Depressed? Take A Sugar Pill
Sounds like it works as well as Prozac and the others, except for the severely depressed. Sarah Boseley writes for The Guardian:
Prozac, the bestselling antidepressant taken by 40 million people worldwide, does not work and nor do similar drugs in the same class, according to a major review released today.The study examined all available data on the drugs, including results from clinical trials that the manufacturers chose not to publish at the time. The trials compared the effect on patients taking the drugs with those given a placebo or sugar pill.
When all the data was pulled together, it appeared that patients had improved - but those on placebo improved just as much as those on the drugs.
The only exception is in the most severely depressed patients, according to the authors - Prof Irving Kirsch from the department of psychology at Hull University and colleagues in the US and Canada. But that is probably because the placebo stopped working so well, they say, rather than the drugs having worked better.
"Given these results, there seems little reason to prescribe antidepressant medication to any but the most severely depressed patients, unless alternative treatments have failed," says Kirsch. "This study raises serious issues that need to be addressed surrounding drug licensing and how drug trial data is reported."
...A spokesman for GlaxoSmithKline, which makes Seroxat, said the authors had failed to acknowledge the "very positive" benefits of the treatment and their conclusions were "at odds with what has been seen in actual clinical practice".
He added: "This analysis has only examined a small subset of the total data available while regulatory bodies around the world have conducted extensive reviews and evaluations of all the data available, and this one study should not be used to cause unnecessary alarm and concern for patients."
But, it's not just one study. Others have come up with similar findings.
The study by Kirsch and colleagues is here. An excerpt:
What Did the Researchers Do and Find?
The researchers obtained data on all the clinical trials submitted to the FDA for the licensing of fluoxetine, venlafaxine, nefazodone, and paroxetine. They then used meta-analytic techniques to investigate whether the initial severity of depression affected the HRSD improvement scores for the drug and placebo groups in these trials. They confirmed first that the overall effect of these new generation of antidepressants was below the recommended criteria for clinical significance. Then they showed that there was virtually no difference in the improvement scores for drug and placebo in patients with moderate depression and only a small and clinically insignificant difference among patients with very severe depression. The difference in improvement between the antidepressant and placebo reached clinical significance, however, in patients with initial HRSD scores of more than 28—that is, in the most severely depressed patients. Additional analyses indicated that the apparent clinical effectiveness of the antidepressants among these most severely depressed patients reflected a decreased responsiveness to placebo rather than an increased responsiveness to antidepressants.What Do These Findings Mean?
These findings suggest that, compared with placebo, the new-generation antidepressants do not produce clinically significant improvements in depression in patients who initially have moderate or even very severe depression, but show significant effects only in the most severely depressed patients. The findings also show that the effect for these patients seems to be due to decreased responsiveness to placebo, rather than increased responsiveness to medication. Given these results, the researchers conclude that there is little reason to prescribe new-generation antidepressant medications to any but the most severely depressed patients unless alternative treatments have been ineffective. In addition, the finding that extremely depressed patients are less responsive to placebo than less severely depressed patients but have similar responses to antidepressants is a potentially important insight into how patients with depression respond to antidepressants and placebos that should be investigated further.
Popping a pill is easier than working on thinking more rationally, which may not even take a therapist's intervention. You may be able to do it on your own, or by spending $10.20 (the discounted price on Amazon) for A Guide to Rational Living, by Drs. Albert Ellis and Robert A. Harper.
Ellis, with Aaron Beck, originated what's now known as cognitive behavioral therapy, what I see as the shortest-term, most effective type of therapy out there: "Change the way you think and you'll change the way you feel." You're disturbed because you're thinking irrationally. Get rational about whatever's bothering you, and you'll remove or minimize your disturbance, and feel better. It really is that simple.
If you'd prefer a little intervention, you can get a referral to a therapist trained in Ellis' methodology here, at his non-profit institute. You should be able to change your thinking within a few months if you aren't resistant or lazy, and then set that into practice with a little good old-fashioned self-discipline.
What about all those people who spend years and years and thousands of dollars in analysis? They're wasting their money. Freud was, to a great extent, a coke-addled fraud who just made shit up and called it science.
Here's my column on that, Things That Go Bump In The Nightie. And here's an excerpt:
Thanks to Freud, you're prone to believe your dreams are repressed desires for your exes when they could just as easily be X-rated mental lint. A growing body of evidence suggests Freud's famous book, "The Interpretation of Dreams," might be more correctly titled "The Misinterpretation of Dreams," or "I'll Make A Bunch Of Stuff Up Because I'm Sex Mad, And Get Real Famous, And Make A Fortune."...You can read something into anything -- just as Freud decided patient "Dora" must've overheard her parents having sex (an incident she never recalled), and out of devoted love for her father, reproduced his heavy breathing by giving herself asthma.
Here's Frederick Crews debunking Freud: The Memory Wars: Freud's Legacy in Dispute (New York Review Books Collections).
And here's an essay essay by Crews on the controversy surrounding his two New York Review Of Books pieces in the book (just click off the thing asking for a login, and it'll go away). An excerpt:
Then, too, there was my report of what a number of scholars have independently discovered about the birth of psychoanalysis--namely, that Freud, amid the ruins of his untenable 'seduction theory', peremptorily and gratuitously saddled his patients with a repressed desire for the incestuous acts that he had until then been unsuccessfully goading them to remember. (His later contention that they had told him about having been molested in early childhood was a characteristic reshaping of facts to comply with theory.) My readers were thus being invited to confront the unsettling fact that psychoanalysis arose from nothing more substantial than a confused effort on Freud's part to foist his explanatorily worthless hobbyhorse onto the fantasy life of his patients -- patients who, moreover, far from being cured by his revised ministrations as he would eventually claim, had for the most part already lost faith in him and abandoned his practice. My essay left a plain impression that such opportunistic improvising, which was to become Freud's chronic way of handling theoretical crises, could not have been the work of a genuine scientific pioneer.
Hmm. It looks like you're arguing yourself out of Ritalin here. Or that the company making it could substitute sugar for the active ingredients in every other pill. Even though it's not an "antidepressant".
Radwaste at March 1, 2008 9:30 AM
Ritalin works, as do many other drugs. To suggest that drugs in general don't work is just silly.
As for Ritalin, I'd rather not take it, and sometimes forget to take it (hello, ADHD!), but it's apparent to me when I haven't taken it after a while writing without it, because there's a positive and very discernable difference between my brain on Ritalin and my brain not on Ritalin.
Amy Alkon at March 1, 2008 9:41 AM
My takeaway on this is that for the severely depressed, go ahead and try it. Otherwise, doctors and practioners need to stop using these drugs as the first and only line of attack.
I was dx'd with bipolar. None of the drugs seemed to work well and had many side effects that interfered with the functioning of my daily life(the little I had, hahaha). It finally came down to be drugged or be employed. Gradually I have improved immmensely. Same job for 5 years, same landlord for 4, health insurance for me and children, decent home life. It all came down to self-discipline and STRUCTURE. My shift is 4 on 4 off, and each day off has a structure. Some people think my life is limited and boring, but I bet if you ask my kids they would bless boring ol'structure with hymns of praise and relief.
Turns out I was a tad mis-diagnosed. I have a minor issue with bipolar disorder, but the main issue was I was an aspie and didnt know it. Looking back at my life Most of my depression was about being slightly off and different from the world, and the manic episodes were stupid ways of trying to relieve it--shopping, or drinking or fucking.
Medication does not help me, will not help me and did not help me--just made everything worse. Now if Doctors couldnt just say--oh, depressed, of course here is your prescription, if they had to digg deeper and consider other underlying reasons of WHY depression is manifest, I would have had the good outcome much sooner.
Just another reason for patients to be vigilant self-advocates.
rsj at March 1, 2008 10:00 AM
Great post, rsj. I also take many steps beyond drugs to make my life work. Do I have ADHD? Who knows. I don't consider myself "disordered"; I just have a different type of brain function than most people seem to. So, I work hard to be on time and manage the results of having a brain that's a bit like a superball, or that sometimes feels like it's home to a family of squirrels, each of which wants to do about 10 different things at once.
And your advice, which I've given before -- be vigilant, don't trust shrinks or doctors blindly -- is very wise. A shrink I saw in Manhattan once, after seeing me for about 30 minutes, the very first time he'd ever even met me, wanted to give me lithium...a rather serious drug, with serious side-effects. Uh, no.
I wasn't seriously mentally ill -- I was just feeling down because I wasn't making enough money to live humanely in Manhattan, and I couldn't find a boyfriend. Yeah, let's strap her down and give her shock treatments!
Amy Alkon at March 1, 2008 10:13 AM
Thanks amy. It hasnt been easy, and for others out there dealing with depression/mental issues it is very difficult, but it can be done. It comes down to the fact that if meds WORK for you, go for it, if they havent, maybe go back to square one and re-examine your dx.
I also figure part of it is just plain old growing the hell up. In some ways it has helped me. When I wound up at the women's shelter and watched others around me shellshocked and unfunctional I kept ticking. It was liek a litle voice in my head saying "Ok, depressed. yep. been there, done that now get up and get ready for your shift. Make that money and get your own apartment. This feeling will go away eventually and you still need to get up and work."
Oh, and for the poster bringing up ritilin, that is for attention disorders, not "mood disorders".
I bought the book by Dr Ellis. Havent read it yet, but it is next up on my reading list. The little I encountered on the web looking him up souonded just like something I needed to check into.
Thanks for that Amy.
rsj at March 1, 2008 11:06 AM
> a confused effort on Freud's
> part to foist his explanatorily
> worthless hobbyhorse onto the
> fantasy life of his patients
This is such horseshit. It's not just low-hanging fruit, it's wormy low-hanging fruit.
It's from a fucking professor of English, probably a Scientologist or something.
Besides, we've covered this.
Crid at March 1, 2008 11:13 AM
The first guy who saw a rainbow wrote a note about it. But he confused aqua with teal, and now you're gonna cluck at him.
Crid at March 1, 2008 11:20 AM
The colorblind or color-confused don't get people to waste thousands of dollars and years of their lives in analysis, which, by the way, can be pretty damaging...bringing childhood traumas into the now and reinforcing them and their damage.
Amy Alkon at March 1, 2008 11:54 AM
I take two pretty powerful anti-depressents, Seroquel and Lexapro. There were no side-effects, and I can feel the diffrence in terms of my mood, which is stable. Also my life got turned around in a matter of days. Everyone has said how much prettier I look and I feel that I am the person that I should be. I have a great doctor, and I made sure she was great before I took her advice (she also used cognitive behavioral therapy). I've had pretty shitty ones, so I know the diffrence. Oh and this all happened in a matter of months, the only time I see her now is to check if the medication is doing it's job and whether life is still going good. It is, and she said I was the poster child for recovery. I might come off it soon, we'll see. My final advice is find a good doctor, a real good one because I've been to shitty ones like the Freud type Amy mentions. The therapy didnt go anywhere and she wasted my time and money. And yes--most of our conversation centered around my mother which pisses me off even now.
PurplePen at March 1, 2008 12:56 PM
Personally, I find it most helpful to simply ignore or forget stuff I can't change. This doesn't mean you avoid stuff you need to work through to be an emotionally healthy person, but every little thing does not have to be dredged up and flailed around with in therapy or on a mountain top until you're lying limp on the floor of your life. If daddy will never change, stop gnashing about him, do what you can to minimize his disturbance in your life, and get on with the business of living.
Amy Alkon at March 1, 2008 3:31 PM
As the director of Novus Medical Detox, I often see patients who are on alcohol or opioids, central nervous system depressants, also taking antidepressants. When they detox they find they don't need the antidepressants.
This is good news because a Swedish study showed that 52% of the 2006 suicides by women on antidepressants. Since antidepressants work no better than placebos and are less effective than exercise in dealing with depression.
There is a prescription drug epidemic and these are leaders in the list of terribe abuses.
Steve Hayes
http://novusdetox.com
steve hayes at March 1, 2008 8:06 PM
You know what my mom used to tell me, if I pushed on something in my body and it hurt? I'd say, mom, when I push on my wrist it hurts, and she'd say, stop pushing on your wrist then. Our bodies have evolved ways of dealing with trauma (emotional and physical). And it's okay. Repressed memories? Maybe they were repressed for a reason, leave them there. I'm really concerned about how the prescription meds seem to be a way for people to get out of learning and growing. Your mom just died and you're sad? You should be. You need to learn to deal with that sadness and get by in the world, not try to suppress it. guess what? it's okay to be sad. No one is happy all of the time. No One.
anne at March 1, 2008 9:55 PM
I didnt think I needed the meds, but I was wrong because my chemistry is diffrent so perhaps this is why the anti-depressents work so well. For example I made a great achievement of traveling the world, but it was soon followed by a great setback of coming home and not being able to leave my house for months because I was anxious about the outside, about having to be in contact with people. An interesting ability when I was at my most depressed was I would spend hours studying because I was obsessed with learning about everything. A particular favorite hobby of mine was writing notes, and notes about coelacanths. I feel "normal" emotions, they dont rocket to the top and swing all the way down. I dont get angry the way I used to. I am able to concentrate on shit I need to concentrate on. I am enjoying life very much, people, social situations, etc. Workout whats best for you, by surrounding yourself with information. Is my chemistry off or do I just need to change the way I think about people? It might be one, or the other, or both. Research, research, research. I combined cognitive behavioral therapy and meds. The CBT was hard, very hard but it paid off.
PurplePen at March 2, 2008 2:12 AM
I hate that you're so wrong about this
Crid at March 2, 2008 2:49 AM
Who?
Amy Alkon at March 2, 2008 7:18 AM
You, blogger Amy Alkon!
Crid at March 2, 2008 9:39 AM
About all of this, or you're still sore about the Freud remarks?
Amy Alkon at March 2, 2008 9:45 AM
Since I was a little kid, I was nervous, anxious, explosively angry, hated myself, contemplated suicide constantly (didn't try it 'cause I failed at everything)pissed off any friends I made, and on and on...tried all the self-help books, nothing...then my 18 year-old cat died, the only friend I had, I was so freaked out I went to the doctor. He gave me a script for Xanax, 100 mg every 8 hrs.
I take 75 mg every day (1/4 rec dosage). Now I feel normal.No longer want to jump out of the window or beat the crap out of everybody.
Still miss the cat though.
Talnik at March 2, 2008 10:42 AM
I think what we have here is another "cell phones cause cancer", "no they don't", "yeah huh!" "nuh uh!" issue. Just watch. More studies will show SSRIs to be effective in cases of moderate depression. Then others will say no. Repeat and rinse.
This will never be settled, because this kind of science can never be settled.
Larry at March 2, 2008 10:43 AM
I've been taking Lexapro for horrific PMS for a few years. It had made the difference between feeling mentally ill for 25% of my existence, and being able to get through that week NORMALLY.
Lexapro is the best thing since sliced bread, IMHO.
ALP at March 2, 2008 10:48 AM
I think the question is, how much of what we think of as depression is biologically driven and how much is just irrational thought stuff that could be overcome by changes in thinking and behavior?
Also, Larry, if you go to the link on "others" who've found a similar placebo effect, Ackerman and Greenland did work on this that I think you'll find unimpeachable, stats-wise.
Many, many studies are crap in terms of their methodology and conclusions, but what makes a difference is being at a level where you can discern the flaws. Few people are at that level, including me. I manage with anthropology/ev. psych stuff -- sometimes bugging friends who are statisticians for help three or four times on a particular study to make sure I've got it right (or, rather, the authors have got their methodology and analysis right or right enough...since, as I've learned, all studies have flaws).
Amy Alkon at March 2, 2008 11:05 AM
rsj wrote I was dx'd with bipolar. None of the drugs seemed to work well and had many side effects that interfered with the functioning of my daily life...
Yea, Aspie. Been there, done that. Online tests are here and here.
From my sample set of 4, anti-depressants don't help Aspies. They may make it worse.
As best I can tell, Cognitive Behavioral Therapy does help.
Dishman at March 2, 2008 11:14 AM
Amy, honestly I'm agnostic on the validity of these reports, because, like you, I have neither the wherewithal nor the time to dissect the stats. So we defer to experts. But then the experts disagree, and where does that leave us?
One side of the controversy probably has a commercial dog in the fight, and the other side may have an ideological dog in the fight. For a good example outside of this context of a controversy over use of statistics that refuses to die, google "Mann hockey stick".
That was all I was saying. Even if the study is unimpeachable, that's not going to stop interested parties on the other side from building other studies up completely from scratch, and with some subtle parametric choices in how the experiment is structured, they can almost certainly conclude the opposite. Such is statistics.
And only a small handfull of uberstatisticians will understand the subtleties that make this all possible.
Larry at March 2, 2008 11:24 AM
slightly OT, I hope no one minds.
Dishman
Yeah. My boyfriend is Aspie too. Oddly I am more socialized than him and other aspie people I know. More capable with the social chit chat and social cues. People still baffle me at times and I can be very oblivious but I am a bit more able in the social interaction area. (Which helps in the South, it is a total chit-chat society)We puzzled over it and figured it was the 3 years I spent as a waitress. Small interactions, bits of chit chat, here is your food, here is my tip, bye bye. over and over and over. Trained myself by doing. hehehe a weird combo of occupational therapy and Cognitive therapy?
rsj at March 2, 2008 11:26 AM
You indicate that Cognitive Behavioral Therapy works, yet offer no information of its efficacy. The studies I've seen show that CBT is AS EFFECTIVE AS PROZAC after six weeks...no longitudinal studies have been disclosed.
So...CBT is as effective at six weeks as prozac after four weeks and as effective as placebo right out of the box...got any further suggestions?
matt at March 2, 2008 11:27 AM
Actually, there are studies, but you'll have to go find them, because I'm now on deadline and working with my assistant. Furthermore, cognitive behavioral therapy is a fancy way of saying "Change your self-defeating thoughts and behaviors." I use this thinking on myself all the time to feel better. Don't you? Realize how your thinking is irrational, and change it and think and behave in a way that doesn't serve to make you miserable?
See, unlike Freudian shrinkage, you don't need a degree to practice cognitive behavioral therapy and change your life...yourself. It really wrecks how special certain people feel about their Ph.D.'s.
Amy Alkon at March 2, 2008 11:30 AM
Amy, there are a couple of issues with this study (and I'm a mathematician/computer scientist who also went to medical school, before anyone asks.) The first one is that the population of many of the studies may well have been getting antidepressants when heir depression is situational. Because it's easy and cheap, patients who present with depression are given the drugs first, and often a depressed patient, when the drugs don't work, will say "See? I told you I was hopeless." The problem here is that sometimes ones life really does suck; it's not pathological to be depressed when, for example, you're marriage is ending and you have cancer. Since SSRI's aren't mood elevators themselves, they don't help these people.
But the effect is to dilute the population of the study with a population who aren't appropriate for the drugs anyway.
The second issue is that any meta-analysis introduces random error, and (Central Limit Theorem) random error will inevitably reduce any effect that any of the studies showed. Meta-analysis is more than a little controversial for just this reason.
This isn't to say the study is necessarily wrong, although as one of those "Peter Kramer" people who saw a radical change in personality when I found the right SSRI dose, I find I doubt it. Claiming the study proves SSRI's have no effect, however, is certainly wrong.
Speaking of Peter Kramer, his book Against Depression would be a useful counterweight to this study.
Charlie (Colorado) at March 2, 2008 12:20 PM
I've read somewhere that exercise works better than drugs to treat depression and a lot of other mental illness. If this paper is correct, it would work better than a sugar pill too. Why don't we see regular, vigorous exercise prescribed instead?
Unbeliever at March 2, 2008 6:07 PM
As a practicing psychiatrist with thirty years experience, educated at Yale and University of California, one thing I have learned is to be skeptical of studies of any kind.
And I would take this one with a huge grain of salt... Charlie's cautions about the limitations of meta-analyses are well taken.
Anyone who prescribes these drugs daily, following their effects on a wide range of sufferers, develops a healthy dose of skepticism about the limitations of psychotropic medication. But limitations do not equate with impotence or utter lack of efficacy.
And in response to "Unbeliever" immediately above, I always prescribe exercise; for moderate depression, it is very often sufficient in itself.
There is a name, by the way, for the school of therapeutics which gives rise to this article and others like it: "Therapeutic nihilism." It has been around for a long, long time.
Jamie Irons
Jamie Irons at March 2, 2008 8:32 PM
one thing I have learned is to be skeptical of studies of any kind.
Starting with those that come out on the side of use of SSRI's to "cure" anything from a hangnail on? And going onto the "wisdom" of those with degrees in psychiatry and psychology?
The last time I needed to see a therapist, two years ago, to correct a problem that was affecting my writing, I flew all the way to New York for a double session with a guy whose thinking I read about in detail in a friend's book. Why? Because I respect so few people in the profession, and from reading about his thinking, I could tell he had real wisdom.
I'm not anti-drug. I take Ritalin, which has changed my life. But, remember, I was also offered lithium after about a half hour with a shrink in Manhattan who heard 20-something me talk about how I didn't make enough money and couldn't find a boyfriend.
Amy Alkon at March 2, 2008 9:02 PM
The pill-popping mentality is problematic. It doesn't resolve problems or address underlying imabalances of thought or life.
In particular:
1) I'm glad that exercise was introduced to this thread. Connecting diet and exercise to mental health is a no-brainer in most other societies. Again the Christian mind-body split and the pill-popping, buy-a-solution mentality hide this obvious truth.
2) A lot of what psychologists do, used to be done - probably more effectively - by friends and mentors within an organic community. With their studies on the importance of "social interaction" to mental health, the modern "experts" confirm what would be a commonplace in other generations.
Again, mental health is shown to be related to the large issue of how you live your life.
Ben-David at March 2, 2008 10:46 PM
The fundamental problem is that there is no money in studies that aim to falsify profitable assumptions.
In a rational system, the FDA and private agencies (e.g. insurance companies covering the drug makers) would shell out big bucks for independent studies indicating safety or efficacy problems with blockbuster drugs.
Indeed, a futures market (as for wheat, oil etc.) would provide very useful hints as to the future viability of a drug - often there are small groups of people who know years before any official action that a drug has major problems. A market mechanism would tease out such information.
Ben H. at March 2, 2008 11:22 PM
> Thanks to Freud, you're prone
> to believe your dreams are
> repressed desires
Thanks to Freud, people are at least applying rational appraisals to the meaning of dreams, even if they're using the wrong metrics. Isn't that an improvement from thinking of them as witchcraft, which was pretty much the global state of the art when he took up the matter?
> Freud's chronic way of
> handling theoretical crises,
> could not have been the
> work of a genuine scientific
> pioneer.
That's just an inexcusably stupid thing to say, and dressed with wholly unearned condescension. With Darwin, Marx and maybe Mendel, Freud was a transformative thinker in a shaky century. Before Freud, a grown, sane, sober man would have been appalled at the suggestion that his interior life was subject to forces of which he was not aware. After Freud, there was no doubt. If you want to fault Freud, fault him for having shitty students. To complain that his preferred talking cures still haven't hit the big time is trivial. It's like you're complaining that Reese Witherspoon was never considered for the role of Ilsa Lund in Casablanca.
Once more, per Paglia: "Freud is one of the major thinkers in world history. One reads him not for his conclusions, which were always tentative and in process, but for the bold play of his speculative intelligence. He shows you how to conceptualize, how to frame long, overarching arguments, how to verbalize ambiguous, nonverbal psychic phenomena. Reading him, you feel new tracks being cut in your brain."
Meanwhile, be very careful before you condemn old fashions. Doctors used to drain "humors" with leeches... It turns out, some still do.
A famous doctor once wrote a book in which he described an early experience as a caregiver. One day while he was making his rounds as an intern, an obese, middle-aged patient went into cardiac arrest. The young doctor followed the current (1950's) protocol: He cut open the man's ribcage as fast as he could, and tried to massage the heart back into rhythm with his bare hand. The procedure failed. A few minutes later, the attending physician walked into the room to find a dead patient, and an essentially teenaged boy with a bloody fist sitting in a chair, dumbstruck. He said "Now you know what it's like to be a doctor."
(By the way, that same doctor has some similarly relevant things to say about the treatment of depression.)
About ten years later, Christiaan Barnard was doing transplants. Does that mean the heart-massagers of the 1950's were wrong? Does context count for anything?
If it does, then you need to get out of the habit of comparing historical figures --and uncharted sciences-- to simplistic, Consumer Reports-style fantasies of mundane quality control and drive-thru convenience.
And if it doesn't count for anything, then maybe you're just a smirking baby boomer who wants to sit in smug modernity and pretend the richness of your times came about by dint of your own magnificence. Would you like to take a cheap shot at an important historical figure? People like to pick on Jefferson for taking an inappropriate interest in the flesh of slaves (though Hitchens says this is incorrect). But I personally think too little attention is paid the inappropriate interest Washington took in their bones (see later paragraphs).
What makes this prattling so particularly weird to hear coming from you is that your fanciful little sociobiology fables are so directly, nakedly descended from Freud.
And I'm all like, get serious.
Crid at March 3, 2008 2:56 AM
And by the way, if I hear that dinka-dinka-dinka music from the TED lectures just one more time, I'm gonna kill a guy.
Or at least crash into some fucker's Beemer.
Crid at March 3, 2008 3:08 AM
> These findings suggest...
Ah, yes, basing your opinions on "suggestive" studies. Do you always let others make your opinion for you? My guess is that you don't much about science and take all of these news "studies" at face value (do you know what a metastudy is? It's study of other studies - this is not a scientific analysis).
How about asking people who actually take prozac? How about asking people who actually do psychoanalysis? Both have been immensely helpful for me for depression and anxiety.
Oh, yes, I did CBT for a while, and it does work, but it is like setting a bone so it will heal, while psychotherapy is like doing the physical therapy to build the muscles back up.
My blog is about my experiences and thoughts about psychotherapy.
FortyEighty at March 3, 2008 4:39 AM
My guess is that you don't much about science
My guess is that you don't. What worries me is certainty, not those who are guarded about what the data seems to indicate.
And yes, I'm well-aware of what a meta-analysis is.
And perhaps you've heard: "The plural of anecdote is not data."
Amy Alkon at March 3, 2008 7:32 AM
The study examined all available data on the drugs, including results from clinical trials that the manufacturers chose not to publish at the time
Pay special attention to that second part. I blogged about this recently, from a story in The New York Times about how drug companies hold back data that doesn't serve their sales.
Amy Alkon at March 3, 2008 7:39 AM
Info on meta-analytic techniques is here:
http://wilderdom.com/research/meta-analysis.html
Amy Alkon at March 3, 2008 7:44 AM
Figures. No Ellis'ites in Ohio. Bah.
Jamie at March 3, 2008 1:09 PM
The Cult of Islam is a devotion to bloodshed-entertainment. ref: Atlas Shrugs Indonesia.
It seems that Indonesia adapted an Islam totally different from the traditional Islam the great Profit teaches us in the glorification of Allah the Supreme. Indonesia transformed Islam into a Cult of bloodshed-entertainment, terror, arson, rape and massacres.
Reference to: Atlas Shrugs Indonesia.
The Cult of Islam is enclosed in a frenzy of satanic emotions and crimes not open to dialogue nor criticism. Example to Theodoor van Gogh. Mudered by a paid assassin Mohammed Bouyeri a Muslim pig. Never to join society all his life. But Samir Azzouz and Imam Hermanto are both enjoying life to the full.
The Jemaah Isliamiah is an Islamic militant guerrilla network that is synonyms to Indonesia. In the urge of revenge against America. The Jemaah Islamiah in their military strategies bomb America in Jakarta and Bali. Happy to do so as an inspiration from Allah.
Reference to: Jakarta and Bali under siege by Islamic Jihad.
The Special Assignment Anti-Terrorism Police in Jakarta needs our assistance and cooperation in the fight of Islam Extremism.
I just want to name one particular location for Islamiah Jihad Academy. Who teaches Jihad slaughter to young jobless innocent Indonesians to be used as human bombs to their criminal activities. The sort of group I mean in the South Jakarta district of Tebet Timur Dalam "Rahima". A center for education and information on Islam.
Reference to: http://www.rahima.or.id
or
Rahima Sipkema Amsterdam
In particular of the Rahima curriculum of the NGO's academy of studies inclusive of hatred towards America and Europa and Do-it-yourself-Jihad. An easy and effective revenge of opportunity towards those who oppose, offend or ridicule the Cult of Islam.
Today the 19th.September,2009. Amsterdam. My name is Listiani Lestari id: 530971312. Converted to traditional Islam by my Dutch husband.
Listiani Lestari at September 19, 2009 3:56 PM
The Cult of Islam is a devotion to bloodshed-entertainment. ref: Atlas Shrugs Indonesia.
It seems that Indonesia adapted an Islam totally different from the traditional Islam the great Profit teaches us in the glorification of Allah the Supreme. Indonesia transformed Islam into a Cult of bloodshed-entertainment, terror, arson, rape and massacres.
Reference to: Atlas Shrugs Indonesia.
The Cult of Islam is enclosed in a frenzy of satanic emotions and crimes not open to dialogue nor criticism. Example to Theodoor van Gogh. Mudered by a paid assassin Mohammed Bouyeri a Muslim pig. Never to join society all his life. But Samir Azzouz and Imam Hermanto are both enjoying life to the full.
The Jemaah Isliamiah is an Islamic militant guerrilla network that is synonyms to Indonesia. In the urge of revenge against America. The Jemaah Islamiah in their military strategies bomb America in Jakarta and Bali. Happy to do so as an inspiration from Allah.
Reference to: Jakarta and Bali under siege by Islamic Jihad.
The Special Assignment Anti-Terrorism Police in Jakarta needs our assistance and cooperation in the fight of Islam Extremism.
I just want to name one particular location for Islamiah Jihad Academy. Who teaches Jihad slaughter to young jobless innocent Indonesians to be used as human bombs to their criminal activities. The sort of group I mean in the South Jakarta district of Tebet Timur Dalam "Rahima". A center for education and information on Islam.
Reference to: http://www.rahima.or.id
or
Rahima Sipkema Amsterdam
In particular of the Rahima curriculum of the NGO's academy of studies inclusive of hatred towards America and Europa and Do-it-yourself-Jihad. An easy and effective revenge of opportunity towards those who oppose, offend or ridicule the Cult of Islam.
Today the 19th.September,2009. Amsterdam. My name is Listiani Lestari id: 530971312. Converted to traditional Islam by my Dutch husband.
Listiani Lestari at September 19, 2009 3:58 PM
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