Efficacy and effectiveness of antidepressants: current status of research - PubMed (original) (raw)
Review
doi: 10.1159/000318293. Epub 2010 Jul 9.
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- PMID: 20616621
- DOI: 10.1159/000318293
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Review
Efficacy and effectiveness of antidepressants: current status of research
H Edmund Pigott et al. Psychother Psychosom. 2010.
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Abstract
Background: This paper examines the current status of research on the efficacy and effectiveness of antidepressants.
Methods: This paper reviews four meta-analyses of efficacy trials submitted to America's Food and Drug Administration (FDA) and analyzes STAR*D (Sequenced Treatment Alternatives to Relieve Depression), the largest antidepressant effectiveness trial ever conducted.
Results: Meta-analyses of FDA trials suggest that antidepressants are only marginally efficacious compared to placebos and document profound publication bias that inflates their apparent efficacy. These meta-analyses also document a second form of bias in which researchers fail to report the negative results for the pre-specified primary outcome measure submitted to the FDA, while highlighting in published studies positive results from a secondary or even a new measure as though it was their primary measure of interest. The STAR*D analysis found that the effectiveness of antidepressant therapies was probably even lower than the modest one reported by the study authors with an apparent progressively increasing dropout rate across each study phase.
Conclusions: The reviewed findings argue for a reappraisal of the current recommended standard of care of depression.
Copyright 2010 S. Karger AG, Basel.
Comment in
- Widespread methodological problems limit validity of meta-analytic results.
Huf W, Kalcher K, Kasper S. Huf W, et al. Psychother Psychosom. 2011;80(4):246; author reply 247-8. doi: 10.1159/000322788. Epub 2011 May 4. Psychother Psychosom. 2011. PMID: 21540625 No abstract available. - Do pharmacotherapy and/or psychotherapy work in depression? It depends!
Hoyer J, Höfler M. Hoyer J, et al. Psychother Psychosom. 2011;80(4):245; author reply 247-8. doi: 10.1159/000322634. Epub 2011 May 4. Psychother Psychosom. 2011. PMID: 21546782 No abstract available.
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