Top

European Archives of Psychiatry and Clinical Neuroscience

Published in:

01-12-2008 | REVIEW

Isn’t the efficacy of antidepressants clinically relevant? A critical comment on the results of the metaanalysis by Kirsch et al. 2008

Author: Prof. Dr. Hans Jürgen Möller

Published in: European Archives of Psychiatry and Clinical Neuroscience | Issue 8/2008

Abstract

The metaanalysis of Kirsch (PLoS Med 5:e45, 2008) has (unfortunately!) attracted too much attention in the specialized press and especially in the lay press. Therefore, intensive critical commenting is necessary to not further alarm experts and health authorities as well as patients and family members. The specified commenting on these metaanalyses shall be prefaced with a short and critical commentary regarding the general significance of metaanalyses. The results of metaanalyses should not too naively be interpreted as the ‘truth’ as regards to the evidence based psychopharmacotherapy, but should be qualified in their significance due to principal methodological reasons Maier (Nervenarzt 78:1028–1036, 2007; Möller (Nervenarzt 78:1014–1027, 2007). Especially from these derived effect sizes should be interpreted carefully.

Anderson IM (2000) Selective serotonin reuptake inhibitors versus tricyclic antidepressants: a meta-analysis of efficacy and tolerability. J Affect Disord 58:19–36PubMedCrossRef

Baghai TC, Volz HP, Moller HJ (2006) Drug treatment of depression in the 2000s: an overview of achievements in the last 10 years and future possibilities. World J Biol Psychiatry 7:198–222PubMedCrossRef

Baldwin D, Broich K, Fritze J, Kasper S, Westenberg H, Möller HJ (2003) Placebo-controlled studies in depression: necessary, ethical and feasible. Eur Arch Psychiatry Clin Neurosci 253: 22–28PubMedCrossRef

Bauer M, Bschor T, Pfennig A, Whybrow PC, Angst J, Versiani M, Moller HJ (2007) World federation of societies of biological psychiatry (WFSBP) guidelines for biological treatment of unipolar depressive disorders in primary care. World J Biol Psychiatry 8:67–104PubMedCrossRef

Fritze J, Aldenhoff J, Bergmann F, Maier W, Möller HJ (2005) Antidepressiva: Lebensgefährliche Placebos? Arznei-Telegramm: fahrlässiges journal? Psychoneuro 31:480–484CrossRef

Fritze J, Möller HJ (2001) Design of clinical trials of antidepressants. Should a placebo control arm be included? CNS Drugs 15(10):755–764PubMedCrossRef

Geddes JR, Carney SM, Davies C, Furukawa TA, Kupfer DJ, Frank E, Goodwin GM (2003) Relapse prevention with antidepressant drug treatment in depressive disorders: a systematic review. Lancet 361:653–661PubMedCrossRef

Kirsch I, Moore TJ, Scoboria A, Nicholls S (2002) The emperor's new drugs: an analyses of antidepressant medication data submitted to the U.S. Food and Drug Administration. Prevention & Treatment 5 (Artikle 23)

Kirsch I, Deacon BJ, Huedo-Medina TB, Scoboria A, Moore TJ, Johnson BT (2008) Initial severity and antidepressant benefits: a meta-analysis of data submitted to the food and drug administration. PLoS Med 5:260–268CrossRef

10.

Maier W, Möller HJ (2007) Metaanalysen. Methoden zur Evidenzmaximierung von Therapiestudien. Nervenarzt 78: 1028–1036PubMedCrossRef

11.

Möller HJ (2008a) Is there a need for a new psychiatric classification at the current state of knowledge? World J Biol Psychiatry 9:82–85PubMedCrossRef

12.

Möller HJ (2008b) Methodik empirischer Forschung. In: Möller HJ, Laux G, Kapfhammer H-P (eds) Psychiatrie und psychotherapie. Springer, Heidelberg, pp 346–367

13.

Möller HJ, Maier W (2007) Probleme der “evidence-based medicine” in der Psychopharmakotherapie. Problematik der Evidenzgraduierung und der Evidenzbasierung komplexer klinischer Entscheidungsprozesse. Nervenarzt 78:1014–1027PubMedCrossRef

14.

Montgomery SA, Kasper S (2007) Severe depression and antidepressants: focus on a pooled analysis of placebo-controlled studies on agomelatine. Int Clin Psychopharmacol 22:283–291PubMedCrossRef

15.

Montgomery SA, Möller HJ (2008) The clinical relevance of the significant advantage of escitaloprom compared to other antidepressants. (in preperation)

16.

National Institute for Clinical Excellence (2004) Depression: management of depression in primary and secondary care. Clinical practice guideline no 23. National Institute for Clinical Excellence, London

17.

Nutt DJ, Sharpe M (2008) Uncritical positive regard? Issues in the efficacy and safety of psychotherapy. J Psychopharmacol 22:3–6PubMedCrossRef

18.

Russh AJ (2007) STAR*D: what have we learned? Am J Psychiatry 164:201–204CrossRef

19.

Storosum JG, Elferink AJ, van Zwieten BJ, van den BW, Gersons BP, van Strik R, Broekmans AW (2001) Short-term efficacy of tricyclic antidepressants revisited: a meta-analytic study. Eur Neuropsychopharmacol 11:173–180

20.

Turner EH, Matthews AM, Linardatos E, Tell RA, Rosenthal R (2008) Selective publication of antidepressant trials and its influence on apparent efficacy. N Engl J Med 358:252–260PubMedCrossRef

Title: Isn’t the efficacy of antidepressants clinically relevant? A critical comment on the results of the metaanalysis by Kirsch et al. 2008
Author: Prof. Dr. Hans Jürgen Möller
Publication date: 01-12-2008
Publisher: D. Steinkopff-Verlag
Published in: European Archives of Psychiatry and Clinical Neuroscience / Issue 8/2008
Print ISSN: 0940-1334
Electronic ISSN: 1433-8491
DOI: https://doi.org/10.1007/s00406-008-0836-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Isn’t the efficacy of antidepressants clinically relevant? A critical comment on the results of the metaanalysis by Kirsch et al. 2008

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 8/2008

Iron states and cognitive abilities in young adults: neuropsychological and neurophysiological assessment

Tyrosine hydroxylase immunoreactivity in the locus coeruleus is elevated in violent suicidal depressive patients

The Upper Bavarian longitudinal community study 1975–2004. 2. Long-term course and outcome of depression

Familiality of major depressive disorder and patterns of lifetime comorbidity. The NEMESIS and GenMood studies

Suicide attempters: biological stressmarkers and adverse life events

Toward the delineation of mania subtypes in the French National EPIMAN-II Mille Cohort