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.
Similar content being viewed by others
References
Anderson IM (2000) Selective serotonin reuptake inhibitors versus tricyclic antidepressants: a meta-analysis of efficacy and tolerability. J Affect Disord 58:19–36
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 7:198–222
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: 22–28
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 8:67–104
Fritze J, Aldenhoff J, Bergmann F, Maier W, Möller HJ (2005) Antidepressiva: Lebensgefährliche Placebos? Arznei-Telegramm: fahrlässiges journal? Psychoneuro 31:480–484
Fritze J, Möller HJ (2001) Design of clinical trials of antidepressants. Should a placebo control arm be included? CNS Drugs 15(10):755–764
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 361:653–661
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 5:260–268
Maier W, Möller HJ (2007) Metaanalysen. Methoden zur Evidenzmaximierung von Therapiestudien. Nervenarzt 78: 1028–1036
Möller HJ (2008a) Is there a need for a new psychiatric classification at the current state of knowledge? World J Biol Psychiatry 9:82–85
Möller HJ (2008b) Methodik empirischer Forschung. In: Möller HJ, Laux G, Kapfhammer H-P (eds) Psychiatrie und psychotherapie. Springer, Heidelberg, pp 346–367
Möller HJ, Maier W (2007) Probleme der “evidence-based medicine” in der Psychopharmakotherapie. Problematik der Evidenzgraduierung und der Evidenzbasierung komplexer klinischer Entscheidungsprozesse. Nervenarzt 78:1014–1027
Montgomery SA, Kasper S (2007) Severe depression and antidepressants: focus on a pooled analysis of placebo-controlled studies on agomelatine. Int Clin Psychopharmacol 22:283–291
Montgomery SA, Möller HJ (2008) The clinical relevance of the significant advantage of escitaloprom compared to other antidepressants. (in preperation)
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
Nutt DJ, Sharpe M (2008) Uncritical positive regard? Issues in the efficacy and safety of psychotherapy. J Psychopharmacol 22:3–6
Russh AJ (2007) STAR*D: what have we learned? Am J Psychiatry 164:201–204
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
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 358:252–260
Author information
Authors and Affiliations
Corresponding author
Additional information
The metaanalysis of Kirsch 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.
Rights and permissions
About this article
Cite this article
Möller, H.J. Isn’t the efficacy of antidepressants clinically relevant? A critical comment on the results of the metaanalysis by Kirsch et al. 2008. Eur Arch Psychiatry Clin Neurosc 258, 451–455 (2008). https://doi.org/10.1007/s00406-008-0836-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00406-008-0836-5