A Comparison of Antidepressants and Cold Medications

Remember the firestorm about taking children’s cold medications off the market that occurred several months ago? Pediatricians were up in arms. It was a public health crisis. Newspapers reported about all the children that were dying. Here’s one of my posts about the topic.

Just to update everyone, here’s a quote from a “Public Health Advisory” the FDA put out on January 17, 2008 about “Nonprescription Cough and Cold Medicine Use in Children.”

“FDA is recommending that these drugs not be used to treat infants and children under 2 years of age because serious and potentially life-threatening side effects can occur.” (emphasis mine).

“FDA’s recommendation is based on both the review of the information we received about serious side effects in children and the discussion and recommendations made at the October 18–19, 2007, public advisory committee meeting at which this issue was discussed. FDA strongly supports the actions taken by many pharmaceutical manufacturers to voluntarily withdraw cough and cold medicines that were being sold for use in this age group.”

The PAC meeting that the FDA referenced in its advisory discussed how “Overall, if you look at the data that’s available, you would come to the conclusion that these drugs are no more effective than placebo in the relief of cold and cough symptoms in children.” (Part 1 of transcript at page 41). Of course, this FDA panel on the effects of cough medications on CHILDREN was chaired by the chief of GERIATRICS at Yale, but that’s beside the point.

To summarize, the FDA’s recommendation to avoid use of nonprescription cough and cold medications in children was made (1) because those medications were deemed no more effective than placebo, and (2) because “serious and potentially life-threatening side effects can occur” with their use.

Who cares about children’s cold meds, though. That’s old news. Let’s talk about antidepressants.

There’s a new study out on the effectiveness of antidepressants. See articles in Fox News, the Washington Post, Time Magazine, The Guardian (UK), The Scotsman (Scotland). The study results?

There was “virtually no difference” between effects of drug and placebo at “moderate levels of initial depression” and there was a “relatively small difference” between the effects of drug and placebo for patients with very severe depression.” The only time that the drugs were statistically better than placebos was when patients were “at the upper end of the very severely depressed category.”

In summary, the study stated that “These findings suggest that, compared with placebo, the new-generation antidepressants do not produce clinically significant improvements in depression in patients who initially have moderate or even very severe depression.”

Prozac, Effexor, Serzone, and Paxil are “no more effective than placebo.” Hmmmm. Where have I seen that statement used before?

This article in ABC.net from Australia states that the study included data not previously released by drug companies that the researchers had to obtain under the Freedom of Information Act.

Well … who cares if antidepressants don’t work better than a sugar pill. The side effects probably aren’t as bad as those dangerous children’s cough medications.

Here is the prescribing information for Prozac, Effexor, Serzone, and Paxil. Suicide risk in antidepressants vs. tachycardia in cough meds. Close call. I’ll have to think about that one.

Eli Lilly reportedly admitted in internal documents from 1978 that there were “a fairly large number of reports of adverse reactions.” There is a fascinating discussion of the side effects of common antidepressants at this link. See also other articles about how Lilly faces another Prozac lawsuit after husband hangs himself, or the CNN article about how Paxil causes risks of suicide.

Neither class of medication works better than placebo. Both medications cause serious side effects.

Generic children’s cough medicine is a public health threat. Prescription antidepressants aren’t.

I can think of about 2.7 billion … no, 824 million … no, 891 million reasons why the FDA won’t put out a public health advisory about antidepressants … at least until the patents expire.

But that probably won’t be for another 13 years or so, right?