Mike Williams wrote that "The other medications, including all the 
antidepressants, have no
treatment effect."  Mike later says, when describing the effecs of such 
medicatiions, that "there is nothing there."

    Mike, I had thought your very point was because most studies of 
antidepressants aren't conducted in a strictly double-blind fashion (because of 
medication side effects...although you didn't address active placebo studies), 
we cannot draw clear-cut conclusions from them.

    But Mike, you are now saying that we can conclude with confidence that 
antidepressants have no treatment effect.  One can't have things both ways - if 
the studies are categorically "invalid" (not merely imperfect) as you asserted 
in previous messages, then one can't draw conclusions from them one way or the 
other.  Mike, I don't follow your logic here.

      Mike, you also never responded to my points or Jim Clark's questions 
regarding your earlier claims that "all" of the dependent measures in 
antidepressant studies come from either clients or therapists themselves.  When 
I pointed out (with references to meta-analyses) that this assertion was false, 
you merely continued to reiterate your previous points without acknowledgng our 
criticisms.

    I have to confess that I'm finding this TIPS discussion regarding 
antidepressant and therapeutic efficacy increasingly troubling.  It seems to be 
more of a discussion of ideology than science.  It also seems to be marked by 
the kind of dichotomous, categorical claims (e.g., studies of therapeutic 
efficacy are "invalid", antidepressants "have no treatment effect," "there is 
nothing there," "ECT is pure behavior therapy," "ECT is a punishment 
condition," "the Beck Depression Inventory..is not a measure of mood") that we 
would rightly criticize in our students.

     Again, I am somewhat skeptical of many claims of strong antidepressant 
efficacy myself, so have no particular agenda in this debate.  But shouldn't we 
be refraining from drawing extremely strong conclusions from large, extreme 
complex bodies of literature that we all agree are challenging to interpret 
given various methodological limitations?

      I also worry that this discussion is mixing up epistemic with ontological 
assertions. It's one thing to say "I think that studies of antidepressant 
medication are inconclusive because of methodological flaws (and that many 
people have overstated the strength of evidence for their efficacy)" but 
another to say "It's clear that antidepressant medications don't work." One is 
an assertion about the evidence for claim X, the other is an assertion about 
the verimissilude of claim X.  These are two entirely different assertions, and 
Mike wants to be able to make both of them.  I don't think he can.

....Scott
________________________________________
From: Mike Wiliams [jmicha5...@aol.com]
Sent: Tuesday, September 20, 2011 2:47 AM
To: Teaching in the Psychological Sciences (TIPS)
Subject: [tips] CHRONICLE: Are Psychiatric Medications Making Us Sicker?

Reading this article brought back many memories and disillusionment with
clinical trials.  However, I believe there are opportunities to
study what a placebo is, and how this condition influences our dependent
measures.

The only psychotropic medications that work are those that sedate
patients who are anxious, manic, or actively psychotic.  They
actually help people because they chemically suppress the worst
symptoms.  They don't cure people and they are associated with
so many adverse side effects that no one can take them day in and day
out without becoming a zombie.

The other medications, including all the antidepressants, have no
treatment effect.  The effects represents the manipulation of the
patients to endorse positive changes on the dependents measures.  As a
result of the expectation biases I described before, the
patients endorse change on the measures but their mood stays the same.
Anyone who describes placebo as a treatment effect is
just trying to extract something positive from ingesting these chemicals
when there is nothing there.

The positive change endorsed by the subjects is not a positive change.
The validity of the depression measures have been
compromised by the expectation bias.  The Beck Depression Scale is now a
measure of expectation bias and
not a measure of mood.

ECT is pure behavior therapy: "Mr. Smith, we understand that you are
unhappy.  We will continue to induce seizures until you feel better."
After a few seizures, Mr. Smith endorses positive change on the Beck
Depression Inventory.  The psychiatrist stops inducing seizures.

ECT is a punishment condition.

Just to belabor the point: There are no double blinded studies of
psychotropic meds and any psychotherapy interventions.  Given
this situation, we are currently ruminating about the significance of
noise.

Mike Williams

Are Psychiatric Medications Making Us Sicker?
By John Horgan
Several generations of psychotropic drugs have proven to be of little or no 
benefit, and may be doing considerable harm.
http://chronicle.com/article/Are-Psychiatric-Medications/128976/



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