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About 10% of Western adults take antidepressants, making them one of the most popular types of drugs in the world. On the surface, their prevalence seems difficult to reconcile with low evidence of their utility. For most people, they are slightly more effective than only one placebo, and often can induce dependence or affect unwanted side effects.
Then, are they determined so many times? A possible explanation is a bias in scientific literature, on which doctors rely on the treatment while deciding. Studies that make drugs useful are more likely to appear in magazines, which show very little effects. An analysis of antidepressants approved by the Food and Drug Administration (FDA) in the US found that, in 51 relevant trials cited in academic letters in 1985-2006, the agency has a “37 (73%) as” adequate evidence of effectiveness ” Was classified. ,
In contrast, the results of 23 tests of these drugs unpublished showed a serious picture. Just one had made the FDA-recognized positive discovery, reduced the part of such results to 51%in a full sample.
In 2022, BMJ published the breakdown of the entire universe of tests filed with the FDA in 1979-2016. It was found that Plessbos repeated the benefits of most bullets. In lightly depressed patients, who began testing with a score of 13–17 on the Hamilton rating scale, which improved the drugs with an average of 7.1 points.
Seeing a placebo, people saw a decline in depression 6.1 points, one-point intervals. For severely depressed patients, with starting a score above 22, the difference was still a minor 2.2 points: 11.3 for drugs, and 9.1 for a placebo.
However, these average is another reason unclear why doctors prescribe antidepressant so many times: patients’ reactions vary widely for them. Instead of a bell curve, the distribution of individuals in BMJ studies looked like a plateau, with a minor summit at one end. For drugs, this peak was sitting on the side representing the major decrease in depression. For Placebo, it landed in favor of small decline.
The author managed to reproduce this pattern by dividing patients into groups, who saw large, medium or negligible reforms, each with the distribution of their own bell shape. He estimated that antidepressants for 15% of people provided independent major benefits from the placebo effect.
Publication prejudice has shrunk during the last 15 years, thanks to the new rules on pre-regulation of how the results of the study will be assessed. However, antidepressants are popular. Because doctors cannot guess whether a given patient has been assisted by medicines, the only way to find out is to give them an attempt.
In recent years, researchers have begun to discover psychological and biological symptoms that show in patients who receive great benefits from antidepressants. If they are successful, doctors will be able to replace their current test-and-trunk approach with data-powered precision.
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