http://medicine.plosjournals.org/perlserv/...al.pmed.0050045

If this study is true, what a scary scenario.

How depressing!

Prozac has probably killed more people than it has saved....
But that is no surprise as the field of Psychiatry today is little more than clinical research on humans...... They used to lobotomize people or zap their brains with electrodes. Now they do it chemically, but the result is often the same.......

It's been explained to me that it's not so much a psychiatry issue as it is people getting prescriptions from physicians; especially in the case of children, where in the US there's a shortage of child psychiatrists and 90% of kids on anti-psychotics get the prescription from the paediatrician. Call me a softie but it's very tragic.

they should just put lithium in the water system like they do floride, it will keep the masses subdude

Now hold on a second. Prozac has a relatively well understood mechanism of action - that of a seratonin uptake inhibitor.
Other substances which work in a similar manner (such as MDMA aka ecstasy) are _highly_ effective and can in no way be remotely compared to a placebo (just ask anyone who has tried it). So what's the dealie?

The mechanism of action (the way it fixes the problem) of Prozac is poorly understood. Many of the physiological effects of Prozac (including the inhibition of serotonin reuptake) have been studied extensively, however we do not know why, how, or if these effects contribute to relief from the symptoms of depression.

What we do know is that it works. Not for everyone, and not immediately, and not perfectly. However, all that new study says is that it's easy to lie with statistics. Different studies use different measures for depression and different outcome measures as well. Some consider the drug a success only if it cuts a patient's depression rating score in half (regardless of the start or endpoints) others measure success as reduction to a certain fixed level.

There is so much data, you could swing it to say anything. And when you add to the meta analysis unreported data, usually it was unreported for a reason. Greed of the drug companies is just one of many reasons data isn't published. Often it simply wasn't up to the same rigorous standards. Best guess is Prozac ain't perfect, but it helps sometimes, somewhat, and for some people.

It is known that the effect is to increase the overall level of seratonin binding itself to seratonin receptor neurons in the brain. As to how or why that effects mood is of course not fully understood since the way the brain works is not fully understood. However it is a well accepted notion that neurons with seratonin receptors (which are very long and extend into many areas of the brain from the raphe nuclei) are responsible for the mood.



That's not what the study says. I quote its conclusion:



The first sentence says that the differences between prozac and a placebo are relatively small, even for severely depressed patients. This means that the placebo has basically the same effect as the drug.

Depression medications, not working better than placebo, is something I have posted here many years ago (though no one here seemed to be ready to accept it). In fact, an article I posted here, is authored by the same person who did this current study (Karsh).

Int, your comment has no intelligible meaning. Just because you have demonstrated that prozac inhibits serotonin, does not prove that it helps depression. One very troubling point about the whole prozac issue is that no one is publicly suggesting why prozac would work. Are depressed people suffering from seretonin production problem in their brain, and this somehow is causing there depression? This is not something anyone can believe. The only explanation I have heard, that makes some sense is that somehow prozac dulls a persons emotions (as morphine dulls pain). This however would make prozac a way to avoid symptoms, by ignoring the problem.