Clinical Trials Exaggerate Antidepressant Benefits
107 CommentsBy Ed Silverman // January 16th, 2008 // 5:53 pm
How is this possible? A review of unpublished studies submitted to the FDA by drugmakers found many of the meds have little or no effect on patients, according to a new review of the previously unknown results, which was published in this week’s New England Journal of Medicine (subscription may be required). The upshot is that docs and patients are getting a distorted view of the effectivness of such drugs as Effexor, Zocor, Cymbalta and Paxil.
The researchers looked at reviews from the FDA for trials between 1987 and 2004 on 12 widely used antidepressants involving 12,564 patients, and whether the research was published. Those studies that were published were then compared against FDA versions. The found that the results determined whether and how studies were published. Most of the studies that were not positive were not published or they were published with a positive spin, such as emphasizing positive secondary outcomes when a primary outcome proved negative. While drugmakers don’t have to publish all their studies, the researchers identified unpublished studies by comparing databases of medical journals with documents filed with the FDA.
In discussing their findings, the researchers wrote that the FDA deemed 38 of 74 studies to be positive and all but one of those studies was published, the researchers said. The remaining 36 were either had negative or questionable results; of those, 22 weren’t published. Of the 14 that were published, 11 were mischaracterized as positive, according to the researchers, who were led by Erick Turner, a former FDA reviewer who is now an assistant professor of psychiatry, physiology and pharmacology at Oregon Health & Science University and Medical Director of the Portland Veterans Affairs Medical Center’s Mood Disorders Program.
“We found a bias toward the publication of positive results. Not only were positive results more likely to be published, but studies that were not positive, in our opinion, were often published in a way that conveyed a positive outcome. we found that the efficacy of this drug class is less than would be gleaned from an examination of the published literature alone,” they concluded.
“We cannot determine whether the bias observed resulted from a failure to submit manuscripts on the part of authors and sponsors, from decisions by journal editors and reviewers not to publish, or both. Selective reporting of clinical trial results may have adverse consequences for researchers, study participants, health care professionals, and patients.”
Lisa Van S
Ed,
Are you serious!!! This has been known since 2004. The Congressional Hearings revealed this, This info isnt new,.. just refurbished…
Donna
What is the percent of those no longer with us in that time frame, that’s what I would like to know……..
Brian
The quote is “Little or no effect on patients” that means it couldn’t have harmed anyone either… Right??????
Lisa Van S
Brian,
You need to get a life..
Brian
Quote from Kettle: What say you Pot?…
You’ll have to give all that money back!!! Who to blame now?…
Lisa Van S
brian,
Got me baffled!!!! English Please….
Nathan
What a suprise: Negative results aren’t published. Wow. I better go write some publications about all those experiments I did that failed. Maybe a journal will accept them now that this “groundbreaking” story came out.
Lisa Van S
Nathan,
If you are truly a scientist, maybe you should reconsider comments, Sarcasm doesnt do you any justice…
Brian
You know who
If you agree the drug has no effect then how can you blame it for someone’s attempted suicide. You didn’t tell the whole story here..I’m convinced there is a genetic component to mental illness and then there’s impact of parenting….
Nathan
By the way Ed — watch your titles. “Clinical Trials Exaggerate Antidepressant Benefits” isn’t an accurate statement what-so-ever based on the story your wrote.
A better statement is: “Publication of Clinical Trial Data Exaggerates Antidepressant Benefits”.
Donna
Nathan,
I think Ed Know’s he’s doing……
Lisa Van S
By the way Nathan,
I noticed you had no Rebuttal to my comment.. Can one assume that I am correct that you have absolutely no conception of the serious adverse effects children endure while on SSRI’s? Or would you still rather accuse me of being a Stalker?…
Brian
Why were they on antidepressants? Doesn’t sound like the first thing you would try. I would expect their behavior was in a long term decline. If that decline continued and they were treatment resistant you might expect a bad outcome while on a SSRI. I don’t expect everyone would understand this..
Lisa Van S
Brian
Have any Scientific data to back that up!.. Or would you rather be one of those individuals who would prefer to state that its a chemiacal Imbalance..
Nathan
Donna,
I made a very simple observation. Do you think this title makes sense? Someone reading this title would think that pharmaceutical companies are exagerating the results of an individual clinical trial. They aren’t. The scientists at the company simple choose to write articles about those trials with positive outcomes.
The more I think about this story, the more it irks me. This is a non-story. Drugs fail for many, many reasons. Maybe the drugs were tries at too low of a dose. Maybe they were tried at too high of a dose and side too many side effects were observed. Maybe the endpoint was poorly choosen.
Nathan
Lisa, your thoughts aren’t worth the imaginary paper that you are typing them on. Get a life and take your comments elsewhere.
—–
Lisa wrote:
By the way Nathan,
I noticed you had no Rebuttal to my comment.. Can one assume that I am correct that you have absolutely no conception of the serious adverse effects children endure while on SSRI’s? Or would you still rather accuse me of being a Stalker?…
v
Nathan
For those of you that haven’t written up a scientific article for publication, I’ll make you aware of a few things:
1) Journals don’t accept an article just because it is written. Journal editors scrutinize it and submit it to reviewers who further scrutinize it — very frequently rejecting articles that aren’t conclusive or are poorly written.
2) Scientists write scientific articles — not public relations representatives.
3) Scientists generally don’t waste weeks (or months) of their time writing up articles that don’t prove anything and probably won’t be accepted by the journal. A negative result is generally meaningless in science. Do you think Thomas Edison wrote up articles about the 900 filaments that failed to light a light bulb?
Now I’ll ask again: Is it any surprise that the negative clinical trials were not written up as publications?
Here’s one example: The Paxil trial may have tried doses of 10, 25, and 50 mg. The 10 and 25 mg dose failed to show an effect. The 50 mg dose did show an effect. Why should anyone waste their time writing up a journal article explaining why the 10 and 25 mg dose failed? It’s obvious that drug levels just weren’t high enough to observe an effect.
Truthman
OK guys enough of the petty squabbling…
Some people might like to downplay and dismiss this article (ie. Nathan
and Brain) , but it actually is quite an important one.
And the fact of the matter is, many campaigners , such as myself and others have known this for years, but that doesn’t mean it was “public knowledge”… It has got a lot of coverage in the mainstream news , deu to this research, and that can only be a good thing..
On the subject of publishing trials with positive outcomes only and not publishing trials with negative outcomes, anyone who argues that this behaviour is good for patients and the public at large needs a dose of reality…
It is deply harmful and deeply shameful, and there should be a law against it…
Chris
> Someone reading this title would think that pharmaceutical companies are exagerating the results of an individual clinical trial.
> emphasizing positive secondary outcomes when a primary outcome proved negative.
Nathan,
If you neglect the (negative or neutral) primary endpoints, and focus only on postive secondary endpoints (as mentioned above), then this can qualify as inappropriately exaggerating the overall results of the study.
Brian
All you can say from the experience with SSRI clinical trials is that it is difficult to prove benefits / uncover risks in clinical trials of the size currently attempted. As we know, the true impact of a medicine becomes apparent in the larger population. If you want to get to this answer faster, it sounds like you need bigger trials. The problem is; who pays for these trials and who will volunteer?
Nathan
Chris & Truthman:
I understand how this APPEARS to be a smoking gun. But I’ll state again why I believe it is not: Let’s say I do a clinical trial with Paxil at 10 mg (once per day), 20 mg (once per day), 20 mg (twice per day), and 50 mg (twice per day). That’s a total of 4 trials. Only the 50 mg dose works. Are the other three trials counted as “negative” evidence that the drug doesn’t work? Of course not.
Should I write up journal articles about the 3 trials that failed? It would be a waste of my time. Maybe you can find the spare time to write them up.
One more note to Truthman: Publishers are independent of pharmaceutical companies. Even if I tried to write a paper about a failed experiment or an ineffective dose of a compound, the journal would likely reject it. Or (best case scenario) it would be published in a low-quality journal — maybe the Scandinavian Journal of Psychology would accept it…
Lisa Van S
Nathan,
“Scientists write Scientific Articles– Not Public Relations Represenatives”
If you truly believe this, then I have The Brooklyn Bridge Id like to sell you!
Interesting Read:
http://www.healyprozac.com/ghostlydata/default.htm
Brian
The underlying biology around depression still in the process of being understood. One can’t predict which patients will respond to SSRI’s modification of serotonin. It is true that there is a large segment of the depressed population that will not respond to this therapy but who they are is hard to predict. In practice these patients may be seen to get worse and the question then is do we take them off medication entirely? Research into this area needs to continue but most companies don’t see any incentive given their experience with previous clinical trials. There are other mechanisms related to, glutamate substance P and CRF and other hormones but it has been tough to bring any of these therapies forward..
Lisa Van S
Another Interesting Read:
Critical Docs:
http://www.healyprozac.com/trials/criticaldocs/default.htm
Nathan
For those of you that haven’t read the article, here’s a few quotes from the article in question that are pertinant to this discussion:
“We wish to clarify that nonsignificance in a single trial does not necessarily indicate lack of efficacy. Each drug, when subjected to meta-analysis, was shown to be superior to placebo. On the other hand, the true magnitude of each drug’s superiority to placebo was less than a diligent literature review would indicate.”
“Because we excluded articles covering multiple studies, we probably counted some studies as unpublished that were — technically — published. The practice of bundling negative and positive studies in a single article has been found to be associated with duplicate or multiple publication, which may also influence the apparent risk–benefit ratio.”
“It might be argued that some trials did not merit publication because of methodologic flaws, including problems beyond the control of the investigator. However, since the protocols were written according to international guidelines for efficacy studies and were carried out by companies with ample financial and human resources, to be fair to the people who put themselves at risk to participate, a cogent public reason should be given for failure to publish.”
There is some truth to this last statement. But all clinical trial data, published or not, is publicly available, right?
Johnson Chen
Realistically, shall we now consider a new perspective besides those from government agencies, research community, and pharmaceuticals in this matter? The debate can go on and on, but many people are awaiting for results if there is any. The current reality may dictate that experiences from patients and physicians count in determining the exact side effects and effectiveness.
That was how HealthLat came into being. Patients and physicians are welcome to report their experiences and check how a treatment has been used by others in http://www.healthlat.com
Brian
The above post leads you to a page with this statement: “Drugs that work for a few in clinical trials may not work for millions in the market. Side effects and interactions may not be known for a long time. Only individuals experienced it know it first.”
While this is a distortion of the fact that MOST folks do well on approved drugs and a small percentage (still a large number) do not
The solution is bigger clinical trials with more patients
who pays and who volunteers??
Bob Freeman
Nathan has raised an important issue that has been known for years: clinical journals have a negative bias against studies that don’t show clinical improvement. Editors want “breakthrough” studies that call attention to their journal, not studies that are equivocal or show little if any clinical benefit. And, the dirty little secret is that editors have their favorites who get positive peer reviews based on reputations and affiliations, and if an editor doesn’t know you, you don’t get an expedited review. An editor also knows which ones of his/her reviewers will give favorable reviews (in general) and those who won’t. An editor can therefore kill or facilitate an article that he/he wants published.
Years ago, a journalist was allowed to sit in meetings of the editorial staff of the NEJM. (This goes back a long time and I don’t remember where it was published: Atlantic Monthy or New Yorker, perhaps). Publication reviews just aren’t that objective.
Finally, some researchers took articles that had been published in referred psychology journals, changed the name of the authors and their affiliations to lower-tier state universities and sent them out for review. Guess what: the majority of studies were rejected. (I forgot where this was published but it is from the distant past.)
Jane
Brian, The link below hurts every arguement you have attempted to make http://clinpsyc.blogspot.com/2008/01/antidepressants-hiding-and-spinning.html
Brian
Jane,
No, This web site deals with the controversy of how the results are viewed interpreted and reported to the lay public. The data have always been there for those in the field.. The question is the interpretation given that some folks and perhaps a majority receive a benefit from SSRI’s. The question remains, what is the underlying causes for all types of depression?
BTW: Why do you not view the information on your web site with the same suspicion Science is always a battle between factions..It is not designed to end but you have to understand its principles first
Melody
Nathan wrote: 1) Journals don’t accept an article just because it is written. Journal editors scrutinize it and submit it to reviewers who further scrutinize it — very frequently rejecting articles that aren’t conclusive or are poorly written.
Nathan–take a look at a recent article by Roy Poses on HealthCare Renewal blogsite: http://hcrenewal.blogspot.com/2008/01/antipsychotic-drugs-for-depression.html#links
If you read the article carefully, I think it trashes much of your “integrity” argument.
Melody
Nathan further states:–One more note to Truthman: Publishers are independent of pharmaceutical companies. Even if I tried to write a paper about a failed experiment or an ineffective dose of a compound, the journal would likely reject it. Or (best case scenario) it would be published in a low-quality journal — maybe the Scandinavian Journal of Psychology would accept it…
Read the article I referenced. Again, the integrity, and thus the validity, is questionable when the EDITOR is also a co-author! Perhaps you are remembering a time when science, scientists and researchers were not for sale. While there are some who also remember such days, and practice/write accordingly–they are NOT the majority.
Johnson Chen
Brian,
I don’t see much difference we have. As you pointed out, without funding and volunteers, large clinical trials are impossible. So the public, lay or not, have no choice but to rely on the (sometimes conflict-of-interest prone) small clinical trials. Yes, the experience information is in the field, as it has been since Vioxx was there for 5 years and taken by 20MM people.
Now what HealthLat does is to collect the information and make it useful as complementary information in decision makings. For the many good drugs, people get a peace of mind; for the potential bad, people are alerted. Another thing, HealthLat reports consider not only the self-interpretation of a drug but also any new conditions or symptoms after.
Brian
You might call vioxx a dangerous drug but more people have been injured by aspirin. Individual reports of drug issues are not reliable and are also biased by the potential for tort litigation. Money drives this process and drives all processes. This is a complex area and many have continued tightening the grip on pharma but to what end? Scrutiny of publications seems like a red herring. Let’s deal with the actual problem that pharma can’t operate under your strict rules.
Nathan
Melody,
I’m a scientist at a big-pharma company. I guess you’ll just have to take my word on it. Editors of journals are not “paid off” by the company. Scientists write the articles (not public relations people). I’ve written several myself. Here is the process we go through when publishing in big-pharma:
1) Do the science
2) Patent the science (when possible)
3) Write the paper
4) Submit it to legal clearance (company lawyers)
5) (for clinical studies) Submit to internal review board/clinicians/public relations
6) Submit it to the journal
7) The journal sends it to the reviewers (experts in the field)
8) The reviewers recommend changes or acceptance or rejection.
As Bob pointed out, editors like to accept articles that make their journal look good. NEJM is probably not going to accept a bunch of articles about clinical trials that didn’t work. That doesn’t mean the editors are in some sort of under-the-table deal with the company. It simply means that they are looking out for the best interest of the JOURNAL, not the public.
I think we’re all missing the point. Of course scientists like to publish things that work, not things that fail. The point is that ALL clinical trial data (the good, the bad, and the ugly) is available to the public, the FDA, and anyone else interested. Whether or not the data makes it into a journal is irrelevant.
Bob Freeman
Nathan, you said it far better than I. Great post
Nathan
Melody,
In specific response to the link you mentioned:
The link says that there was a article with Charles B. Nemeroff as a lead author in 2006 while he was also editor-in-chief of Neuropsychopharmacology. I was very surprised at this. So I decided to check it out for myself. Sure enough, it’s correct.
I don’t know if this is a common practice or not. Certainly it’s a conflict of interest and it seems rather inappropriate to me.
Non-the-less, in general, the publication process favors articles that describe SUCCESSFUL experiments/studies. The failures (unless they are catastrophic failures) just don’t generate much interest to the scientists, the journal editors, or the readers.
Philip Dawdy
Natan, Brian and other spinners for Big Pharma
I’m sorry but you guys are wrong on several counts. 1) ghost-written, PR based research gets published all the time. 2) these unpublished anti-depressant studies were not available to the field until recently and a lot of patients and docs were lied to in the 1990s as a result. 3.) the sad fact is your employers wildly overstated effects of anti-depressants as a result and still do, check the recent dinging of wyeth by the fda. 4.) how do you look at yourself in the mirror in the morning? 5.) maybe you should start reading my site in addition to ed’s.
Truthman
Nathan…
I think you are missing the point i was making.
Of course i understand why negative trials are not published. Of course it would be of no benefit to a pharma company to have them published,(at least commercially) so why would they?
But i disagree about your opinion of independent publishers( and I presume you were refering to medical journals such as the Lancet , BMJ , New England-Journal etc?)
Independent publishers don’t publish negative clinical trial date for three main reasons.
1. Some journals are heavily influenced or affiliated with the Pharma Industry (bias opinion is rampant as is conflict of interest).
2. Most negative trials and data on Drugs are concealed by drug companies and they do not have to disclose this data (for commercial reasons/trade secrets etc)
3. And because of the reasons above, even if independent researchers wanted to clinically trial a drug, it is difficult to get funding , so independent(non-biased) trials are rare (Thus few ever make it to publication).
Let me put it this way…
Should it take a Vioxx, a Paxil , an Avandia or a Paxil catastrophe before the real risks are made public?…
Robyn
Nathan,
Please show us where ALL clinical trial data is available to the public.
My understanding is that all protocols are now required to be registered (only since a few years ago) but that there is no requirement to make results publicly accessible.
Bear in mind as well that trials are also conducted outside the legal jurisdiction of the US.
Truthman
Oh and one last thing…
I would hardly call a “clinical trial of an SSRI a worthy endeavour…(ie. attempting to treat psycho-emotional-spiritual manifestations with drugs is not only useless , it is severly damaging to patients, particularly if continued long term).. The human condition does not compose of neurons, synapses and chemicals..And the brain is not a computer hardrive which needs to be interfered with.. We are talking about people here… (people with identities, emotions, feelings and thoughts..not robots..)
And on the subject of science… Pychiatric drugs are completely unscientific, as there is no way of measuring “chemical”(serotonin) levels in the brain or the body. And also results can be interpreted and doctored favourably very easily in these trials; due to the nature of the “condition” they attempt to treat, and also the structure of the trials themselves( washout, recoding of side effects etc) ..
SSRI clinical trials are about as scientific as banging a faulty TV set with your fist to make it work… Their premise and purpose is wholly unjustified, and the only reason SSRI’s exist is because they make a lot of money for the pharmas.. They are no more effective than the Tricylics , they were launched in order to tap new markets (PTSD, OCD ect). And they were marketed as better because the pharmas needed new drugs to patent … They have done nothing to further the cause or understanding of “mental illness”, as a matter of fact they have put this understanding back 50 years…
Truthman
Brian , you asked the question..
The question remains, what is the underlying causes for all types of depression?
.. I suggest you read some of Dorothy Rowe’s literature on the subject.. maybe it will give you an insight…?
or better still, maybe it will give you the answer…
http://www.dorothyrowe.com.au/
(If Doctors and psychiatwits prescribed her books to patients and not their pharma-death-pills then possibly the treatment of depression would be revolutionised)
Bob Freeman
Truthman, yes, the evidence is that tricyclics and SSRIs are essentially equally effective. The side effect profiles are different and in favor of the SSRIs, all things considered.
I’ve noticed over the years that many drug classes are promoted on the basis of patient preference rather than clinical benefit (which, due to the nature of many clinical trials is done for the purpose of establishing equal efficacy)
Nathan
Philip,
I’m glad you consider me to be a “spinner” for big-pharma! I only wish my employer recognized me as such. I’m a non-managerial benchtop scientist. As as benchtop scientist, I have the opportunity to view the science being done firsthand — and what is being written about it. I can assure you that most of you here don’t know what the hell you are talking about. If you want to know how things work in the pharma industry, then try getting a job here. We are always hiring.
Just don’t expect great payoffs. That’s reserved for the upper management. Most of us get virtually nothing beyond my monthly paycheck and a yearly miniscul bonus.
Nathan
Robyn,
You make a good point — lots of (early phase) clinical trials are now being done in India and China. What happens to that data? I don’t know.
I can’t vouch that all data IS being made publicly available. I’m saying that it SHOULD be publicly available. But that’s very different than saying that all data should be put into a peer-reviewed journal. That’s just not going to ever happen for the reasons I’ve outlined in the previous posts.
Brian
Truthman (sic)
psycho-emotional-spiritual manifestations are all caused by neuron and neuro transmitters interaction. I admit it’s complex but with you it’s probably less complex..
Philip Dawdy
I have made a difference with people w/ mental illness. You are focused on the treatment resistant population of which there are many. I am trying to help them too. It took years of work and we were very cautious before attempting to treat humans. To put us on an equal frame. I would like to have your free speech regulated as it could harm mentally ill people, that you control, who need treatment but listen to you instead.
BTW to all..writing papers is a huge amount of work….the glory is fleeting..I wouldn’t publish any of the 10,000 things that I now know don’t work..
Truthman
“Bob Freeman
Truthman, yes, the evidence is that tricyclics and SSRIs are essentially equally effective. The side effect profiles are different and in favor of the SSRIs, all things considered”
… just to correct you, “the evidence is that tricyclics and SSRIs are essentially equally INeffective”
For a vast majority of people who take SSRI’s, they cause a littanty of side effects which are just as undesirable and intolerable as the Tricylics…
This “class” of drugs can be worse in a lot of cases for a lot of people…
And if as you say the SSRI’s are equal to the tricylics in efficacy then why were they promoted as much safer and more effective option? ( could it be for drug patents and pharma profit reasons perhaps?)
“Brian
Truthman (sic)
psycho-emotional-spiritual manifestations are all caused by neuron and neuro transmitters interaction. I admit it’s complex but with you it’s probably less complex..”
Just to correct you again Brain…
To say that psycho-emotional-spiritual manifestations are all caused by neuro transsmitter interaction is the height of ignorance…(and totally arrogant)
It is text-book pseudo-science psycho-babble nonsense…
Many things can cause anxiety, depression OCD etc…
Trauma, inability to cope with life, stress, grief, dissapointment , fear etc .. These can all lead to didorders and dysfunction of the mind and personality…
Are you a psychiatrist Brian?… Do you work in the drug marketing industry…
If so, then i’m not at all suprised by your outlandish opinions … But i am dismayed at your narrow vision…
Brian
Truthman (sic)
What do you think (sic) goes on in that mass of jello in that watermelon above your shoulders. Huh??..what do think it’s smoke and mirrors up there??? Every thought , emotion and stupid idea is linked (eventually) to a mass of synapse firing and neurotransmitter release. I’m not saying anyone can pin down the exact cause and effect but somewhere My very words are causing a neuron to fire in your head. Trauma, inability to cope with life, stress, grief, dissapointment , fear etc .. all lead to disorders and dysfunction of the mind and personality which can be eventually linked to a mass of neurons firing and disfiring. BTW Stay away from Tom Cruise..he’s no good for you
Mark’s Daily Apple » Blog Archive » Where Have All the Studies Gone?
[...] Pharmalot: Clinical Trials Exaggerate Antidepressant Benefits [...]
Truthman
Brian
Truthman (sic)
What do you think (sic) goes on in that mass of jello in that watermelon above your shoulders. Huh??..what do think it’s smoke and mirrors up there??? Every thought , emotion and stupid idea is linked (eventually) to a mass of synapse firing and neurotransmitter release. I’m not saying anyone can pin down the exact cause and effect but somewhere My very words are causing a neuron to fire in your head. Trauma, inability to cope with life, stress, grief, dissapointment , fear etc .. all lead to disorders and dysfunction of the mind and personality which can be eventually linked to a mass of neurons firing and disfiring. BTW Stay away from Tom Cruise..he’s no good for you
Yes, Of course
I am not disputing this..
But in a way you have made my point for me…
“Trauma, inability to cope with life, stress, grief, dissapointment , fear etc .. all lead to disorders and dysfunction of the mind and personality which can be eventually linked to a mass of neurons firing and disfiring”…
So there you go.. The human experience (fear, trauma, emotion etc)_happens BEFORE the synaptic (brains) reaction… So to try to treat someone who’s problem is primarily on an emotional/human experienc level with a drug like an SSRi is treating the symptom of the problem and not the cause! .. Which is not only unscientific and ineffective it is downright dangerous!..
For Example, if someone happens to develop clinical depression in later life from the suppression of feelings of being abused or neglected as a child, the chemical changes (such as a possible drop in dopamine/serotonin production) which take place in the brain are as a result of the individuals mood( and emotions)infulencing this ..
So how the hell is prescribing an SSRI useful in a scenario such as this? ..
Prescribing an SSRI for a Symptom , is a chemical band aid, it does not address the root cause of the problem, which, with depression and Anxiety is usually related to the psychology of an individual…
Lisa Van S
Brian,
How does one diagnose depression/Bipolar or Schitzo effective disorder in those under the age of 5 years?
Maybe the NJ Doctors who prescribe Dangerous Mind Altering Drugs to this most “vulnerable population” at Tax Payers Expense can tell you.
One question I have is what incentives are driving these prescribing habits?
New Jersey Medicaid Record and Dr.s who Prescribe Powerful Mind Altering drugs off-label:
http://www.psychdrugdangers.com/atypicalantipsychotics.html
http://www.psychdrugdangers/notapprovedpediatric.html
Brian
Lisa,
I have no idea..I question doctors who are prescribing to children at that age..I’m guessing parents are demanding this…probably a bad idea
Lisa Van S
Brian,
If the #’s didnt exceed 39,500 I may take the same position as you. These numbers only reflect Medicaid, no one has any idea what the numbers are in in the private insurance area.
There is also a program called Teen Screen (If you have children in grades 5-12 There is a good chance your child participated) The subjective test is given to students, if they fail they are refered to a Mental Health Professional, in many cases students who fail arent permitted to return to scool unless they are medicated, Parents arent given a choice. These tests have an 84% failure rate.
Insurers should jump on the band wagon,..They have a good chance of saving millions.
Lisa Van S
Children In Clinical Trials; Psychiatrist Indicted for Fraud
http://www.usdoj.gov/usao/lae/press/2007/2007_06_04_palazzo_ind.htm
peter
As a psychiatrist I handed out SSRIs far too easily throughout the late 90s and early this decade. I was doubting their efficacy and also noting a lot of agitation reactions and starting to reduce prescribing before the real data started to come to light in the last 6 years or so.
I could have done with knowing all the data earlier!
Those patients of mine who had adverse reactions and I tried to persuade them to keep going when they just didn’t benefit and could’ve put themselves in grave harm given their deteriorating mental state because of the SSRIs - could’ve done with me knowing the data even moreso!!
That is not to say the occasional patient, especially with OCD, is not helped by SSRIs - but generally prescribe after psychotherapy and general lifestyle measures, fish oils etc. And even then the data shows much improvement is placebo.
truthman
“As a psychiatrist I handed out SSRIs far too easily throughout the late 90s and early this decade. I was doubting their efficacy and also noting a lot of agitation reactions and starting to reduce prescribing before the real data started to come to light in the last 6 years or so.
I could have done with knowing all the data earlier!”…
Thank you Peter for being a humane pshychiatrist and for speaking the truth about these SSRI’s…
Maybe Nathan and Brian will listen to what I have been trying to tell them if they hear it from you…
Brian
Truthman,
As you admitted in a recent post, counseling increases the levels of serotonin in the brain. So why would use of SSRI’s to increase those same levels in a patient with neuronal abnormalities cause harm? What your psychiatrist friend does not understand is the following about treatment resistant patients.
1. From the Journal Neuron and Jan 24, 2008 WSJ (My point: Treatment resistant patients make up most of the probable suicides after ineffective SSRI use)
Only about one-third of depressed patients feel better after taking any given antidepressant. And there’s no way to tell in advance which drug will work for a particular patient.
A person’s response to antidepressants is thought to be related, in part, to how well a drug can move from the bloodstream into the brain. And the ease of access appears to vary. The walls of blood vessels feeding the brain form a barrier that protects the organ from infections and toxins. But the barrier can also block some helpful substances, such as drugs.
Researchers from the Max Planck Institute of Psychiatry in Munich, Germany, used mice with missing genes to determine that some drugs were able to penetrate the blood-brain barrier more easily when a gene similar to the human one called ABCB1 was turned off.
And the researchers then examined the gene in 443 depressed individuals and found that some variations were associated with significantly greater improvement in depression symptoms in patients taking Forest Laboratory’s Celexa, or citalopram, and Wyeth’s Effexor, or venlafaxine.
Truthman
Brian : - “As you admitted in a recent post, counseling increases the levels of serotonin in the brain. So why would use of SSRI’s to increase those same levels in a patient with neuronal abnormalities cause harm?”
Well it is not nessacarilly the councelling itself which increases feel good reactions … Any release or relief felt by the patient would induce feel good reactions, of course it is all subjective in the sense that each individual would have unique responses to therapy , depending on their own ability to heal and deal with their underlying truamas and fears etc…
Brian : -
“Only about one-third of depressed patients feel better after taking any given antidepressant. And there’s no way to tell in advance which drug will work for a particular patient.
A person’s response to antidepressants is thought to be related, in part, to how well a drug can move from the bloodstream into the brain. And the ease of access appears to vary. The walls of blood vessels feeding the brain form a barrier that protects the organ from infections and toxins”
Well we could quote abstract and random studies for eternity Brian but it doesn’t really address the real issues with SSRI’s now does it?…
The fact of the matter is ANY long term use of psychiatric drugs is severly harmful…
Unfortunately due to severe withdrawal symptoms, (particularly with Paxil and Effexor), Patients who actually want to come off these drugs cannot because of the debilitating withdrawal reactions…
Nobody is arguing that SSRI’s can be helful in some cases when used moderately, short term and with careful monitoring .. But in the vast majority of cases this does not happen.. And Pharma is in part to blame for this reckless overprescription due to its shameless and fraudulant overpromotion of these meds as non addictive , non habit forming and safe.. When clearly they are very harmful, unsafe and can cause dependence ..
You ask the question : “why would use of SSRI’s to increase those same levels in a patient with neuronal abnormalities cause harm? ..
Have you looked at the PIL’s (patient info leaflet) of psychiatric Drugs Brian??? Have you seen the sheer littany of side effects ,physical and mental suffering that these drugs induce???
Councelling doesn’t make you shit your pants in public, councelling doesn’t make you sweat profusely, or give you muscle spasms, serotonin syndrome, intense agitation, aggression, hostility, suicidal thoughts, panic attacks, weight gain, nausea, vomiting, erectile dysfunction, lack of orgasm, inability to sit still (akathisia) , nightmares… The List goes on and on… (more being added almost every year)
Check out the Paxil (seroxat) PIL from 1996 to 2006 from my blog..
http://truthman30.wordpress.com/category/seroxat-link-9-pil-1996-to-2006/
How can you say prescribing a pill to a fragile, vulnerable and scared individual who obviously needs some human support is justified , particularly considering the probability that they will suffer these types of side effects?…
A drug having some mild side effects is one thing, but a drug causing these types of reactions is to me a defective and useless drug…
It may be one thing if the companies were truthful in the first place about the side effects, but they were not…
Pills can’t replace human sympathy, empathy, love and support Brian..
And in the vast majority of cases, that’s what should be prescribed… Not SSRI’s…
Nathan
Truthman says:
“Nobody is arguing that SSRI’s can be helful in some cases when used moderately, …And Pharma is in part to blame for this reckless overprescription…”
I finally agree with something you say! I’ve never argued that Pharma is not partly to blame. It is. I’ve never argued that the drugs are completely safe. They aren’t. However, there is a place for SSRIs in treatment. Just not quite to the degree they are currently being used.
Truthman says:
“The fact of the matter is ANY long term use of psychiatric drugs is severly harmful…”
Would you put caffeine into this category? Ethanol?
What about drugs for treatment of migraine headaches, epilepsy, Parkinson’s, MS, Alzheimer’s, autism, and Huntington’s? True treatments for all of these disease states will involve drugs that cross into the brain and have some sort of neurological/psychiatric effect. Currently, there are few effective treatments for any of these conditions. Are you in favor of banning drug treatments of these diseases?
I would suggest you limit your arguments to SSRIs in the future… At least for SSRIs you have a tiny platform to stand on.
CNS research has a long, long way to go. I would make the argument that the field is really just in its infancy, much as the very early cancer treatments of the 1950’s. Our current treatments are (in many cases) ineffective and sometimes unsafe. That’s why the pharmaceutical industry is pumping billions and billions of dollars into researching the underlying biochemistry that is behind all these disease states. Hopefully in 10-15 years we will look at SSRI’s the same way we now look at some of the early treatments for cancer. They were an early tool that helped many people and harmed many people – but they blazed the way for current treatments that are far, far more effective.
Lisa Van S
Nathan,
Maybe you should just stick to “Beakers and Bunson Burners”
RTW
Lisa I think your comment to Nathan was uncalled for. You have no idea what the trenches of drug research is really like. You have a problem with drug company management PR etc that is one thing. So do I but I am a former lab rat just like Nathan. CNS research is probably the most difficult drug research there is to do.
I worked in Cardiovascular and Anti-Cancer research for about 20 years. I prefered Anti-cancer research. Much clinical need there and I think in the next 20 years we are going to see some really great things in that area. I for one will never take a CNS drug. I have bouts of depression and mood swings. I live with it. Drugs to make me feel better are not worth the risk for altering my brain chemistry. Much too valuable to me..
Might change my mind in other circumstances. People today I think WAY over medicate due to emotional or other “perceived” mental problems. God - If i where growing up today the school system would have made me a zombi because I could not sit still. I was curious about everything and had an “apparent” short attention span, which thankfully I had good teachers that got me to focus on things that got me excited. As a result I became a research scientist. I learned to focus… drugs are not a substitute for that.
truthman
“CNS research has a long, long way to go. I would make the argument that the field is really just in its infancy, much as the very early cancer treatments of the 1950’s. Our current treatments are (in many cases) ineffective and sometimes unsafe” says Nathan
…..and at last i agree with something you say too Nathan..
Glad to see you could finally admit the truth…
But the problem is..
If the scientific community and pharma are aware that CNS research is still in its infancy then the prescription of CNS drugs like SSRI’s is akin to using the general population as a global clinical trial is it not?…
Would you like to take part in a global clinical trial without your knowledge? I bet you wouldn’t…
Would you like to be a walking lab experiment? ..
I doubt it…
“That’s why the pharmaceutical industry is pumping billions and billions of dollars into researching the underlying biochemistry that is behind all these disease states. Hopefully in 10-15 years we will look at SSRI’s the same way we now look at some of the early treatments for cancer. They were an early tool that helped many people and harmed many people – but they blazed the way for current treatments that are far, far more effective” Says Nathan
I don’t believe for one nanosecond that the pharmaceutical industry is pumping billions of dollars into researching the biochemistry of these disease states as you put it.
First of all..
They are not diseases, and they should not be classified as such… (they don’t fit any medical crieria of the disease defintion)
Secondly…I explained to you many times that the biochemistry changes in depression, anxiety disorders and most mental illnesses are a symptom of the condition, not the cause, so if the industry is spending billions looking for chemical solutions for human conditions, then it might as well flush those billions down the toilet… Chemical quick fixes for emotional/psychological truamas are red herrings… SSRI’s made billions because they were cleverly and aggressively marketed .. And I have yet to meet one person who has ever said they cured their biochemistry.. But i have met many who believe they have messed theirs up..
And thirdly …
Your Audacity astounds me..
“I would suggest you limit your arguments to SSRIs in the future… At least for SSRIs you have a tiny platform to stand on”.. Says (the omni-impotent) Nathan
Well as would be clear to anyone with half a brain reading our discussion of SSRI’s here Nathan, it is you who has no clue, no insight, no understanding, no compassion and no knowledge on the subject of SSRI’s or the conditions they have been ineffective in treating…
And to Echo Lisa’s comment..
Why don’t you stick to disecting lab rats…
I would rather a monkey to stick a screwdriver up my nose than to let you attempt to treat me with anything…
Nathan
Truthman says:
“I don’t believe for one nanosecond that the pharmaceutical industry is pumping billions of dollars into researching the biochemistry of these disease states as you put it.
First of all..They are not diseases, and they should not be classified as such… (they don’t fit any medical crieria of the disease defintion)”
Look back at my statement, Truthman. Here’s the disease states I mentioned: migraine headaches, epilepsy, Parkinson’s, MS, Alzheimer’s, autism, and Huntington’s.
It’s a tragedy that you don’t recognize these horrendous diseases as true diseases. I sure hope counseling works to treat them… Best of luck.
Notice that not ONCE in my previous statement did I mention depression or anxiety. You (and others) make a reasonable argument that treatment is not worth the risk. I prefer to leave that decision to an individual patient. Regardless, my assertions have to do with other psychiatric conditions that you claim can be treated by counseling: epilepsy, Parkinson’s, MS, Alzheimer’s, autism, and Huntington’s. Again, good luck.
I suggest you work in the industry before you conclude anything about the money we spend and how we spend it. We do, in fact, spend billions and billions researching the disease areas I quoted.
PS. I like your screwdriver comment. I hope that when you have terminal cancer someday that you choose to stick a screwdriver in your nose rather than take some of the drugs that I help develop.
Brian
Truthman,
Since we know counseling predates medication.. Check that..sorry… Folks have been medicating themselves for years in the hope of treating depression, anxiety etc etc. So if counseling worked for all, there would be no need for nicotine, heroin, cocaine etc right? Now as it turns out those medications have their own side effects of addiction but is there anything better out there?…the better question is.. can there be anything better? Should we try to help the inconsolable?
So if you have the responsibility for a patient and he doesn’t respond to your best counseling efforts what do you say then? Should there be no hope beyond your “human sympathy, empathy, love and support”? Perhaps the patient is suffering from an underlying neuronal deficiency which if corrected would return him to normalcy. Should we try to accomplish that? What if our first efforts are only partially successful (like counseling, SSRIs). Should we stop there and not try to devise a better medication for the treatment resistant?
If you say no to the efforts being made to correct the physical reasons for mental illness doesn’t that make you an uncompassionate man as you have called me?
Nathan
Truthman,
Have a look at the SEC filings for the top 10 pharma companies. They spent more than $50 billion on drug research last year alone. If my company is any indication of the others, we spend ~20-30% of that budget on CNS active drugs. Only about 1/3 of that chunk (so ~5-10% total R&D) goes towards depression/anxiety. The other ~20% (which amounts to ~$10 billion annually) goes towards CNS agents to treat everything from Alzheimer’s to to autism to obesity. CNS drugs are highly lacking meaningful animal models for testing. That’s (partly) why we have so much difficulty. Believe me we’ve only scraped the surface of CNS drugs.
I’ve been especially impressed with Pfizer drug, Chantix. There’s finally an area of brain chemistry that we know a lot about and were able to put it to good use. A partial agonist at the nicotinic receptor – that serves two roles: slight stimulation (like nicotine) but still blocking the “high” that you get from nicotine. I suppose you think that counseling will cure smoking too… Fortunately or unfortunately, Americans would rather pop a pill once a day than see a shrink a few times a week.
Lisa Van S
RTW,
And you point is?…What?..
Lisa Van S
Nathan,
You should run for President,… You are a great Flip,.. Flopper!!!!!!!!!!!!!!!!!!!!!!!!!!!
Nathan
Lisa,
You are correct — I’m proud to say that (unlike you) I try to look at evidence in order to justify and form my opinions about things. Thanks to yours and Truthman’s challenges, I looked up the appropriate information and was able to find absolutely no evidence that SSRIs prevent suicide in any population group. That’s what convinced me to change my opinion (slightly) about SSRIs.
You and truthman should start looking at some evidence now and then. You might just find that the pharma industry isn’t always as bad as you think it is.
Lisa Van S
Nathan,
You may not be so bad after all, but many in the Industry are, profit over safety is never acceptable.
Truthman
To Brian and Nathan .. (the two peas of a pharma pod)
It really is quite funny how the both of you continually avoid the context of this discussion, which was in this instance the recent news of “clinical trials exaggerate antidepressant benefits”…
As Nathan has admitted, SSRI (CNS) drug treatments are in their infancy, so if these drugs are in their infancy then why are patients not told that they are ?…
If people were aware of that do you think they would be taking them?…
Do you think people have a right to know the true risk/benefit ratio of prescription medicines? ..
Or is it ok for pharma to doctor studies, change end points, exaggerate benefits and play down and deny side effects for decades thus harming and killing patients in the process?
Just thought i would bring this discussion back to where it originated from…
Truthman
Oh and One more Thing..I think Either Brian Or Nathan works for Pfizer in Groton, Connecticut..
I wonder what your opinion is on this guys?…
http://www.washingtonpost.com/wp-dyn/content/article/2007/05/29/AR2007052902107.html
Very constant garderner(esque) if you ask me…
Brian
Truthman,
Would you admit to a patient as he walks into a session that counseling doesn’t really work for the majority of depressed, psychotic or addicted? I think that could ruin the outcome if there was to be one. How about a mature ability to understand that treatments don’t always work and that misplaced optimism on the patients part can injure. Where you come up short is in giving up on future treatment advances before they are invented. Your choices are surgery, medication or couseling or “first do no harm” and walk away
Brian
Truthman,
No good deed goes unpunished. When you create a drug to help sick people you have to go to where they live. These serious infections exist only in Africa where literacy is non-existent. How would the readers of this post propose to advance medical care in this environment? No one cries for the millions of kids that die untreated. The doctor’s mantra: “first do no harm” means doctors are comfortable letting people die if they haven’t touched them. Most of the folks here wouldn’t lift a finger to help someone because they are afraid of being sued. Give Pfizer some credit for trying to help folks that would have certainly died without treatment.
Truthman
Oh Brian..
Gimme a break…
You defend your beloved pharma like a surrogate (money) mommy…
What Pfizer did here was absolute and total opportunism…
They explloited the fact that there was an outbreak, they went in and tested drugs on illiterate and poor africans, they got their information, then buggered of well before the outbreak was over, if they were s concerned then why did they up and leave when their trial was done?…
Pharmaceutical companies don’t do humanitarian work..
I hope Nigeria wins this ..
Pharma has been getting away with this kind of thing for far too long…
Brian
Truthman
Your position is “let em die”. Compassion is not your strength but you do like to cause trouble.. Thanks
Truthman
Brian
Truthman
Your position is “let em die”. Compassion is not your strength but you do like to cause trouble.. Thanks
No Brian , I do not, I just disagree with your bioligical depression arguement and your pharma slant on things..
Your position seems to be “drug em to death”…
pg
I think the author of “Unsafe at Any Dose” in his video,
Curing Mental Pain, 1, is one good exampl of a psychiatrist actually practising psychiatry - a skill that not only appears to work but seems to have been forgotten by the majority since the pharmaceutical industry took psychiatry over.
The video:
http://video.google.com/videoplay?docid=1580550859337309430
Laurie
“NEJM is probably not going to accept a bunch of articles about clinical trials that didn’t work.”
So, based on this statement, the NEJM is a marketing tool, not true research reporting.
ol cranky
Sadly, any journal publication (not limited to top tier journals) is considered a marketing tool by the industry. You should see the amount of effort that goes into a publication plan for a product. Some smaller companies spend an extraordinary amount of money on off-label investigator sponsored trials in lieu of of company sponsored development programs that are done to support a publicity, err I mean, publication plan on an off-label indication. They do this because they don’t think they can get a win in that indication, they can stroke the investigator by giving him/her a profitable research grant and the investigator may not publish negative results.
Pharma has to submit a clinical study report (CSR) for their trials conducted under an IND. The best bet we have now to ensure that there is at least synopsis information that is supposed to be a true report of the study results is to require that the study synopsis portion of an ICH style CSR that is submitted as part of the CSR is posted publicly at clinicalstudyresults.org or on the company’s corp. website (a link to the results any publications are supposed be placed on the study notice posted on clinicaltrials.org to make it easier to find results).
I’m pretty sure that most ICH regions are also trying to require public posting of study results but we could press our elected officials to require that all clinical trial results of a study of any product (drug/biologic/device) for an approved product or for which trials are planned/being conducted in the US be posted publicly (in English) regardless of where the study was conducted.
pg
“So where is the junk science? The answer is that it’s in the hiding of what you need to know.”
(from http://en.wikipedia.org/wiki/Junk_science)
“We cannot determine whether the bias observed resulted from a failure to submit manuscripts on the part of authors and sponsors, from decisions by journal editors and reviewers not to publish, or both. Selective reporting of clinical trial results may have adverse consequences for researchers, study participants, health care professionals, and patients.”
truthman
Anti-depressants to carry suicide Warnings in the UK…
http://www.huntspost.co.uk/content/hunts/news/story.aspx?brand=HPTOnline&category=News&tBrand=cambs24&tCategory=NewsHPT&itemid=WEED05%20Feb%202008%2017%3A24%3A51%3A883
WARNINGS of the dangers of suicidal thoughts and behaviour are to be included in the packages of anti-depressants. Warnings will be carried in the patient information leaflet in the packets from October this year.
The direction was issued yesterday (Tuesday) by the Government’s Medicines and Healthcare Products Regulatory Agency. (MHRA)
(for the rest of the article see link)
Well Done To Janice SImmons of the Seroat Users Group UK!
This is a big Victory for patients wordlwide…
Brian
Truthman,
Since suicide is a already a known side effect of depression, how do you know that a patient’s suicide wasn’t because they were “treatment resistant” to counseling and or medication? It is possible, is it not, that their suicide was due to the fact that nothing worked? Would you recommend we go through a treatment hiatus where no one gets medication to prove this?.. I’m not sure what you are asking the world of psychiatry..
Laurie
If all the reported suicides had a depression history, then that argument works. That is not the case. There have been suicides across the diagnostic spectrum. Anxiety, abdominal pain, irritable bowel, headaches, PMS, “stress”, school phobia, test taking anxiety.
Brian
Laurie,
Not sure I agree with that. Chronic anxiety certainly can lead to depression so the question is where do the symptoms fall on the spectrum of a chronic condition. Have they been treated for anxiety with the available agents and failed? The other indications with no obvious other physical cause can lead to depression. Chronic back pain, migraine headaches, people with fibromyalgia fall into this category. Test taking anxiety may stem from a combination of internal symptoms which may be exacerbated by social and parental pressure. The latter two could lead to a patient’s feeling of worthlessness. How do you dissect the true reasons? My main point is if the treatment or treatments do not work with an illness that has psychological roots, the patient is increasingly likely to try suicide as the condition worsens. What should be done with patients who are treatment resistant?? And I mean any kind of treatment
Truthman
Since suicide is a already a known side effect of depression, how do you know that a patient’s suicide wasn’t because they were “treatment resistant” to counseling and or medication? It is possible, is it not, that their suicide was due to the fact that nothing worked? Would you recommend we go through a treatment hiatus where no one gets medication to prove this?.. I’m not sure what you are asking the world of psychiatry..
… Im kinda fed up of hearing your “treatment resistant” angle Brian, it smells like propaganda to me…
And spookily similar to “discontinuation syndrome” instead of “withdrawal”and “treatment effects” instead of “side effects”..
And , by the way i ask nothing of the world of psychiatry… I don’t believe in classifying the human experience and drugging people to death…
In my opinion… psychiatry is a tried , tested and ultimately falied belief system which should be consigned to the waste bin of loony notions…
pg
Suicidality also occured in mentally healthy clinical trial volunteers, and in very short periods of time. That must be down to underlying mental illness that had never been spotted prior to their participating - not even during pre-trial screening to exclude any. Or something equally as …
pg
At about the same rates that they occured in participants who weren’t healthy volunteers, even though I believe that in some trials they too were screened for suicidal ideation.
I wonder what the odds of that kind of coincidence are in, say, gambling.
Brian
Truthman
Your comments leave me cold. What do you do with patients that you can’t fix..You have avoided this question..it is your downfall
pg
Clinical trials like this one, as an example:
http://www.ahrp.org/infomail/04/02/10.php
“….Lilly’s clinical trial [duloxetine] is one that tests “healthy volunteers,” who do not have depression or incontinence, in order to evaluate how the human body metabolizes the drug and to examine proper dosages and side effects…”
Truthman
Brian
Truthman
Your comments leave me cold. What do you do with patients that you can’t fix..You have avoided this question..it is your downfall
There is alway a way to heal people with all mental illnesses.. Drugs compound the illness.. they do not treat it…
Truthman
Brian..
Please do not take my opinions too personally…
Nathan
Truthman says:
“There is alway a way to heal people with all mental illnesses.. Drugs compound the illness.. they do not treat it…”
Truthman, you have yet to say whether its OK to treat migraine headaches, epilepsy, Parkinson’s, MS, Alzheimer’s, autism, and Huntington’s with CNS active drugs. Your lack of a responce strongly suggests that you think counseling is the most effective treatment for these disease states. If your sister is diagnosed with Parkinson’s tomorrow are you going to send her to counseling? I didn’t think so…
CNS active drugs can work and do work for a wide variety of disease states, including (but not limited to) mental illnesses.
pg
I posted this one further up, better bring it down in light Truthman’s comment. It does seem that there is at least one (maybe more) relatively successful way of curing mental illness without drugs and their side effects:
http://video.google.com/videoplay?docid=1580550859337309430
Truthman
Nathan
Truthman says:
“There is alway a way to heal people with all mental illnesses.. Drugs compound the illness.. they do not treat it…”
Truthman, you have yet to say whether its OK to treat migraine headaches, epilepsy, Parkinson’s, MS, Alzheimer’s, autism, and Huntington’s with CNS active drugs. Your lack of a responce strongly suggests that you think counseling is the most effective treatment for these disease states. If your sister is diagnosed with Parkinson’s tomorrow are you going to send her to counseling? I didn’t think so…
CNS active drugs can work and do work for a wide variety of disease states, including (but not limited to) mental illnesses.
The condistions you described above are not psychiatric illnesses..
So no it would not be appropriate to treat them as such…
Brian
Truthman,
Drugs are the only available choice after failures in counseling and electroshock therapy. What are you talking about in terms of healing all mental illness? You said there’s always a way.. You don’t understand the scope of what you are talking about.. Meanwhile patients are waiting for effective treatment..
My counseling of you has also failed
Truthman
There is an Irish psychiatrist (whom I have had the honour of personally meeting) He successfully advocates non drug treatments for mental illness.. His name is Michal Corry, and this is his Web Site..
Brian and Nathan.. (do yourselves a favour, read the web site and get informed)
http://www.depressiondialogues.ie/
Truthman
You don’t understand the scope of what you are talking about.. Meanwhile patients are waiting for effective treatment..
I understand the scope because I have lived it Nathan! Have You Lived it???
Brian
Truthman
I’ll need full disclosure on the number of suicides under his care.. He’s a huckster who denies that the brain is an organ with synapses and neurotransmitters that control one’s emotions, feelings and thoughts. Admittedly it’s too complex for us mortals but it operates under some basic principles. I can guarantee your man is no more effective than an SSRI and there’s only one of him…
Truthman
Brian
Truthman
“I’ll need full disclosure on the number of suicides under his care.. He’s a huckster who denies that the brain is an organ with synapses and neurotransmitters that control one’s emotions, feelings and thoughts. Admittedly it’s too complex for us mortals but it operates under some basic principles. I can guarantee your man is no more effective than an SSRI and there’s only one of him…
… Thats a very presumptuous and conceited view of it, considering i posted the link 5 minutes ago Brian…
“He’s a huckster who denies that the brain is an organ with synapses and neurotransmitters that control one’s emotions, feelings and thoughts”…
again… it is the other way round Brian!…
The emotions, feelings and thoughts control the synapses and neurotransmitters reactions… That’s well established as FACT…
Nathan
Truthman says: “Meanwhile patients are waiting for effective treatment..”
I agree! Patients are waiting for effective treatments. The treatments we have just aren’t good enough. However, you are seeking to deny patients access to effective treatments. You’ve stated time and again that psychiatric drugs are not and WILL NOT (in the future) be effective at treating mental illness. You presume to know the future standard of medical care. Don’t talk about arrogance to me — this is the ultimate of arrogant attitude. At least Brian and I completely agree with you the counseling is effective. We just disagree about its RELATIVE effectiveness.
You agree that drugs can get into the brain an have a positive effect on non-psychiatric illness. There is no reason to believe that they can’t get into the brain and have a positive effect on psychiatric illnesses as well.
Nathan
Truthman,
Now for Michael Corry:
Check out this link to an interview with Corry:
http://www.veritymagazine.com/October%202006/interviewdrcorry.html
I’m going to quote a section of that interview:
Magazine: What are people afraid of in terms of the irrational? Do you consider Tarot or clairvoyance/chakra energy as a positive force in mental health care?
Corry: I myself work with the concept of the chakras. They make sense for me because I can see how the body is organised into seven different levels. It fits, the whole notion that the body is made of wave and particle when you go into the quantum state.
Magazine: Will it ever be accepted?
Corry: It is accepted particularly in America, where there is enough money and centers to support the use of chakra and vibrational medicine. We already know that one of the things that happens when people get depressed is that their heart actually closes. The fourth chakra actually shuts down. Science has no problem recognising the chrakras. I mean each system corresponds to a colour. And each colour corresponds to a particular vibration of light. Each chakra vibrates to a particular frequency easily identifiable and it’s completely understood in some circles. But the tragedy is that at the moment, that dominant medicine doesn’t really want to look at those things.
———————
Now, is this a guy that I would turn to for treatment? HELL NO! I would put myself or my kids under the care of a licensed psychiatrist. I would use drugs with caution, and I would go in with my eyes open — there are side effects, and I (and my family) would watch for signs of them.
If you are interested, here’s another link where Corry talks about “Charka”. Supposedly, he blames some mental illnesses on bad events that happened to you in a prior life. ( in his book “Going Mad”.) And here’s a quote (from his own website) that strongly suggests that he believes that mental illness can be blamed on your “past life” (ie reincarnation):
“This healing model includes awareness of the chakra system in healing, the future integration of past life knowledge, psychotherapy, homeopathy and, sometimes, prescription of psychoactive drugs”
quoted from: http://www.depressiondialogues.ie/alliance/
Talk about psuedoscience… I’m all for counseling. But not with this hack…
Truthman
“Nathan
Truthman says: “Meanwhile patients are waiting for effective treatment..”
I agree! Patients are waiting for effective treatments. The treatments we have just aren’t good enough. However, you are seeking to deny patients access to effective treatments. You’ve stated time and again that psychiatric drugs are not and WILL NOT (in the future) be effective at treating mental illness. You presume to know the future standard of medical care. Don’t talk about arrogance to me — this is the ultimate of arrogant attitude. At least Brian and I completely agree with you the counseling is effective. We just disagree about its RELATIVE effectiveness.
You agree that drugs can get into the brain an have a positive effect on non-psychiatric illness. There is no reason to believe that they can’t get into the brain and have a positive effect on psychiatric illnesses as well.”
“Nathan
Truthman says: “Meanwhile patients are waiting for effective treatment..”
You totally misquoted me again Nathan..(actually I didn’t say what you qouted at all!)
And you fail to see the Real issues around psychiatric medication…
“You’ve stated time and again that psychiatric drugs are not and WILL NOT (in the future) be effective at treating mental illness.” …
Yes, And drawing from a history of about 100 years of ineffective and dangerous psychiatric medications I think my opinion is quite valid don’t you?…
“You presume to know the future standard of medical care. Don’t talk about arrogance to me — this is the ultimate of arrogant attitude. At least Brian and I completely agree with you the counseling is effective. We just disagree about its RELATIVE effectiveness”
No, i don’t presume to know the future of standard medical care…But I DO KNOW that psychiatry is a dead science
(actually it was never really a science in the first place.. It’s a byproduct of the Nazi era and it should have been left there…)
Councelling is relatively effective , yes..(with no adverse effects)
But SSRI’s are relatively ineffective, (with many adverse effects) ..
So when you weigh it all up..
It’s not that I am arrogant, i just have a much better insight than you and Brian, because I have lived it Nathan , Have You????
Truthman
“Now, is this a guy that I would turn to for treatment? HELL NO! I would put myself or my kids under the care of a licensed psychiatrist. I would use drugs with caution, and I would go in with my eyes open — there are side effects, and I (and my family) would watch for signs of them.
If you are interested, here’s another link where Corry talks about “Charka”. Supposedly, he blames some mental illnesses on bad events that happened to you in a prior life. ( in his book “Going Mad”.) And here’s a quote (from his own website) that strongly suggests that he believes that mental illness can be blamed on your “past life” (ie reincarnation):
“This healing model includes awareness of the chakra system in healing, the future integration of past life knowledge, psychotherapy, homeopathy and, sometimes, prescription of psychoactive drugs”
quoted from: http://www.depressiondialogues.ie/alliance/
Talk about psuedoscience… I’m all for counseling. But not with this hack…”
Brian I am sorry to say..
But your attempt at discrediting Michael Corry is pathetic.. You find some random article where Mr Corry Discusses some of the more spiritual aspects of his beliefs and you make a ridiculous assumption based on that..
I have Met Michael Corry and I have been to his meetings, he is an absoulte champion for the rights of the mentally Ill, he stands out bravely like David Healy, Joeseph Glenmullen and Peter Breggin.. ( you gonna try to discredit these guys too? )
They are ALL heros to the mentall ill, who have been expoited for far too long by the likes of you greedy inhumane pharma people and the fascist control freak psychiatrists , with your money making psych drugs and insatiable GREED! whoring your reputations to an industry which has no respect for human life…
And on the subject of chakras, past lives and spirituality.. What gives you the right to disprespect these spiritual beliefs? ..Many millions of people have beliefs which incorporate these elements… You are an Arrogant A - Hole… The problem with scientists trying to make drugs for people with life crisis is that you don’t see the whole person, you just see molecules and neurons! That is why your poisonous treatments will never work! ..
Brian and Nathan..
Two very silly men with very silly opinions..
pg
SPIRITUAL BELIEFS TO ONE SIDE for a moment or two, I notice how nobody managed to pick on DR BOB JOHNSON, Author of
“UNSAFE AT ANY DOSE” (that should wake up the pharma protection squad)
and the video CURING MENTAL PAIN part 1(http://video.google.com/videoplay?docid=1580550859337309430 )
As posted now twice above. I don’t know, but I’m guessing that this is because he is:
http://www.jnf.org.uk/
Registration:
GMC specialist register psychiatry (registration number 0400150)
Qualifications:
MA (Psychol) Cambridge University 1958
MB BChir Cambridge University 1961
Diploma in Psychotherapy Neurology & Psychiatry (Psychiatric Institute New York City) 1965
DPM (Diploma in