Depression Marathon Blog

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Diagnosed with depression 16 years ago, I lost the life I once knew, but in the process re-created a better me. I am alive and functional today because of my dog, my treatment team, my sobriety, and my willingness to re-create myself within the confines of this illness. I hate the illness, but I'm grateful for the person I've become and the opportunities I've seized because of it. I hope writing a depression blog will reduce stigma and improve the understanding and treatment of people with mental illness. All original content copyright to me: etta. Enjoy your visit!

Saturday, August 2, 2008

All Aboard the Viagra Bus! You too, Ladies!

For those of you who've been under a rock lately, listen-up! Viagra, in a small study of 98 participants, was shown to decrease the sexual dysfunction of women on anti-depressants. The study was published in The Journal of the American Medical Association (JAMA) within the last two weeks.

According to the Wall Street Journal, the study subjects were women with major depression who reported sexual dysfunction after they began taking antidepressant drugs such as Zoloft and Prozac. The women were randomly assigned to receive either Viagra or a placebo for eight weeks, although I don't know if the researchers were also blinded to the drug assignment. (A double-blind study's results are generally considered more valid than a single-blind study.)

The participants rated their sexual dysfunction, on a scale of 1-7 with 7 being the worst, prior to the study commencing. The average rating of the Viagra group was nearly identical to the placebo group's average. However, after the eight week trial, the Viagra group's rating went from 4.8 to 2.8, which was significantly larger than the placebo group's change from 4.7 to 3.6. The Viagra group also reported more side effects than the placebo group.

As the WSJ noted, Viagra has not been approved for use in women, and Pfizer gave up pursuing FDA approval after previous drug studies failed to show a significant benefit.
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I planned to write a comical commentary about this topic when the news first broke. However, after following the news for a bit, it became clear that I needed a different approach. The study, and the reporting of the study, has created a sea of controversy. Comments across the web ridicule the study's small sample size and its funding by Pfizer (although Pfizer apparently had no input into the study). More derisiveness has been leveled at JAMA for publishing a poor study and accusing them of publicity-seeking. And of course, the "depression isn't a medical illness which should even be medicated in the first place" crowd is up in arms about throwing another medication on top of "ineffective antidepressants." Whew...was there this much controversy when Viagra for MEN arrived on the scene??
But I digress...

My concern involves none of the above. A small study can be remedied by repeating the research with a larger, double-blind study. Many discoveries began as tiny case studies which subsequently encouraged larger, more comprehensive research. Obviously, the Pfizer funding conflict can be easily remedied in a repeat study--get the funding elsewhere! As far as JAMA's decision to publish, follow-up studies, whatever they show and wherever they appear, will quell the JAMA concerns as well. Lastly, the depression-is-not-an-illness and the anti-medication crowds will likely voice similar concerns no matter how many repeat studies are performed. That is their right. So, I look at this study as an interesting starting point with room to grow. None of the above criticisms are overly concerning to me. They are all fixable with follow-up.

My concern is much simpler and also fixable, but likely the damage has already been done. People have a short attention spans. (If you've read this far, congrats!) If my behavior is any indication, and I think it is, many of us get our news from headlines alone. Who's got time to read beyond that? Following are four of the hundreds of recent, similar headlines I came across:

Fight Mom's Depression With Viagra
Viagra for Women's Depression
Viagra may CURE Women Suffering from Depression
Viagra may Revive Women on Depression Drugs

Can you see why I'm concerned? Has anyone else already overheard someone say, "I heard women can use Viagra now to treat depression?" This study was about improving sexual dysfunction in premenopausal women who are on anti-depressants, and who reported decreased libido after beginning their medication. Maybe it's not a big deal, but it's another way people are being misinformed and mis-educated about my illness. And that only makes life more difficult.

4 comments:

Kristen said...
This comment has been removed by the author.
Bradley said...

I can hardly believe there was actually a headline that said Viagra would cure depression. Talk about sending a completely wrong message.

You're right about the no medications crowd. They will protest no matter what.

Jim said...

Everybody is different, and some meds that may work for one person are likely to cause serious problems for someone else. I am one of those people who is very sensitive to almost all meds, and I have quit taking all of them. On the other hand, I know many people who say that their medications have literally saved their lives. Studies are okay, but the treatment still needs to consider individual differences, Unfortunately, doctors spend so little time with patients that they tend to apply one-size-fits-all treatment.

Denise said...

One more reason why it is so important to keep writing our stories... somebody out there has to educate not only the public in general but the medical "professionals" as well...



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