6 Reasons To Be Skeptical
That’s right! A study in this month’s American Journal of Psychiatry was written up by the BBC yesterday–not sure if there was a report on the radio or TV–and framed as establishing that anti-depressants work “instantly” to quote the BBC’s headline. That would run counter to what most researchers and patients believe to be true (and plenty of studies have shown to be true) that anti-depressants take as long as several weeks to deliver a measurable effect. What Oxford researchers found was that depressed patients had a quick response to an anti-depressant called Reboxetine. They established this by measuring how patients’ negative thoughts improved (using emotional recall kinds of tests) and found that negative thoughts improved within a few hours and even did so in healthy, non-depressed volunteers taking the drug.
“Dr Harmer said: ‘We found the antidepressants target the negative thoughts before the patient is aware of any change in feeling subjectively.’
“‘Over time, this will affect our mood and how we feel because we are receiving more positive information.’”
Michael Thase, a psychiatry professor at the University of Pennsylvania, called the finding possibly “paradigm changing.”
We live in interesting times when researchers can claim an anti-depressant is “working” when a patient has no sign of depression symptom improvement. As usual, several skeptical thoughts come to mind.
1. You don’t know you are feeling better but you are is one of the study’s main conclusions. That strikes me as a dubious claim, especially absent any knowledge of how the patients and healthy volunteers fared over time. I mean, isn’t the point of treating depression to treat depression and not get all wound up about emotional recall tests? To the degree that it might predict later response to depression treatment, the response might be interesting.
2. The choice of Reboxetine (brand name Vestra) is an odd one. A recent study found it the least effective of all the modern anti-depressants and the FDA has not approved it for use in the US (which tells you something) and it’s not widely-used in Europe. Why the researchers didn’t choose a more commonly used medication is beyond me. It really doesn’t tell doctors and patients much in a clinically useful way.
3. The study is of a small enough sample size–31 depressed patients, 30 healthy volunteers; half of each group on active medication–to make its findings little more than suggestive and not the paradigm changer Thase claims. It’s research that needs to be replicated several times.
4. I’m not buying that someone on Reboxetine identifying more faces (two more on average) on a facial recognition test than someone not on Reboxetine means that much in a real world way. Maybe I’m being too skeptical here, but it doesn’t quite add up.
5. The study’s two primary authors (Guy Goodwin and Catherine Harmer–interesting name for a doc) have oddles of pharma funding in their past from the likes of AstraZeneca, BMS, Lilly and so on.
6. For the BBC to generalize from results of a Reboxetine study that its findings apply to all anti-depressants is complete bunk and lazy reporting and editing. And that’s pretty much what the article and its headline claim.
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Related posts:
- Treatment For Depression
- Antidepressants Don’t Work For You?
- Antidepressants Have Immediate Effect
- Hunting For The Prozac Gene
- Why Antidepressants Don’t Work For So Many?
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