Antidepressiva oft wirkungslos 2

[Karlheinz]

Die neueste Studie zum Thema:

http://jama.ama-assn.org/cgi/content/abstract/303/1/47

http://online.wsj.com/article/SB10001424052748703436504574640641607761408.html

http://www.latimes.com/news/nationworld/nation/la-sci-depression6-2010jan06,0,4335963.story

"Results Medication vs placebo differences varied substantially as a function of baseline severity. Among patients with HDRS scores below 23, Cohen d effect sizes for the difference between medication and placebo were estimated to be less than 0.20 (a standard definition of a small effect). Estimates of the magnitude of the superiority of medication over placebo increased with increases in baseline depression severity and crossed the threshold defined by the National Institute for Clinical Excellence for a clinically significant difference at a baseline HDRS score of 25.

Conclusions The magnitude of benefit of antidepressant medication compared with placebo increases with severity of depression symptoms and may be minimal or nonexistent, on average, in patients with mild or moderate symptoms. For patients with very severe depression, the benefit of medications over placebo is substantial. "

Bei einem HDRS unter 23 ist Cohens gegenüber Placebo d<0,2. Klinisch signifikant wird die Wirkung erst ab HDRS-Werten von 25.

Wer das genauer verstehen will kann im CSN-Blog nachlesen:

http://www.csn-deutschland.de/blog/2009/07/28/psychostudien-unter-der-lupe/

http://www.csn-deutschland.de/blog/2009/08/17/effektstaerken-in-der-psychotherapie/

[Karlheinz]

FEBRUARY 5, 2010.

Glaxo to Stop Research on New Antidepressants as Its Shifts Focus

http://online.wsj.com/article/SB20001424052748704041504575044901266169316.html

Das Gebiet sei zu riskant, da es schwer sei, die Wirkung in Studien zu belegen. Das sei ein Nachteil in einer Zeit, in der Versicherungen und andere Kostenträger sehr darauf achten, für ihr Geld auch einen klaren Gegenwert zu sehen.

... \"Part of the reason is financial risk. Clinical trials of antidepressants are among the \"most expensive and highest-risk\" of all drug trials, Mr. Witty said, because companies often don\'t know until the end of very large studies whether a drug works. It is also hard to prove that a depression drug is working, he said, because patient improvement is measured by subjective mood surveys, and not by the clear-cut blood tests and biological measures used in other diseases.

That\'s a drawback in an era when insurers and other health-care payers want to see clear value for their money, Mr. Witty said.

Payers \"want big benefits to make it worth their while to invest their resources,\" he said, adding that Glaxo would scrap research into pain drugs for the same reasons.\" ...
- Editiert von Karlheinz am 05.02.2010, 07:42 -