5 ms·

The fatal error in his reasoning is fundamentally units vs. integration. The "comprehensive" studies still show that SSRIs are effective [0], the mechanism of a

by gburt 12y ago

The fatal error in his reasoning is fundamentally units vs. integration. The "comprehensive" studies still show that SSRIs are effective [0], the mechanism of action is just not likely to be "because you didn't have enough serotonin." [0] Cochrane Review: http://www.cochrane.org/CD007954/DEPRESSN_antidepressants-versus-placebo-for-depression-in-primary-care http://www.cochrane.org/CD007954/DEPRESSN_antidepressants-ve...

Alex3917 12y ago
> The "comprehensive" studies still show that SSRIs are effective From the article: "Most of the studies were supported by funds from pharmaceutical companies and were of short duration." In other words, what they are saying is that the published research papers show efficacy for SSRIs, which is completely different from saying that the research shows that SSRIs are effective.
- cwyers 12y ago
  > "Most of the studies were supported by funds from pharmaceutical companies" Isn't that true of MOST drugs?
  - jMyles 12y ago
    Generally not plants.
  - SoftwareMaven 12y ago
    Yes, which, by itself, would not be a problem (of course, you would need to watch closely for conflicts of interest clouding the issue). No, the real problem is that the drug companies do not have to release all of the data associated with the trials they perform. They don't even have to publish all of the trials they perform. Given that, I have a very hard time trusting any drug that does not show amazingly stellar clinical trial results. If you have the options of cherry picking what you publish, and your drug only "helps" 50% of the participants, I see that as random noise. Ben Goldacre[1] is trying to shine a spotlight on this, and is doing a pretty good job. His Ted Talk[2] is well worth watching. 1. http://www.badscience.net/ http://www.badscience.net/ 2. http://www.ted.com/talks/ben_goldacre_battling_bad_science http://www.ted.com/talks/ben_goldacre_battling_bad_science
    - DanBC 12y ago
      Depression probably isn't a single illness, and so it's not surprising that meds don't work for everyone. We've recently discovered genetic differences in medication efficiency - at some point in the future you'd have a genetic test that would tell you that meds A, B, and C probably aren't going to work for you. (Except by then we'll probably have better meds and better access to better talking therapies.) These genetic differences were not known at the time of the drug trials. I totally agree with you about the problems of drug research and drug companies cherry picking which data to release. Goldacre's books are good.
      - Osiris 12y ago
        This is already true. Both my wife and I had genetic tests done that showed which medications were likely to be more or less effective. In my wife's case it was a deficiency in an enzyme to break down folic acid and nothing to do with serotonin levels. Without the genetic test she'd still be taking the wrong medications.
        porker 12y ago
        I didn't realise genetic testing like this was possible - it seems unknown in the UK (esp in the NHS). Can you share more details?
        Osiris 11y ago
        here's one: http://genomind.com/ http://genomind.com/ Basically they give you a report of your genetic variations and how those relate to different medications or treatments.
- bayesianhorse 12y ago
  That is a deeply unfair misunderstanding of the pharmaceutical industry and the medical profession. First of all, not all these studies are funded by the producers themselves. And even when they are, it is still hard or next to impossible to outright cheat. There are standards in place, and thousands of people are involved, of which hundreds would need to collude. Has this happened? Yes, it has. And when it came out it had a devastating effect. But ruling all scientific studies were these stakeholders foot some of the bill invalid is just unfair and dangerous!

by gburt 12y ago

Alex3917 12y ago

> The "comprehensive" studies still show that SSRIs are effective From the article: "Most of the studies were supported by funds from pharmaceutical companies and were of short duration." In other words, what they are saying is that the published research papers show efficacy for SSRIs, which is completely different from saying that the research shows that SSRIs are effective.

cwyers 12y ago
> "Most of the studies were supported by funds from pharmaceutical companies" Isn't that true of MOST drugs?
- jMyles 12y ago
  Generally not plants.
- SoftwareMaven 12y ago
  Yes, which, by itself, would not be a problem (of course, you would need to watch closely for conflicts of interest clouding the issue). No, the real problem is that the drug companies do not have to release all of the data associated with the trials they perform. They don't even have to publish all of the trials they perform. Given that, I have a very hard time trusting any drug that does not show amazingly stellar clinical trial results. If you have the options of cherry picking what you publish, and your drug only "helps" 50% of the participants, I see that as random noise. Ben Goldacre[1] is trying to shine a spotlight on this, and is doing a pretty good job. His Ted Talk[2] is well worth watching. 1. http://www.badscience.net/ http://www.badscience.net/ 2. http://www.ted.com/talks/ben_goldacre_battling_bad_science http://www.ted.com/talks/ben_goldacre_battling_bad_science
  - DanBC 12y ago
    Depression probably isn't a single illness, and so it's not surprising that meds don't work for everyone. We've recently discovered genetic differences in medication efficiency - at some point in the future you'd have a genetic test that would tell you that meds A, B, and C probably aren't going to work for you. (Except by then we'll probably have better meds and better access to better talking therapies.) These genetic differences were not known at the time of the drug trials. I totally agree with you about the problems of drug research and drug companies cherry picking which data to release. Goldacre's books are good.
    - Osiris 12y ago
      This is already true. Both my wife and I had genetic tests done that showed which medications were likely to be more or less effective. In my wife's case it was a deficiency in an enzyme to break down folic acid and nothing to do with serotonin levels. Without the genetic test she'd still be taking the wrong medications.
      - porker 12y ago
        I didn't realise genetic testing like this was possible - it seems unknown in the UK (esp in the NHS). Can you share more details?
        Osiris 11y ago
        here's one: http://genomind.com/ http://genomind.com/ Basically they give you a report of your genetic variations and how those relate to different medications or treatments.
bayesianhorse 12y ago
That is a deeply unfair misunderstanding of the pharmaceutical industry and the medical profession. First of all, not all these studies are funded by the producers themselves. And even when they are, it is still hard or next to impossible to outright cheat. There are standards in place, and thousands of people are involved, of which hundreds would need to collude. Has this happened? Yes, it has. And when it came out it had a devastating effect. But ruling all scientific studies were these stakeholders foot some of the bill invalid is just unfair and dangerous!