December 06, 2011
Antidepressants: A complicated picture
"But what about long-term effectiveness and true remission of symptoms? In the NIMH-funded Sequenced Treatment Alternatives to Relieve Depression (STAR*D) Study, the outcome measure was remission of depressive symptoms, e.g., becoming symptom-free. (emphasis mine) This outcome was selected because people who reach this goal generally function better socially and at work, and have a better chance of staying well than do people who only achieve a response but not a remission. STAR*D reported remission rates of 31 percent after 14 weeks and 65 percent at six months. These results may seem modest (placebo response rates are often over 30 percent in antidepressant trials). But STAR*D was not a good test of efficacy or effectiveness because it did not have a placebo comparison. While STAR*D was helpful for comparing antidepressants, in the absence of placebo, one does not know how many people would have been in remission without active medication."
Thomas Insel is using falsely reported results in his column on the NIMH website which amounts to fraud---definitely unethical conduct---As the head of the NIMH, it is his ethical duty to rely on an accurate analysis of the raw data collected; not on the biased reporting of results which misinform the public; and which serve only to advance the pharmaceutical industy's marketing agenda.
Thomas Insel is taking liberty with the facts---there is no way in hell this is being done unknowingly. As the Director of the National Instituties of Mental Health, he should definitely have his facts straight. The actual percentage of trial participants in STAR*D who remitted and remained well was 3%; and the actual number of trial participants who remitted and remained well was 108 people out of 4,041! The STAR*D trial cost the American people $35 million dollars and was funded by the very agency that Thomas Insel is the Director of; it is wholly inappropriate, and unethical for this guy to be lying about the results to the American people on the NIMH website. Why is he still the Director of the NIMH?!
via Psychology Today:
We Need a Thorough Investigation of the STAR*D Scandal"
an excerpt:
"We need to know all of the scientific sins that were committed, and we need an accounting of the investigators' financial conflicts of interest. STAR*D was hailed as the largest trial of antidepressants ever conducted, at a cost of $35 million to the American taxpayers, and we deserve to know why the results weren't honestly reported."
via Psychiatry Online
"The study also documented the frequency of relapse,
especially among those who were not in remission."
Ed Pigott has spent 5 years investigating and documenting the numerous errors which were made by the Federally funded investigators. Ed has also questioned the "peer-review" process which continues to disseminate the flawed and outright fraudulently reported exaggerated rates of efficacy to Medical Professionals through "peer-reviewed" professional journal articles. There is a lot there, it is well worth the time to read through. Ed has written letters to some of the journals asking them to retract the articles, with some pretty interesting responses; and a lack of response which is equally telling.
MedScape article August 24, 2010 —" A new review of 4 meta-analyses of efficacy trials submitted to the US Food and Drug Administration (FDA) suggests that antidepressants are only "marginally efficacious" compared with placebo and "document profound publication bias that inflates their apparent efficacy."
The Last Psychiatrist begins his critique, "STAR*D Augmentation Trial: WRONG!" with the question, "I can't be the only person who actually reads the articles and not just the titles, can I?"
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