they were able to use the genetic clues to at least find a good starting point.
- zdragnar 8y ago
  I can say with absolute certainty that I would be in a far, far worse position in life without lexapro. Others were far less effective, but it absolutely turned me around.
leekyle333 8y ago
I'm not totally familiar with the placebo process. Are there anyways you could throw off the process like having the placebo doctors be really mean and the drug doctors be really nice? Is everything completely randomized in terms of people that are taking the drugs? IE if there was a magic formula for determining that an individual is more likely to respond positively to placebos could they pick those people?
- taejo 8y ago
  Double blinding is supposed to prevent this. Nobody who sees the patient should know which patients are taking the placebo (person A puts either placebos or treatments in bottle X, person B gives patient X the bottle).
- fsloth 8y ago
  Yes, it seems that other people are more susceptible to placebo than others. It is likely there are portions of the population, who have a better response to a placebo than to the actual drug - but! - the reverse is also a likely scenario. I.e. there are people who don't respond to a placebo and show a strong therapeutic response to an actual drug. Hence, if one is capable, one should always have an active attitude to ones treatment - what works for someone else, may not work for you, and vice versa. I hope someone can dig out the reference to this... I read this from a reputable source, but damn if I can remember from where anymore.