Andrea Cipriani, Toshi A. Ruhe, Erick Turner , Julian P. Ioannidis, John R. Background: Major depressive disorder is one of the most common, burdensome, and costly psychiatric disorders worldwide in adults.
Research Updates in Psychiatry: ADHD and Antidepressants
NIMH » Antidepressants: A complicated picture
Most people with depression are initially treated with antidepressants. But how well do the data support their use, and should we reconsider our strategy? The National Institute for Health and Clinical Excellence NICE recently recommended that antidepressants, in particular selective serotonin reuptake inhibitors, should be first line treatment for moderate or severe depression. The continuing concern that selective serotonin reuptake inhibitors may increase the risk of suicidal behaviour w1 w2 means there needs to be further consideration of evidence for the efficacy of antidepressants in adults as there has been in children. Although the NICE meta-analysis of placebo controlled trials of selective serotonin reuptake inhibitors found significant differences in levels of symptoms, these were so small that the effects were deemed unlikely to be clinically important. However, in our comments on the draft guidelines, we pointed out that these categorical outcomes were derived from the same continuous data for symptoms scores that were found to show no clinically relevant effects.
Efficacy of Antidepressants
Konstantinos N. Recently there has been much debate on the true usefulness of antidepressant therapy especially after the publication of a meta-analysis by Kirsch et al. PLoS Medicine , 5 , e The aim of the current paper was to recalculate and re-interpret the data of that study. Effect-size and mean-score changes were calculated for each agent separately as well as pooled effect sizes and mean changes on the basis of the data reported by Kirsch et al.
There is considerable debate, both in the scientific literature and in the mainstream media about the efficacy and safety of antidepressants Ioannidis, , so a major new review in this field is very welcome. People who take antidepressants have been bombarded by mixed messages about their medication over recent years. The majority of patients had moderate-to-severe depression. This review is an update of a previous meta-analysis Cipriani et al, , which just included head-to-head comparisons of 12 antidepressants, so whichever way you look at it, this is a big piece of important evidence. They identified all double-blind RCTs comparing antidepressants with placebo, or with another antidepressants head-to-head trials for the acute treatment 8 weeks of major depression in adults aged 18 years or more.