Friday, December 9, 2022

Comments by Peter C. G√łtzsche, MD

Showing 4 of 4 comments.

  • I commented on a network meta-analysis. A risk with these is that when all studies are put in a pot, also seriously flawed ones, such an analysis is flawed. In this case, and in Cipriani‚Äôs horrible network meta-analysis in Lancet, which I also describe, this is what happened. Studies with a drug-withdrawal comparison group (misleadingly called a placebo group, but they lead to abstinence depression, which is not a true depression but a drug harm) were included. Therefore, table 2 in this paper should be ignored (the one with a huge number of comparisons). The flawed studies contribute to overestimating the effect of pills and therefore also the effect of pills in the comparisons between pills and psychotherapy.

    What is indisputable is the authors’ conclusion that psychotherapy has an enduring effect, which pills do not have. This has also been shown in head-to-head meta-analyses where pills and psychotherapy have been compared directly (not in a network analysis). But the authors dared not conclude that we should not use pills.

  • Interesting comments. One asks if there are any unbiased trials of depression pills? I am still looking, hoping to find one some day.

    Another says we should try how it is like to come of psychiatric drugs. I have often thought that I should try a depression and a psychosis pill, but I don’t dare to try! Some people become violent or suicidal, so why run this risk when you are healthy? I cannot even recommend sick people to run the risk, as none of these drugs have clinically relevant effects.

  • There is no question that SSRIs and also many other psychiatric drugs can cause suicide, although many psychiatrists and the drug companies deny this. However, the three references Bradshaw lists in support of the terribly interesting hypothesis that more psychiatry means more suicides are not convincing. These are ecological studies, which are likely full of all sorts of between-country confounding factors, and the authors of these studies admit this. I very much hope more robust studies will appear.

  • We got by far most reports on duloxetine, and also on a number of other SSRIs, before the outrageous law suit instigated by AbbVie and InterMune hit the EMA. Please sign the petition to stop this law suit at Healy’s website:

    We study suicidality in these reports, as it has been seriously underreported, even in the data the companies sent to the FDA when the agency wanted to study this in more detail in 2006. I write about this in the book, some of it you can see in the free chapter of the book, which is available on Radcliffe’s homepage: “Pushing children into suicide with happy pills:”