Reanalysis of Data Shows Antidepressant Impacts on Depression “Not Clinically Significant”

Rob Wipond
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The apparently positive effects of antidepressants on depression are even smaller than previously thought and “fall far short” of clinical significance, according to a new analysis of the trial data published in Contemporary Clinical Trials. The study was conducted by Irving Kirsch, author of The Emperor’s New Drugs: Exploding the Antidepressant Myth, and MIA Blogger Joanna Moncrieff.

“Meta-analyses indicate that antidepressants are superior to placebos in statistical terms, but the clinical relevance of the differences has not been established,” began Kirsch and Moncrieff in their paper. They noted that antidepressant trials typically found small effect sizes and mere 3-point differences on the Hamilton rating scale for depression (HAM-D). Such tiny impacts, they suggested, may not even be “clinically significant” or meaningful to people.

In their analysis, Kirsch and Moncrieff then compared scores on the HAM-D with scores from the Clinical Global Impressions-Improvement (CGI-I) scale. They determined that “a HAM-D difference of 3 points is undetectable by clinicians using the CGI-I scale.” Conversely, “A difference of 7 points on the HAM-D, or an effect size of 0.875, is required to correspond to a rating of ‘minimal improvement’ on the CGI-I.”

“By these criteria differences between antidepressants and placebo in randomised controlled trials, including trials conducted with people diagnosed with very severe depression, are not detectable by clinicians and fall far short of levels consistent with clinically observable minimal levels of improvement,” concluded Kirsch and Moncrieff. This insight, they argued, should be considered when physicians and patients weigh the risks of antidepressants. “Clinical significance should be considered alongside statistical significance when making decisions about the approval and use of medications like antidepressants.”

Moncrieff, Joanna, and Irving Kirsch. “Empirically Derived Criteria Cast Doubt on the Clinical Significance of Antidepressant-Placebo Differences.” Contemporary Clinical Trials 43 (July 2015): 60–62. doi:10.1016/j.cct.2015.05.005. (Full text)

14 COMMENTS

  1. “This insight, they argued, should be considered when physicians and patients weigh the risks of antidepressants.”

    I understand that given the overwhelming evidence the informed consent will now look like that: “these drugs don’t work and are very toxic (insert the list of possible side effects and mention that it is likely not complete) on the other hand you may get better if you really disregard all I’m saying and believe they actually help.” Or maybe it’s going to be business as usual?

  2. Almost everyone who takes them and doesn’t feel better or gets worse thinks they are just part of an unlucky minority cause “everyone’s chemistry is different”.

    Everyone’s chemistry is different… No not really that just the number one stupid excuse when there stupid pills make you sick like they do most people .

    Look at your fellow patients, anyone “find the right meds” yet ?

    One reason could be is that they LIED and said your serotonin was broken to sell drugs.

    • See, these drugs should have never been approved in the first place. But since they managed to cheat their way through now it’s “there are people who benefit” and “I’ve seen people recover on them so they work”. Evidence based medicine is praised when it shows their drugs are great. When it shows they suck – well, but it’s not so good anyway, and it may not detect everyone for whom these drugs work and… blah, blah, blah.

      Damned if you do, damned if you don’t.

  3. Of course these drugs are effective. Think of how effective they are! They killed Robin Williams. They caused the Germanwings disaster. They have caused countless murders and suicides. They are very effective in the purpose for which they were designed: to accrue filthy lucre for psychiatrists and pharmaceutical companies. These drugs ARE effective, just not in the way that they are supposed to be.

    • It’s not just psychiatrists who must have the light shown on them so that they can be exposed for the frauds that too many of them seem to be. The number one prescribers of these drugs in America today are not psychiatrists but general practitioners. People watch those adds for Abilify and Zoloft on television and run to their GP’s and badger them for the damned toxic drugs and the GP’s comply because they want to keep their patients and they don’t want to be known as bad doctors who won’t help the people depending on them.

      But you do point out a very important fact about the effectiveness of the toxic drugs!

    • The antidepressants can cause depression like symptoms and the antipsychotics cause psychosis. It is seemingly that simple.

      “People with [antidepressant] discontinuation syndrome have been on an antidepressant for at least four weeks and have recently stopped taking the medication, either abruptly or after a fast taper.[1] Common symptoms include flu-like symptoms (nausea, vomiting, diarrhea, headaches, sweating), sleep disturbances (insomnia, nightmares, constant sleepiness), sensory/movement disturbances (imbalance, tremors, vertigo, dizziness, electric-shock-like experiences – “brain zaps”), mood disturbances (dysphoria, anxiety, agitation) and cognitive disturbances (confusion and hyperarousal). In cases associated with sudden discontinuation of MAO inhibitors, acute psychosis has been observed.[1][2][3] Over fifty symptoms have been reported.”

      And these symptoms get misdiagnosed (according to the DSM-IV-TR) as “bipolar,” resulting in an inappropriate neuroleptic prescription, which causes a first ever psychosis within two weeks. But rather than taking the person off the drug they are allergic to, the psychiatrists feel the need to massively poison the patient with lots and lots of neuroleptics, and pump the incessant “voices” of the patient’s enemy into the patient’s head, via the central symptoms of neuroleptic induced anticholinergic intoxication syndrome.

      “Neuroleptic induced deficit syndrome is principally characterized by the same symptoms that constitute the negative symptoms of schizophrenia—emotional blunting, apathy, hypobulia, difficulty in thinking, difficulty or total inability in concentrating, attention deficits, and desocialization. This can easily lead to misdiagnosis and mistreatment. Instead of decreasing the antipsychotic, the doctor may increase their dose to try to “improve” what he perceives to be negative symptoms of schizophrenia, rather than antipsychotic side effects.”

      “neuroleptics … may result in … the anticholinergic intoxication syndrome … Central symptoms may include memory loss, disorientation, incoherence, hallucinations, psychosis, delirium, hyperactivity, twitching or jerking movements, stereotypy, and seizures.”

      This is how the psychiatric industry turns healthy people into schizophrenics, completely with their drugs, for profit. Thankfully, one can largely heal once taken off all the psychosis inducing neuroleptics and “mood stabilizers.”

      However, none of this behavior is commensurate with “first and foremost, do no harm.” And poisoning people is technically attempted murder, even if a doctor is the one doing the poisoning. This is how psychiatrists cover up medical evidence of child abuse and easily recognized iatrogenesis for incompetent doctors and child molesters.

      And John Read’s research does seem to prove that psychiatric cover ups of child abuse, resulting in inappropriate neuroleptic prescriptions, is the likely most common cause of schizophrenia today. Do we really need an industry whose primary actual function within society is turning child abuse victims into schizophrenics with drugs? I think we should start arresting the child molesters and get rid of the psychiatric industry instead.