Monday, January 11, 2010

A depressing study about depression meds on JAMA

There's a JAMA (Journal of the American Medical Association) review article that was published on January 6 titled, "Antidepressant Drug Effects and Depression Severity." The authors performed a patient-level meta-analysis and looked at quite a few different clinical studies to explore the effects of antidepressant medications in patients who have clinical depression. Here's what they found:
Conclusions: The magnitude of benefit of antidepressant medication compared with placebo increases with severity of depression symptoms and may be minimal or nonexistent, on average, in patients with mild or moderate symptoms. For patients with very severe depression, the benefit of medications over placebo is substantial.
So what does this really mean? Does it mean that those patients who have mild or moderate depression are mainly experiencing a clinical benefit derived from the placebo effect? Could this review article be flawed? Maybe the authors missed a critical factor among patients who have mild or moderate depression.

In any case, this is certainly a depressing study for pharmaceutical companies who are sell antidepressant medications. I'm sure this article will stir some considerable controversy among those who are considered "high volume" prescribers of antidepressant medications like SSRIs and SNRIs. We're talking about drugs like: bupropion, citalopram, duloxetine, escitalopram, fluoxetine, fluvoxamine, mirtazapine, nefazodone, paroxetine, sertraline, trazodone, and venlafaxine.

To read the abstract on JAMA, click here.

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