I went back and read article in the Journal of the American Medical Association that started the debacle called “The Newsweek Article.” I am even more convinced that circulation trumped sound journalism in the Newsweek article.
Authors of the study published in JAMA base their findings on the results of six, randomized placebo-controlled trials of TWO ANTIDEPRESSANTS. Let me say that again: TWO ANTIDEPRESSANTS.
Three of the studies were of Paxil. They varied in length from 8 to 11 weeks and from dosage levels of 20 to 50 mg/d. The other three studies were of imipramine – Tofranil. They varied in length from 6 to 8 weeks and from dosage levels of 100 to 250 mg/d.
Upon review of these six studies the researchers found that “the magnitude of benefit of antidepressant medication compared with placebo increases with severity of depression symptoms and may be minimal or non-existent on average in patients with mild or moderate symptoms. For patients with very severe depression, the benefit of medications over placebo is substantial.“
Personally, I have a problem with making sweeping assumptions about the “benefit of antidepressant medication” based only on studies of TWO ANTIDEPRESSANTS!!! I am not a psychiatrist but I think there are a lot more than TWO ANTIDEPRESSANTS out there.
The JAMA article also references the findings researcher Irving Kirsch, who analyzed the antidepressant vs placebo effect in 47, pre-1998 company sponsored trials of six antidepressants: Prozac, Paxil, Zoloft, Effexor, Serzone and Celexa. Kirsch found that antidepressants are about as effective as a dummy pill – except in cases of severe depression. In those cases antidepressants are substantially more effective than placebo.
Instead of focusing on the undeniable benefits of antidepressants in severe cases of depression, the Newsweek article focuses on Hirsch’s findings of those with mild or moderate depression – and does so with snark and cynicism, suggesting that antidepressants are “basically expensive Tic Tacs” and that those who get well with a placebo do so for the same reason that “Dumbo could initially fly with only a feather clutched in his teeth.”
Newsweek also gives ink to “one team of researchers (who) wondered if antidepressants were “a triumph of marketing over science.” ” Another researcher mentions that some of his colleagues call the phenomenon “a dirty little secret.”
Where does this leave me and the 2 million Americans who will suffer a severe depression this year: ANTIDEPRESSANTS DO WORK. Yes, psychotherapy works, too. And antidepressants AND psychotherapy will likely work even better.
But for those of you in your black hole, who may be practicing a hangman’s knot, gathering pills or loading a gun, you need to turn the magazine upside down and read ANTIDEPRESSANTS DO WORK.
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Last reviewed: 10 Feb 2010