More conspiracy-mongering about anti-depressants (revised)

I normally enjoy reading Crooks & Liars, the liberal video weblog, but a post today hit upon a pet peeve of mine. To quote the original news article,

An analysis published in the New England Journal of Medicine suggests that studies of antidepressants that had positive results were more likely to be published in medical journals compared with those that had negative or questionable results. The findings showed that 94 percent of all published trials appeared to have positive results, while FDA reviews determined that 51 percent of all trials, both published and unpublished, had positive outcomes.

In the analysis, the researchers examined data for 74 antidepressant studies submitted to the FDA between 1987 and 2004. The results showed that 37 of the 38 trials the agency considered as having positive results were published, compared with 14 of the 36 trials that the FDA considered negative or questionable. Additionally, of the 14 negative or questionable studies that were published, 11 “conveyed a positive outcome” that was not justified by the FDA review, lead author Erick Turner stated.

The C&L post is irksome for a number of reasons.

The post brought out a number of conspiracy theorists including, it seems, John Amato, the founder of C&L. Aha! Bad studies are being underreported! Obviously this is a pharmo-fascist conspiracy to hide to truth and line the pockets of big business!

There’s a real problem with that logic. Suppose, for a moment, that we were talking about papers in geography, instead of antidepressants, and a study reported found that “94 percent of all published results suggested the Earth is round, while reviews determined that only 51 percent of all papers, both published and unpublished, suggested this.”

What would this suggest to you? We are quite confident that the Earth is round, so we would probably assume that the flat-Earth studies were flawed, and therefore rejected through the peer-review process. That’s what peer-review is supposed to do! Peer-review is supposed to filter poor and flawed results from being included in the general body of scientific knowledge.

That isn’t to say that there couldn’t be a conspiracy to promote antidepressants. But the study as quoted doesn’t prove it one way or another! It could be a conspiracy to hide the negative results of drugs that don’t work, or it could be the peer-review process supporting the reality that the drugs do work!

That hasn’t stopped the conspiracy theorists from coming out of the woodwork. To quote from a few flawed comments:

Oh and did you know that most all of the school, mall shooters in the last 20 years were on one type of SSRI or another?

This is a classic ‘correlation vs. causality’ logical flaw. Emotionally unstable people are more likely to be treated with medications, including antidepressants. Emotionally unstable people are also more likely to shoot up a mall. The common link between antidepressants and mall shootings is emotional instability. Again, independent of the effectiveness or lack thereof of antidepressants, I would expect mall shooters to be highly likely to be on them.

Stick to pot.I was on anti-depressants. Turns out I needed to change things in my life. Like taking control of it, and getting rid of bad influences around me. They did help short term. But only you are going to fix yourself long term.
Part of the bias against antidepressants is the idea that emotional problems are ‘all in your head’ and are therefore not a medical condition. One of the big breakthroughs in medicine was the realization that chemical imbalances can lead to emotional trouble. It’s amusing that people will extol endless pot usage but will attack antidepressants as unnatural.

Recent study shows that consistent exercise is much more effective at treating depression than any modern anti depressants.

It’s worth listening to the europeans, and people who have taken the anti depressants. These things are dangerous and the last people who will tell you will be your doctor, pharmacist, and government.

Full disclosure: I’ve been taking Zoloft for nearly a decade now. I was horribly depressed for a long, long period of my life, and no therapy, exercise, or ‘change of attitude’ could fix that. In fact, I over-exercised in order to make myself feel better, and ended up with permanent back problems as a result. Once I started taking Zoloft, my life was completely transformed, in ways that are difficult to appreciate unless you’ve been there yourself. I have personal experience, in other words, that antidepressants work. For me, there have been no significant side effects. I’ve also known many, many people who have taken antidepressants to positive outcomes.

Incidentally, note the utter absence of links in all the assertions in the comments above. There’s no evidence used to back up any of these ‘claims’; they’re little more than conspiracy-laden rants.

It’s fair to be suspicious of over-optimistic claims that come from profit-motivated businesses, but it’s absurd and even dangerous to automatically discount new medicines and technologies simply because they come from ‘the man’.

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5 Responses to More conspiracy-mongering about anti-depressants (revised)

  1. Mark Frey says:

    “It could be a conspiracy to hide the negative results of drugs that don’t work, or it could be the peer-review process supporting the reality that the drugs do work!”

    Very true. There’s also a third factor at play here that the conspiracy theorists are likely to ignore (in part because it is admittedly a fine point to anyone who is not trying to maintain a career in research): the built-in bias of a peer-review process that requires manuscripts to “significantly advance the field” to be publishable. This is usually interpreted by editors and referees as “show something new to be likely true” and only rarely as “rule out some obvious possibilities or widely-held assumptions.”

    I can’t speak for other disciplines, but in the biological sciences it’s tough to get negative data into print regardless of whether the study addresses the clinical relevance of a drug or the developmental pathways of a nematode. So some studies which fail to show positive results with drugs are probably disappearing not for nefarious reasons, but because nobody is interested in spending ink on them when they could be publishing something more exciting.

    This phenomenon wastes a lot of research time and money, actually, as several labs will often pursue experiments that already didn’t work but were not published because no journal wanted the negative data.

    Don’t get me started on the great international nematode conspiracy.

  2. Mark wrote: “I can’t speak for other disciplines, but in the biological sciences it’s tough to get negative data into print regardless of whether the study addresses the clinical relevance of a drug or the developmental pathways of a nematode.”

    Well put! Similar problems certainly arise in physics. Your observation is a good reminder that the peer-review process has significant weaknesses in it, and that those weaknesses aren’t addressed as much as they should be. “Outsiders” fail to realize, however, that those flaws are not necessarily evidence of a grand conspiracy as much as evidence of the human side of science.

    I’m afraid to ask about the ‘great international nematode conspiracy’! (GINC?) 🙂

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  4. conour says:

    I am %100sure that antidepressaints are pioson my cusin has been an antidepressaints sence she was 6 because her dad is a peace of shit and she lived with my famly for a while and we would wake up to hear screaming her head off and and the second someone would run in there she would turn in to the happiest person everyone i know who is not retarted that took antidepressants includuing my self says that they are poison and im pritty shur that that 6 year old that killed himself with a a garden hose would think so too. DDDDDDDDDDDDDDDDont taaaake antidepressants they turn you into an emotionless zombie like person

  5. John W says:

    Your reasoning is pure shit sir. Perhaps it is that you’ve depended on these drugs for a decade to feel good about your life that you carelessly rationalize why the harmful effects of these drugs are hidden away. I am often depressed and have considered suicide, but I am not afraid to feel the emotions of despair and meaninglessness. Living in this culture, if you think everythings hunky dory, I would argue your the one with a real problem.

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