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Analysis of Antidepressant Paxil Finds Data on Teen Risk Was Held Back

scientificamerican.com

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Re: Analysis of Antidepressant Paxil Finds Data on Teen Risk Was Held Back

#31

Post by cryoshon »

cantstop wrote: post #29
xlm1717 wrote: post #12

I've been seeing this pop up on all the major news outlets and science websites, but still have not seen one mention of the side effect that may be behind both increased risk of suicide and increased risk of violent behavior: akathisia. Akathisia is a side effect of antidepressants that causes an intense inner restlessness and inability to sit still. This can cause agonizing pain and terrible anxiety, and people can…

I've had medicine induced akathisia before and it was by far the worst thing I've experienced in my life. Unless you've had it yourself, there is no way to convey just how terrible it actually is. I can easily see why people would want to die when facing this. I've heard this is used as a form of torture in some countries. Being strapped down and injected with a medication that induces akathisia would make the most h…

Interesting, got a source that you had in mind for that torture claim? I'd like to read more.

Re: Analysis of Antidepressant Paxil Finds Data on Teen Risk Was Held Back

#32

Post by DanBC »

This study is more interesting. young people on certain anti-depressants are at higher risk of violence. We don't know which way causality runs. We don't see the effect in older people.

http://journals.plos.org/plosmedicine/article?id=10.1371/jou...

> These findings show an association between SSRIs and violent crime that varies by age group. They cannot, however, prove that taking SSRIs actually causes an increase in violent crime among young people because the analytical approach used does not fully account for time-varying risk factors such as symptom severity or alcohol misuse that might affect an individual’s risk of committing a violent crime (residual confounding). In addition, some people who committed a violent crime might have subsequently taken SSRIs to cope with the anxiety and stress of arrest (reverse causation). The lack of a significant association between SSRIs and violent crime among most people taking SSRIs is reassuring; the association between violent crimes and SSRIs among individuals younger than 25 years is worrying. However, this finding needs confirming in studies with other designs undertaken in other settings. If confirmed, warnings about the increased risk of violent behavior among young people when being treated with SSRIs might be needed. But, note the researchers, it might be inappropriate to restrict the use of SSRIs in this age group because increases in adverse outcomes associated with poorly treated depression, such as suicide, might outweigh the public health benefit accruing from decreases in violence.

Re: Analysis of Antidepressant Paxil Finds Data on Teen Risk Was Held Back

#33

Post by mzs »

xlm1717 wrote: post #12

I've been seeing this pop up on all the major news outlets and science websites, but still have not seen one mention of the side effect that may be behind both increased risk of suicide and increased risk of violent behavior: akathisia. Akathisia is a side effect of antidepressants that causes an intense inner restlessness and inability to sit still. This can cause agonizing pain and terrible anxiety, and people can…

Every time someone in my family has been prescribed an SSRI the doctor has listed this side effect, though they don't always use the term. The doctor that I am most fond of in fact lists the side effects in three categories, this one being in the most unlikely one. Then says should it be a problem it can be treated with therapy and benzos. He also mentions that there are options there for how fast they act. A therapist knowing this can offer coping skills. Insomnia can be a problem in particular and for that there are options outside of benzodiazepines. Finally there are non SSRIs available as well. For our family at least it has not been an unmanageable issue.

Re: Analysis of Antidepressant Paxil Finds Data on Teen Risk Was Held Back

#34

Post by acveilleux »

marincounty wrote: post #5
acveilleux wrote: post #3

I use to work in pharma research (at the data acquisition and analysis side, blinded from treatment) and the fact that pharmas are able to start clinical trials and then shut them down without reporting result is a problem. The folks who make those decision usually have access to unblinded data and in the least objectionable case they do it due to lack of efficacy but you never know. Maybe they found a side-effect an…

"I use to work in pharma research (at the data acquisition and analysis side, blinded from treatment) and the fact that pharmas are able to start clinical trials and then shut them down without reporting result is a problem." This Cherry Picking should become a felony? Spit out the data you have on hand, even if incomplete? Give the results of the studies to the FDA, or make whatever data you have available to the sc…

So sometimes, the population of a trial does not show efficacy but some subgroup does. Like folks with a different gene, a different stage in the disease, etc.

Frequently those sub-populations lack statistical power.

So then a new trial will be made targeting that sub-population if it looks promising enough (i.e.: cost vs. potential benefit/market size).

Is that a bad thing? It's variable whether the study that failed to get statistical results will get published and if so, how.

The legally required filings with the FDA are done in any case.

Re: Analysis of Antidepressant Paxil Finds Data on Teen Risk Was Held Back

#35

Post by mzs »

totalrobe wrote: post #11
nickysielicki wrote: post #6

Why are you ending every sentence with a question mark? It makes you sound unsure?

I call it the "Bill O'Reilly". It's the either-or fallacy, also known as the false dilemma, and commonly employed by internet forum bullies. https://en.wikipedia.org/wiki/False_dilemma

I do not see marincounty being a bully in that comment, just some odd punctuation. This discussion is derailing from the topic at hand.

Re: Analysis of Antidepressant Paxil Finds Data on Teen Risk Was Held Back

#36

Post by cantstop »

cryoshon wrote: post #31
cantstop wrote: post #29

Earlier quoted context omitted.

I've had medicine induced akathisia before and it was by far the worst thing I've experienced in my life. Unless you've had it yourself, there is no way to convey just how terrible it actually is. I can easily see why people would want to die when facing this. I've heard this is used as a form of torture in some countries. Being strapped down and injected with a medication that induces akathisia would make the most h…

Interesting, got a source that you had in mind for that torture claim? I'd like to read more.

Other than having a couple of independent psychiatrists tell me, I have no source. I've searched high and low for years but have always come up empty.

Re: Analysis of Antidepressant Paxil Finds Data on Teen Risk Was Held Back

#37

Post by mzs »

pella wrote: post #28

-> http://www.alltrials.net/ and this topic: http://www.alltrials.net/news/new-research-on-old-data/ - BMJ Editorials: "Liberated trial data have enduring potential to benefit patients, prevent harm, and correct misleading research" : http://www.bmj.com/content/351/bmj.h4601 - BMJ "No correction, no retraction, no apology, no comment: paroxetine trial reanalysis raises questions about institutional responsibility" ht…

That last link in particular as a very good read for me, thank you for sharing.

Re: Analysis of Antidepressant Paxil Finds Data on Teen Risk Was Held Back

#38

Post by function_seven »

DanBC wrote: post #20
xlm1717 wrote: post #7

Earlier quoted context omitted.

I've been noticing that as a nasty habit picking up steam on HN. It's usually the commenter talking down to a previous commenter.

marincounty just uses a lot of question marks. Your nasty attack is incorrect, and you should probably apologise.

I'm sorry, but one can't "just use a lot of question marks" without completely destroying whatever meaning they're trying to get across. I don't give a rat's ass if someone confuses "their" with "there", or "it's" with "its". The meaning is entirely left intact.

But ending every single sentence with a question mark is very confusing to the reader. I still have no idea if marincounty is agreeing with the parent, calling them out on those statements, or something in between.

Re: Analysis of Antidepressant Paxil Finds Data on Teen Risk Was Held Back

#39

Post by pfortuny »

throwaway98031 wrote: post #26

This is an egregious violation on many levels. It highlights a massive gap in the clinical trials process (companies can stop trials without reporting negative results) that really should be addressed. I think everyone (outside of drug companies) can agree on that much. I would like to say a few words on SSRIs (the class of drugs that Paxil is in) and their risks in general, because articles like these tend to cultiv…

I have some experience as a patient with Escitalopram (an SSRI) and can only say: indeed. The first two weeks it was utter confussion (I feel so worse) but reading the prospect (a very good one in Spain) and talking to my doctor clarified the situation.

After some weeks the "new normal" settled and to me, the medication helped.

It is good to have your doctor handy anyway.

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