More doubts about Prozac

[unixronin]

Recently, Prozac and related SSRI antidepressants were dealt a blow when it was made public that Eli Lilly, Glaxo-SmithKline and the other manufacturers of the drugs had failed to disclose data from unfavorable clinical studies that showed patients using SSRIs had an increase as much as four to one in suicide risk.  Now, a new study from Hull University, using the data submitted to the FDA to gain approval for the drugs, has found that for most patients, SSRIs are no more effective than a placebo.

Eli Lilly, of course, defends the drugs' effectiveness; and another researcher, the head of psychopharmacology at Bristol University, says that "if they provide some sort of placebo benefit, this shouldn't be discounted."

Now, the thing that immediately occurs to me is this: If you have the choice between a placebo that is medically inert, and has no side effects that aren't psychosomatic, or a drug that performs no better than the placebo, but has a vicious side-effect profile and may quadruple your likelihood of suicide ... aren't you better off with the placebo?

Clarification:

I should point out that I have not read the studies cited; I have only read summaries.  My intention here was not to discuss the studies per se, but rather to question the idea that it's still a good idea to use a drug with known severe side-effects for it's placebo-like effect if it's (allegedly) no better than a placebo.

Comments

[unixronin.livejournal.com]

I'd been given to believe that the results were "well, they do work better than a placebo, but not as much as we thought, and let's not forget that placebos _do work_. Oh, and the more severe the depression, the better the drugs work."

The summary I read was a little inconsistent ... in at least one point, it was saying that the drugs were no more effective than a placebo "except for the most severely depressed patients". Yet later on, it seemed to be saying the reverse — that the least depressed patients saw the most benefit.

As noted in my reply to nephthys510 above, I wasn't questioning the value of placebos, either. I was just trying to point out that, if the assertion that the drug works no better than a placebo is correct, then it seems to me that medical prudence should dictate at least trying the placebo first.

[unix-jedi.livejournal.com]

was just trying to point out that, if the assertion that the drug works no better than a placebo is correct,

I'd also add that it's possible that the study isn't set up correctly, or has variables that we don't know or can't test for. (Which is still an incorrect study, but I think a different sort.)