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Medicating a nation

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It is well known fact that placing each American on anti-depressant drugs is the ultimate desire of the Big Pharma. Bringing billions of profits, meeting sick “targets” and moving to the next step – medicating the whole world. It would be nice if the SSRI drugs worked at least. Turns up that they don’t, not for people with mild and moderate depression, which is the majority of the cases. People are left only with the side effects and debilitating health. Taxpayers are left with lighter pockets, paying for ineffective therapy. That can bring a taxpayer into a depression mode itself. While typing this, I get depressed. I need a pill but I read that it doesn’t work, so I get even more depressed.

Enough is enough. If you suffer from mild or moderate depression, you better help yourself alone. Nobody will help you, surely not the drugs.

Here is an abstract from the January 2010 issue of Journal of American Medical Association (JAMA) article:

Antidepressant Drug Effects and Depression Severity
A Patient-Level Meta-analysis
Jay C. Fournier, MA;
Robert J. DeRubeis, PhD;
Steven D. Hollon, PhD;
Sona Dimidjian, PhD;
Jay D. Amsterdam, MD;
bmit=Submit”>Richard C. Shelton, MD;
Jan Fawcett, MD
[-] Author Affiliations

Author Affiliations: Departments of Psychology (Mr Fournier and Dr DeRubeis) and Psychiatry (Dr Amsterdam), University of Pennsylvania, Philadelphia; Departments of Psychology (Dr Hollon) and Psychiatry (Dr Shelton), Vanderbilt University, Nashville, Tennessee; Department of Psychology, University of Colorado at Boulder (Dr Dimidjian); and Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque (Dr Fawcett).
Context Antidepressant medications represent the best established treatment for major depressive disorder, but there is little evidence that they have a specific pharmacological effect relative to pill placebo for patients with less severe depression.

Objective To estimate the relative benefit of medication vs placebo across a wide range of initial symptom severity in patients diagnosed with depression.

Data Sources PubMed, PsycINFO, and the Cochrane Library databases were searched from January 1980 through March 2009, along with references from meta-analyses and reviews.

Study Selection Randomized placebo-controlled trials of antidepressants approved by the Food and Drug Administration in the treatment of major or minor depressive disorder were selected. Studies were included if their authors provided the requisite original data, they comprised adult outpatients, they included a medication vs placebo comparison for at least 6 weeks, they did not exclude patients on the basis of a placebo washout period, and they used the Hamilton Depression Rating Scale (HDRS). Data from 6 studies (718 patients) were included.

Data Extraction Individual patient-level data were obtained from study authors.

Results Medication vs placebo differences varied substantially as a function of baseline severity. Among patients with HDRS scores below 23, Cohen d effect sizes for the difference between medication and placebo were estimated to be less than 0.20 (a standard definition of a small effect). Estimates of the magnitude of the superiority of medication over placebo increased with increases in baseline depression severity and crossed the threshold defined by the National Institute for Clinical Excellence for a clinically significant difference at a baseline HDRS score of 25.

Conclusions The magnitude of benefit of antidepressant medication compared with placebo increases with severity of depression symptoms and may be minimal or nonexistent, on average, in patients with mild or moderate symptoms. For patients with very severe depression, the benefit of medications over placebo is substantial.