They designed a script to Google the names of several antidepressants in the context of someone who's taking them, and checks to see if they describe any side-effects.A large number of URLs were rapidly screened through Google Search™, using one server situated in Ohio, USA. The search strategy used language strings to denote active antidepressant drug usage, such as “I'm on [name of antidepressant]…” or “IThey then used a thing called OpenCalais™ to read the search hits and decide whether they were mentioning particular diseases or symptoms. OpenCalais is a natural language processor which is meant to be able to automatically extract the meaning from text. However, to make sure it wasn't doing anything silly (natural language processing is quite tricky), they manually checked the results.
have been on [antidepressant] for ….”, or “I've started [antidepressant]…”, or “the [antidepressant] is giving me or causing me…”
What happened? They found about 5,000 hits in total from people taking antidepressants, ranging from 210 for mirtazapine (Remeron) up to 835 for duloxetine (Cymbalta). That doesn't seem like all that many considering they searched on the entire internet, although they only searched English language websites.
Anyway, drowsiness, sleepiness or tiredness was mentioned in from 6.4% (duloxetine) down to 2.9% (fluoxetine) of the hits. Insomnia was noted in 4% (desvenlafaxine) down to 2.2% fluoxetine. And so on.
These results are a lot lower than anything previously reported from clinical trials, where the prevalence of drowsiness, for example, is often around 25% (vs. 10% on placebo); with some drugs, it's higher. So there's a big discrepancy, and it's hard to interpret these results. Maybe lots of people are having side effects and just not bothering to write about them. Or they're too embarrassed. Etc.
Still, it's a very clever idea it would probably be better used trying to discover which drugs work best. Neuroskeptic readers will know that clinical trials of antidepressants are flawed in several ways. I'd say they're actually better at telling us about side effects (which are probably roughly the same in clinical trials and in real life) than they are at telling us about efficacy (where this assumption doesn't hold)...
Links: There are many websites where people describe their experiences of medical treatments ranging from the fancy to the crude (but much more informative)...
Rizo C, Deshpande A, Ing A, & Seeman N (2010). A rapid, Web-based method for obtaining patient views on effects and side-effects of antidepressants. Journal of affective disorders PMID: 20705344
11 comments:
Quite interesting. The internet is usually toploaded with drug horror stories, so you would expect that the side effect profile from the net would come out to be exaggerated, compared to the experience of patients in clinical trials.
In general, people seem to post about a drug when they're having problems, not when everything is going swell. These counter-intuitive findings suggest, to me at least, that the side-effects of SSRIs for most users are far less dramatic and troublesome than the popular press would have it.
Quite interesting but quite meaningless. All it does is filter out the category of people ready to talk about their issues in public.
As far as a representative sample as you can get imo.
A lot of the people writing about their antidepressants are people who've made the decision to try something that is still not universally accepted (using medication for a mood disorder rather than trying "positive thinking", etc) and who may either be defending their decision or, more likely, urging other depressives to seek help. People with chronic depression, in my experience, worry about and try to support others with the same kind of issues. So you have to think about the context that people are making these statements in.
Trawling google for other people's stash habits should be illegal.
Are you people familiar with the concept of selection bias? Jeez....
I sense much selection bias in him.
(Lexipro = headaches, bruxism, agitated feeling,
Pristiq = headaches, bruxism, *severe* acid reflux, 2 weeks of discontinuation syndrome ("brain-zaps").
Wellbutrin = bruxism, agitation/tension).
Didn't work out so well for me, but I assume zillions of other people can pop these things like candy, so, I'm obviously an outlier. Can you parse that, Calais?
To me, the most obvious selection bias, and a darn hard one to get around, is when the effect/side-effect changes posting behavior. As in: "I'm so depressed and lethargic I don't even get out of bed" or "I'm quite manic and I'm spending 22 hours a day tweeting".
interesting use of web data. it is funny how the web makes it seeminly easy to do "research", when in fact this is just a collection of information with no real statistical meaning.
there is a web site called "patients like me" and the very premise is to collect data like this in a more direct manner.
HaHA LMFAO @ Cute cat #NO SRSLY
It's the latest antidepressant, fluLOLxetine.
Also coming soon, LMAO inhibitors.
I fully agree with anything you've printed here.
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