Antidepressant Drug Research Has a Problem, Study Says


pills medication antidepressants

A new study revealed that research studies for new antidepressant medications do not evaluate the effectiveness of the drugs on the general population.

Mark Zimmerman, M.D., a clinical researcher at Rhode Island Hospital, and his team analyzed the criteria used in antidepressant efficacy studies (AETs) and learned that the inclusion/exclusion criteria for AETs have narrowed so much over the past five years that most patients are excluded.

In other words, the results of the trials may not be applicable to most of us.

Dr. Zimmerman explained why the research was needed:

The inclusion/exclusion criteria for AETs have narrowed over the past five years, thereby suggesting that AETs may be even less generalizable than they were previously.

More than a decade ago, our clinical research group raised concerns about the generalizability of AETs and suggested that the majority of patients seen in routine clinical practice would not qualify for an AET.

These results were replicated multiple times. We therefore wondered if drug companies changed how they recruited patients into studies. In fact, they have, but in an unexpected way. The more recent AETs are even less generalizable than the prior studies, which themselves excluded most depressed patients from drug company-sponsored treatment studies.

Dr. Zimmerman examined 170 placebo-controlled studies published during the past 20 years, 56 of which were published during the past five years. The more recent studies were significantly more likely to:

  1. exclude patients with co-morbid Axis I disorders and personality disorders;
  2. exclude patients because the episode duration was too long or too short;
  3. exclude patients who met diagnostic criteria for major depression but did not score high enough on a rating scale.

In a public release, Dr. Zimmerman elaborated on the findings:

For severely ill patients, such as those who express suicidal thoughts, it makes ethical sense to exclude them from a study where they may receive placebos.

However, excluding patients with co-morbid psychiatric disorders has become more frequent, and patients with any comorbid Axis I disorder are twice as likely to be excluded in recent studies.

This is important because the majority of depressed patients have another psychiatric diagnosis. The exclusion of depressed patients who score too low on rating scales is the most concerning.

This would exclude approximately half of the patients seen in clinical practice. In addition, studies have shown that antidepressants do not work as well for less severely depressed patients.

Thus, drug companies seem to be stacking the deck to demonstrate that their products work, even though they might work only for a narrow segment of depressed patients.

One response to this post.

  1. Posted by Nafsica (Sasa) Kelly on December 9, 2015 at 11:01 am

    Prevention is better than cure.. .change cannot take place until it is clear what needs changing,one of the main task of psychiatrist is to approach with care anything that invite a person to examine his or her interpersonal style emotional experience and behaviours.The psychatrist job is to helped to idintify areas where change could produce some desired effect,but it is essential that the client make the choice of action and acknowledge responsibility.Ideally,they are first of all committed to their own growth physical intellectual,social.
    Psychiatrist some of them (are charlatans) rooking a gullible public with a highly expensive worthless treatment,Long term medication cause brain damage.The goal of healing is not medicated mediocrity but the integration of self through catharsi.Reconstruction and challenge the enormous emotional energy into productive creativity.Only basic goodness gives life to technique permanet success.
    No other person in society has the kind of power the psychiatrist has and that is the power of which psychiatrist must be deprived.If the psychiatrist’s conscientiousness is supplanted by greed,pride,the already vulnerable person must bear the brunt.I feel medical science and practice are largely based on assumption that scientific knowlegde grows by the accumulated knowledge.On this traditional model of professionalism,authority is the ideal and precisely understood to be free from error.This approach to learning encourage intellecual disonesty.They should aware of mistakes and they are fallibility and constant need to learn and grow.Ongoing personal development and staying in touch with other psychiatrist help to keep their work from becoming pathologilise disease. Identifying incivility as the misuse of power.At the moment psychiatrist are cuaght in a vicious cycle


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