Anti-Depressants in 2018: Debunked, Discredited, Dangerous.

this video is about 30 minutes long and
it's not easy to watch it could change your life if you share this video with someone else who is either using antidepressants now or has used antidepressants in the past or who is considering seeking help from a psychiatrist in the future it could change their lives to the better very fundamentally this is a video sharing hard facts published and proven in the last 20 years in the medical sciences facts that are inconvenient for many of us to face up to it may be that someone you know and love and trust placed their faith in the hands of the medical establishment of the psychiatric establishment and that these drugs have changed their lives it may be very hard for them to hear or accept the implications of what this video is now going to tell you there are two senior experts in this video who devoted many years of their lives to researching this question and it's just our luck both of them speak English one of them is dr. Irving Kirsch you'll notice that the first major peer-reviewed study he mentions is from the Year 1998 the first study of his own the first meta-analysis and he worked on this issue from 1998 to 2008 and then from 2008 to 2018 that's a tremendous level of devotion and dedication and as you'll see he still to this day publishing books writing essays and touring the world trying to get this message out to the general public people like you and I'm making a relatively insignificant effort in editing together these few sources and trying to present them in a form that maybe a few thousand other people will see and duly give consideration to share this video it's not for my benefit and it may not be for yours but I have personally known people from all walks of life from all levels of education who believed in these drugs and there are medical doctors at all stages of their career young and old who still believe widely-held assumptions from 50 years ago what's taught in the textbooks lags behind the leading edge but this is now something that's proven I like right now I can't like talk like I usually do I tried talking to my doctorate and I got sent up psycho tryst and I got prescribed antidepressants and I've been taking down since two weeks it has a lot of side effects it's here because one of the side effects is to decrease anxiety and but you still get anxiety as a side effect sometimes and I've heard other side effects are headaches insomnia nausea and also have a diet and for some reason I'm experiencing all the side effects mr. Blunt has virtually no signs of his original illness now the signs at the movements of his mouth are completely side effects of the drugs that he was on for 20 years mr. blonde is quite rational he understands what's going on and if you're patient he can carry on a very rational conversation with you the movements that he makes with his mouth and with his tongue he can't stop their involuntary movements he can slow them down by concentrating on them but as soon as he stops concentrating on them then they come back and are more mr. blown also has some movements of his diaphragm when the diaphragm contracted then it causes him to make sounds out of his mouth but that's all part of the same condition if it was not for the side effects of the drugs mr. blunt would in all probability be able to leave the hospital [Music] FTC the identity makes time must reserve for this Bonilla to sell more about [Music] asset are due to skin EC sorry oppa to a saint in Sedna are the England miss Vista battalion suffered unknown back avatar do to skin you see after email at omaha's / handling for neuroleptic entirety Tico and not a commerce awarded today lion I received some essential for Medina many wounds helmet cos no electric apprehending thr do to skinny she was held in the present when TX a guard Marcus it is a limited forced upon your lips occur sati in Ponte are known for Sarah Merrell no electric evaced nellyville' or ticker very norm so she ate steamed SEC and Hassan own goofily muscular appearance a man Tigers a big file mainly so she ate some Leo but I like nurses that are known as a leader as I said is an interested just to mean Sammy so to pursue the salon crafty mostly spaceman some curvy Irma's Mary fool Esaias Elmo Elmo's kid means to whoever f30 here can skate for fairly scary at Nia so they would be clearly the monkey training percentage yet say sasuke decay assembly Nick faded I didn't know where to go first to talk about my symptoms actually thought that nothing like was wrong I have been put on medication I went to a psychiatrist at the hospital and I told them my symptoms and and I got I know they got medication prescribed I was told that he side effects would go away I was told that the side effect go away within a couple of weeks so I'm waiting for them to be over early in February actually in 2008 an analysis of antidepressant medications that I did with some colleagues was published in the medical journal PLoS Medicine I woke up that morning to find that our study had become the lead front-page news and virtually all of the UK daily newspapers two years later was still making news of the four-page cover story in Newsweek and two years after that this came on television the medical community is at war battling over the scientific research and writings of a psychologist named Irving Kirsch so how did this all come about and to tell you that story I have to go back to 1998 so we combed the literature now is not enough to look at the placebo effect because you know if you if you have a cold and I give you a placebo and I measure how you're doing a week later you will have gotten better right it's not a placebo effect that's just the passage of time Natural History so just as to measure the drug effect you need to have a placebo control to measure the placebo effect you have to have a control for natural history so what would happen if you didn't get the placebo and so we scoured the literature and we were looking for for trials clinical studies in which depressed patients had been randomized to either get a placebo or get no treatment at all being placed let's say on a waiting list and getting treatment later now as it turns out the only place we could find data on press patients get being given placebo was in drug trials so that meant that we had the drug trial data when you have data you analyze it and what we're looking here is change pre to post in the drug condition and you get a standardized mean difference different outcome scales of about 1.5 that's a big healthy effect and change improvement in medical literature and a nice big placebo response and very little improvement much less improvement in the no treatment condition so that means we do have a real placebo effect it turns out about 25 percent of the response to the active medication you get anyway even without doing anything you get another 50 percent of it by giving an inner pill a placebo that's the placebo effect in the treatment of depression fine great that's what we were interested in but now there's a surprise that leaves only 25% of the response as a true drug effect and that seemed to both gyein and and me to be too small for a treatment that had been heralded as constituting a revolution in the treatment of depression so in the early part of the 20th century generally it was felt that there were no there was no way of really targeting the biological origins of mental disorders and the treatment for people who were considered to be mad crazy depressed whatever was very nonspecific it consisted of helping them to be in a creating a structured environment for them where there were activities they could do where there was work they could get involved in giving them fresh air and exercise and and if they were very disturbed using sedative type drugs but those drugs were not seen as doing anything was related to the origins of their problem they were seen as as sedatives as chemical straight jackets or restraints if you like so that was the situation in the early 20th century and then in the nineteen thirties and forties various physical treatment procedures start to be introduced into psychiatry like insulin coma therapy for example and then later ECT electroconvulsive therapy now these treatments are start to be spoken of and represented as if they are somehow targeting the underlying basis of a particular mental condition so incident coma therapy for example even though no one knew for certain what it was doing people speculated that it was working by targeting the underlying basis of schizophrenia so so it was significant for that for that reason that psychiatrists even though it's not the case psychiatrists started to believe when insulin coma therapy came in that they had a specific treatment that targeted the underlying biological mechanism that produced schizophrenia all the symptoms of schizophrenia and the same sort of thing happens with ECT electroconvulsive therapy is introduced again for the treatment of schizophrenia but it becomes more associated in the literature anyway with the treatment of severe depression or melancholia or sometimes manic depression and again even though people have no real idea how it might be working in depression there's this idea that somehow it's acting on the underlying biological mechanisms that produce depression so by the 1950s psychiatry has gone from a state where it really didn't believe it was possible have any treatments that were thought to be specifically targeting the biological processes underlying mental disorders to a situation where it is believed commonly believed that there are two treatments that are that specifically target two of the main psychiatric disorders incident coma therapy for schizophrenia and ECT for depression or manic depression not surprisingly turned out to be very controversial and one of the most serious criticisms was that our analysis was flawed that it derived from a minuscule group of unrepresentative inconsistently and erroneously selected articles what are we going to do well what we did was try to replicate our own meta analysis and we did that by where are we gonna find another dataset that doesn't overlap ours and see if we can get similar results or not we went to the FDA and we use the Freedom of Information Act and we got from them all of the data that the drug companies had sent to them in the process of getting approval for what at that time were the six most widely prescribed antidepressant medication well if you look at the published trials you'll find that three out of four of them show a significant benefit of drug versus placebo if you look at the unpublished trials that shrinks 12% now we had the published trials the unpublished trials we put them all together we did the same kind of analysis that we did before and we get this nice healthy response on average to get being given the antidepressant drug and of an even bigger response i'm lucy bow now it's the placebo response not the SIBO effect but we know that that counts for relatively little the-the-the spontaneous remission the natural history the placebo response is now accounted for eighty-two percent of the response to the active drug and the difference between drug and approval is less than two points on the Hamilton scale now the Hamilton scale can you can have scores ranging from zero to fifty three points you can get a six point difference just by changes in sleep patterns with no changes in any other symptom of depression that's a small difference and you don't have to take my word for it because there's an organization in England called the National Institute of Health and Clinical Excellence the acronym is nice and they're very nice organization what they do is to set treatment guidelines for the National Health Service and in revising their treatment guidelines they have established a criteria for clinical significance for saying that a drug is not only statistically but clinically better than a placebo and that's a three point difference on a Hamilton depression scale or an effect size of 0.5 and as you see that comes nowhere close when you look at it historically you realize that that idea first came about in the context of treatment of a treatment ie insulin coma therapy that we now know was completely useless not only useless but highly dangerous but but certainly no one would now defend the idea that incident Giacomin therapy was specifically treating schizophrenia specifically targeting the biological cause of schizophrenia this was a really good day and they felt really stable and sometimes you like really get happy like like this yeah I will take it easy and not let these side effects affect me too much but it's getting better yay I must have seemed really weird at the start of the video but like it was really difficult to like turn on the camera camera but I'm still glad I did it Wow good good I probably feel like [ __ ] again like in a couple of hours but thank you it's so good it's wishful thinking basically it's wishful thinking that I think is probably quite deep-seated and people who have a medical training because because that's what medicine aims for it aims to find the ultimate causes of things and um that the mechanisms which produce symptoms and it aims to be able to target those mechanisms in some way well we published this second meta-analysis in 2002 and the critics complained that a patient's weren't depressed enough you see they said sure if you give antidepressants to mildly depressed patients or moderately depressed patients what you're going to see is probably a placebo effect there won't be much difference between the drug in effect and the SIBO effect but you know we see severely depressed patients and in severely depressed patients that's where you'll see that the drug really does make a difference well ok that's a plausible argument what are we going to do now well let's go back to our data and let's see how severely depressed on average the patients were at baseline before being given drug or placebo as it turned out there was only one study on patients with moderate levels of depression none and mild depression one study in the early study of prozac early true clinical trial prozac showed absolutely no difference between drug and placebo there weren't any studies of patients with severe depression all of the rest of the studies were in patients with very severe depression according to the categorization used by both the American Psychiatric Association and by nice we did find within very severe depression there was a relationship between drug placebo difference its effect size and severity of depression and at the very extreme very extreme levels of depression there was a small group of studies showing patients with scores 28 or above on the Hamilton Depression Inventory show a benefit of antidepressants that in fact passes the criterion for clinical significance we had 7% who were moderately depressed 78% who were very severely depressed and only 15% who were very severely depressed but at the extreme end abut going beyond 28% they benefited in this data set that meant that about 85 percent did not show a clinically meaningful benefit as a function of taking the active drug doesn't that looks familiar and what does that represent in terms of the distribution of patients well now we're getting a clinically significant benefit and about 10% of the patients when you include some mildly and some severely depressed patients meaning that 90% of the patients were not showing you benefited clinically meaningful benefit at all and then there was the critics last resort which is a true believer high argument David Nutt in the UK said antidepressants work everybody knows they work and another critic wrote clinical practice plus millions of content patients can't be that wrong well the history of medicine is replete with treatments that have worked for millions and that's why we don't depend on anecdotal evidence for making treatment decisions we do clinical trials and we look at the data and if you look at the data everybody gets the same result here it's going to be now my study with my colleagues our studies nicest studies Turner in Canada my two harshest critics they're my harshest critics did two meta analyses to show that we were wrong the difference between drug and placebo is small and even the FDA agrees the reason that we do randomized trials is that depression like many other conditions is not predictable so it's not the case that you know we know that you become depressed and we know you will stay like that for at least a year for example and therefore if you get better before a year's time then we can say all you know it was the antidepressant that made you better depression is not like that it's a highly variable and the heart and fluctuates and therefore it is very difficult to say if someone starts feeling better whether it's due to the weather it's due to something they've done whether it's just what would have happened anyway or whether it might be due to some sort of new treatment that they've been started on and that's why we do trials and the trials show that there is a very substantial placebo response so that people feel you know a lot better when they take a placebo do almost as much better and there's very little difference as they do if they take an antidepressant the difference between the small difference that you see in trials between antidepressants and placebos is probably what you might call an active placebo effect it's the fact that when people take an antidepressant they're not just taking a chalk tablet they're not taking something that's in urge their taking an active drug and they will notice some more or less subtle changes from taking that drug now most people again going into antidepressant trials think want the antidepressants the people who really don't think hazard presents are going to work for them other people who don't go into those trials in the first place so if you've got a trial full of people who mostly want antidepressants most you think they're going to be beneficial and then they take you know they get allocated to the antidepressant and they get a few side effects you a situation where they're going to be hopeful you know particularly hopeful that they're going to that they're going to get better and so I think you get an enhanced placebo effect with the active medication in antidepressant trials and it doesn't matter if you look at the short-term trials or you can find yourselves to looking at the long-term trials and it doesn't matter whether you look at the freshen or you look at these same drugs for the treatment of anxiety disorders the difference is small barber and colleagues they did a 16-week trial comparing sertraline to placebo and two inside oriented brief insight oriented psychotherapy 16-week trial is very long for a drug trial happens to be the length of trial of the star D trial patients very much like the patients who would be excluded from conventional clinical trials many of them economically disadvantaged high level of comorbidity chronically depressed and here's the part I like best non-responders at week eight people halfway through the trial they didn't respond to search Raeleen they were switched to venlafaxine good you know when drug doesn't work to try another non-responders in the placebo group or switched to a different recibo that's the part of here's what they got in the drug group here's what they got in the placebo group virtually no difference at all and the same level of response that you're getting in the star D trial and certainly no drug effect when we did our first meta-analysis back in 1998 guidance a Kristine and I when we first saw those data we assumed we must have done something wrong something is not right here everyone knows that antidepressants work maybe maybe we made the mistake of including drugs that were effective for depression as well as drugs that weren't effective for depression if we had done that maybe some antidepressants are better than others and if we're including Studies on ineffective drugs that's going to lead us to underestimates the potential of antidepressants to ameliorate depression and maybe overestimate the placebo component of it so we went back to our data and we look at looked at what drugs were the patients in these studies ah somewhere on tricyclics some were on us as our eyes somewhere on other antidepressants and we did mi a lo inhibitors and things like that and we found there were some other drugs in there too there was some studies that were looking at things like barbiturates and benzodiazepine and lithium for not for unipolar depression and thyroid medications for people without a thyroid disorder unipolar depressed patients and in case after case three-quarters of the response of the drug was duplicated by placebo it didn't matter whether there's a try cyclic an SSRI some other antidepressant or even something that's not conventionally considered an antidepressant here are results from meta-analyses of head-to-head comparisons between in this case SSRI and other antidepressants MDR eye sight rice eye so these are all comparator trials nope placebo controls head-to-head comparisons response rates they're all the same they're all the same and there's yet another drug that we should take into account that I don't have up here and that is TNF teen how many of you have heard of TNF teen very few TNF teen is a drug that is has been approved by French regulators and it is marketed in France and a number of other countries as an antidepressant the most common antidepressants these days are SSRIs selective serotonin reuptake inhibitors TNF teen is an SSR II it's a selective serotonin reuptake inhibitor is are supposed to do instead of inhibiting the reuptake so that there's more serotonin available in the synapses it's supposed to enhance reuptake so that there's less serotonin available in the synapses were there any truth to the serotonin theory of depression and I don't know a responsible researcher in the area that still contends there is it's only in marketing that you'll see that talked about were there any truth to that SSRIs art should not help people recover from depression it ought to make them depressed here's what it does in head-to-head trials against both SSRIs and imipramine and tricyclics so what do you call pills the effects of which are independent of their chemical composition and they should be taken with a grain of salt I didn't know where to go first actually thought nothing was wrong the people who are harmed by these drugs are reaching out for help these drugs end up hurting people who are weak and they end up hurting strong people at moments in their lives at times in their lives when they're at their weakest it's exactly when their most devastated distracted and demoralized when they can't take the time to get on google get on you to get on Wikipedia and figure out these facts lurking behind the figures when they can't scrutinize what their doctor or psychiatrist is telling them and that's why I say again please do your small part share this video share it with someone you love share with someone you're concerned about Cher it so that we can help the whole world catch up with what dr. Irving Kirsch already knew in 1998