Drugs vs. placebo

Hi, I've been lurking around on these boards for a while. I'm a 21 year old female and I've recently been diagnosed with Bipolar II and severe social anxiety and was told to take Wellbutrin XL, Seroquel, and Xanax (as needed for panic attacks).

I'm interested in finding out how well drugs like Wellbutrin XL and other antidepressants work when tested against placebos. Does anyone know of any website where I can see the straightforward percentages of the effectiveness of the drugs vs. the placebos? I can't seem to find one.

It would be greatly appreciated. Thanks.

I found one article on three clinical trials in which Wellbutrin's effectiveness in treating SAD ("seasonal affective disorder") was compared with placebos aka "sugar pills." I realize this is not quite the information you're wanting, since you are researching for your diagnosis - bipolar ii and severe social anxiety (These are not "separate" or discrete problems but expressions out of the same soup of biochemistry/electrical brain conductivity issues we have.)

http://seroxatsecrets.wordpress.com/200 ... -official/

In the above-quoted article, the author says:
"The Mayo Clinic reported:

Pooled results of the three studies showed that 84 percent of people taking Wellbutrin XL were free of depression, compared with 72 percent taking the placebo. All of the studies were funded by Wellbutrin XL’s manufacturer, GlaxoSmithKline.

As with other antidepressants, Wellbutrin XL poses potential side effects and health risks. Certain antidepressants, including Wellbutrin XL, may be associated with worsening symptoms of depression or suicidal thoughts or behavior”.

As the author of the article notes, the placebo was nearly as effective as the Wellbutrin in treating SAD and does not pose the same potentially serious health risks. If you do some investigating on your own, you will find that Wellbutrin can trigger seizures and was in fact taken off the market for that reason at one point.

I would be interested to know the numbers from each of the three individual studies, not only the "pooled" results - particularly if one (or more) of the studies showed the placebo actually performed better than the Wellbutrin.

Well, thanks for the info. Doesn't sound as promising as I'd hoped, but then again I'm not surprised. I'm coming into this treatment out of sheer desperation, because nothing else has helped me. As if the social anxiety and spontaneous panic attacks at work weren't enough, the lethargy and apathy I experience during depressive phases is so ridiculous that it's getting to the point that I'm at risk of being fired from my job. I honestly can't believe they haven't fired me. I'll constantly hide at work just to sit down and rest my eyes due to the overwhelming lack of energy. I lose the motivation to even smile or speak at work unless I absolutely have to, and I have a bad reputation because of it. My boss keeps telling me to cheer up, but I literally can't. I end up just standing there motionless for like 15 minutes straight, pretending to be focusing on something, but really my mind is either blank or swamped in morbid negativity. It's like my mind forces itself to start shutting down, and when I get home I just lay around all day. And I get plenty of sleep during depressive phases, so a lack of sleep doesn't account for the lethargy. I'm also physically fit and practice a good diet, and that hasn't helped at all. It keeps getting worse as the years drag on.

Anyway, I have a lot of skepticism, and I'm trying to be as unbiased and realistic as possible with my approach. I just want a medication that has been proven to have higher levels of effectiveness against placebos, and as far as I can tell based off of what I've been reading, just about none of the most commonly prescribed antidepressants test well against placebos. Correct me if I'm wrong.

This won't cheer you up about "social anxiety disorder," I'm sure, but it's necessary for us to know what is real and what is not, so we don't get sidetracked into treatments that may not be beneficial

Honestly, I believe that those of us with depression and shyness (here I am substituting the good old generic term for "social anxiety disorder," before the advent of drug branding campaigns - see below.) are the ones who perceive the realities of this world best, not those who don't. I would not wish life in my environment at this time on any being. When I lived abroad in other cultures, I was not depressed.

http://seroxatsecrets.wordpress.com/201 ... ing-works/

The article above is entitled "Branding Disease - how drug marketing works" by Dr. Carl Elliott. He demonstrates how one drug company used a marketing campaign to reshape "shyness" into "social anxiety disorder" in order to market their drug. In part, the article says...

"Another good candidate for branding is a condition that can be plausibly portrayed as under-diagnosed. Branding such a condition assures potential patients that they are part of a large and credible community of sufferers. For example, in 1999, the FDA approved the antidepressant Paxil for the treatment of “social anxiety disorder,” a condition previously known as “shyness.”
See more CNN.com opinion articles

In order to convince shy people they had social anxiety disorder, GlaxoSmithKline, the maker of Paxil, hired a PR firm called Cohn and Wolfe. Cohn and Wolfe put together a public awareness campaign called “Imagine being allergic to people,” which was allegedly sponsored by a group called the “Social Anxiety Disorders Coalition.”

GlaxoSmithKline also recruited celebrities like Ricky Williams, the NFL running back, and paid them to give interviews to the press about their own social anxiety disorder. Finally, they hired academic psychiatrists working on social anxiety disorder and sent them out on the lecture circuit in the top 25 media markets.

The results were remarkable. In the two years before Paxil was approved for social anxiety, there were only about 50 references to social anxiety disorder in the press. But in 1999, during the PR campaign, there were over a billion references.

Within two years Paxil had become the seventh most profitable drug in America, and Cohn and Wolfe had picked up an award for the best PR campaign of 1999. Today, social anxiety disorder, far from being rare, is often described as the third most common mental illness in the world.

It is hard to brand a disease without the help of physicians, of course. So drug companies typically recruit academic “thought leaders” to write and speak about any new conditions they are trying to introduce. It also helps if the physicians believe the branded condition is dangerous."

I wanted to add that I don't discourage anyone from taking medications. In the past, they have helped me through crises. If that was placebo effect, then I'd still choose it over the continuation of suffering.
The body itself has an extremely powerful ability to heal from almost anything, or at least to rebalance itself, if not totally correct the issue for once and for all. What people may not realize is that placebo effect, far from proving that "it's all in your head," may prove that our bodies, given the psycho-chemical jumpstart of someone appearing to care about our well-being (the people administering the studies/giving the medications), can perform amazing feats of biochemical readjustment toward health and rebalance.

I’m well aware that the criteria required to be declared as mentally ill is broadened in order to encompass more people as being mentally ill, which in turn allows the pharmaceutical industry to boom.

And it’s part of the reason I have been so resistant to resorting to psychiatry and medication. I do think, based on what I’ve learned, that many people are being exploited, and that more people than necessary are being told that they have a particular “illness”. It’s quite obvious. I do think that most of the medications don’t work as well as their marketers portray, and that many of these placebo studies may be manipulated, or hidden from the public. I don’t want to fall victim to a potentially damaging treatment, I don’t want to be another statistic, I don’t want to be fooled. But I’m getting desperate.

I at least have to be able to perform at a job without fighting the constant urge to close my eyes, and without the threat of hyperventilating and shaking to the point of being unable to perform any basic motor actions. I know it must sound ridiculous, but there is nothing else I can do. If that doesn’t sound like a problem, then how bad does it have to get until it is considered a problem? (This last statement is not directed toward you, Ori)

While it is true that mental illness is likely over-diagnosed to an alarming degree, and that many people are likely being scammed, this doesn’t mean that mental illness doesn’t still exist; just maybe not to the extreme degree that is being portrayed by the psychiatric industry. I was never TOLD by anyone that I had a mental problem until I sought help, (I live around people who don't believe in psychiatry and who tell me to "just stop being scared") though I’m not saying that the culture I was brought up in had NO effect. Perhaps it did. But the panic attacks and extreme lack of energy are so severe that culture alone cannot account for it. I honestly don’t think that I would behave differently in another culture, but I could be wrong. It’s just that the unsettling reactions toward social situations and the lethargy are not “just in my head”. I mean, technically they are, but, you know. I've experienced them to a highly uncomfortable degree since I was quite young. I experienced severe panic in social situations before I had even heard of “social anxiety disorder”. With or without the term and its broad symptoms, I have a problem. I've had too many people tell me that I "just need to calm down, everyone has social anxiety these days. Just learn to deal.” And it really irritates me.

And again, Ori, not all of this is directed toward you. I just needed to vent. I understand that you're not discouraging anyone from taking medication. And I appreciate your replies. Sorry for all the self-pity and defensiveness. I’m just trying to figure all this out. At this point, I honestly think that the medication most likely won’t work, except maybe the Xanax, and even then, only partially. I just want to know if there is any hope of finding a medication that will help better than a placebo.

PubMed is a good resource, as it has the primary research, including clinical trials and not just press releases from pharmaceutical companies. It is best to use the pharmaceutical's generic name though.

mjpam wrote:PubMed is a good resource, as it has the primary research, including clinical trials and not just press releases from pharmaceutical companies. It is best to use the pharmaceutical's generic name though.

Thank you, this is the kind of straightforward information I was looking for.

mjpam, thanks for the great research link.

Someone Else, psych meds may work well, with minimal to zero side effects, for some people. I've been taking meds for about seven years. I did have reasonable results with Lexapro/Celexa. Unfortunately, for me, all drugs so far have stopped working after a time - the Lexapro falls into this category - or the side effects are too severe (such as triggering seizures).

No one yet fully understands the root cause or root causes of bipolar or other mood disorders. Medications are at best based on educated guesses by the scientific community. As much as I would love to know that there is an entirely trustworthy treatment, there isn't yet.

If you have insurance that will cover it or can borrow money or have enough saved up, you could investigate Transcranial Magnetic Stimulation (TMS) which uses external magnets to target specific areas of the prefrontal cortex. It is a relatively new, non-invasive therapy with few reported side effects. It seems to have a much better record at providing relief, even remission, than standard drug therapy. I would have gone this route, but my insurance won't pay for it.