SSRIs may cause personality change --Archives of General Psychiatry (Dec 2009)

From: Can SSRIs Change Your Personality?

Patients taking a SSRI antidepressant to treat depression may experience changes in their personality separate from the alleviation of depressive symptoms, according to a report in the December 2009 issue of Archives of General Psychiatry.

“Patients taking paroxetine reported 6.8 times as much change on neuroticism and 3.5 times as much change on extraversion as placebo patients matched for depression improvement,” the authors write.

The findings provide evidence against a theory known as the state effect hypothesis, which proposes that any personality changes during SSRI treatment occur only as a result of alleviating depressive symptoms, the authors note. Several alternative explanations could be considered. “One possibility is that the biochemical properties of SSRIs directly produce real personality change,” they write. “Furthermore, because neuroticism is an important risk factor that captures much of the genetic vulnerability for major depressive disorder, change in neuroticism (and in neurobiological factors underlying neuroticism) might have contributed to depression improvement.”

Poll: Scientific American readers trust what scientists say about "depression drugs" least, second to only "flu pandemics"

Interesting poll here by the Scientific American: In Science We Trust

The basic point of the article and poll is to see how trustworthy a selection Nature and Scientific American readers thought scientists were in the wake of "climategate" and hyperbolic swine flu epidemic predictions.

The more interesting thing for this blog is how much the respondents trusted scientists in a breakdown of selected subjects.

Flu Pandemics is dead last at 3.19

Depression Drugs is just a few ticks above that at 3.21

And strangely, both pharmaceutical related. Hmm.

I realize that this isn't a scientific poll, but I still find this interesting.

"Antidepressants Under Scrutiny Over Efficacy" --WSJ January 2008

Antidepressants Under Scrutiny over Efficacy -- Wall Street Journal, Jan 2008

More evidence that (surprise, surprise) drug manufacturers attempt to present their products in the best possible light. And why not... if they happen to get called on fraud they just settle for a couple hundred million... peanuts.

A total of 74 studies involving a dozen antidepressants and 12,564 patients were registered with the FDA from 1987 through 2004. The FDA considered 38 of the studies to be positive. All but one of those studies was published, the researchers said.

The other 36 were found to have negative or questionable results by the FDA. Most of those studies -- 22 out of 36 -- weren't published, the researchers found. Of the 14 that were published, the researchers said at least 11 of those studies mischaracterized the results and presented a negative study as positive.

...

Dr. Turner, who once worked at the FDA reviewing data on psychotropic drugs, said the idea for the study was triggered in part by colleagues who questioned the need for further clinical drug trials looking at the effectiveness of antidepressants.

"There is a view that these drugs are effective all the time," he said. "I would say they only work 40% to 50% of the time," based on his reviews of the research at the FDA, "and they would say, 'What are you talking about? I have never seen a negative study.'" Dr. Turner, said he knew from his time with the agency that there were negative studies that hadn't been published.

...

In this week's study, the researchers found that failing to publish negative findings inflated the reported effectiveness of all 12 of the antidepressants studied, which were approved between 1987 and 2004. The researchers used a measurement called effect size. The larger the effect size, the greater the impact of a treatment.

Effexor's estimated effect size was 27% (XR) and 28% in the study. Zoloft 64%. Paxil 40%. Prozac 14%. These are the increased apparent effectiveness of the drug treatments because of the omission of negative reports. You could read this as X% less effective when the positive bias is removed.