Placebo as Good as Paxil, Tofranil for Most DepressionFrom the “What the…?!” file, new research we reported on today found that two antidepressants — Paxil (still commonly prescribed) and Tofranil (not commonly prescribed) — seem to …

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Placebo as Good as Paxil, Tofranil for Most Depression

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  1. This study makes sense to me, based on my experience with SSRIs (not these two specific ones). I was as depressed as a human can be, and thus received an ongoing assortment of prescription drugs, none of which helped much. When we finally hit upon the correct drug combination (after two years of trying), I experienced a significant improvement in my depression. For example, for the first time in a lifetime of dysthmia, I rated a 7 on the Beck Depression Inventory. I theorize that I was too skeptical to be susceptible to the placebo effect, so a drug had to be genuinely effective for me to improve. (Now I’m drug free and use meditation, exercise, and diet to maintain a modest equilibrium).

  2. Hmm, well give me some of them placebos. A wanna’ get a buzz on.

    Seriously: Antidepressants where made for people with real clinical depression however most people who take antidepressant are not clinically depressed. They are people who because of allot of stress, the way there life is going, basically because of the crap in there life they are depressed. yes they are depressed but its not clinical depression, its not the kind of depression that even when things are going good, your still depressed. Antidepressant are not for these people, they are for people with strong clinical depression.

  3. nice study, i have always believed in the effectiveness of psychotherapy more than medication.

  4. This reform must be appropriate because many families depend on it, the health system a long time that is weak and patients suffering from cancer, chronic fibromyalgia, rheumatoid arthritis, Parkinson’s, diabetes, chronic pain, chronic anxiety among many other diseases, Need proper medical attention, according to the measure should be findrxonline for 80% of patients with these diseases.

  5. Hope is the main ingredient for healing. Placebos provide hope and hope heals.

  6. Pharmaceutical companies have struggled for decades to beat the placebo effect. One way they sometimes succeed is by using totally inactive, inert placebos that have no direct physiological effects at all to compare with their medications. Thus, it isn’t difficult for many patients to realize that they are in a “placebo” group because they experience no side effects. Thus, the effectiveness of the placebo is somewhat diminished.

    The solution? Run studies with “active” placebos that at least cause some mild effects–such as benadryl. That makes it harder for patients to know if they’re receiving a placebo or the real thing. Of course, this approaches reduces the chances of finding signficance for the drug vs. placebo. And not surprisingly, this procedure is rarely used.

  7. Hmm, Paxil worked wonderfully for me. That makes me think that maybe I’m even crazier than I already knew I was!

  8. After much experience with SSRI’s I can safely say that they only ever made me WORSE. I regret so much having gone on them now. I originally went on for social anxiety, but the side effects and withdrawal was horrendous. I didn’t realize that you can’t stop them cold-turkey, and I suffered from horrific depression, panic attacks, de-realization, memory and attention problems, brainfog…for a long time after. I recently went on Lexapro, and on wanting to come off it, have only just found out that all my problems were caused by SSRI withdrawal.
    It seems that taking an SSRI affects your serotonin receptors somehow, so once you stop taking it, you become low in serotnin, your brain chemistry gets messed up, and it takes a long time to stabilize. I am now suffering from depression/anhedonia BECAUSE of SSRI’s. I don’t know how long it will be until I recover. Someone should seriously research the potential DAMAGE SSRI’s can cause to the brain and body, but no one seems to consider that. So often I hear things like “well if it even helps a few people it’s worth it”. But is it? Is it worth potentially making your depression WORSE and damaging your body? Maybe we should all ponder that.

  9. I know I’m late to the party, but here’s something I found interesting that relates to this read…:

    “A new study published in the Journal of the American Medical Association has revealed that most of the antidepressant drugs in the same class as Paxil that contain paroxetine and imipramine actually do nothing more than a placebo does.”

  10. I would not say any antidepressant is better than placbos, why-the side effects are horendus. I’ll dopsyctherapy any time over those dangerous drugs that every one seems to agree we just gotta keep trail and err until we find the right one? If any of those drugs were effective they would not have to go thought trail and err for so very many years! Instead of having one starting dose they need to have differat doses depending on weight and gender. Very early on I was given a dose of medicine that was the same dose they were giving 300lb patenets, I passed out, when I came too hours later they asked me if I would have passed out if there had been no one to catch me? I never knew passing out was a choice-that was the first and last time I passed out-I refused to take any pysch drug based on the drug companys say so, I will only start at 1/4 of the dose, I weigh significanly less than most people. baa hiss for drug companies that will not disclose the truth of side effects unti forced to.

  11. To K:

    I understand that you had a frightening experience and that must have altered your perception of psychopharmacology. I’m not a big fan either as I’ve had quite a few side effects myself but I have to recognise that for many people it does work. With each box of SSRIs (or whatever drug)there is an information sheet. There are contraindications on the information sheet clearly stating that you should not suddenly stop taking the srug as it may induce substantial withdrawal symptoms. Like many drugs, once you stop suddenly you will get withdrawal symptoms. You even get it off certain foods!

  12. : 1) I think most SSRIs, NDRIs, and other less powerful/ non additive psychotropic meds (e.g. Buspar for anxiety, etc.), just don’t do or rather work that well; however, point 2) placebo and attitude/ expectancy effects in patients (especially those naive to treatment are powerful). I see a pipeline here with many of my patients– they want meds, they get meds, meds don’t work well and then they actually engage in CBT, etc. and poof they get allot better, 3) point bottom line: we don’t know much about the science of these meds — it seems to be that when you push down on one part of the brain, something/ somewhere else (neuron) pushes up somewhere else — i.e. statis, etc. -and- the best evidence says this: meds vs. talk psychotherapy is about the same for most MH patients (not necessarily true for extreme bipolar, psychotic, etc.); and Benefit of no meds is that when you take them away, gains can generally be maintained (with brain imaging studies post BH/ CBT/ etc. treatment confirming this). Mechanism of action = unknown, still! Also, keep in mind that “time” (i.e. time heals all wounds) can also containment treatment effect (that is, for example SSRIs take about 4 to 6 wks to “build up” in someone’s system if researchers put SSRIs against time (i.e. nothing) many times — what might causing — something like “depression,” for someone has went away and thus they could better regardless of meds, — point 4) there is some cutting edge research going on with dopaminergic vs serotonergic vs neuroadrelnalin as well as glutamate pathways for mood/ anxiety/ depressive disorders (see: http://www.biopsychiatry.com/glutamate-depression.htm – for instance) — psychiatry (which has lost ground in the medical world in recent years in addition to neurology and I’ll add rx for psychologists — need to stay on up on this research as the FDA (for many reasons) makes IRB and clinical trial approval so difficult (and expensive) for new drugs or “new uses” for old drugs — can be almost impossible to research (see for example — new = Reboxetine, not approved in US, appears to be for political/ lobby reasons and for old — Survector an older – Dopamine Re-uptake Inhibitor (DRI) pulled of the market for fears of its addictive potential (uh, and kids get prescribed adderral, as young as 6 for ADHD what? But we can have just as powerful meds for depression in adults? I don’t get that personally). Also, using meds like psycho stimulants to treat lethargy for atyical/ treatment resistant depression is arguable vs. behavioral activation as psycho-stim meds might be counter indicated (this is a complicated argument for another time; however — I still like it as a creative approach in treatment for certain depression sxs), and meds like provigil for energy boosts might be better, which leads to my final point 5) there are many good meds, old, new, and progressive/ creative/ or even aggressive poly pharm approaches to treat psych issues (even for minor disorders like depression NOS), or more serious ones pain (Lyrics is new and promising actually), energy, sleep problems — but we get down to this “art of prescribing issue,” and good prescribes to MH patients/ and medical world or psychiatrist almost start to look like witch doctors (e.g. a “dash” of gabapentin, topomax, a little lexipro over zoloft, and maybe some ritilan to treat chronic pain, mood dysregulation, and low energy in a patinet); but the “why” gets hard to justify with these more “creative” drugs and/ also drug companies are hesitant to pursue (for instance) new clinical trials for off label uses to provide evidence or efficacy for these meds– for ex. think seroquel for sleep (and allot can be said here, regarding legal issues as well — the “black box” warning on SSRIs has basically been dis-proven scientifically/ and statistically, but the warning persists). What this comes down to is that there is a high degree of variability between medication prescribes (including psychiatrists) because there are not well articulated practice parameters (and psychologists don’t even really have them for behavioral/ psychotherapy tx for that matter) — that there are no true practice parameters — for the more creative approaches for treatment resistant mental health/ BH conditions in terms of psychiatric medications. Thus, in conclusion, MH patients suffer. They might not be able to afford/ or understand who the “best” psychiatrists are, insurance won’t pay for the best psychologists, and meanwhile they get 60mg of celexa from their PCM/ GP and ultimately their depressive or anxiety symptoms are not well treated. I think a way to somewhat resolve this is advertise the more creative poly pharm approaches and continue to push on the new research for clinical trials (as noted above).

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