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A Study In This Month's Journal Of Nervous And Mental Disease Reveals Hope For Recovery From Suicidal Thinking And Treatment Resistant Mental Illness
Date:1/15/2009

cent respond only partially. As many as 50 percent of people with major depressive disorder are considered treatment resistant.

Untreated, or inadequately treated, these cases will often lead to suicide, which is itself a growing problem. Between 1999 and 2005 the overall suicide rate rose 0.7 percent. In the United States alone, there are 750,000 suicide attempts each year and an estimated five million living Americans have attempted suicide.

Faced with such challenging cases, and so many poor outcomes, many researchers have questioned the effectiveness of medication therapy, which is often the first and last resort for mental illness, even in the most serious cases. It turns out, though, that the research supporting psychopharmacotherapy may be less germane to treatment resistant mental illness than is widely thought. For one, the clinical trials, by design, often exclude any person with more than one diagnosis, or with suicidal ideation or other complicating factors, so the screening process routinely shuts out 7 of 10 potential subjects. This desire for empirical purity ends up diminishing the real-world applicability of the findings, because many people -- and most very troubled people -- do suffer from more than one malady at a time.

Perhaps even more important, the full findings of drug trials are not always brought to light by their industry sponsors. Drawing on FDA records, a recent New England Journal of Medicine study dug out unpublished data on twelve major anti-depressants. While published material on the medications had shown them to be powerfully effective, it turned out that a whopping 74 trials on the same substances -- all with less sanguine results -- had been shelved. When all the data were taken into account, the medicines turned out to be about as effective as placebos.

One reason that drug therapies so dominate the treatment field is that alternatives are often seen as old-fa
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SOURCE Austin Riggs Center
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