Evidence for Effectiveness of Antidepressants Seems Underwhelming
A new study shows that the results of around a third of drug trials have not been released. Once these are taken into account, the advantage of antidepressants over placebos shrinks significantly. This amounts to seriously misleading the public about the drugs’ effectiveness.
The New York Times is among the many major news outlets covering a forthcoming study in the New England Journal of Medicine which shows that the makers of antidepressants have not released the results of around a third of drug trials. Once these are taken into account, the advantage of antidepressants over placebos shrinks significantly. This amounts to seriously misleading the public about the drugs’ effectiveness.
In published trials, about 60 percent of people taking the drugs report significant relief from depression, compared with roughly 40 percent of those on placebo pills. But when the unpublished trials are taken into account, drugs outperform placebos by a modest margin.
This analysis reviews data from 74 trials involving 12 drugs, between 1987 and 2004, and found that 94% of studies showing a positive result for antidepressants were published, as opposed to 14% of those with less strikingly positive results.
The reasons for this may be myriad; not only the large pharmaceutical companies’ financial interests come into play here but also study authors who may feel that the study is unsatisfactory, or journal editors who may feel that the study is just not conclusive enough to be interesting.
But the ethical issue here is that if information is available, it should be available to the doctors who prescribe medicine and the people who take it, so that neither are left wondering what is wrong with them when the drugs don’t work.
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This article was last reviewed by on Wednesday, 30th January 2008. You can leave a response below.
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30th January 2008
Thanks for drawing my attention to this.
Academic journals are usually reluctant to publish negative findings (across all disciplines) which leads to many problems.
Anti-depressants played a part in probably saving my best friend’s life so I am not against them entirely. However the hassles finding the right one (try it for a couple of weeks, doesn’t work, wait two weeks for it to get out of your system, try the next one [repeat]) and then getting off them [they are in our experience addictive whatever is said about this) means they are very much a last resort I think.
I’d love to see a study where the drugs are compared with the same kind of supervision given to non-drug alternatives: talking to friends, going for a walk, counseling and so forth. To may knowledge a study of this kind hasn’t been done unfortunately.
2nd February 2008
I agree, anti-depressants definitely have their place and can even be life savers. It is a shame that marketing and big business skew the information available…
7th June 2008
I was put on Thorazine, the first popular anti-psychotic drug, in 1952, and have taken one or more psychoactive medications for most of the intervening time, including most of the anti-depressants. Although I have all of the symptoms of depression, the only anti-depressant which ever worked is Ritalin (prescribed for depression before any of the others were invented). Of course, tolerance is a problem, but compared to the SSRIs et al, it is benign. What baffles me is that most of the doctors who prescribe these drugs have never tried them, and therefore do not understand that the negative effects frequently outweigh the positive.