Research Antidepressant Trials Exclude Most Real-world Patients

[Queen Boudica]

Hence results would probably be skewed....
http://www.psypost.org/2015/07/anti...ost-real-world-patients-with-depression-35828

 

[anthony]

Its why I often say... don't read too much into trials. They're general statistical data only based on stringent criteria typically ascertained in order to participate.

Like the majority of PTSD trials, they won't accept complex trauma cases as they would lower their test results. They only want those who are, medium level, even borderline for diagnosis, thus their results look best then.

 

[Ocean5]

If you've ever been to Atlanta (home of CDC, Emory Hospital, and other major medical places.) Rail is filled with mostly ads looking for patients to study. Real eye opener to how messed-up these studies are.

To give you idea...other ads are lawyer ads to sue other people....

 

[Truthful_Whispers]

One of the meds I take is Cymbalta. I found out that, during the clinical trials, a female test subject committed suicide right in the laboratory.

 

[Anarchy]

I look the ref out for one of the trials for an atypical neuroleptic,

The control was thorazine, for which no additional therapeutic effects occur at above approximately 350mg a day. Side effects continue increasing in a fairly linear manner with increasing dose.(discovery of that ceiling for therapeutic dose came several decades after thorazine became available, hence the mental hospital inmates of my childhood memories, had something very visibly wrong with them, with distorted faces, weird movements,twitches,and slurred speech... Because they'd been receiving ludicrous doses of thorazine for years).

The trial had the atypical at an optimum therapeutic dose, the thorazine was at some ludicrous dose, iirc, about 3.5g day.

Result, the atypical had fewer side effects...

Even if a quack spotted that particular skew in that particular trial. Later meta analysis assumes that all trials are created equal, and the skew can be inherited by an analysis claiming a larger sample size and hence greater statistical significance for its conclusions. Few, outside of the industry would have the time inclination or resources to go through all the included studies to find that kind of deliberate flaw.

To say that it is almost as bad as politics for lies and distortions, would be partly true

The lies and distortions are inherited from politics, via the state's grant of monopoly privileges in return for a payment to the state - in the form of a patent.

A clear example of the distortion is available in the histories of the two main drugs for psychoses, the neuroleptics and lithium.

The effects of both were discovered and published at around the same time, however, lithium was a common widely available and cheap chemical, thorazine was patented by Rhône Poulenc...

Without the special privileges available with a patent for one, we could probably have expected physicians looking for the best treatment for their patients to have adopted both with similar rapidity, that isn't what was seen.

Similarly the rush for atypical neuroleptics appears to have more to do with their patents than it has to do with their therapeutic advantages compared to the typicals.