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The debate continues to rage about whether psychiatric medications work. This controversy especially has brewed about antidepressants and antipsychotic medications, some of the most widely used medications in the world. An important study just published in the British Journal of Psychiatry sheds light (not just makes for heat and wind) on this vital subject.
In a carefully constructed research study called a meta-analysis (where the results of many studies are examined to answer specific questions), the authors provide (in their words) "The first ... panoramic overview of major drugs." They looked at 48 different drugs used to treat 20 general medical diseases and 16 different drugs used to treat eight psychiatric diseases. The researchers concluded that the psychiatric drugs, overall, were as effective as those used in general medicine.
Their research approach was to select a specific disease and then look at rigorous studies on the response of that disease to medications commonly used to treat it. Examples for general medical diseases included:
In chronic heart failure, how well were angiotensin converting enzyme inhibitors and receptor blockers, beta-blockers and diuretics in reducing death and how did digitalis do in reducing hospital admissions?
How effective were proton pump inhibitors (PPIs) in controlling symptoms for acute reflux esophagitis and in maintaining control of those symptoms?
How effective was aspirin therapy in preventing cardiovascular events and death?
In the treatment of Parkinson's disease, how effective were drugs that increase brain dopamine?
How well did steroids and beta-2 agonists control chronic asthma?
What about the efficacy of chemotherapy for breast and lung cancer?
Some other common diseases (and their treatments) they reviewed included hypertension, hypercholesterolemia and rheumatoid arthritis.
The researchers also asked, and answered:
In people with schizophrenia, how well did antipsychotic medications reduce overall symptoms and prevent relapse?
In bipolar disorder, how effective were mood stabilizers in acute mania and for relapse prevention?
In major depression, how well did antidepressants (ADs) work for acute depression and for relapse prevention? (By the way, they found better for the latter, though the data is confusing for the former because ADs were used in mild and moderate cases where their performance is not as robust as it is with severe depression.)
For people with Obsessive Compulsive Disorder (OCD) how did the serotonin reuptake inhibitors (SRIs) do in controlling symptoms?
How effective were psychostimulants on the symptoms of attention deficit hyperactivity disorder (ADHD)?
They also reported on treatments for panic disorder and Alzheimer's disease.
While some individual drugs for (a few) medical conditions outperformed the psychiatric drugs they studied (and a few did not perform as well!), as a whole the two groups were about the same in terms of their efficacy.
The authors also noted that the benefits of medications can accrue over time -- a reminder that continuous (ongoing) treatment makes more of a difference. This is a message for patients, families and policymakers alike.
All medications have side-effects and risks, not only benefits. Informed patients and their families need to carefully weigh, and discuss with their doctor, risks and benefits when making decisions about their health, including the use of medications.
It is important for those affected by psychiatric illnesses to see this research. When it comes to benefits, psychiatric medications hold their own when compared with general medical medications in the treatment of a great number of diseases that affect so many people.
References:
[1] Stefan Leucht, Sandra Hierl, Werner Kissling, Markus Dold and John M. Davis. "Putting the efficacy of psychiatric and general medicine medications into perspective: review of meta-analyses." The British Journal of Psychiatry 2012, 200:97-106.
The opinions expressed here are solely mine as a psychiatrist and public health advocate. I receive no support from any pharmaceutical or device company.
Visit Dr. Sederer's website (www.askdrlloyd.com) for questions you want answered, reviews, commentary and stories.
-------------------- Nothing I say or do is factual; every single thing I write is a work of fiction. Got no idea what I'm talking about here~
"Once in awhile, you get shown the light, in the strangest of places if you look at it right"~ (Grateful Dead)
"o puer, qui omnia nomini debes"; "You, boy, who owe's everything to a name"~ Mark Anthony
"Nihil est incertius vulgo, nihil obscurius voluntate hominum, nihil fallacius ratione tota comitiorum."; "Nothing is more unpredictable than the mob, nothing more obscure than public opinion, nothing more deceptive than the whole political system."~ Cicero
Re: Comparing Psychiatric and General Medical Medications: What Does the Evidence Say? [Re: LongStrangeTrip] #16029011 - 04/01/12 02:22 PM (1 year, 1 month ago)
psychiatry is bullshit; you know what they actually said to me over here? That they will exchange my medications because there is a cheaper variant on the market. This is my neurochemistry they are talking about. (i'm in here for an addiction; read: self-medicating for a sleep)
I rather cherish my neurochemistry and if you get shoved an anti-psychotic, anti seizure medication (for sleep disorder), HALF a pill of trazolam it makes me question my psychiatrists sanity. I flush these down without remorse. I gave it a try the first week and when you only experience a sedating effect you think to yourself why do they want to dampen my mind whilst there is nothing wrong with myself? Unfortunately i'm in an enviroment where there is no room for suggestion whilst there is nothing inherently wrong with me; I just chose a diffirent medication and am fully aware of how it works, how it is made and how it is ingested effeciently with no side-effects.
-------------------- Je sens que je vais aller voir ailleurs
Là où tout est beau et plein de douceur!
Les femmes. Je sens mon corps se remplir de bonheur
Et mon sourire noyé par les pleurs
Je danse mais j'hésite encore...
Des larmes.
Registered: 04/02/08 Posts: 2,497 Last seen: 1 day, 9 hours
Re: Comparing Psychiatric and General Medical Medications: What Does the Evidence Say? [Re: Beanhead] #16030212 - 04/01/12 07:19 PM (1 year, 1 month ago)
Registered: 06/30/07 Posts: 10,464 Loc: Outer Space
Last seen: 13 minutes, 33 seconds
Re: Comparing Psychiatric and General Medical Medications: What Does the Evidence Say? [Re: durian_2008] #16031071 - 04/01/12 10:30 PM (1 year, 1 month ago)
Registered: 04/27/07 Posts: 1,605 Loc: your moms bedroom
Last seen: 1 month, 22 days
Re: Comparing Psychiatric and General Medical Medications: What Does the Evidence Say? [Re: aiyobro] #16032821 - 04/02/12 11:19 AM (1 year, 1 month ago)
a chemical is a chemical . i believe there is a place for these substances, they are just way over used and aren't very effective in treating mental issues that most of us just have to deal with and get past.
Registered: 03/18/12 Posts: 10 Last seen: 1 year, 1 month
Re: Comparing Psychiatric and General Medical Medications: What Does the Evidence Say? [Re: biggysmall] #16070447 - 04/10/12 04:09 PM (1 year, 1 month ago)
i'm really really surprised @ this article. For me personally when someone tells me I have to be on meds for this or that for life they better have the "life" research to back up the meds and the side effects the person will be dealing with for life. I trust pure Nature over the FDA any day.
-------------------- We have to hang in there, the world we have envisioned is blossoming, don't lose hope ~ me
(anything this username says on this website or any other is for entertainment purposes only, fiction, from a dream)
Re: Comparing Psychiatric and General Medical Medications: What Does the Evidence Say? [Re: sukibluehoney] #16074445 - 04/11/12 10:59 AM (1 year, 1 month ago)
The FDA has "ego's" to deal with... a stake in some silly game for profits and influence.
nature, does not. Use it or lose it
-------------------- Nothing I say or do is factual; every single thing I write is a work of fiction. Got no idea what I'm talking about here~
"Once in awhile, you get shown the light, in the strangest of places if you look at it right"~ (Grateful Dead)
"o puer, qui omnia nomini debes"; "You, boy, who owe's everything to a name"~ Mark Anthony
"Nihil est incertius vulgo, nihil obscurius voluntate hominum, nihil fallacius ratione tota comitiorum."; "Nothing is more unpredictable than the mob, nothing more obscure than public opinion, nothing more deceptive than the whole political system."~ Cicero
Re: Comparing Psychiatric and General Medical Medications: What Does the Evidence Say? [Re: Beanhead] #16074488 - 04/11/12 11:14 AM (1 year, 1 month ago)
Quote: Beanhead said: Unfortunately i'm in an enviroment where there is no room for suggestion whilst there is nothing inherently wrong with me; I just chose a diffirent medication and am fully aware of how it works, how it is made and how it is ingested effeciently with no side-effects.
So you might just as well NOT go to a psychiatrist if you don't trust his/her judgement. Or, if you really cherish the delicate balance of your brain chemistry, you might even choose NOT to take massive amounts of drugs and fuck it all up. Instead, you choose to put the blame entirely outside yourself. Whatever happened to taking responsibility for one's own actions?
Re: Comparing Psychiatric and General Medical Medications: What Does the Evidence Say? [Re: koraks] #16078563 - 04/12/12 03:25 AM (1 year, 1 month ago)
Quote: Beanhead said: Unfortunately i'm in an enviroment where there is no room for suggestion whilst there is nothing inherently wrong with me; I just chose a diffirent medication and am fully aware of how it works, how it is made and how it is ingested effeciently with no side-effects.
So you might just as well NOT go to a psychiatrist if you don't trust his/her judgement. Or, if you really cherish the delicate balance of your brain chemistry, you might even choose NOT to take massive amounts of drugs and fuck it all up. Instead, you choose to put the blame entirely outside yourself. Whatever happened to taking responsibility for one's own actions?
I do have a sleeping disorder which I self-medicate for. I'm a bit confused here.
I'm in forced psychiatry
-------------------- Je sens que je vais aller voir ailleurs
Là où tout est beau et plein de douceur!
Les femmes. Je sens mon corps se remplir de bonheur
Et mon sourire noyé par les pleurs
Je danse mais j'hésite encore...
Des larmes.
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