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  #1  
Old 26th February 2008, 15:36
cheesehoven cheesehoven is offline
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Default The drugs don't work

Anti-depressants' 'little effect'


Anti-depressant prescription rates have soared


New generation anti-depressants have little clinical benefit for most patients, research suggests.
A University of Hull team concluded the drugs actively help only a small group of the most severely depressed.
Marjorie Wallace, head of the mental health charity Sane, said that if these results were confirmed they could be "very disturbing".
But the makers of Prozac and Seroxat, two of the commonest anti-depressants, said they disagreed with the findings.
A spokesman for GlaxoSmithKline, which makes Seroxat, said the study only looked at a "small subset of the total data available".
Reviewed data
And Eli Lilly, which makes Prozac, said that "extensive scientific and medical experience has demonstrated it is an effective anti-depressant".
There seems little reason to prescribe anti-depressant medication to any but the most severely depressed patients


Professor Irving Kirsch
University of Hull



Q&A: Anti-depressant study
Popularity of 'happy pills'


Alan Johnson, the Health Secretary, has announced that 3,600 therapists are to be trained during the next three years in England to increase patient access to talking therapies, which ministers see as a better alternative to drugs.
Patients are strongly advised not to stop taking their medication without first consulting a doctor.
The researchers accept many people believe the drugs do work for them, but argue that could be a placebo effect - people feel better simply because they are taking a medication which they think will help them.
In total, the Hull team, who published their findings in the journal PLoS Medicine, reviewed data on 47 clinical trials.
They reviewed published clinical trial data, and unpublished data secured under Freedom of Information legislation.
They focused on drugs which work by increasing levels of the mood controlling chemical serotonin in the brain.
These included fluoxetine (Prozac) and paroxetine (Seroxat), from the class known as Selective Serotonin Reuptake Inhibitors (SSRIs), alongside another similar drug called venlafaxine (Efexor) - all commonly prescribed in the UK.
The number of prescriptions for anti-depressants hit a record high of more than 31 million in England in 2006 - even though official guidance stresses they should not be a first line treatment for mild depression.
There were 16.2m prescriptions for SSRIs alone.
The researchers found that the drugs did have a positive impact on people with mild depression - but the effect was no bigger than that achieved by giving patients a sugar-coated "dummy" pill.
People with severe symptoms appeared to gain more clear-cut benefit - but this might be more down to the fact that they were less likely to respond to the placebo pill, rather than to respond positively to the drugs.


Lead researcher Professor Irving Kirsch said: "The difference in improvement between patients taking placebos and patients taking anti-depressants is not very great.
"This means that depressed people can improve without chemical treatments.
"Given these results, there seems little reason to prescribe anti-depressant medication to any but the most severely depressed patients, unless alternative treatments have failed to provide a benefit."
Professor Kirsch said the findings called into question the current system of reporting drug trials.
Reviewing guidance
Dr Tim Kendall, deputy director of the Royal College of Psychiatrists Research Unit, has published research concluding that drug companies tend only to publish research which shows their products in a good light.
These medicines have been licensed by a number of regulatory authorities around the world, who looking at all the evidence, have determined that they do work better than placebo


Dr Richard Tiner
Association of the British Pharmaceutical Industry


He said the Hull findings undermined confidence in the ability to draw meaningful conclusions about the merit of drugs based on published data alone.
He called for drug companies to be forced to publish all their data.
The National Institute for Health and Clinical Excellence (NICE) is currently reviewing its guidance on the use of antidepressants.
Marjorie Wallace of Sane commented: "If these results were upheld in further studies, they would be very disturbing.
"The newer anti-depressants were the great hope for the future.... These findings could remove what has been seen as a vital choice for thousands in treating what can be a life-threatening condition."
Dr Andrew McCulloch, of the Mental Health Foundation, said: "We have become vastly over-reliant on antidepressants when there is a range of alternatives.
"Talking therapies, exercise referral and other treatments are effective for depression.
"It is a problem that needs a variety of approaches matched to the individual patient."
Dr Richard Tiner, of the Association of the British Pharmaceutical Industry, said there was no doubt that was a "considerable placebo effect" from anti-depressants when treating people with mild to moderate symptoms.
But he said no medicine would get a licence without demonstrating it was better than a placebo. Dr Tiner said: "These medicines have been licensed by a number of regulatory authorities around the world, who looking at all the evidence, have determined that they do work better than placebo."
http://news.bbc.co.uk/1/hi/health/7263494.stm
  #2  
Old 26th February 2008, 16:32
david mckenna david mckenna is offline
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Default Re: The drugs don't work

Quote:
Originally Posted by winterdavid
ehhh not supprising.

all them SSRI's and other anti-depressants may have short term effects but in the end, underlying issues is what can cause depression, and if they dont get sorted, then itll keep coming back.


so the Government finally says it will put more money into making "talking therapies" available. which they also said they would do years ago, and it never happened.

its a lottery depending on where you live in the country , what kind of mental health services are available to you...

and in some areas, its an absolute joke.

government needs to wake up and see the extent of the mental health crisis in this country and do something about it.
ive been banging on for ages now about how useless medication is so hopefully after this people will finally start listening to me
  #3  
Old 26th February 2008, 16:57
david mckenna david mckenna is offline
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Default Re: The drugs don't work

Quote:
Originally Posted by winterdavid
well not all medication is useless.


things like diazepam ( sp?) are like a blunt hammer to your anxiety, mashing up your brain in the process.

id say meds in general are like a plaster over a wound.

in conjunction with proper therapy they can be useful, but on their own its just a cop-out by doctors really.

i wudn't put chemicals in my system in a million years
  #4  
Old 26th February 2008, 16:59
Diluted Diluted is offline
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Default Re: The drugs don't work

Quote:
Originally Posted by david mckenna
i wudn't put chemicals in my system in a million years
If I hadn't I'm quite sure I'd be dead.
  #5  
Old 26th February 2008, 17:18
Diluted Diluted is offline
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Default Re: The drugs don't work

It was made clear to me that my problems wouldn't be solved my a pill. It's more of a crutch.
  #6  
Old 26th February 2008, 17:39
ponder ponder is offline
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Default Re: The drugs don't work

Ah, I was wondering when this would show up on here... the media have certainly jumped on this one. I'm somewhat dismayed by the way the media behave with things like this - one published study (meta-analysis really, not a new study, and meta-analyses have problems with bias of their own) and they treat it like it's gospel without waiting for any other scientists to respond to it and also ignoring many other published studies which come to a different conclusion. Shades of the MMR scare... they're also exaggerating what this study says ("no better than placebos"). I've read the study, it doesn't say that - it says that the difference isn't very large, not that it's zero.

I can certainly agree (from my own experience) with the suggestion that these things aren't as great as the pharma companies would have us believe. My own non-blind, uncontrolled, n=1 study suggests that prozac is more effective as an anti-anxiety agent than as an antidepressant anyway
  #7  
Old 26th February 2008, 17:39
david mckenna david mckenna is offline
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Default Re: The drugs don't work

Quote:
Originally Posted by violet echoes*~
Articles like this frustrate / upset / anger me so much - I never want to read them because I really, really don't want to believe they're true.

If medication won't help me, I don't know what will.
there are things out there that can cure ur SA

obviously u r not aware of them
  #8  
Old 26th February 2008, 17:40
david mckenna david mckenna is offline
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Default Re: The drugs don't work

Quote:
Originally Posted by Diluted
If I hadn't I'm quite sure I'd be dead.
thats terrible
  #9  
Old 26th February 2008, 17:44
Grah08 Grah08 is offline
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Default Re: The drugs don't work

I think its a bit of baloney. But, I do think it serves a possible positive purpose in GPs not automatically handing out A.Ds like candy and actually exploring other ways for the patient maybe.
  #10  
Old 26th February 2008, 17:47
Joeythelips Joeythelips is offline
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Default Re: The drugs don't work

Maybe i'm the exception that proves the rule, but anti-depressants had a miraculous effect on me.

Ive never felt better. I've stopped obsessing about s.a, and have been able to get on with my life. I'm only on a 10mg baby dose aswell. I'd recommend medication to anyone.

We all rely on chemicals in some form; alcohol, caffeine, nicotene etc.
  #11  
Old 26th February 2008, 17:55
Mu. Mu. is offline
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Post Re: The drugs don't work

The article is talking specifically about two classes of anti-depressant, and their effects on depression. It doesn't mention anything about the effectiveness of anti-depressants at treating anxiety. It also doesn't mention that different patients will respond differently to different medicines.

Anti-depressants have never really had any positive impact on my mood, but they certainly have helped me with my anxiety.

-

I don't understand the people who refuse to even try taking medication.
  #12  
Old 26th February 2008, 17:59
Deepguy Deepguy is offline
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Default Re: The drugs don't work

If you've tried medication and it has worked for you, that's great. Who cares what some study says? Its your own experience that matters.

I personally haven't tried medication because I don't like the idea of messing with brain chemisty even if it does work.
  #13  
Old 26th February 2008, 18:05
cheesehoven cheesehoven is offline
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Default Re: The drugs don't work

I must agree with David McKenna on this. No doubt short term use of anti-ds can work with some people, but I think they should only be used after other therapies (ie CBT) have been tried. The present day use of anti-ds as a panecea, with them being handed out like smarties, is a very bad practise which should be discontinued as soon as possible.
I was treated for depression for many years, quite wrongly, since the depression was really a symptom of SA. I was given medications for a long while. Not only did this have no effect, but also was being used to brush people like us under the carpet. Eventually having diagnosed myself online a years ago, I went to my gp and demanded therapy. He was reluctant but gave in.
Pill-popping is not the answer to SA. At best they only dull the brain for a short while. Eventually, the only relief is by dealing with the issues you have through counselling and therapy.
  #14  
Old 26th February 2008, 18:13
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Default Re: The drugs don't work

Quote:
Originally Posted by Mand680
I personally haven't tried medication because I don't like the idea of messing with brain chemisty even if it does work.
I'm in the mindset of this and to be honest i don't wanna get hooked on anything like that!
  #15  
Old 26th February 2008, 18:14
Holly Holly is offline
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Default Re: The drugs don't work

Mmmm, interesting, but as others have said, this is just one study amidst tons of others suggesting otherwise. I think everyone just has to make up their own mind based on experience really.

Personally, I know meds aren't the "answer" as such - I've been on them on and off since 1995 - but until I find the answer - again, I've been trying to find that since 1995, to no real avail - I'll just have to keep popping the pills to keep me functional. And that's just it with me - my meds cerainly don't make me happy but they do keep me functional. And when I've come off them in the past I'm a bloody wreck - desperate, prone to very very bleak thoughts and feelings and unable to face life in general. At those times, I'm prone to either spending half my life in bed or lying curled up on the floor or rocking back and forth like a mad woman!!! Not good.

All I know is, I'd LOVE to get off these sexuality - killing pills, but I really don't feel I can. And it sucks!!!!!

Love the positivity that others on here have re. med free ways to help yourself. And I'm not doubting these methods have a lot of value for some. But for me, nothing has cut the mustard. And yes, I have worked really hard - CBT, various other schools of talk therapies, thoughts diaries, mood diaries, natural remedies, and LOTS and LOTS of exposure. I work in an extremely sociable environment which can be really tough when I'm a ball of anxiety. And through this, I've learnt to "fake it" pretty well. People have often said I come across as "bubbly", "upbeat" etc etc.....

But it's still sodding there! My being prone to awful bouts of anxiety and an overwhelming dread that my life will never ever improve. I can do short and sweet bursts of faking that I'm OK..but forming and maintaining relationships are a total minefield and my brain always comes up with new and innovative ways of pushing people away.

Sorry, a long rant and pretty off topic, didn't mean to go on this long, but hey!!!!

Anyway...yeah, drugs...crappy but in my experience, better than the alternative. Ie. psychiatric unit / unemployment/ general nervous breakdown!
  #16  
Old 26th February 2008, 18:19
Mu. Mu. is offline
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Post Re: The drugs don't work

Quote:
Originally Posted by Mand680
I personally haven't tried medication because I don't like the idea of messing with brain chemisty even if it does work.
For what it's worth, your brain is not a static, pristine piece of machinery. It is a chaotic mass of tissue and fluid. And in the case of the mentally ill, it could use some fine tuning.

Most anti-depressants have a biological half-life of about a day which means that, after a day, half of what you took is already completely out of your system. Anti-psychotics are more like 6 hours. Any change they make to your "brain chemistry" is transient, not permanent-- and changing how you think is exactly what you're trying to do, if you want to be cured.

You have nothing to lose by trying them.


Edit: I was a functional mute before I started taking medication. I would not have been able to make meaningful progress in therapy without it.
  #17  
Old 26th February 2008, 18:24
Deepguy Deepguy is offline
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Default Re: The drugs don't work

Quote:
Originally Posted by Mu.
For what it's worth, your brain is not a static, pristine piece of machinery. It is a chaotic mass of tissue and fluid. And in the case of the mentally ill, it could use some fine tuning.

Most anti-depressants have a biological half-life of about a day which means that, after a day, half of what you took is already completely out of your system. Anti-psychotics are more like 6 hours. Any change they make to your "brain chemistry" is transient, not permanent, and changing how you think is exactly what you're trying to do, if you want to be cured.

You have nothing to lose by trying them.
You may be right. But my view is that we still understand so little about the brain that it's still not ideal to meddle. SSRIs are at best a blunt instrument for dealing with a very complex problem.

I do see why other people use them though, especially if your SA is extremely severe. They might provide the the initial push needed to start tackling the problem. I've never seen my SA as severe enough to use meds. Although with the bad patch I'm having at the moment a bit of chemic relief might not come asmiss to be honest..
  #18  
Old 26th February 2008, 18:26
Mu. Mu. is offline
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Post Re: The drugs don't work

Quote:
Originally Posted by Mand680
They might provide the the initial push needed to start tackling the problem.
This is exactly how I think they should be prescribed.
  #19  
Old 26th February 2008, 21:34
RachaelHale RachaelHale is offline
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Default Re: The drugs don't work

I've been given medication by doctors since i was about 15 and i know now that they never helped me and where never going to.
I thought that i could take a drug and all my anxiety would go away forever. Of course thats not the case, its still there just surpressed (sp?)

The only medication that worked for me was prozac, and that helped with the depression not the anxiety.
I supose different things work for different people. Medication didnt work for me.
  #20  
Old 26th February 2008, 23:32
Innervision Innervision is offline
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Default Re: The drugs don't work

Just popped into sa-uk and saw this thread.

I heard today that this research is not new at all, and is in fact a decade old, or so said BBC news. It was also said that SSRI medications were still thought to be useful for patients with moderate to severe depression, but less so for those with mild depression.

Talking therapy was put forward as being more beneficial to those with more mild symptoms of depression/anxiety. What made me laugh is that it was suggested today that there simply are not enough counsellors/therapists out there to deliver these talking therapies. This is total and utter rubbish. There are literally thousands of counsellors and therapists out there looking for work, but no one wanting to fund that work. Even in the practice I work at as a counsellor, a number of paid counsellors were put out of work because of lack of funding. The government has said funds will soon be made available, but only time will tell on that score.

Anyway, studies such as these are not set in stone. This study says this, another study says that. People have to make their own minds up. Different studies say different things.

Personally, had it not been for SSRI medication I would now be dead. I don't advocate meds being given out like sweets, and I certainly don't think they should be the first line of treatment unless the case is extreme, but I do believe they have their place and can be extremely useful in many cases.

In my case, meds calmed down the seething morass of fear, anxiety, anguish, despair and depression that was my mind, and helped me find enough mental stability to embark on other avenues of help that ultimately helped me find a better way of living. So for me, they were priceless, and any potential negative effects were offset by the benefits.

There is no definitive answer, and meds will never be that answer - well not unless further advancements are made. They are not put forward as the answer, or at least they shouldn't be. To me, beating SA requires an holistic approach. There is no single thing that will take SA away. People have to find the approaches that help them personally. For some, medication will be a useful tool in their progress. For others, meds will be something that they either will not consider or they have tried without success.

I recall something a surgeon said to me some years back. He said that SA is like a cycle, and what is important is breaking that cycle in any way that we can. For me, medication helped break that cycle. Meds didn't kill my SA, but they helped me gain a little stability of mind. Depression lifted, this brought more motivation. I used the increased motivation to do more things, read more self-help strategies, push myself into college etc... All this brought more confidence and esteem. I could throw myself more into positive things such as learning how to relax, how to do CBT on myself etc. In short, I managed to use meds to break a negative cycle and create a positive, more beneficial one.

Anyway, meds don't cure you ... but they can assist you in your efforts to solve your own issues. They don't help everyone, of course, but they certainly can be useful to some people.

I was anti-meds after being put on them when I was a teenager and they simply wiped me out. I never took another pill until I was at death's door (suicidal) at age 40. I see them as a last resort, but given the fact I'd be dead otherwise anyway, I decided taking meds was a risk worth consideration.

Incidentally, some research has also found that the use of CBT alongside medication has been particularly effective for some clients.

It's pretty clear that these drugs do something. People can experience many initial side-effects and many of those people have not even been aware that such side-effects were likely to occur. Few people research the meds they take or even bother to read the enclosed leaflet. Sexual dysfunction is common and comes as a complete shock to many new to meds. So these meds are indeed doing something. It's no use on one hand saying they are no more useful than placebo, then on the other hand saying that they are powerful drugs. They either do something or do nothing. It's pretty clear that for many people they clearly do something, and often something helpful to them.

Prescribed appropriately I think meds have their place. As far as SA is concerned their place is not as a cure, but more as one avenue of assistance available when other means are maybe not proving useful.
  #21  
Old 26th February 2008, 23:45
Winnie57 Winnie57 is offline
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Default Re: The drugs don't work

I was going to post a similar thread with the same title Cheesehoven!

I am not sure how effective they are but I went through some horrendous times and suffered depression at various times in my life with no drugs at all.

I have only been on AD's a couple of years or so and have been convinced I felt better. I am now starting to question this and wonder if it's a placebo effect.

I think there's a danger that in light of these findings people will just stop taking their drugs and will have horrible side effects. It is important to discuss with your doctor coming off drugs and to do it gradually to lessen the side-effects. I've heard of people having horrible side-effects even when coming off gradually. I think the fear of side-effects is what will keep me taking the pills.

EDIT: Excellent post Innervision. Sorry was still writing mine so cross-posted.
  #22  
Old 27th February 2008, 00:00
Innervision Innervision is offline
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Default Re: The drugs don't work

Quote:
Originally Posted by Winsome
...I think there's a danger that in light of these findings people will just stop taking their drugs and will have horrible side effects. It is important to discuss with your doctor coming off drugs and to do it gradually to lessen the side-effects. I've heard of people having horrible side-effects even when coming off gradually. I think the fear of side-effects is what will keep me taking the pills...
I heard a doctor expressing those same concerns today, winsome. Hopefully, those who do decide to come off meds after reading this story today will consult their GP's and do so in the correct manner in order to hopefully minimise any potential withdrawal problems.

UPDATE 27/2/08: I've just been reading Dr Miriam Stoppard and she points out that mixed evidence for SSRI's may have another possible explanation. This being that research in the US has found that genetic factors may play a part and see some patients responding to SSRI's and others not. So some people are more genetically receptive to these meds than others.
  #23  
Old 27th February 2008, 18:37
indiegirl1980 indiegirl1980 is offline
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Default Re: The drugs don't work

I suspect that GPs dish out anti-depressants like sweeties in the hope that people will go away. When I worked on the patient records department in the NHS, every other letter was suggesting the patient take anti depressants. The doctor would cheerily begin 'I think we will start with 10 mg of such and such', as though he had a never ending supply, (which he probably did).
Although, to their credit, the doctors in my area were also very good at referring people to counselling, taking the approach that the medication in itself wasn't going to cure anything, the patient needed to talk about what it was that was making them feel depressed in the first place.
I dunno how long the waiting lists for the counselling places were though.
  #24  
Old 27th February 2008, 18:37
david mckenna david mckenna is offline
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Default Re: The drugs don't work

Quote:
Originally Posted by Joeythelips
Maybe i'm the exception that proves the rule, but anti-depressants had a miraculous effect on me.

Ive never felt better. I've stopped obsessing about s.a, and have been able to get on with my life. I'm only on a 10mg baby dose aswell. I'd recommend medication to anyone.

We all rely on chemicals in some form; alcohol, caffeine, nicotene etc.
i must admit that when i tried medication years ago it did have a great effect on my anxiety levels. i felt so calm and confident however i also had some negative side effects:

dry mouth
sore balls
insomnia
suicidal thoughts for about 3 weeks

evn if i'd have suffered no side effects though i still don't agree with taking them (i only took them at the time cos it was years ago and i simply didn't have a clue how to beat my sa cos i was lost and clueless) because anxiety is in ur life for a reason.

one person has anxiety whilst another doesn't and the reason is that the person with anxiety has issues in his/her life that need to be dealt with.

you are not dealing with ur issues if you are drugging urself up, all that does is hide the issues.

i strongly beleive that a person should earn his/her own fullfilment in life by proactively admitting to and dealing with ur issues but by taking medication all u are doing is running away and berrying ur head in the sand. its the easy way out and requires no effort on ur part.

im beating my SA by proactively taking big actions to face my fears , im putting in the work myself therefore I AM responsible for my fullfilment

but i person who pops a pill is letting the pill do all of the work, the pill is responsible for his fulffilment not HIM, so he hasn't done any work
  #25  
Old 27th February 2008, 19:06
Diluted Diluted is offline
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Default Re: The drugs don't work

Quote:
Originally Posted by david mckenna
you are not dealing with ur issues if you are drugging urself up, all that does is hide the issues.
If you have severe depression and don't take immediate action, you're in a very dangerous place. With respect, I don't think you are familiar with the depressed state of mind.
  #26  
Old 27th February 2008, 19:14
david mckenna david mckenna is offline
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Default Re: The drugs don't work

Quote:
Originally Posted by Diluted
If you have severe depression and don't take immediate action, you're in a very dangerous place. With respect, I don't think you are familiar with the depressed state of mind.
no im not familaiar witht he depressed state of my at all, just been constantly depressed since i was 5 years of age (note the sarcasm)

depression can be 100% cured in a matter of minutes with time line therapy so there is no need to pop a pill
  #27  
Old 27th February 2008, 19:23
Occultus Occultus is offline
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Default Re: The drugs don't work

Quote:
Originally Posted by david mckenna
depression can be 100% cured in a matter of minutes with time line therapy so there is no need to pop a pill
Got any evidence to back up that bold statement?
  #28  
Old 27th February 2008, 19:30
david mckenna david mckenna is offline
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Default Re: The drugs don't work

Quote:
Originally Posted by Occultus
Got any evidence to back up that bold statement?
absolutley !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

there are thousand of practionaires of NLP out there who guaranty to have dealt with ur issue of depression in one session and if not then u get ur second session free.

i personally know a practionaire who has treated thousand of clients and has a 25% record of curing people in the first session. the other 75 % took 2 - 3 sessions which is better that pooping a pill and is still curing ur condition in a matter of minutes (wether it be 60 or 180 minutes) . 180 minutes is better than 20 years on meds

the best eveidence though is to try it urself cos as the saying goes '' the proof is in the pudding''
  #29  
Old 27th February 2008, 19:33
Occultus Occultus is offline
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Default Re: The drugs don't work

That'd be a no, then.
  #30  
Old 27th February 2008, 19:42
david mckenna david mckenna is offline
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Default Re: The drugs don't work

Quote:
Originally Posted by Occultus
That'd be a no, then.

what???????????

ive just sed a personal know a person who has cured thousands in minutes

u no wot stik to ur medication cos its no skin of my nose
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