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→Antidepressants fail to meet clinical significance beyond placebo in treating depression
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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 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, the point is that meta-analyses do not show a clinically significant response to antidepressants with the exception of maybe the top 10% most severely depressed patients. | 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 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, the point is that meta-analyses do not show a clinically significant response to antidepressants with the exception of maybe the top 10% most severely depressed patients. And for them, exercise would even work better. | ||
==="Monoamine hypothesis"=== | ==="Monoamine hypothesis"=== | ||