TY - JOUR
T1 - Is the antidepressive effect of second-generation antidepressants a myth?
AU - Bech, P
N1 - Keywords: Antidepressive Agents; Anxiety Disorders; Depressive Disorder, Major; Drug Administration Schedule; Factor Analysis, Statistical; Guilt; Humans; Psychomotor Disorders; Randomized Controlled Trials as Topic; Recurrence; Severity of Illness Index; Treatment Outcome; Truth Disclosure
PY - 2010
Y1 - 2010
N2 - Two recent meta-analyses on second-generation antidepressants versus placebo in mild to moderate forms of major depression, based on data on all randomized clinical trials using the Hamilton Depression Scale (HAMD) submitted to FDA, have shown an effect size of approximately 0.30 in favour of antidepressants in the acute therapy of major depression. The clinical significance of an effect size at this level was found to be so poor that these meta-analyses have subscribed to the myth of an exclusively placebo-like effect of second-generation antidepressants. A re-allocation of HAMD items focusing on those items measuring severity of clinical depression, the HAMD6, has identified effect sizes of >or=0.40 for second-generation antidepressants in placebo-controlled trials for which even a dose-response relationship can be demonstrated. In the relapse-prevention phase during continuation therapy of patients with major depression, the advantage of second-generation antidepressants over placebo was as significant as in the acute therapy phase. To explore a myth is not to deny the facts but rather to re-allocate them.
AB - Two recent meta-analyses on second-generation antidepressants versus placebo in mild to moderate forms of major depression, based on data on all randomized clinical trials using the Hamilton Depression Scale (HAMD) submitted to FDA, have shown an effect size of approximately 0.30 in favour of antidepressants in the acute therapy of major depression. The clinical significance of an effect size at this level was found to be so poor that these meta-analyses have subscribed to the myth of an exclusively placebo-like effect of second-generation antidepressants. A re-allocation of HAMD items focusing on those items measuring severity of clinical depression, the HAMD6, has identified effect sizes of >or=0.40 for second-generation antidepressants in placebo-controlled trials for which even a dose-response relationship can be demonstrated. In the relapse-prevention phase during continuation therapy of patients with major depression, the advantage of second-generation antidepressants over placebo was as significant as in the acute therapy phase. To explore a myth is not to deny the facts but rather to re-allocate them.
U2 - 10.1017/S0033291709006102
DO - 10.1017/S0033291709006102
M3 - Journal article
C2 - 19490744
SN - 0033-2917
VL - 40
SP - 181
EP - 186
JO - Psychological Medicine
JF - Psychological Medicine
IS - 2
ER -