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You can stop feeling like it's your fault that you haven't found an antidepressant that works. Not that you should have ever felt that way anyway, but most depressed people blame themselves for everything that goes wrong in their lives.
But this one is definitely not your fault, and probably not your doctor's either, for that matter. Last week a paper published in The New England Journal of Medicine showed that publication bias put antidepressants in a more positive light than was warranted by the evidence. To put that in plain English, when drug makers ask the FDA to approve a drug, they have to submit all studies that have been done for that drug, even the ones that show the drug to be less than successful. However, they are under no obligation to publish all the studies in medical journals. They can, and apparently did in this case, cherry-pick the studies and only submit the positive ones for publication. Not only that, some of the negative studies that were published were slanted to make them appear more positive.
Here's the bottom line: if you looked at only the reports that were published, you would see that in 94 percent of the studies, antidepressants performed better than a placebo. But if you added in the reports that the FDA saw, but the public didn't see, that drops down to about 51 percent.
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I've never been officially diagnosed with Generalized Anxiety Disorder (GAD), partly, I believe, because there have been so many other disorders for my doctors and I to focus on (depression, Obsessive Compulsive Disorder and Attention Deficit Disorder, anyone?). Looking at the description of GAD, though, I am pretty sure that I have had at least mild anxiety disorder most of my life. I'm definitely a worrier, although I've learned to control it to some extent, and I have had tension knots on my neck since I was a teenager. And I'm really, really bad at relaxing. It's almost impossible for me to relax unless I'm physically exhausted. I used to think that it had something to do with my ADHD, but I'm beginning to think that's not the culprit.
Another tipoff is my nail biting. I've bitten my nails as long as I can remember, down to the quick. I've tried to stop many times, and have even succeeded, sometimes for a year or more, but the majority of my life has been spent with virtually no nails. It took me a long time to figure out why I could stop sometimes and why I couldn't, but I think I've finally hit on it. I think that when I go through periods of heightened anxiety, I start biting my nails again. When I am going through those fairly rare periods of low anxiety, it's a snap to stop.
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Addiction isn't a weakness; it's an illness. Now vaccines and other new drugs may change the way we treat it.
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Scientists have identified the part of the brain that may hold the key to why some cocaine users become addicts while others just take the drug socially, researchers said on Tuesday.
Brain scans of cocaine users while they performed simple computer tasks showed changes in the part of the brain responsible for controlling behavior and making appropriate decisions, they said.
This could explain why some people find it easier to quit than others and may shed light on long-term addiction, said Hugh Garavan, a cognitive neuroscientist at Trinity College Dublin who presented his research to a meeting of the Royal Society in London.
"Most people who try to quit drugs relapse," Garavan said in a telephone interview. "It might have to do with how intact these brain regions are."
Cocaine, initially used in patent medicines, beverages and tonics around the turn of the 20th Century, is a drug that in powdered form can be snorted or dissolved in water and injected. Its derivative crack cocaine is even more powerful.
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Best-selling anti-depressants like Prozac and Seroxat are barely more effective than placebos in treating most people with depression, a study led by a British university said Tuesday.
The research, which analysed 47 clinical trials, breaks new ground by incorporating data not previously released by drug companies which researchers obtained under US freedom of information laws.
Its findings prompted some academics and mental health campaigners to question whether people with mild and moderate depression should be prescribed drugs like Prozac, which has been taken by 40 million people worldwide.
"The difference in improvement between patients taking placebos and patients taking anti-depressants is not very great," said Professor Irving Kirsch of Hull University, in northern England, who led the team.
"This means that depressed people can improve without chemical treatments.
"Given these results, there seems little reason to prescribe antidepressant medication to any but the most severely depressed patients unless alternative treatments have failed to provide a benefit."
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