SSRI fail…

I stumbled onto this 2008 meta-analysis regarding the efficacy of fluoxetine (Prozac) and related SSRI antidepressants…

Meta-analyses of antidepressant medications have reported only modest benefits over placebo treatment, and when unpublished trial data are included [!!!], the benefit falls below accepted criteria for clinical significance. Yet, the efficacy of the antidepressants may also depend on the severity of initial depression scores. The purpose of this analysis is to establish the relation of baseline severity and antidepressant efficacy using a relevant dataset of published and unpublished clinical trials.

(my emphasis)

This study was looking for a depression baseline for efficacy: the researchers concluded that how down you feel is positively correlated with how well the drugs work… sort of.

If you’re moderately depressed, you can pretty much forget it and save your cash. Spend it on candy or unicorn rides or whatever it is happy people spend their money on; if you’re severely depressed, you might get something out of it… maybe; and if you’re muttering-to-Jesus-walking-in-the-middle-of-a-busy-road-in-pajamas, severely, with whipped cream and chocolate sprinkles depressed, there’s a fair chance you’ll get something out of it. But here’s the kicker… the efficacy of treatment for this extreme type of depression was attributed not as much to the drugs as to decreased responsiveness to placebo.

…hope you have faith in your doctor’s dope.

Too bad looking for answers for depression outside of the serotonin/norepinephrine/dopamine axis and studying the endogenous opioid system seem to be evil and taboo. Or something…

…too bad I had to turn my back on the Establishment and find my own answers.

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