Show us the sources
The Herald has a good story today about attitudes to depression (unfortunately, only in Australia, but you can’t have everything).
Judging from the information on the beyondblue website about the 2001-2 survey, this is a real survey using random telephone sampling. It’s asking important questions, and the Herald’s story summarises the worrying level of ignorance about depression among Aussies. Notably, “62 per cent wrongly believe antidepressant medication is addictive” — the problem is the reverse, these medications are often difficult to keep taking for the necessary extended periods of time.
I said that I was judging from the information about the 2001-2 survey. The webpage was last updated in 2006, and it says they are looking to do a second survey in 2004. Some more Googling suggests that they did a second survey in 2007-8, but I can’t find any results. The media releases page doesn’t say anything, and the most recent release listed is from a month ago.
In the modern world it’s a pity that organisations can’t be more consistent about posting for the rest of us the information that they send out to the media. Then we might even have more success in persuading the media to link to it.
Thomas Lumley (@tslumley) is Professor of Biostatistics at the University of Auckland. His research interests include semiparametric models, survey sampling, statistical computing, foundations of statistics, and whatever methodological problems his medical collaborators come up with. He also blogs at Biased and Inefficient See all posts by Thomas Lumley »
Most antidepressants have fairly intense withdrawal effects. Colloquially, the presence of withdrawal effects is associated with addiction, even if it’s not a sufficient condition…I don’t think this implies people are mistaken.
Sorry to digress again, but I was wondering if you have any opinion on the hypothesis that antidepressants are active placebos? This has become quite popular lately and people claim it is consistent with the studies, but I’m nowhere near as good at interpreting medical studies as you are.
12 years ago
It’s a bit hard to tell. It’s fairly clear that publication bias plus other trial design problems have exaggerated the real benefits, and that the fact that you can’t fully blind the studies also makes the antidepressants look better.
Given the relatively low quality of the trial literature (to be fair, it’s hard to do good trials in major depression) and the possibility of enhanced placebo effects mediated by side-effects, it’s hard to say definitively that the trials are inconsistent with anything.
That being said, any enhanced placebo effect should have been weak in the earlier SSRI trials, when the new drugs were being marketed based on safety and tolerability — people weren’t expecting side-effects from Prozac back then. I think they really work, but given the importance of the question, the evidence is not as good as it should be.
12 years ago
Thanks!
12 years ago