Pharmaceuticals Anonymous

Monday, June 30, 2008

Bitter Pill

Furious Seasons blog owner Philip Dawdy's article on researcher Erick Turner's paper on unpublished anti-depressant efficacy data and what that meant for the class of drugs was reprinted in the Missoula Independent last Thursday. It originally ran in Willamette Week in April, so if you missed it the first time out, check it out. Link

Turner’s paper leaves little question that antidepressants don’t work nearly as well as conventional wisdom would have it. Of the 30 million daily users in this country, many millions would be no worse off if they took a placebo every day. Yet doctors continue to prescribe the drugs, people continue to take them, and Big Pharma rings up the sales.

One could argue, “What’s so wrong with that?” If people are helped by believing that something works, even if it is not medically true, doesn’t it still work?

Carlat, who called Turner’s work important, nevertheless argues that the question may not matter.

“The fact is, we’re not allowed to prescribe placebos in our practices, and we have patients coming to us and banging down our doors because they are miserable,” says Carlat. “We can’t offer them a sugar pill, but we can offer an antidepressant even if its effect is 80 percent sugar pill. A lot of our patients are getting better. That’s why we prescribe antidepressants even in the face of this recurrent data.”

However, there is evidence that taking antidepressants can be harmful to some people’s health. In recent years, the FDA has mandated warnings on all antidepressants due to elevated risks of suicide and suicidal thinking in some people under the age of 25 who take the drugs. In addition, antidepressants can cause very intense withdrawal problems for some patients, most notably with Effexor and Paxil. The drugs can also cause internal agitation—akathisia—in some patients, and, tragically, antidepressant use sometimes has been connected, however peripherally, to school shootings, most famously at Columbine High School in 1999, where one of the shooters, Eric Harris, had been taking Luvox.

There is also the not-insignificant cost of the drugs.