Psychiatry: Difference between revisions

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===Antidepressants fail to meet clinical significance beyond placebo in treating depression===
===Antidepressants fail to meet clinical significance beyond placebo in treating depression===
In metastudies of antidepressant effectiveness, according to the NICE criteria of clinical significance (more than 4+ points on the HAM-D depression rating scale, or HRDS).
In metastudies of the effectiveness of antidepressants, according to the NICE criteria of clinical significance (more than 4+ points on the HAM-D depression rating scale, or HRDS).


The latest meta-analysis of anti-depressants, here [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5889788/], shows that when compiling the results of many different studies, antidepressants did not produce more than an equivalent of a 4 point improvement on the HRDS, meaning the antidepressants were not clinically meaningful in treating depression beyond placebo.   
The latest meta-analysis of anti-depressants, here [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5889788/], shows that when compiling the results of many different studies, antidepressants did not produce more than an equivalent of a 4 point improvement on the HRDS, meaning the antidepressants were not clinically meaningful in treating depression beyond placebo.   


A look at Irving Kirsches dataset reveals only clinical significance at the tail end of the '''very''' severely depressed (about 10% of patients).  Which only yields a 4.28 HRDS decrease.  Fournier et. al 2010 also only found about 10% of patients pass the NICE criteria for a clinically significant response to antidepressants [https://www.ncbi.nlm.nih.gov/pubmed/20051569].  Just 30 half an hour of treadmill walking for 10 consecutive days is sufficient to produce a clinically relevant and statistically significant reduction in depression (reduction of 6.5 points from baseline on HRDS).[https://www.ncbi.nlm.nih.gov/pubmed/11273973/].  The exercise part aside, my point is the meta-analyses do not show a clinically significant response to antidepressants with the exception of maybe the top 10% most severely depressed patients. [[User:Neiltyson1fan|Neiltyson1fan]] ([[User talk:Neiltyson1fan|talk]]) 22:07, 28 December 2018 (UTC)
A look at Irving Kirsches dataset reveals only clinical significance at the tail end of the '''very''' severely depressed (about 10% of patients).  Which only yields a 4.28 HRDS decrease.  Fournier et. al 2010 also only found about 10% of patients pass the NICE criteria for a clinically significant response to antidepressants [https://www.ncbi.nlm.nih.gov/pubmed/20051569].  Just 30 half an hour of treadmill walking for 10 consecutive days is sufficient to produce a clinically relevant and statistically significant reduction in depression (reduction of 6.5 points from baseline on HRDS).[https://www.ncbi.nlm.nih.gov/pubmed/11273973/].  The exercise part aside, my point is the meta-analyses do not show a clinically significant response to antidepressants with the exception of maybe the top 10% most severely depressed patients. [[User:Neiltyson1fan|Neiltyson1fan]] ([[User talk:Neiltyson1fan|talk]]) 22:07, 28 December 2018 (UTC)
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