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European Archives of Psychiatry and Clinical Neuroscience

Published in:

01-10-2018 | Editorial

Possibly no baseline severity effect for antidepressants versus placebo but for antipsychotics. Why?

Authors: Stefan Leucht, S. Z. Levine, M. Samara, A. Cipriani, J. M. Davis, T. A. Furukawa

Published in: European Archives of Psychiatry and Clinical Neuroscience | Issue 7/2018

Excerpt

10 years ago, a meta-regression analysis [1] of 35 clinical trials submitted to the FDA found that the efficacy of antidepressants compared to placebo increases with baseline severity, and that a clinically significant effect defined as an effect size of at least 0.50 can only be expected in patients with a Hamilton Depression Rating Score of above 28. This was interpreted by Kirsch et al., to mean that antidepressants are efficacious for depression only for patients who are severely ill at baseline. This paper had a major impact on treatment guidelines and fueled a heated discussion about the usefulness of these agents [2]. …

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Cipriani A, Geddes JR (2014) Placebo for depression: we need to improve the quality of scientific information but also reject too simplistic approaches or ideological nihilism. BMC Med 25:105CrossRef

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Furukawa TA, Maruo K, Noma H, Tanaka S, Imai H et al (2018) Initial severity of major depression and efficacy of new generation antidepressants: individual participant data meta-analysis. Acta Psychiatr Scand 137:450–458CrossRefPubMed

Rabinowitz J, Werbeloff N, Caers I, Mandel FS, Stauffer V et al (2014) Determinants of antipsychotic response in schizophrenia: implications for practice and future clinical trials. J Clin Psychiatry 75:e308–e316CrossRefPubMed

10.

Furukawa TA, Levine SZ, Tanaka S, Goldberg Y, Samara M et al (2015) Initial severity of schizophrenia and efficacy of antipsychotics: participant-level meta-analysis of 6 placebo-controlled studies. JAMA Psychiatry 72:14–21CrossRefPubMed

11.

Samara MT, Goldberg Y, Levine SZ, Furukawa TA, Geddes JR et al (2017) Initial symptom severity of bipolar I disorder and the efficacy of olanzapine: a meta-analysis of individual participant data from five placebo-controlled studies. Lancet Psychiatry 4:859–867CrossRefPubMed

12.

Levine SZ, Kodesh A, Goldberg Y, Reichenberg A, Furukawa TA et al (2016) Initial severity and efficacy of risperidone in autism: results from the RUPP trial. Eur Psychiatry 32:16–20CrossRefPubMed

13.

Furukawa TA, Weitz ES, Tanaka S, Hollon SD, Hofmann SG et al (2017) Initial severity of depression and efficacy of cognitive-behavioural therapy: individual-participant data meta-analysis of pill-placebo-controlled trials. Br J Psychiatry 210:190–196CrossRefPubMedPubMedCentral

14.

Leucht S, Kane JM, Kissling W, Hamann J, Etschel E et al (2005) What does the PANSS mean? SchizophrRes 79:231–238CrossRef

15.

Leucht S, Fennema H, Engel R, Kaspers-Janssen M, Lepping P et al (2013) What does the HAMD mean? J Affect Disord 148:243–248CrossRefPubMed

16.

Cipriani A, Furukawa TA, Salanti G, Chaimani A, Atkinson LZ et al (2018) Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. Lancet 391:1357–1366CrossRefPubMedPubMedCentral

Title: Possibly no baseline severity effect for antidepressants versus placebo but for antipsychotics. Why?
Authors: Stefan Leucht
S. Z. Levine
M. Samara
A. Cipriani
J. M. Davis
T. A. Furukawa
Publication date: 01-10-2018
Publisher: Springer Berlin Heidelberg
Published in: European Archives of Psychiatry and Clinical Neuroscience / Issue 7/2018
Print ISSN: 0940-1334
Electronic ISSN: 1433-8491
DOI: https://doi.org/10.1007/s00406-018-0940-0

At a glance: The STEP trials

Springer Medicine

Possibly no baseline severity effect for antidepressants versus placebo but for antipsychotics. Why?

Excerpt

At a glance: The STEP trials

Springer Medicine

Excerpt

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