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Commentary: Meta-analysis of trials comparing antidepressants with active placebos

Published online by Cambridge University Press:  02 January 2018

David Healy*
Affiliation:
North Wales Department of Psychological Medicine, Hergest Unit, Bangor, Wales LL57 2PW

Extract

This attempt to establish treatment effect sizes follows a tradition, which dates back over 20 years, of assessing the effects of antidepressant treatment under ‘blinder conditions'. The method adopted by Moncrieff et al has some merit but involves a recourse to studies, many of which are over 30 years old. While the studies may not be seriously flawed, it is difficult to have much confidence in them. None appears to have included what the authors describe as an ‘inert’ placebo, which strictly speaking would be a non-drug arm to the study. The number of studies is small. The dose of drugs used, which might be expected to have some influence on outcomes, is not mentioned. Finally, as experience with studies in obsessive-compulsive disorder indicates, treatment effect sizes can vary substantially from one decade to another –most probably because different individuals are recruited although all may apparently meet the same diagnostic criteria.

Type
Papers
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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References

British Association of Psyxhopharmacology (1997) Consensus statement. Paediatric and learning disability psychopharmacology. Journal of Psychopharmacology, 11. 291294.CrossRefGoogle Scholar
Greenberg, R. P., Bornstein, R. F., Greenberg, M. D., et al (1992) A meta-analysis of antidepressant outcomes under “blinder” conditions. Journal of Consulting and Clinical Psychology, 60, 664669.CrossRefGoogle ScholarPubMed
Healy, D. (1997) The Antidepressant Era, p. 102. Boston, MA: Harvard University Press.Google Scholar
Healy, D. & McMonagle, T. (1997) The enhancement of social functioning as a therapeutic principle in the management of depression. Journal of Psychopharmacology, 11 (suppl. I). 2531.Google Scholar
Moncrieff, J., Wesseley, S. & Hardy, R. (1998) Meta-analysis of trials comparing antidepressants with active placebos. British Journal of Psychiatry, 172, 227231.CrossRefGoogle ScholarPubMed
Wheatley, D., Van Moffaert, M., Timmerman, L., et al (1998) Mirtazapine: efficiency and tolerability in comparison with fluoxetine in patients with major depression. Journal of Clinical Psychiatry. in press.CrossRefGoogle Scholar
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