Comments on: Antidepressant Publication Bias http://www.overcomingbias.com/2008/01/antidepressant.html Overcoming Bias is economist Robin Hanson’s blog, on honesty, signaling, disagreement, forecasting, and the far future. Sat, 11 Feb 2012 23:03:19 +0000 hourly 1 http://wordpress.org/?v=3.1.3 By: Depression’s Upside? « Permutations http://www.overcomingbias.com/2008/01/antidepressant.html#comment-443617 Depression’s Upside? « Permutations Tue, 02 Mar 2010 17:36:03 +0000 http://prod.ob.trike.com.au/2008/01/antidepressant-publication-bias.html#comment-443617 [...] depression and to be willing to consider pharmaceutical approaches.  On the other hand, their track record is extremely spotty.  I know that some researchers have claimed that physical exercise and some [...] [...] depression and to be willing to consider pharmaceutical approaches.  On the other hand, their track record is extremely spotty.  I know that some researchers have claimed that physical exercise and some [...]

]]> By: Antidepressants http://www.overcomingbias.com/2008/01/antidepressant.html#comment-409274 Antidepressants Thu, 23 Oct 2008 02:46:16 +0000 http://prod.ob.trike.com.au/2008/01/antidepressant-publication-bias.html#comment-409274 So, who is likely to pay for "large well-designed trials?" Not likely drug businesses. It will take lots of hard work -- and collective action -- to get establishment funders to attend to this. So, who is likely to pay for “large well-designed trials?” Not likely drug businesses. It will take lots of hard work — and collective action — to get establishment funders to attend to this.

]]> By: Pete Bertine http://www.overcomingbias.com/2008/01/antidepressant.html#comment-409273 Pete Bertine Sat, 19 Jan 2008 14:02:20 +0000 http://prod.ob.trike.com.au/2008/01/antidepressant-publication-bias.html#comment-409273 How should the continued mis-information and dis-information (referencing sci-tology) regarding the "evil of psychopharm medication," that is rampant on and off line, be approached in the least biased way? How should the continued mis-information and dis-information (referencing sci-tology) regarding the “evil of psychopharm medication,” that is rampant on and off line, be approached in the least biased way?

]]> By: Jor http://www.overcomingbias.com/2008/01/antidepressant.html#comment-409272 Jor Sat, 19 Jan 2008 02:26:13 +0000 http://prod.ob.trike.com.au/2008/01/antidepressant-publication-bias.html#comment-409272 This is a big problem, and many people are aware of it. It use to be the case that a pharma could run a clinical trial and never disclose it was even done if it didn't like the result. I believe, now, every trial has to be registered in advance. However, disclosure of all results still isn't as transparent as it should be. Although a lot of people are trying to push this forward. Silas: The conclusion is the same, anti-depressants are effective, but using undisclosed data, the _effect size_ is smaller, than just using published data. This is a big problem, and many people are aware of it. It use to be the case that a pharma could run a clinical trial and never disclose it was even done if it didn’t like the result. I believe, now, every trial has to be registered in advance. However, disclosure of all results still isn’t as transparent as it should be. Although a lot of people are trying to push this forward.

Silas: The conclusion is the same, anti-depressants are effective, but using undisclosed data, the _effect size_ is smaller, than just using published data.

]]> By: Adam Safron http://www.overcomingbias.com/2008/01/antidepressant.html#comment-409271 Adam Safron Fri, 18 Jan 2008 20:31:05 +0000 http://prod.ob.trike.com.au/2008/01/antidepressant-publication-bias.html#comment-409271 Another interesting note on anti-depressants: on an hourly basis, insurance companies reimburse psychiatrists far more generously than psychologists. What they may not realize is that cognitive behavioral therapy for depression is equally efficacious compared with pharmacological interventions. More importantly, cognitive behavioral therapy has a far lower relapse rate once you discontinue treatment. A few states (I believe New Mexico and Louisiana, which both have low population density) have granted psychologists anti-depressant prescribing privileges after completing a year-long training program. Due to pressure from the medical-establishment, there has been major resistance to introducing these prescription certification programs in other states. It's a shame because many psychologists know their patients better and thus are in a better position to prescribe anti-depressants than their psychiatric colleagues. Contrary to what vested interests want you to believe, titrating doses for SSRI's is not rocket science. Another interesting note on anti-depressants: on an hourly basis, insurance companies reimburse psychiatrists far more generously than psychologists. What they may not realize is that cognitive behavioral therapy for depression is equally efficacious compared with pharmacological interventions. More importantly, cognitive behavioral therapy has a far lower relapse rate once you discontinue treatment. A few states (I believe New Mexico and Louisiana, which both have low population density) have granted psychologists anti-depressant prescribing privileges after completing a year-long training program. Due to pressure from the medical-establishment, there has been major resistance to introducing these prescription certification programs in other states. It’s a shame because many psychologists know their patients better and thus are in a better position to prescribe anti-depressants than their psychiatric colleagues. Contrary to what vested interests want you to believe, titrating doses for SSRI’s is not rocket science.

]]> By: Silas http://www.overcomingbias.com/2008/01/antidepressant.html#comment-409270 Silas Fri, 18 Jan 2008 20:00:33 +0000 http://prod.ob.trike.com.au/2008/01/antidepressant-publication-bias.html#comment-409270 Don't be fooled by imitators! Only use Placeba(tm)-brand sugar pills! Oh, heh heh, I crack me up. So basically, most results came up negative, but this is hidden by the fact that most published results showed the drugs to be effective? And the FDA still deems them effective why? Don’t be fooled by imitators! Only use Placeba(tm)-brand sugar pills!

Oh, heh heh, I crack me up.

So basically, most results came up negative, but this is hidden by the fact that most published results showed the drugs to be effective? And the FDA still deems them effective why?

]]> By: Robin Hanson http://www.overcomingbias.com/2008/01/antidepressant.html#comment-409269 Robin Hanson Fri, 18 Jan 2008 18:01:12 +0000 http://prod.ob.trike.com.au/2008/01/antidepressant-publication-bias.html#comment-409269 Adam, yes that is a big neglected problem. Adam, yes that is a big neglected problem.

]]> By: Adam Safron http://www.overcomingbias.com/2008/01/antidepressant.html#comment-409268 Adam Safron Fri, 18 Jan 2008 17:50:10 +0000 http://prod.ob.trike.com.au/2008/01/antidepressant-publication-bias.html#comment-409268 A big problem with psychiatry research is that they compare efficacy with sugar-pill placebos. But just because a drug bests a sugar-pill, that does not mean that it's efficacy isn't due to placebo effects. Psychiatric drugs are physiologically active. Side-effects enhance the placebo effect by making people think that they're getting the goods: "This erectile dysfunction and dry-mouth are real downers. This stuff must really be working! I'm going to get better!" Ideally, trials would compare drugs to some sort of active placebo. Put some caffeine in the placebo condition and then we'll see what SSRI's are really worth. A big problem with psychiatry research is that they compare efficacy with sugar-pill placebos. But just because a drug bests a sugar-pill, that does not mean that it’s efficacy isn’t due to placebo effects. Psychiatric drugs are physiologically active. Side-effects enhance the placebo effect by making people think that they’re getting the goods: “This erectile dysfunction and dry-mouth are real downers. This stuff must really be working! I’m going to get better!” Ideally, trials would compare drugs to some sort of active placebo. Put some caffeine in the placebo condition and then we’ll see what SSRI’s are really worth.

]]> By: Peter McCluskey http://www.overcomingbias.com/2008/01/antidepressant.html#comment-409267 Peter McCluskey Fri, 18 Jan 2008 17:23:28 +0000 http://prod.ob.trike.com.au/2008/01/antidepressant-publication-bias.html#comment-409267 Don't give much credit to reports of placebo effects that aren't based on comparisons to the effects of no treatment. And unless you're also selling erectile dysfunction drugs, you'd probably prefer cheaper placebos. Don’t give much credit to reports of placebo effects that aren’t based on comparisons to the effects of no treatment. And unless you’re also selling erectile dysfunction drugs, you’d probably prefer cheaper placebos.

]]> By: Constant http://www.overcomingbias.com/2008/01/antidepressant.html#comment-409266 Constant Fri, 18 Jan 2008 16:47:48 +0000 http://prod.ob.trike.com.au/2008/01/antidepressant-publication-bias.html#comment-409266 Where can I get some of this Placebo that I keep hearing great things about? Where can I get some of this Placebo that I keep hearing great things about?

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