Antidepressant fraud over antidepressant ineffectiveness

It's long been known that many antidepressants seem to be little better than placebo for major depression.

The typical answer from the psychiatric world, if not from every individual psychiatrist, has been "give it a little longer." (To the degree that anti-Ds, whether old tricyclics, newer SSRIs or newer yet SNRIs, do seem to have any direct physical effects, stimulating synapse and/or brain cell growth does take several weeks.)

If that still doesn't work, then the psych world answer is: "Let's try another." Lexapro instead of Celexa. An SNRI instead of any SSRI. Etc., etc.

What if the primary research cornerstone that still upholds the antidepressant world is itself based on Big Pharma research fraud? What if the mainstream media hasn't picked up on that yet, because it largely follows psych world PR?

That's exactly the contention of psychiatrist Bruce Levine, a regular Counterpunch contributor. Levine says this isn't totally new, either; only 4 years after the 2006 STAR*D study, the issue of publication bias in general, though not actual research fraud or the spirit thereof, was raised about anti-D efficacy.

Yes, research fraud or the spirit thereof, as STAR*D investigators didn't disclose their pharmaceutical ties. And, the fraud that's documented is clear and easy to see. Dropping people out of results although part of a test group, for example, if they dropped themselves out of the research before complete. (These people made up almost one-quarter of the test cohort.)

What if they had?

Levine links to a piece from the Mad in America site that covers this in more detail. That said, unless I'm hitting a paywall, it ends with this as a rhetorical question.

And, Levine himself shoots down the rhetorical alternatives. He says, for example, that ketamine is as overhyped as SSRIs.

(T)he research on ketamine as an antidepressant is worse than disappointing.

Given its clear side effects, it's hard to see how it could not have a placebo effect as big as SSRIs.

He also notes that, even if the "chemical imbalance" theory of depression isn't accepted today, if STAR*D's truth had been told early on, this idea never would have taken off. 

Among issues involved, to the degree that anti-Ds do appear to change neurons, we don't know how they change them, if they change only brain neurons, what changes may affect mental health and more. Re the demise of the chemical imbalance theory, all brain neurons have multiple receptors for each of the main neurotransmitters. We don't know which ones might be affected by depression, anxiety, etc., and how anti-Ds may or may not affect that.

Levine doesn't discuss electromagnetic interventions, such as old electroshock or more modern transcranial magnetic stimulation. He does say he has his own antidepressant:

I do have my own personal antidepressant, which is Albert Camus’s essay The Myth of Sisyphus. Camus argues that the realization of the absurd does not justify suicide, and instead compels rebellion that can be vitalizing. Camus concludes, “The struggle itself towards the heights is enough to fill a man’s heart. One must imagine Sisyphus happy.”

And, we shouldn't take that as a joke. Without going fully Thomas Szasz, we need to look more at the social psychology aspects of depression. I say that because I think things like schizophrenia are not totally socialized psychology, and so, don't totally go down the road of Szasz.

John Horgan, who's long been critical of the Big Pharma world on mental health, had this to say after I tweeted him Levine's link:

This is a huge medical scandal, which should be much more widely disseminated and discussed. https://t.co/BogjK3WAl8

— John Horgan (@Horganism) January 18, 2024

He's right. And, of course, this coming in the wake of COVID and conspiracy theories over mRNA vaccines overshadowing people like me who see their relatively low effectiveness, and also see a Biden Administration refusing to use federal power to deal with copyright issues, and you have additional problems both social and political.

Side note: The Twitter exchange has drawn at least one COVID anti-mRNA vaxxer, if not more than that. But, said person has been told the truth, has been seen to retweet racism from VDare and other stupidity, and the conversation has been ended. 

As for that person and others? The real scandal, not just over mRNA vaxxes, but to some degree, all COVID vaccines, is that neither Trump nor Biden, based on federal whipping of "Operation Warp Speed," that neither one exercised federal patent rights.

==

Personal note: I have been on antidepressants before for the flip side of depression, acute anxiety. They seemed to have work, but how much of that was placebo effect? How much of it was me "aging out" of the anxiety problem? And, I have had the side effects.