Cognitive behavioural therapy is the best-studied form of psychotherapy. But researchers are still struggling to understand why it works (Single Link Nature.com). [more inside]
Falling STAR*D?: It is common practice for psychiatrists to switch depressive patients between different antidepressants if their current drug does not evince a symptomatic response. Despite clinical wisdom supporting this, little empirical, controlled evidence exists to direct “switching” protocols (e.g. if a patient with Z characteristics is on drug X, is it usually better to switch to drug A, B, or C? Will switching help at all?) in the psychopharmacological treatment of depression. The NIMH-funded STAR*D (Sequenced Alternatives to Relieve Depression) study aimed to address these questions of treatment direction in a very large (n>4000), “real-world” sample using a multi-phase treatment plan with different drugs (and cognitive therapy) at every step to maximize chances of eventual remission. Overall, the NIMH reported that about 67% of patients eventually achieved remission, with few differences in effectiveness between different types of treatment at each step. However, researchers and commentators have raised concerns regarding inconsistent reporting of outcomes, after-the-fact changes in study design and analysis, and other issues that may have inflated, partially invalidated, or misrepresented widely reported treatment outcomes. These inequities may also have implications for the secondary moderator analyses (i.e. does trait A predict switching to X or Y is better?) that were a major reason for the study. [more inside]
"Researchers found that failing to publish negative findings inflated the reported effectiveness of all 12 of the antidepressants studied." See also: Serotonin and Depression: A Disconnect between the Advertisements and the Scientific Literature. [more inside]
Talking back to Prozac. Review article in The New York Review of Books, covering some issues concerning the diagnosis and treatment of depression.
Anti-depressants increase suicide risk in young adults, FDA warns. "When results are analyzed by age, it becomes clear that there is an elevated risk for suicidality and suicidal behavior among adults younger than 25 years of age that approaches that seen in the pediatric population." More here and here. This follows the FDA finding that anti-depressants increased the risk of suicide in young children. The FDA now requires manufacturers of anti-depressants to include warnings, and plans to meet on Dec 13 to discuss the findings further.
Zoloft Found Safe, Effective in Children The study was funded by Pfizer Inc., which makes Zoloft. Visit The International Coalition For Drug Awareness to find out what SSRI Meds can really do to your kids...
Anxious? Depressed? - you need more brain cells. Just take one of these twice a day. New research shows that antidepressants may not work as we thought at all, rather they actually stimulate growth of cells in the hippocampus area of the brain. This may all be for the good - but it seems strange that we release millions of happy pills and market them as safe without knowing for sure what they do. Perhaps its the money talking.
Hmm. Why am I not surprised? Muddling with your serotonin in such a drastic way has always struck me as an overreaction to depression. Let's be honest. In a world jam-packed with aggressive apes who deny that they are apes, a little depression is a healthy response. Taking a serotonin re-uptake inhibitor just because you feel blue is like taking 10000 micrograms of Acid because you like the Harry Potter books.