Clinical trials vs. anecdotal evidence

I often site anecdotal evidence for much of what I talk about on this site. I don’t get why people so very often are so obstinately opposed to considering anecdotal evidence. I know the reasons they give but they don’t hold up under scrutiny.

The hard-core scientific, “evidence based” believers in the world of psychiatry and medicine refuse to accept anecdotal evidence of efficacy of alternative most often “unstudied” treatments. They insist that until there is a valid double-blind systematic clinical study of something proving it to be true, nothing else can be valid. This is ridiculous and short-sighted. Granted an isolated few anecdotal stories should be questioned, but if there is a compelling anecdotal story and once you dig deeper there are more and more of those stories you should start wondering if something is valid. That is, in fact, a very scientific stance.

Clinical trials cost money and they cost a lot of money. Pharmaceutical companies have that money and they come out with all sorts of supposedly reliable evidence. As most of us know, however, much of the data in these studies are manipulated and massaged into what the pharmaceutical company wants the data to say. Just spend some time on Cl Psych’s website, or Philip Dawdy’s Furious Seasons. Go into the pharma blogosphere for more evidence. An easy example of this, commonly known, is how antidepressants tend to perform only about 2 points better than placebo and still get hailed as wonder drugs. If you take a closer look at the studies the slight performance over placebo has to be questioned as well. Read Grace Jackson’s Rethinking Psychiatric Drugs for a closer look at how trials are done and how people who might negatively effect positive outcome for drugs are often let go and not even allowed in the study. We have no reason to trust clinical trials done by pharmaceutical companies in most cases. So I don’t trust clinical trials in general. I’m not saying there are no credible trials, of course that is not true, but one has to study the study carefully to know how credible they are.

On the other hand I have come to seriously consider anecdotal stories. At this point I have hundreds of examples of people who have responded to alternative treatments for mental health. First I had to entertain that the early stories I became aware of might have validity. I did not immediately assume each and every story was conclusive of anything. But over time, scouring over websites, participating in email groups, reading countless books and then finally experiencing anecdotal relief myself, I can no longer deny that anecdotes are powerful evidence when accumulated en masse.

There are some alternative treatments that have been studied. Fish oil to treat mental anguish is now considered viable since there has been clinical trials. But the vast majority of alternatives have no studies. Who is going to pay to see if a healthy lifestyle with all it’s many components cures? No one. You just have to try it yourself. (yes there has been some studies for individual foods and simply lifestyle changes like exercise, for example, the health qualities of individual food properties like anti-oxidants or the beneficial qualities of fiber) These studies are actually done all the time, but they get drowned out by pharmaceutical marketing. Money is simply limited when it comes to studying extensively and then especially when it comes to marketing alternatives. Neither is done enough and it never will be as long as we as a society are beholden to traditional medicine.

It’s a shame so many people are missing out of viable, safe, effective alternatives to toxic drugs. This is true in all medicine, not just psychiatric medicine.

In addition what’s also unfortunate is that even some of the most vocal and informed critics of big pharma don’t venture into the realm of alternatives either. They understand the trauma damage that psychiatry can create yet offer no options other than reforming the current  system which isn’t going to happen at a pace that helps people right now. I don’t argue reform can be helpful, not all traditional medicine is bad–certainly I’m not suggesting we throw it all out–but there is more–yes there is more. And if we as a society were responsible about health care we would include serious scientific study of alternatives. I know responsible science would shed light on the truth of alternatives. Science, as practiced, however is beholden to pharma and capitalism.