ArticleAnnals of general psychiatry2013
No role for initial severity on the efficacy of antidepressants: results of a multi-meta-analysis.
Article in Annals of general psychiatry, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 4 syntheses or guidelines pooled it, 66 citations in OpenAlex.
- Omega-3 fatty acids for depression in adults.The Cochrane database of systematic reviews · 2021Pooled it
- ω-3 Fatty acids for major depressive disorder in adults: an abridged Cochrane review.BMJ open · 2016Pooled it
- Omega-3 fatty acids for depression in adults.The Cochrane database of systematic reviews · 2015Pooled it
- Efficacy and acceptability of pharmacological treatments for depressive disorders in primary care: systematic review and network meta-analysis.Annals of family medicinePooled it
- Neither serotonin disorder is at the core of depression nor dopamine at the core of schizophrenia; still these are biologically based mental disorders.Molecular psychiatry · 2024Article
- The sociodemographic and clinical profile of patients with major depressive disorder receiving SSRIs as first-line antidepressant treatment in European countries.European archives of psychiatry and clinical neuroscience · 2022Article
- Switching Selective Serotonin Reuptake Inhibitors in Adolescents with Selective Serotonin Reuptake Inhibitor-Resistant Major Depressive Disorder: Balancing Tolerability and Efficacy.Journal of child and adolescent psychopharmacology · 2019Article
- Response rate profiles for major depressive disorder: Characterizing early response and longitudinal nonresponse.Depression and anxiety · 2018Article
- Buspirone in Children and Adolescents with Anxiety: A Review and Bayesian Analysis of Abandoned Randomized Controlled Trials.Journal of child and adolescent psychopharmacology · 2018Review
- Functioning outcomes with adjunctive treatments for major depressive disorder: a systematic review of randomized placebo-controlled studies.Neuropsychiatric disease and treatment · 2018Review
- Changing response rates in clinical trials of depression: how did the introduction of DSM-III and DSM-III-R influence the outcome?Evidence-based mental health · 2017Article
- Consistent superiority of selective serotonin reuptake inhibitors over placebo in reducing depressed mood in patients with major depression.Molecular psychiatry · 2016Article
- EPA guidance on improving the image of psychiatry.European archives of psychiatry and clinical neuroscience · 2016Article
- From Randomized Controlled Trials of Antidepressant Drugs to the Meta-Analytic Synthesis of Evidence: Methodological Aspects Lead to Discrepant Findings.Current neuropharmacology · 2015Article
- Risk assessment and predicting outcomes in patients with depressive symptoms: a review of potential role of peripheral blood based biomarkers.Frontiers in human neuroscience · 2015Review
- A systematic approach to pharmacotherapy for geriatric major depression.Clinics in geriatric medicine · 2014Review
- Are antidepressants clinically useful? Conclusion of a decade of debate.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2014Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
Abstract
introductionDuring the last decade, a number of meta-analyses questioned the clinically relevant efficacy of antidepressants. Part of the debate concerned the method used in each of these meta-analyses as well as the quality of the data set. MATERIALS AND
methodsThe Kirsch data set was analysed with a number of different methods, and eight key questions were tackled. We fit random effects models in both Bayesian and frequentist statistical frameworks using raw mean difference and standardised mean difference scales. We also compare between-study heterogeneity estimates and produce treatment rank probabilities for all antidepressants. The role of the initial severity is further examined using meta-regression methods.
resultsThe results suggest that antidepressants have a standardised effect size equal to 0.34 which is lower but comparable to the effect of antipsychotics in schizophrenia and acute mania. The raw HDRS difference from placebo is 2.82 with the value of 3 included in the confidence interval (2.21-3.44). No role of initial severity was found after partially controlling for the effect of structural (mathematical) coupling. Although data are not definite, even after controlling for baseline severity, there is a strong possibility that venlafaxine is superior to fluoxetine, with the other two agents positioned in the middle. The decrease in the difference between the agent and placebo in more recent studies in comparison to older ones is attributed to baseline severity alone. DISCUSSION: The results reported here conclude the debate on the efficacy of antidepressants and suggest that antidepressants are clearly superior to placebo. They also suggest that baseline severity cannot be utilized to dictate whether the treatment should include medication or not. Suggestions like this, proposed by guidelines or institutions (e.g. the NICE), should be considered mistaken.
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.