Efficacy of antidepressants

doi:10.1136/bmj.39510.531597.80

BMJ 2008;336:516-517 (8 March), doi:10.1136/bmj.39510.531597.80 (published 4 March 2008)

Editorials

Efficacy of antidepressants

Is not an absolute measure, and it depends on how clinical significanceis defined

The first 150 words of the full text of this article appear below.

In February 2008, Kirsch and colleagues reported a meta-analysisof the efficacy of antidepressants using data from clinicaltrials submitted to the Food and Drug Administration.¹ Theyprovocatively concluded, "there seems little evidence to supportthe prescription of antidepressant medication to any but themost severely depressed patients."

In January this year, we published an article about the selectivepublication of antidepressant trials and its influence on apparentefficacy,² in which we also used FDA data. Our main findingwas that antidepressant drugs are much less effective than isapparent from journal articles. From the FDA data we derivedan overall effect size of 0.31. Kirsch and colleagues used FDAdata from four of the 12 drugs we examined and calculated anoverall effect size of 0.32.

Although these two sets of results were in excellent agreement,our interpretations of them were quite different. In contrastto Kirsch and colleagues’ . . . [Full text of this article]

Erick H Turner, assistant professor¹, Robert Rosenthal, distinguished professor²

¹ Department of Psychiatry, Oregon Health and Science University, Portland, OR 97239, USA, ² Department of Psychology, University of California, Riverside, CA 92521, USA

turnere@ohsu.edu

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