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neuro__atypical t1_ivpil5o wrote

Reply to comment by bekilledoff in New study (n=276) finds that a standardized mindfulness program is as effective as a common antidepressant (Escitalopram) at treating anxiety, with both treatments leading to about a 30% reduction in symptoms. by fotogneric

SSRIs are "effective," in the clinical statistical use of the term. But the effect size and success rate is very small compared to other drugs. They're pretty crappy.

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continentalgrip t1_ivps7hi wrote

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172306/

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neuro__atypical t1_ivpt4j7 wrote

SSRIs' slight advantage over placebo could also be explained by their downstream effects on BDNF. Not everyone is responsive to BDNF/neurogenesis as a treatment for depression though, and the effects on BDNF are extremely weak compared to other neurogenesis-promoting drugs.

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continentalgrip t1_ivpubg5 wrote

The link it kind of looks like you didn't read? indicates they are not clinically effective.

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neuro__atypical t1_ivpy51l wrote

Sorry, I seem to have mixed up clinical and statistical significance. I was trying to respond to this part of your link:

> Even the small statistical difference between antidepressants and placebos may be an enhanced placebo effect, due to the fact that most patients and doctors in clinical trials successfully break blind.

Saying that it could be better explained by SSRIs' small but very real effect on BDNF (agents which promote BDNF to a much higher degree show actual clinically significant improvements in rats, e.g. Semax) than a hypothetical "enhanced placebo effect."

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continentalgrip t1_ivq6vgm wrote

I have worked last ten years as a clinical trials study coordinator. Some patients start taking study drug and immediately have obvious side effects making it trivially obvious they're not on placebo. So I definitely believe in enhanced placebo. Additionally I have given the HAMD to many patients over extended periods and have seen scores go up and down ten points easily. 1.8 points is really not much.

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