Antidepressants to treat grief? Psychiatry panelists with ties to drug industry say yes

[HiPointDem]

192. 1) It doesn't take a 'qualified medical professional' to assert that bereavement is not a

psychiatric condition, is not clinical depression, and is not 'mental illness'.

2) I presume that one does not need to be a 'qualified medical professional' to cite findings from the scientific literature on a discussion board, any more than one needs to be a 'qualified medical professional' to make claims about 'brain chemistry' & fish oil on the same discussion board.

These people *are* qualified researchers:

Antidepressant Drug Effects and Depression SeverityA Patient-Level Meta-analysis

Journal of the American Medical Association: 2010;303(1):47-53. doi:10.1001/jama.2009


Context Antidepressant medications represent the best established treatment for major depressive disorder, but there is little evidence that they have a specific pharmacological effect relative to pill placebo for patients with less severe depression.

Objective To estimate the relative benefit of medication vs placebo across a wide range of initial symptom severity in patients diagnosed with depression.

Data Sources PubMed, PsycINFO, and the Cochrane Library databases were searched from January 1980 through March 2009, along with references from meta-analyses and reviews.

Study Selection Randomized placebo-controlled trials of antidepressants approved by the Food and Drug Administration in the treatment of major or minor depressive disorder were selected. Studies were included if their authors provided the requisite original data, they comprised adult outpatients, they included a medication vs placebo comparison for at least 6 weeks, they did not exclude patients on the basis of a placebo washout period, and they used the Hamilton Depression Rating Scale (HDRS). Data from 6 studies (718 patients) were included.

Results Medication vs placebo differences varied substantially as a function of baseline severity. Among patients with HDRS scores below 23, Cohen d effect sizes for the difference between medication and placebo were estimated to be less than 0.20 (a standard definition of a small effect). Estimates of the magnitude of the superiority of medication over placebo increased with increases in baseline depression severity and crossed the threshold defined by the National Institute for Clinical Excellence for a clinically significant difference at a baseline HDRS score of 25.

Conclusions The magnitude of benefit of antidepressant medication compared with placebo increases with severity of depression symptoms and may be minimal or nonexistent, on average, in patients with mild or moderate symptoms. For patients with very severe depression, the benefit of medications over placebo is substantial.

http://jama.jamanetwork.com/article.aspx?articleid=185157

Why do I say that for most people, these medications don't provide significant benefit?

1. Most prescriptions are written for mild to moderate depression, not major depression.
2. A significant percentage (like up to half) of newly diagnosed patients stop medication within a brief window (like under 90 days) for various reasons, one of which is the perception that the medication is not helping. Similar phenomenon is seen in clinical tests through washout rates, etc.

http://archpsyc.jamanetwork.com/article.aspx?articleid=481753

Now, if I am unable to cite claims found in legitimate research on a discussion board without being asked for a medical license, why are others allowed to make claims about brain chemistry & fish oil without being asked for same?

And what kind of 'science' is it that attempts to stifle any & all discussion of legitimate research published in mainstream sources?

Thanks for asking. Are *you* a 'qualified medical professional'?

It would not make a damn bit of difference if I had PhDs in psychiatric medicine, neurology and pharmacology. You still wouldn't like anything I say, because you have a different opinion and weigh the evidence differently and you feel I am attacking *you* & *your experience* personally -- which I'm not.

This guy is a professor of psychiatry at Brown University, a 'qualified medical professional'. He says that 'chemical imbalance' isn't the cause of depression, at least in the simplistic form promulgated so widely, contra the experts here at DU. So if I post this video, am I 'dangerous?' Am I 'offering medical advice,' or 'forcing medical advice,' as i have been accused of doing here?

http://www.cbsnews.com/video/watch/?id=7399368n