As promised, here’s more on that New England Journal of Medicine study that suggested failing to publish studies on antidepressants’ effectiveness led to doctors prescribing them unnecessarily.
John M. Grohol at PsychCentral says the findings shouldn’t be that surprising, as researchers naturally want to tell people what works, not what doesn’t work.
However, he says drug companies “should all be required to ensure all negative study data is as readily available as the positive study data.”
Elsewhere, The Last Psychiatrist wonders what the big deal is and challenges the credibility of Dr. Erick Turner, who helped write the NEJM study:
Turner has “30 publications in peer reviewed journals.” How many of those publications had negative results? One: B12 was not effective for seasonal affective disorder. So did he submit negative studies and they were rejected, or did he simply discard them? Turner was also a reviewer for the FDA– why not simply release all that data?
He/she also blames a shift in focus by medical journals:
Keep in mind these studies were done > 5 years ago, back when the culture wasn’t “everything has equivalent efficacy.” Nowadays, that’s the hot topic– studies showing Pharma sucks, or branded meds are no better than generics. Back “then” journals were all about finding the next big thing, the assumption of progress, etc. There’s no room in journals for the null hypothesis.
CL Psych shares the contempt but thinks some negative studies should have made it in:
There have always been journal editors who have some ability to think critically and publish material that runs counter to that of mainstream medicine. Sure, some of the studies would have been rejected a time or two, but I think they would have been published at some point.
On the other hand, at Slate.com, Peter D. Kramer writes that despite obvious flaws with the studies, people shouldn’t automatically be scared off antidepressants.
Kramer and CL Psych (below) point out another major problem by the drug companies:
the study found that drug companies changed their primary outcome measures and statistical analyses in between submitting to the FDA and submitting for journal publication. This resulted in inflated effect sizes for every antidepressant. Kind of a big deal, as the medical literature ends up suggesting the drugs are more beneficial than they actually are.
But Kramer disputes that conclusion:
Perhaps the best thing to say about this new data analysis is that it bears no news at all about antidepressants. They are just as good or as bad as we imagined them to be.
(*Thanks to John M. Grohol for his links.)
January 28, 2008 at 12:10 am
[...] scary when antidepressants may be overdiagnosed and less beneficial than supposed, as my classmate Catherine Guiles discussed in her blog. “One lesson from pharmacology is that you can see effects on emotion and cognition without the [...]