The antidepressant-debunking study

[substitute]

There was a news release today about a study that appears to show the uselessness of popular antidepressants.

This was reported in the Guardian, among other places. The publication can be read here.

There are problems, as summarized:

1. PlOS is not an academic peer-reviewed journal. edit: They are in fact peer-reviewed, based on better information I have received by comments. Read the threads. They say they are peer-reviewed, but when you read their FAQ, you'll see this: "We involve the academic community in our peer review process as much as possible. After professional staff have determined that the paper falls within the scope of the journal, and is of a minimum acceptable quality, decisions on whether to send a paper out for in-depth review are made via a collaboration between experienced, professional editors who work full time at PLoS, and academic editors who are experts in their field."
   
   I'm not saying this is Wikipedia, but it's not the same thing as a traditional journal, either.
   
   
2. It's one study. Beware of an equivalency between "one metastudy showed that these three or four drugs didn't show a good outcome under these conditions" and "antidepressants don't work."
   
   
3. The study measured outcomes at six weeks. That isn't very long in a depression treatment, whether you're using Prozac or a trampoline.

That having been said, anything that keeps family doctors from throwing the best-advertised drug at every problem is going to be helpful at this juncture. And using any kind of medication (except possibly the trampoline) without counseling is, well, crazy.

Comments

[substitute.livejournal.com]

It wasn't a double standard two hours ago. It was caution, solely.

Now that people I trust have given me better information, there's no reason for me to distrust the publisher.

And whoa there, presumer! If a study comes out with radically different news about something in medicine, it's one study wherever it comes from. The question of how the study was published in the first place is at another layer!

[catamorphism.livejournal.com]

And whoa there, presumer! If a study comes out with radically different news about something in medicine, it's one study wherever it comes from. The question of how the study was published in the first place is at another layer!

I don't know what you mean. If the same study came out in JAMA, I assume you would still be posting about it, but I assume you wouldn't be saying "Hey, let's look at those freaks at JAMA and question how their review process works just because of this one paper."

[substitute.livejournal.com]

I would, in fact, not change my behavior based on one study of anything. And if anyone said "hey look they just showed that antidepressants don't work" I would say don't change your behavior based on a news story about one study.

Note that this is two of the three points I listed in my original post, which had nothing to do with the publishing source.

And yes, I did question PLoS. They were new to me, and their FAQ was poorly written. That is all I knew. When I see people posting all over the internet about a shocking new study from an unfamiliar source, I don't immediately say "wow! that must be true!" I question! And I got answers, and accepted them.

What should have been my response to a publication from an unknown nontraditional source, other than questioning it on the Internet and getting better information?

[catamorphism.livejournal.com]

It's rather knee-jerk to even insinuate that PLoS is like Wikipedia ("I'm not saying this is Wikipedia...") without doing the research first.

[substitute.livejournal.com]

Guilty.

I assume that every new thing I see on the Internet is horseshit until I find out differently. Particularly so when it involves health or safety, and even more particularly when it's a topic that half the people on the Internet have strongly held beliefs about.

BTW, I edited the original post to correct my initial reaction.

[catamorphism.livejournal.com]

Then you ought to assume that every single new thing you hear about anywhere is horseshit until you find out differently, too. In 2008, the Internet is distinct from other fora that humans use for communication how?

[substitute.livejournal.com]

I am really not sure what we are doing other than poking each other with sticks, here.

The Internet is the world's best medium for quickly spreading rumors, chain letters, and other memetic disasters. There's a good reason why snopes.com does so well with their "inboxer."

One news story linked from three livejournals to one study published in a way I've never heard of rates about two notches above "chain letter" and slightly below "the news." Your own filter may vary. I don't tell you what to trust, and I doubt you trust very many things either. Do we have to have the same filters?

[catamorphism.livejournal.com]

Am I allowed to suggest more complexity in people's analyses when they lazily dismiss things that I happen to have the experience to evaluate and have already done so?

[substitute.livejournal.com]

You know, the insulting language actually does upset me, no joke. I'm knee-jerk, I call people "freaks," I'm lazy. Thanks, I feel great now.

At this point I have corrected my original post, explained the reason for my reaction, and accepted and welcomed critical and useful information. You are indeed more than allowed to suggest a better analysis and I appreciate the one I got.

Since I didn't send my post to you for peer review (ha) I am reduced to explaining why I took the position I did. I'm sorry that's unsatisfactory, but I can't add much to what I've already said.

[catamorphism.livejournal.com]

Either don't dish it out (e.g.,"turned medicine into a wikiLOL or a club for a particular point of view") or be prepared to take it. And I really do get tired of all the Wikipedia-bashing (not from you in particular, I mean, just in general), speaking as someone who's invested a lot of time and energy into Wikipedia and knows how well Wikipedia's peer review process works most of the time (not that there aren't embarrassing mistakes, but the same could be said about many scientific journals.)

[substitute.livejournal.com]

I don't intend to use that kind of bruising language on you personally, and I hope you won't do so with me again.

It's not something I'm prepared to take from a friend, especially over a harsh remark about a publisher, and I do consider you a friend.

If you genuinely see me as a lazy knee-jerk bigot, then I really don't know what to say other than "that's incredibly depressing."