A recent meta-analysis caused huge waves when it concluded that the effectiveness of antidepressants could be explained by the placebo effect. In this NutritionFacts.org video (which we’ve summarized below), Dr. Greger looks at the current research regarding the success of antidepressants compared to sugar pills.
Why is there such a big discrepancy between the published medical literature on antidepressants and the conclusions of this large meta study?
The key word is published. According to the published literature, the results of nearly all antidepressant trials were positive. But drug companies can choose to selectively publish stories that showed a positive effect and quietly put aside the studies showing that the drugs were ineffective. When researchers applied to the FDA under the Freedom of Information Act to get access to both published and unpublished studies by pharmaceutical companies, they found out that only half of the trials showed positive results. In other words, half the trials showed that antidepressant drugs didn’t work any better than sugar pills.
Watch the above video to find out how drug companies can get away with this, and how the FDA actually knew about the discrepancy between the published and unpublished studies.
Some Facts About Antidepressants:
- Antidepressant medications are prescribed to 8.7% of the US population.
- For the small percentage of people suffering from very severe depression, antidepressants do work better than placebos.
- But the vast majority of depressed patients—as many as 9 out of 10—are being prescribed medications that have negligible benefits to them.
“The pharmaceutical industry is considered the most profitable and politically influential industry in the United States, and mental illness can be thought of as the drug industry’s golden goose: incurable, common, long term, and involving multiple medications.” —Dr. Michael Greger
Dr. Greger’s Sources:
P J Carek, S E Laibstain, S M Carek. Exercise for the treatment of depression and anxiety. Int J Psychiatry Med. 2011;41(1):15-28.
E Penn, D K Tracy. The drugs don’t work? antidepressants and the current and future pharmacological management of depression. Ther Adv Psychopharmacol. 2012 Oct; 2(5): 179–188.
D Spence. Are antidepressants overprescribed? Yes. BMJ. 2013 Jan 22;346:f191.
I Kirsch. Antidepressants and the Placebo Effect. Z Psychol. 2014;222(3):128-134.
C Blease. Deception as treatment: the case of depression. J Med Ethics. 2011 Jan;37(1):13-6.
I Kirsch. Review: benefits of antidepressants over placebo limited except in very severe depression. Evid Based Ment Health. 2010 May;13(2):49.
I Kirsch. Challenging Received Wisdom: Antidepressants and the Placebo Effect. Mcgill J Med. 2008 Nov; 11(2): 219–222.
I Kirsch, B J Deacon, T B Huedo-Medina, A Scoboria, T J Moore, B T Johnson. Initial severity and antidepressant benefits: a meta-analysis of data submitted to the Food and Drug Administration. PLoS Med. 2008 Feb;5(2):e45.
A Vilhelmsson. T Svensson. A Meeuwisse. A Pill for the Ill? Patients’ Reports of Their Experience of the Medical Encounter in the Treatment of Depression. PLoS One. 2013 Jun 18;8(6):e66338.
M A Sugarman, A M Loree, B B Baltes, E R Grekin, I Kirsch. The efficacy of paroxetine and placebo in treating anxiety and depression: a meta-analysis of change on the Hamilton Rating Scales. PLoS One. 2014 Aug 27;9(8):e106337.
J C Fournier, R J DeRubeis, S D Hollon, S Dimidjan, J D Amsterdam, R C Shelton, J Fawcett. Antidepressant drug effects and depression severity: a patient-level meta-analysis. JAMA. 2010 Jan 6;303(1):47-53.
R Shimazawa, M Ikeda. Conflicts of interest in psychiatry: strategies to cultivate literacy in daily practice. Psychiatry Clin Neurosci. 2014 Jul;68(7):489-97.
I Kirsch. Antidepressants and the placebo response. Epidemiol Psichiatr Soc. 2009 Oct-Dec;18(4):318-22.
E H Turner, A M Matthews, E Linardatos, R A Tell, R Rosenthal. Selective publication of antidepressant trials and its influence on apparent efficacy. N Engl J Med. 2008 Jan 17;358(3):252-60.
P W Andrews, J A Thomson Jr, A Amstadhter, M C Neale. Primum non nocere: an evolutionary analysis of whether antidepressants do more harm than good. Front Psychol. 2012 Apr 24;3:117.