Depression

coolx wrote: »

Here is the NEJM meta analysis I was referring to: http://www.nejm.org/doi/full/10.1056/NEJMsa065779

Compared to the placebo group for each study, the results are pretty grim.

"Among 74 FDA-registered studies, 31%, accounting for 3449 study participants, were not published. Whether and how the studies were published were associated with the study outcome. A total of 37 studies viewed by the FDA as having positive results were published; 1 study viewed as positive was not published. Studies viewed by the FDA as having negative or questionable results were, with 3 exceptions, either not published (22 studies) or published in a way that, in our opinion, conveyed a positive outcome (11 studies). According to the published literature, it appeared that 94% of the trials conducted were positive. By contrast, the FDA analysis showed that 51% were positive. Separate meta-analyses of the FDA and journal data sets showed that the increase in effect size ranged from 11 to 69% for individual drugs and was 32% overall."

Our findings have several limitations: they are restricted to antidepressants, to industry-sponsored trials registered with the FDA, and to issues of efficacy (as opposed to “real-world” effectiveness33). This study did not account for other factors that may distort the apparent risk–benefit ratio, such as selective publication of safety issues, as has been reported with rofecoxib (Vioxx, Merck)34 and with the use of selective serotonin-reuptake inhibitors for depression in children.3 Because we excluded articles covering multiple studies, we probably counted some studies as unpublished that were — technically — published. The practice of bundling negative and positive studies in a single article has been found to be associated with duplicate or multiple publication,35 which may also influence the apparent risk–benefit ratio.
There can be many reasons why the results of a study are not published, and we do not know the reasons for nonpublication. Thus, we cannot determine whether the bias observed resulted from a failure to submit manuscripts on the part of authors and sponsors, decisions by journal editors and reviewers not to publish submitted manuscripts, or both.
We wish to clarify that nonsignificance in a single trial does not necessarily indicate lack of efficacy. Each drug, when subjected to meta-analysis, was shown to be superior to placebo. On the other hand, the true magnitude of each drug's superiority to placebo was less than a diligent literature review would indicate.
We do not mean to imply that the primary methods agreed on between sponsors and the FDA are necessarily preferable to alternative methods. Nevertheless, when multiple analyses are conducted, the principle of prespecification controls the rate of false positive findings (type I error), and it prevents HARKing,36 or hypothesizing after the results are known.
It might be argued that some trials did not merit publication because of methodologic flaws, including problems beyond the control of the investigator. However, since the protocols were written according to international guidelines for efficacy studies37 and were carried out by companies with ample financial and human resources, to be fair to the people who put themselves at risk to participate, a cogent public reason should be given for failure to publish.

coolx wrote: »

Here is Whitaker's response to that article

http://www.psychologytoday.com/blog/mad-in-america/201107/the-new-york-times-defense-antidepressants-0?page=2

The points raised mirror those raised in he NEJM article - the results are clinically insignificant. This is expected, since Psychiatrists are willing to admit they don't really even know how these drugs work:P

coolx wrote: »

I support the merging of all the previous scientific content into a new thread:)

This stuff is pretty intereting to debate. Getting kicks off the mentally ill is not a pastime of mine. The scientific theories that people believe without question "because the doctor said so" however are not off my radar. Is rational skepticism ourreally such an evil thing?

coolx wrote: »

I should mention I was explicitly referring to the fact that most of the negative drug trials were suppressed. I am not oblivious to the fact that unaccounted factors may have questioned the integrity of the results published.

The figures I cited where lets just say....not great when you read over them.

TeddyTedson wrote: »

Does anxiety fall under depression or is that something else?