Meta-analysis of antidepressant prescribing

BMJ 1995;311:751 (16 September)

Letters

Meta-analysis of antidepressant prescribing

Drop out rates were presented in a misleading manner

EDITOR,--The meta-analysis by I M Anderson and B M Tomensonis an interesting development in the literature addressing theeffectiveness and cost effectiveness of prescribing of antidepressants.¹The authors estimate that the risk of patients stopping treatmentis 10% lower with selective serotonin reuptake inhibitors thantricyclic antidepressants. They note, however, that this correspondsto an absolute reduction in the total drop out rate of only2.5% (their table IV) and is of borderline significance. Also,as they suggest, biases such as "patient selection, previoustreatment, methodology, and study setting" may exist and makethis result unreliable.

Unfortunately, although this is an apparently carefully constructedand methodologically sound paper, the results are presentedmisleadingly in the abstract, which states that "the total discontinuationrate was 10% lower with selective serotonin reuptake inhibitorsthan with tricyclic antidepressants...and the drop out ratedue . . . [Full text of this article]

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Relevant Article

Treatment discontinuation with selective serotonin reuptake inhibitors compared with tricyclic antidepressants: a meta-analysis: I M Anderson and B M Tomenson
BMJ 1995 310: 1433-1438. [Abstract] [Full Text]

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