Placebo More Effective Than Zoloft
A study came out last April indicating that placebo is more
effective than Zoloft or St. John's Wort. I thought "So what's new?"
But there seems to be an interest here because not everyone realizes yet that
increasing serotonin is the worst thing you could do for someone who is
depressed since their serotonin levels are already too high. What is low is
their ability to metabolise serotonin - exactly what antidepressants lower
even further. So one should conclude that ANYTHING that increases serotonin
will only make the depression worse after the initial high caused by the shock
of the initial serotonin increase.
This morning several of our directors have made some very valid points that
should be applied to this information that I thought you would find to be of
interest:
Subject: Placebo better than SSRI, Zoloft: study of 340 patients at Duke
University. The findings of a major government sponsored, 14-site, controlled
clinical trial, comparing anti-depression treatments-- serrtraline (Zoloft)
vs. Hypericum perforatum (St John's wort) vs. placebo--are reported in the
current Journal of American Medical Association ( JAMA).
In paragraph eight of this URL, it states, "Overall, 32 percent of the placebo
group ended up with better scores on key tests of depression severity,
compared with 24 percent of patients taking St. John's Wort and 25 percent
taking Zoloft."
Hmmm. The Zoloft doses were too low to show much of a beneficial effect? Yet,
even at those levels, Zoloft had the highest adverse effects with nearly half
the patients suffering from diarrhea or nausea. Scary to think what the
adverse effects would have been at Pfizer's recommended dosages.
Dr. Ann Blake Tracy, Executive Director,
International Coalition For Drug Awareness
www.drugawareness.org and author of Prozac: Panacea
Or Pandora? - Our Serotonin Nightmare (800-280-0730)
http://www.philly.com/mld/philly/living/health/3033640.htm
Posted on Wed, Apr. 10, 2002
On depression, placebo proves helpful Participants reported St. John's Wort
was less so. Experts say simply getting help makes a difference.
By Marie McCullough
Inquirer Staff Writer
For treating moderately severe depression, a sugar pill worked better than a
popular herbal supplement and rivaled the prescription antidepressant Zoloft
on most measures of effectiveness, according to a new study.
The research, led by Duke University Medical Center physicians, cannot rule
out the possibility that the herbal supplement, St. John's wort, relieves
milder depression. But the findings suggest that people with serious symptoms
should consult a therapist rather than simply self-medicate with the herb.
"I don't recommend self-medicating with anything if you are suffering from a
major depression," said Duke University psychiatrist Jonathan R. Davidson, an
author of the study in today's Journal of the American Medical Association.
The study also illustrates a well-known problem with studies of treatments for
depression: the placebo effect is a powerful factor that must be taken into
account.
"When people who are depressed get help, they feel more hopeful, and that
alone can lead to improvement," Davidson said.
Indeed, in another article in the journal, Columbia University researchers
analyzed clinical trials of antidepressants over the last 20 years and found
that patients' response to placebo has been increasing. This may mean that
less severely depressed patients are volunteering for studies, or that they
enter studies with a greater awareness that depression is treatable, Columbia
psychiatrist Timothy Walsh said.
"It is crucial to have a placebo group," Walsh said. "If they [Duke
researchers] hadn't had a placebo group, they might have reached a very
different conclusion. We'd be hearing that St. John's wort is as good as
Zoloft."
In the study, 340 patients from 12 psychiatric clinics across the country were
randomly assigned to take placebo, St. John's wort (the plant hypericum), or
Zoloft (known chemically as sertraline) for eight weeks. Overall, 32 percent
of the placebo group ended up with better scores on key tests of depression
severity, compared with 24 percent of patients taking St. John's wort and 25
percent taking Zoloft. The tests measured depressive symptoms such as
insomnia, anxiety and loss of appetite.
Although Zoloft fell short on this overall measure, it was more effective than
placebo or St. John's wort on a scale that measured patients' clinical
improvement. In addition, 23 percent of patients on Zoloft showed a partial
response, compared with only 14 percent on the herb and 11 percent on placebo.
The researchers speculate that the Zoloft doses and duration may have been too
limited to show maximum effect. None of the patients took more than 100 mg,
which is half of the highest dose recommended by Pfizer, the manufacturer.
Zoloft caused the most adverse effects, with 40 percent of patients
experiencing temporary diarrhea and nausea. The desire to avoid side effects
is a big reason many people turn to herbal supplements. But St. John's wort is
not free of such problems.
"Several studies have shown that St. John's wort interacts dangerously with
several medications such as those used to treat HIV/AIDS, certain cardiac
conditions, and even those that keep the body from rejecting organs after
transplant," said Robert Califf, director of the Duke Clinical Research
Institute.
A study presented this week at a San Francisco cancer conference also found
the herb may reduce the effectiveness of irinotecan, a commonly used cancer
drug.
Contact Marie McCullough
at 215-854-2720.
Last Updated on
04/14/04
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