A paucity of research on longterm use of antidepressants. Some important points from a New York Times article on the lack of information about the long-term use of antidepressants. The clear point of the article, written by a psychiatrist, is whatever research there is (any? long-term studies are hard to come by) falls short. Here are some excerpts from the article:
Still, what do we know about the effects of, say, 15 to 20 years of antidepressant drug treatment that begins in adolescence or childhood? Not enough.
The reason has to do with the way drugs are tested and approved. To get F.D.A. approval, a drug has to beat a placebo in two randomized clinical trials that typically involve a few hundred subjects who are treated for relatively short periods, usually 4 to 12 weeks.
Note the disparity! 15 to 20 years of use, versus 4 to 12 weeks for clinical trials.
So drugs are approved based on short-term studies for what turns out to be long-term — often lifelong — use in the world of clinical practice.
And then there’s the problem of the funding of research:
This large gap in our clinical knowledge is compounded by the public’s growing and well-founded skepticism about research sponsored by drug makers. A study in the January 2008 issue of The New England Journal of Medicine, involving 74 clinical trials with 12 antidepressants, found that 97 percent of positive studies were published, versus 12 percent of
Let’s just repeat that: 97 percent of positive studies were published, versus 12 percent of negative studies. And that’s in the New England Journal of Medicine. That means when the results of a study provided positive evidence for the use of a drug 97 percent of those studies were published in the journal. When the results of the study did not show evidence for the drug only 12 percent of those studies were published. The New England Journal of Medicine is a highly respected peer-reviewed journal. What’s going on?
So we have two problems: A shortage of research, and a very distorted picture of research results.
Kalea Chapman, Psy.D.