Thursday, February 28, 2008

Pets On Prozac & Anti-Depressants As Effective As Sugar Pills

In which Douglas goes off on anti-depressants, medicated pets, and sugar pills. Not necessarily in that order.

(cc) HISHAM BINSUWAIFYesterday, I came across two articles that starkly contrasted each other. In one, Australia struggled to come to grips with its national depressed pet crisis. In the other, British researchers revealed studies that showed anti-depressants were no more efficacious than sugar pills.

I found the articles interesting in their own ways. Any headline that reads “Suicidal pets get anti-depressants” is bound to get sniggers unless you are Giselle from Enchanted, and “Study casts doubt on anti-depressants” is bound to tick off an entire industry built around the opposite fact, not to mention their patients — some of them even my own readers. How could I not write about these?

The first story had me snickering by the first blurb:
PETS at risk of self-harm are increasingly being prescribed anti-depressants because they cannot discuss problems in their lives with others, a leading veterinarian says.

The premise sounded like a bad Saturday Night Live skit. Can these people actually be serious? Sure enough, there was plenty to titter about at first, but it quickly went horribly wrong.

“Typically if people go out to work all day their parrot will get very bored and frustrated and eventually develop depression,” [Romain Pizzi] said.

“Symptoms often include plucking out their feathers or self-harming, which is obviously very dangerous.

“When cockatoos in particular are depressed they can start to self-mutilate and peck their own legs to the bone.”

This isn’t depression. This is psychosis. Call it cabin fever or going stir crazy; living creatures don’t like to be caged. If your bird starts pecking itself to the bone and ripping out its metaphorical hair, then it’s time to donate your pet to a local bird aviary. Don’t dope the thing on anti-depressants. Following the above quote the article quickly wound down to a close by stating without irony that “some of the world’s largest pharmaceutical companies have also recognised the need for anti-depressants for animals.” In fact, according to the article, Eli Lilly has created a chewable anti-depressant for dogs called “Reconcile”. But don’t let the Clockwork Orange-esque name unnerve you. This pill is beef flavored. That makes it all better for Fido.

Still shaking my head in disbelief I then came across an article in the Financial Times that detailed how 50 clinical trials were reviewed by psychologists from the University of Hull (original article here) with some surprising results. There are two points to this study you should understand up front:

  1. This is review work done by psychologists.
  2. The data reviewed was from the pharmaceutical companies own research, but not publicly released.

These psychologists discovered that the new-generation anti-depressants worked no better than placebos for mildly depressed patients. This finding mirrors other findings made recently (Be sure to read “Treating Depression with Placebo Therapy”). Anti-depressants are just not working for some people beyond the most severely depressed, and yet they are considered by many as the ONLY tool to combat Depression despite this lack of efficacy.

Even the trials that suggested some clinical benefit for the most severely depressed patients did not produce convincing evidence. Professor Irving Kirsch from the university’s pyschology department said: “The difference in improvement between patients taking placebos and patients taking anti-depressants is not very great.

“This means that depressed people can improve without chemical treatments. Given these results, there seems little reason to prescribe anti-depressant medication to any but the most severely depressed patients.”

Obviously, psychologists who make their living prescribing meds to depressives expressed outrage and indignation over this study. Cynically put, this is their livelihood. Big Pharma is Big Business. Anti-depressants are a product that needs to be marketed. Studies have already shown that negative information is surpressed so that the meds can be approved for sale to the public. Then cutesy animated critters try to convince us that meds are safe, meds are the solution we've been looking for, and that meds are necessary. Seeing how my life was destroyed in part by meds I beg to differ with the message. It's really all about money. You have it and they want it. Your doctors/psychologists get paid to prescribe meds to you AND get bonuses for pushing the same new meds (can we please just call these kick backs?). Your TV station or cable channel gets money for airing all those ads. Your loving, caring pharmaceutical company gets money, and lots of it, when they charge you through the nose for your monthly dosages.

What saddens me is that I come across blog after blog of people complaining about their meds. They complain about the side-effects. They talk about relapses. They voice concerns that the drugs have stopped working and need to be upped or changed. Yet many are quick to defend the medications.

If anti-depressants are no better than placebos, or even only slightly better than placebos, then why continue to rely on them? True, the severely depressed may consider even the slightest relief a boon. I can hardly fault them for that. I would just caution they watch out for side-effects. Some side-effects will last a lifetime. But what about everybody else? Even putting studies on placebos aside I need to ask, if the drugs aren't working, and you're having relapses, why are you continuing the treatment?