Antidepressants would significant efficacy versus placebo in severe depression, according to a new analysis involving six large studies that included more than 700 patients with all levels of disease severity. Published in the Journal of the American Medical Association dated Wednesday, it also indicates that the effectiveness of these treatments would be "minimal or nonexistent" in the mild to moderate depression.
"Antidepressant drugs have shown superiority over placebo in thousands of controlled clinical trials during the past five decades," recalled Jay Fournier University of Philadelphia (Pennsylvania) and colleagues. But they stress that the tests were usually conducted in severe depression, to maximize the demonstration of efficacy compared to placebo. Furthermore, most studies began with a period of "washout" during which all patients received placebo and those were quickly relieved by the fake drug were excluded, biasing the assessment part of the true placebo effect, they note. However, in practice, approximately 70% of patients prescribed an antidepressant have a mild to moderate depression.
Of the 718 patients in six studies, 180 had a mild form of the disease, a form called 255 moderate and 283 suffered from severe depression. Researchers have shown that for less serious cases - mild to moderate - the results were just below the limit to say that a drug has at least a small effect. "Prescribers, policymakers and consumers may not know that the effectiveness of these drugs has been established primarily based on studies that included only people with more severe depressions," note the authors. "This important fact is not reflected by the implicit messages of marketing these products to clinicians and the public." The authors of the analysis therefore request clarification of information.
Anti Depressants:
Asendin
Loxitane
Aventyl
Luvox
Celexa
Pamelor
Paxil
Desyrel
Paxil Cr
Effexor
Remeron
"Antidepressant drugs have shown superiority over placebo in thousands of controlled clinical trials during the past five decades," recalled Jay Fournier University of Philadelphia (Pennsylvania) and colleagues. But they stress that the tests were usually conducted in severe depression, to maximize the demonstration of efficacy compared to placebo. Furthermore, most studies began with a period of "washout" during which all patients received placebo and those were quickly relieved by the fake drug were excluded, biasing the assessment part of the true placebo effect, they note. However, in practice, approximately 70% of patients prescribed an antidepressant have a mild to moderate depression.
Of the 718 patients in six studies, 180 had a mild form of the disease, a form called 255 moderate and 283 suffered from severe depression. Researchers have shown that for less serious cases - mild to moderate - the results were just below the limit to say that a drug has at least a small effect. "Prescribers, policymakers and consumers may not know that the effectiveness of these drugs has been established primarily based on studies that included only people with more severe depressions," note the authors. "This important fact is not reflected by the implicit messages of marketing these products to clinicians and the public." The authors of the analysis therefore request clarification of information.
Anti Depressants:
Asendin
Loxitane
Aventyl
Luvox
Celexa
Pamelor
Paxil
Desyrel
Paxil Cr
Effexor
Remeron