Saturday, March 29, 2008

Upping the anti (depressant) - Everything you'd want to know about the non-functionality of anti-depressants - Log base 2

H/T to Brad DeLong @ Grasping Reality with Both Hands: Economist Brad DeLong's Fair, Balanced, and Reality-Based Semi-Daily Journal, who had this to say about Log base 2:

Nick Barrowman gave his weblog a somewhat deceptive name:

Log base 2: perspectives on history, science, technology, politics, language, and culture from Nick Barrowman.

So he tries to recover:

Friday, March 28, 2008

Upping the anti (depressant)

A paper on antidepressants by Kirsch and co-authors published last month in PLoS Medicine has received a lot of attention. The antidepressants studied are the six most widely prescribed approved between 1987 and 1999: Prozac, Paxil, Effexor, Serzone, Zoloft, and Celexa.

The Editors' Summary explains:
The researchers obtained data on all the clinical trials submitted to the FDA ... They then used meta-analytic techniques to investigate whether the initial severity of depression affected the HRSD [Hamilton Rating Scale for Depression] improvement scores for the drug and placebo groups in these trials. They confirmed first that the overall effect of these new generation of antidepressants was below the recommended criteria for clinical significance. Then they showed that there was virtually no difference in the improvement scores for drug and placebo in patients with moderate depression and only a small and clinically insignificant difference among patients with very severe depression. The difference in improvement between the antidepressant and placebo reached clinical significance, however, in patients with initial HRSD scores of more than 28—that is, in the most severely depressed patients. Additional analyses indicated that the apparent clinical effectiveness of the antidepressants among these most severely depressed patients reflected a decreased responsiveness to placebo rather than an increased responsiveness to antidepressants.
The press simplified it further. The MSNBC headline was "Antidepressants may not help many patients". The Guardian announced: "Prozac, used by 40m people, does not work say scientists".

1 comment:

davidcarney said...

I hope people read the entire article. The opening paragraph or two can create the impression that Logbase 2 is anti-anti-depressant. Logbase2 believes the methodology in the research described in the quoted articles is flawed.

Just because we don't fully understand why various anti-depressants work doesn't mean they are not worth trying. They are not good for people going through puberty, but adults often - not always - but often benefit.

Thanks for reposting it.