Comment · Mon, August 29, 2022 · ND Owner
Fadogia vindicated?! https://pubmed.ncbi.nlm.nih.gov/35969364/
What they were answering
ChasingHealth · 16 points
I love how they literally use an SSRI to induce ED. Blows my mind that they are still so frequently prescribed. If my doc had told me about this, I never would have agreed to take one. Not to mention they literally don't work and we've known it for years. Same shit with alzheimers drugs. Fuck big pharma man, it's so messed up.
Edit: sorry I realize that was completely unrelated but it felt worth pointing out.
u/MisterYouAreSoDumb · ND Owner
It's because SSRIs were approved before they changed the standards a drug needs to meet to reach clinical significance in depression. SSRIs are essentially grandfathered in, because they got approved before the more stringent endpoints were set. Almost no drugs have been approved for depression since they have set the more modern version of HAM-D (Hamilton Rating Scale for Depression) as the standard for assessing clinical effectiveness for major depressive disorder. Older SSRI drugs were approved for depression using the MADRS, or Montgomery–Åsberg Depression Rating Scale. Earlier versions of the HAM-D also suppressed negative effects, giving a more favorable result to earlier drugs.
https://europepmc.org/articles/pmc4592652?pdf=render
There is also evidence that negative studies were suppressed to make the results seem more positive than they actually were.
https://peh-med.biomedcentral.com/articles/10.1186/1747-5341-3-14
So it's not that older SSRIs are more effective. It's that we realized our measures of assessing clinical significance in depression kind of sucked, and we made them more difficult to meet statistical significance. In truth, many older SSRIs on the market today would not pass a modern drug trial. However, they were approved before these changes were made, and the measures used to assess them were built around the effects they gave. This means that drugs that perform better than SSRIs fail to meet primary endpoints, even though they are better than what is on the market. Pretty nuts when you think about it.