Post by Roger (over and out) on May 13, 2014 17:41:48 GMT -5
Fluoxetine, better known as Prozac (also as Serafem), was hailed as the most powerful and effective antidepressant ever invented when it was launched in 1987. Its antidepressant effects had first been noticed by Eli Lilly researchers some thirteen years earlier.
Antidepressants of the selective serotonin reuptake inhibitor class were the "big new thing" in pharmacology at the time.
Prozac went into development, involving thousands of trials and experiments, with the results published in peer-review pharmacological and medical journals. Such was the hype surrounding this new wonder drug, it was the subject of numerous TV programs, and made the cover of hundreds of magazines, including Newsweek. Countless newspaper and magazine articles were written about it. The book, Prozac Nation - which described one woman's experiences with major depression - became a best-seller, and was turned into a major Hollywood movie. It would be hard to overstate the amount of interest and media attention Prozac attracted.
The feedback from doctors, psychiatrists and psychotherapists was overwhelmingly positive, as was the feedback from the 40 million people to whom the drug was prescribed. Prozac relieved depression rapidly and effectively - more effectively than any antidepressant drug previously available.
And for the next 20 years Prozac reigned as the world's number one antidepressant. The evidence for its effectiveness - from clinical trials, feedback from doctors and anecdotal evidence - was overwhelming.
Then, in 2007, a group of independent researchers carried out an extensive review of the evidence for the drug's efficacy. They looked at all the available data, including results from clinical trials that the manufacturers had opted not to publish at the time the drug was launched. They discovered, to the shock and embarrassment of all the doctors who'd been prescribing it for two decades, that Prozac "does not work" and is "no better than placebo".
The drug simply didn't work!
This was the number one drug for treating depression all over the world. It had earned billions of dollars for its manufacturers. And it was useless.
"This study raises serious issues that need to be addressed surrounding drug licensing and how drug trial data is reported," the researchers concluded their report.
So here we have a product that was 13 years in development, tested and assessed by leading chemists, pharmacologists, psychiatrists, doctors and so on, tested at length in field trials, double-blind trials, peer-reviewed and prescribed to 40 million people worldwide - with positive feedback! - for 20 years, and it was actually no more effective than a sugar pill. Or a homeopathic pill.
How is this possible? How could so many experts get it wrong? For the same reasons, I would suggest, that the evidence for "climate change" has been accepted by many people.
First there was the hype surrounding the product/issue. People became emotionally invested in it from day one. Depression was a major problem, and the drugs that were being used to treat it really didn't work. They also had undesirable side-effects, and they were addictive. The prospect of a new type of drug - which wasn't a narcotic - had huge appeal to doctors and psychiatrists. And since it wasn't a narcotic, it was safe to prescribe on a much longer term basis than one could prescribe a sedative such as Valium (diazepam).
For the manufacturer, it meant huge profits. For doctors and therapists it was an effective and popular drug they could safely prescribe. For depressives, it was a drug that they had read about and seen on TV, and by all accounts it was far superior to any antidepressant drug on the market.
All down the line, in other words, there was the potential for evidence selection bias. Too many people had a vested interest in believing that it worked, and that it was an effective drug.
What this illustrates is that consensus is meaningless and evidence is everything. The fact that "everyone" accepts the validity of something doesn't mean that it has any validity. Millions of health care professionals all over the world prescribed Prozac for their patients. Their faith in the drug was reinforced when their patients gave them positive feedback. The researchers who had developed the drug were able to explain precisely how and why the drug worked; how it acted on the brain to relieve depression. Except that, as we now know, it didn't.
The Prozac story is a classic example of how not just the lay public, but also millions of professionals, can be fooled into accepting the validity of something which actually has no validity at all, when they accept claims that have been made by people and organizations they regard as authoritative. And the fact that no one else questions the claims reinforces their confidence in them ("Thousands of experts can't all be wrong").
As I said in a previous post: "The chances of an expert being right about something are roughly 50-50. The chances of a thousand experts being right about anything are approximately zero."
Read more: unfacts.freeforums.net/search/results?what_at_least_one=experts&who_only_made_by=0&display_as=0#ixzz31hdALPps
Prozac, used by 40m people, does not work say scientists
www.theguardian.com/society/2008/feb/26/mentalhealth.medicalresearch
Antidepressants of the selective serotonin reuptake inhibitor class were the "big new thing" in pharmacology at the time.
Prozac went into development, involving thousands of trials and experiments, with the results published in peer-review pharmacological and medical journals. Such was the hype surrounding this new wonder drug, it was the subject of numerous TV programs, and made the cover of hundreds of magazines, including Newsweek. Countless newspaper and magazine articles were written about it. The book, Prozac Nation - which described one woman's experiences with major depression - became a best-seller, and was turned into a major Hollywood movie. It would be hard to overstate the amount of interest and media attention Prozac attracted.
The feedback from doctors, psychiatrists and psychotherapists was overwhelmingly positive, as was the feedback from the 40 million people to whom the drug was prescribed. Prozac relieved depression rapidly and effectively - more effectively than any antidepressant drug previously available.
And for the next 20 years Prozac reigned as the world's number one antidepressant. The evidence for its effectiveness - from clinical trials, feedback from doctors and anecdotal evidence - was overwhelming.
Then, in 2007, a group of independent researchers carried out an extensive review of the evidence for the drug's efficacy. They looked at all the available data, including results from clinical trials that the manufacturers had opted not to publish at the time the drug was launched. They discovered, to the shock and embarrassment of all the doctors who'd been prescribing it for two decades, that Prozac "does not work" and is "no better than placebo".
The drug simply didn't work!
This was the number one drug for treating depression all over the world. It had earned billions of dollars for its manufacturers. And it was useless.
"This study raises serious issues that need to be addressed surrounding drug licensing and how drug trial data is reported," the researchers concluded their report.
So here we have a product that was 13 years in development, tested and assessed by leading chemists, pharmacologists, psychiatrists, doctors and so on, tested at length in field trials, double-blind trials, peer-reviewed and prescribed to 40 million people worldwide - with positive feedback! - for 20 years, and it was actually no more effective than a sugar pill. Or a homeopathic pill.
How is this possible? How could so many experts get it wrong? For the same reasons, I would suggest, that the evidence for "climate change" has been accepted by many people.
First there was the hype surrounding the product/issue. People became emotionally invested in it from day one. Depression was a major problem, and the drugs that were being used to treat it really didn't work. They also had undesirable side-effects, and they were addictive. The prospect of a new type of drug - which wasn't a narcotic - had huge appeal to doctors and psychiatrists. And since it wasn't a narcotic, it was safe to prescribe on a much longer term basis than one could prescribe a sedative such as Valium (diazepam).
For the manufacturer, it meant huge profits. For doctors and therapists it was an effective and popular drug they could safely prescribe. For depressives, it was a drug that they had read about and seen on TV, and by all accounts it was far superior to any antidepressant drug on the market.
All down the line, in other words, there was the potential for evidence selection bias. Too many people had a vested interest in believing that it worked, and that it was an effective drug.
What this illustrates is that consensus is meaningless and evidence is everything. The fact that "everyone" accepts the validity of something doesn't mean that it has any validity. Millions of health care professionals all over the world prescribed Prozac for their patients. Their faith in the drug was reinforced when their patients gave them positive feedback. The researchers who had developed the drug were able to explain precisely how and why the drug worked; how it acted on the brain to relieve depression. Except that, as we now know, it didn't.
The Prozac story is a classic example of how not just the lay public, but also millions of professionals, can be fooled into accepting the validity of something which actually has no validity at all, when they accept claims that have been made by people and organizations they regard as authoritative. And the fact that no one else questions the claims reinforces their confidence in them ("Thousands of experts can't all be wrong").
As I said in a previous post: "The chances of an expert being right about something are roughly 50-50. The chances of a thousand experts being right about anything are approximately zero."
Read more: unfacts.freeforums.net/search/results?what_at_least_one=experts&who_only_made_by=0&display_as=0#ixzz31hdALPps
Prozac, used by 40m people, does not work say scientists
www.theguardian.com/society/2008/feb/26/mentalhealth.medicalresearch
