Tag: antidepressant efficacy

A recent review of the evidence by the American College of Physicians (ACP) determined that cognitive behavioral therapy and antidepressants had similar levels of effectiveness for the treatment of depression. In a critical commentary for the Journal of Mental Health, however, Michael Sugarman from Wayne State University challenges these findings. Pointing to differences in research settings and clinical practice, Sugarman asserts that “these head-to-head comparisons are heavily biased in the direction of psychiatric care.”

When the idea that selective serotonin re-uptake inhibitors (SSRIs) might make people feel suicidal first started to be discussed, I admit I was sceptical. It didn’t seem to me the drugs had much effect at all, and I couldn’t understand how a chemical substance could produce a specific thought. Because these effects did not show up in randomised controlled trials, they were dismissed and few efforts were made to study them properly. Then some large meta-analyses started to find an association between the use of modern antidepressants and suicidal thoughts and actions, especially in children.

What does screening mean, in the ever more prevalent field of Psychiatry? Psychiatric screening is not a biological metric that can be assumed to predict the future in a linear manner. It’s a series of subjective questions. It is, in short, a survey.

The largest-ever meta-analysis of antidepressant trials appeared yesterday in the British Medical Journal. Researchers from the Cochrane Collaboration reviewed 70 trials (involving 18,526 subjects), to find that - counter to the initially-reported findings - antidepressants doubled the risk of suicide and aggression in subjects under 18. This risk had been misrepresented in the original study reports, the authors say, and suggest that the risks to adults may be similarly under-reported.

If antidepressants are effective, and people with depression are more likely to be prescribed them, then you would expect the consequences of depression to start to lessen. One of those consequences, according to government statistics, is being out of work. But what we see is quite the opposite: Increasing use of antidepressants correlates with increased numbers of people with depression who are out of work and claiming benefits, and increasingly on a long-term basis. And this is at a time when disability due to other medical conditions has fallen.

Gepirone, a new depression drug by Fabre-Kramer Pharmaceuticals, did not meet the FDAs efficacy standards. The new drug application for gepirone has now received...

Access to data is more important than access to information about conflicts of interest. It is only when there is access to the data that we can see if interests are conflicting and take that into account. Problems don’t get solved unless someone is motivated for some reason. We need the bias that pharmaceutical companies bring to bear in their defense of a product, along with the bias of those who might have been injured by a treatment. Both of these biases can distort the picture but it’s when people with differing points of view agree on what is right in front of their noses that we can begin to have some confidence about what we have.

People diagnosed with severe depression show the same changes in brain scans when they respond to a placebo as they do when they take an actual antidepressant, according to a new study. Researchers also found that those whose symptoms were decreased by a placebo were more likely to report relief from antidepressant drugs.

By 2002 GlaxoSmithKline had done 3 studies in children who were depressed and described all three to FDA as negative.  As an old post on Bob Fiddaman’s blog reproduced here outlines, several years later they undertook another study in children in Japan. (Editor's note: This is a re-print, by David Healy, of a post by Bob Fiddaman)