Anti Depressant Studies 'Biased and Misleading'

Stan, my Canadian ION LIFE partner, sent me a clipping about how clinical reports are misused and er.. filtered.

We are now told that we have 'evidence-based medicine'. This wonderful sounding newspeak term supposedly 'integrates individual clinical based expertise with the best available external clinical evidence from clinical research'. A good doctor backed up by good data, right?

So you can go to the doc confident that 'evidence-based medicine' willa ssure you of correct diagnosis by an educated unbiased doctor. Right?

One would assume that EBM, by its very nature, would take into account all available evidence. After all, that's what it says it is. Right?

So here's a new term we poor sap-patients have to deal with. It's called 'publication bias'; the phenomenon of'positive outcome' studies being more readily accepted than negative outcome ones. Put another way, everyone wants a good cancer drug, and no-one wants to hear about side effects. So when the Jan 17 issue of the New England Journal of Medicine carried a story identifying 'publication bias' in the release of studies about antidepressant medication, with a survey of 74 studies registered with the FDA, it raises a few hackles.

Of the 74 studies:
38 had positive effects,
36 had negative effects,
...but 22 of the negative ones had - for whatever reason, not been published. This changed the whole 'look' of the total studies. By not publishing 22 negatives, it looked like the positive 'score' on the subject was a highly acceptable 94%. Unfortunately, when reviewed by the FDA, of these 'positive' studies, only 51% were genuinely positive.

So the drugs reviewed appeared around one third more effective than the net research really found.

The author of the study states; "The bottom line for people considering an antidepressant, I think, is that they should be more circumspect about taking it."

Now wait a minute. let me get what he's saying! He is suggesting that a chronically depressed person should study all the reports to decide whether his doctor has been fed a story about the whizbang drug he's about the prescribe.

Come on! Who are you kidding!

Just to muddy the water a little further, the esteemed Lancet journal found that although studies support the use of a variety of antidepressants for kids, the hidden unpublished data shows a tendency towards suicidal behaviour.

Very depressing. Where's the Valium?