This is the
talk page for discussing improvements to the
Antidepressant article. This is not a forum for general discussion of the article's subject. |
Article policies
|
Find medical sources: Source guidelines · PubMed · Cochrane · DOAJ · Gale · OpenMD · ScienceDirect · Springer · Trip · Wiley · TWL |
Archives: Index, 1, 2Auto-archiving period: 30 days |
This article is written in American English, which has its own spelling conventions (color, defense, traveled) and some terms that are used in it may be different or absent from other varieties of English. According to the relevant style guide, this should not be changed without broad consensus. |
This
level-5 vital article is rated B-class on Wikipedia's
content assessment scale. It is of interest to the following WikiProjects: |
|||||||||||||||||||||||||||||||
|
Ideal sources for Wikipedia's health content are defined in the guideline
Wikipedia:Identifying reliable sources (medicine) and are typically
review articles. Here are links to possibly useful sources of information about Antidepressant.
|
Daily pageviews of this article
A graph should have been displayed here but
graphs are temporarily disabled. Until they are enabled again, visit the interactive graph at
pageviews.wmcloud.org |
Hi @ Doc James: I made another edit to that sentence in the lede. Please let me know what you think.
I'm curious about why you removed the link from the "see also" section to the Management of depression article. I think that the link is good to include there. ↠Pine (✉) 01:40, 24 April 2020 (UTC)
According to a rich line of research by Kirsch, Burns and others, there are systematic biases in most research about antidepressants. Keeping in mind that all current research finds tiny effects barely above statistical significance, and definitely below clinical significance, that means that probably all so-called antidepressants are just placebos with underestimated adverse effects.
I tried to add a small paragraph with sources about that in articles on common SSRIs and SNRIs but it keeps getting deleted with little or no explanation. Can I add it here or will someone get offended (or maybe hurt in his/her economic interests)? AndreaGMonaco ( talk) 17:03, 8 March 2021 (UTC).
Research by Irving Kirsch, David D. Burns and many others contends that most studies on so-called antidepressant medication are confounded by several biases: for example the lack of an active placebo, which means that many people in the placebo arm of a double-blind study may figure out that they are not getting any true treatment, thus destroying double-blindness; a short follow up after termination of treatment; studies being paid for by the industry; selective publication of results. [1] [2] [3] [4]
Most studies on antidepressant medication find small positive effects, barely above statistical significance and clearly below clinical significance. Taking into account all of the aforementioned biases, which all play in favor of the drugs, this line of research contends that all currently existing so-called antidepressants have no beneficial effect and have worse adverse effects than is currently thought. In the conclusions of a 2019 meta-review by Jakobsen, Gluud and Kirsch: "The benefits of antidepressants seem to be minimal and possibly without any importance to the average patient with major depressive disorder. Antidepressants should not be used for adults with major depressive disorder before valid evidence has shown that the potential beneficial effects outweigh the harmful effects." [5]
References
It has by now been well-documented that there are a number of unacceptable and significant flaws in the antidepressant research literature, particularly in the early trials conducted in the 90s/00s. In some cases this has led to significant public scandals, as in Study 329 or in Lilly's practice of misclassifying suicides. The flaws in the original trials mean that in many cases the prominent meta-analyses (such as Cipriani's) have had to use low-quality or uncertain evidence. Considering the magnitude of the problem, it is not well-represented in the article, given only a few sentences under MDD and a well-sourced but incomplete treatment in pharmacology. Some issues, such as widespread misreporting and ghostwriting, are mentioned only in passing or not at all. The problems with the literature should be substantially explicated somewhere in the article, possibly even with its own section or at least subsection. When I have the time I will try to do so. Feline negativity ( talk) 08:04, 16 January 2023 (UTC)
There appears to have been a bit of edit-warring about akathisia as a common side effect. Akathisia doesn't seem to be mentioned elsewhere in the article. It is well-known that akathisia can be a side effect of antidepressants, there are countless case reports and I believe the package inserts also mention it. The trouble is that as far as I can tell there are no reliable estimates of how common akithisia actually is. I'll keep looking but if someone does have a source on how often it occurs it would be very helpful. Feline negativity ( talk) 14:12, 24 February 2023 (UTC)
The pharmacology section seems to mainly be about addressing the criticisms of the monoamine hypothesis and antidepressants in general. It is relevant to reference these, but I think it would be fair to mention other documented indirect effects of (certain) antidepressants such as increased BDNF expression and down-regulation of certain serotonin receptors as well. I am not a medical professional so maybe someone who knows about neuropsychopharmacology could provide some information/sources. 83.233.200.105 ( talk) 18:25, 12 March 2023 (UTC)
This is the
talk page for discussing improvements to the
Antidepressant article. This is not a forum for general discussion of the article's subject. |
Article policies
|
Find medical sources: Source guidelines · PubMed · Cochrane · DOAJ · Gale · OpenMD · ScienceDirect · Springer · Trip · Wiley · TWL |
Archives: Index, 1, 2Auto-archiving period: 30 days |
This article is written in American English, which has its own spelling conventions (color, defense, traveled) and some terms that are used in it may be different or absent from other varieties of English. According to the relevant style guide, this should not be changed without broad consensus. |
This
level-5 vital article is rated B-class on Wikipedia's
content assessment scale. It is of interest to the following WikiProjects: |
|||||||||||||||||||||||||||||||
|
Ideal sources for Wikipedia's health content are defined in the guideline
Wikipedia:Identifying reliable sources (medicine) and are typically
review articles. Here are links to possibly useful sources of information about Antidepressant.
|
Daily pageviews of this article
A graph should have been displayed here but
graphs are temporarily disabled. Until they are enabled again, visit the interactive graph at
pageviews.wmcloud.org |
Hi @ Doc James: I made another edit to that sentence in the lede. Please let me know what you think.
I'm curious about why you removed the link from the "see also" section to the Management of depression article. I think that the link is good to include there. ↠Pine (✉) 01:40, 24 April 2020 (UTC)
According to a rich line of research by Kirsch, Burns and others, there are systematic biases in most research about antidepressants. Keeping in mind that all current research finds tiny effects barely above statistical significance, and definitely below clinical significance, that means that probably all so-called antidepressants are just placebos with underestimated adverse effects.
I tried to add a small paragraph with sources about that in articles on common SSRIs and SNRIs but it keeps getting deleted with little or no explanation. Can I add it here or will someone get offended (or maybe hurt in his/her economic interests)? AndreaGMonaco ( talk) 17:03, 8 March 2021 (UTC).
Research by Irving Kirsch, David D. Burns and many others contends that most studies on so-called antidepressant medication are confounded by several biases: for example the lack of an active placebo, which means that many people in the placebo arm of a double-blind study may figure out that they are not getting any true treatment, thus destroying double-blindness; a short follow up after termination of treatment; studies being paid for by the industry; selective publication of results. [1] [2] [3] [4]
Most studies on antidepressant medication find small positive effects, barely above statistical significance and clearly below clinical significance. Taking into account all of the aforementioned biases, which all play in favor of the drugs, this line of research contends that all currently existing so-called antidepressants have no beneficial effect and have worse adverse effects than is currently thought. In the conclusions of a 2019 meta-review by Jakobsen, Gluud and Kirsch: "The benefits of antidepressants seem to be minimal and possibly without any importance to the average patient with major depressive disorder. Antidepressants should not be used for adults with major depressive disorder before valid evidence has shown that the potential beneficial effects outweigh the harmful effects." [5]
References
It has by now been well-documented that there are a number of unacceptable and significant flaws in the antidepressant research literature, particularly in the early trials conducted in the 90s/00s. In some cases this has led to significant public scandals, as in Study 329 or in Lilly's practice of misclassifying suicides. The flaws in the original trials mean that in many cases the prominent meta-analyses (such as Cipriani's) have had to use low-quality or uncertain evidence. Considering the magnitude of the problem, it is not well-represented in the article, given only a few sentences under MDD and a well-sourced but incomplete treatment in pharmacology. Some issues, such as widespread misreporting and ghostwriting, are mentioned only in passing or not at all. The problems with the literature should be substantially explicated somewhere in the article, possibly even with its own section or at least subsection. When I have the time I will try to do so. Feline negativity ( talk) 08:04, 16 January 2023 (UTC)
There appears to have been a bit of edit-warring about akathisia as a common side effect. Akathisia doesn't seem to be mentioned elsewhere in the article. It is well-known that akathisia can be a side effect of antidepressants, there are countless case reports and I believe the package inserts also mention it. The trouble is that as far as I can tell there are no reliable estimates of how common akithisia actually is. I'll keep looking but if someone does have a source on how often it occurs it would be very helpful. Feline negativity ( talk) 14:12, 24 February 2023 (UTC)
The pharmacology section seems to mainly be about addressing the criticisms of the monoamine hypothesis and antidepressants in general. It is relevant to reference these, but I think it would be fair to mention other documented indirect effects of (certain) antidepressants such as increased BDNF expression and down-regulation of certain serotonin receptors as well. I am not a medical professional so maybe someone who knows about neuropsychopharmacology could provide some information/sources. 83.233.200.105 ( talk) 18:25, 12 March 2023 (UTC)