[YSPNetwork] Fwd: re: Antidepressant warnings scared parents, doctors

Thu Sep 13 20:42:55 PDT 2007

It is entirely possible, based my literature reviews, that a reduction in
funding and fewer referrals for services may be the real culprits. The
reported drop in use of antidepressants may be insignificant when compared
to delayed effects of tremendous cutbacks in mental health, social services
and special education nationally.

Good research, attached and linked below, can be used to hypothesize that
caring, concern, hope and expectancy are important factors that may be more
important that the drop in antidepressant use. 

The CDC's reported increase in completed suicide is certainly within the
potential effect of just one standard error of antidepressant placebo
effects. In many studies, placebo effects in antidepressant studies do in
fact help people as often as medications. Placebos are generally more
effective than doing nothing in treating depression. The FDA and the Federal
government may have reduced the experience of "hope and help" more than
anything else by reducing the use of antidepressants and reducing access to
mental health services. There may be an interaction effect. Obviously we
can't intentionally treat people with placebos but that may be in fact what
we are doing much of the time. It has also been argued that up to 84% of the
benefit of any antidepressants in also because there is caring, hope,
concern and expectancy as well as the passage of time and fortuitous events.

It has been demonstrated that (1) "expectancy and hope" as a component of
medication, (2) acceptance that one has depression by seeking help, and (3)
cutbacks in public services are important independent variables. In terms of
suicide prevention, the only truly random designed controlled study (to my
knowledge) suggests that a routine expression of "caring and concern" can be
more effective than services (article attached). This is an important study
according to Marsha Lenehan, PhD because it raises many issues  For example,
funding cut backs may translate into lack of caring and concern. 

A comprehensive peer and common sense review of "The Effectiveness of
Antidepressants and Psychotherapy" can be found at

http://www.mentorresearch.org/Documents/DepressionScienceResearch.pdf .  

Further re-analysis of the CDC data by independent researchers will be worth
following. 

[Michael Conner, PsyD is the first recipient of the Oregon Psychological
Association's Public Education Service Award (2007).]

  _____  

From: yspnetwork-bounces at listsmart.osl.state.or.us
[mailto:yspnetwork-bounces at listsmart.osl.state.or.us] On Behalf Of
ibelizstev at aol.com
Sent: Wednesday, September 12, 2007 12:08 PM
To: conner at CrisisCounseling.com; KDWOLFE at prodigy.net;
Yspnetwork at listsmart.osl.state.or.us
Subject: Re: [YSPNetwork] Fwd: re: Antidepressant warnings scared
parents,doctors

The underlying study in the American Journal of Psychiatry by the Chicago
researchers which caused this line of discussion is an ecological study. The
limitations in interpreting this data are many, and the authors note them in
the article.  It is an interesting association they have found that needs
confirmation through more rigorous testing, which they say themselves.  

Also important to note:  two of the study authors receive funds from the
pharmaceutical industry.  As reported elsewhere (but not as widely as this
paper's conclusions)  the paper was co-authored by Robert Gibbons, a
professor of biostatistics and psychiatry at the University of Illinois at
Chicago, who has served as an expert witness for Wyeth, the company that
sells Effexor and J. John Mann, a psychiatry professor at Columbia
University, who has received research support from Glaxo, which sells Paxil,
and served as an adviser to Eli Lilly, which peddles Prozac and Cymbalta.
While that was disclosed in the Journal article, reporters in the popular
press (that I scanned) didn't disclose that.  While their findings are
interesting and are worthy of further research and discussion, I think their
apparent biases are also very interesting.

Liz Stevenson, JD MPH
6326 N. Omaha Avenue
Portland, OR 97217
(503) 247-3859

-----Original Message-----
From: Michael Conner, PsyD <conner at CrisisCounseling.com>
To: KDWOLFE at prodigy.net; 'YSP-OR' <Yspnetwork at listsmart.osl.state.or.us>
Sent: Mon, 10 Sep 2007 8:38 am
Subject: Re: [YSPNetwork] Fwd: re: Antidepressant warnings scared parents,
doctors

This is a wonderful article that Dr. Wolfe forwarded. 

The following opinion is based on a peer reviewed article and references
that are attached. 

Common sense requires us to consider that the stage for suicidal behavior is
also being influenced heavily by state and federal spending cutbacks in
mental health, social services and education. I don't work for the State of
Oregon and I believe that that we need more funding for services and
education.

The use of antidepressants has increased dramatically in the past 10 years
while funding and actual services has decreased.

Should we medicate more or fund services that lead to less reliance on
medications? I think we need more public services. Psychotherapy can manage
and even cure depression. Medication helps. We must consider both. 

I'm a private practice clinical psychologist and I review the literature and
I am scared for patients and physicians. 

[Michael Conner, PsyD is the first recipient of the Oregon Psychological
Association's Public Education Service Award (2007).]

-----Original Message-----
From: yspnetwork-bounces at listsmart.osl.state.or.us
[mailto:yspnetwork-bounces at listsmart.osl.state.or.us
<mailto:yspnetwork-bounces at listsmart.osl.state.or.us?> ] On Behalf Of
KDWOLFE at prodigy.net
Sent: Monday, September 10, 2007 6:34 AM
To: YSP-OR
Subject: [YSPNetwork] Fwd: re: Antidepressant warnings scared
parents,doctors

Note: Forwarded message attached.

Information, opinions or requests posted by users of the YSPNetwork listserv
are 

not approved by or necessarily in alignment with policies or practicies of 

Oregon's Youth Suicide Prevention Program. This list serv has an open
posting 

policy. Each individual author is responsible for the content of his or her 

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