Research Article

Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration

  • Irving Kirsch mail,

    To whom correspondence should be addressed. E-mail:

    Affiliation: Department of Psychology, University of Hull, Hull, United Kingdom

  • Brett J Deacon,

    Affiliation: University of Wyoming, Laramie, Wyoming, United States of America

  • Tania B Huedo-Medina,

    Affiliation: Center for Health, Intervention, and Prevention, University of Connecticut, Storrs, Connecticut, United States of America

  • Alan Scoboria,

    Affiliation: Department of Psychology, University of Windsor, Windsor, Ontario, Canada

  • Thomas J Moore,

    Affiliation: Institute for Safe Medication Practices, Huntingdon Valley, Pennsylvania, United States of America

  • Blair T Johnson

    Affiliation: Center for Health, Intervention, and Prevention, University of Connecticut, Storrs, Connecticut, United States of America

  • Published: February 26, 2008
  • DOI: 10.1371/journal.pmed.0050045

Reader Comments (48)

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Media coverage

Posted by plosmedicine on 31 Mar 2009 at 00:21 GMT

Author: Graham Steel
Position: No occupation was given
Institution: No affiliation was given
Submitted Date: February 27, 2008
Published Date: February 27, 2008
This comment was originally posted as a “Reader Response” on the publication date indicated above. All Reader Responses are now available as comments.

I wish to congratulate the authors of this Paper for obtaining published/unpublished data and then publishing the results/analysis in an OA Journal.

This Paper has received a phenomenal amount of media coverage. I was encouraged to note that a substantial number of these link back to the Paper/Journal. I therefore felt is appropriate to have this on record.

I don't know the subject matter well enough to make specific comments myself. I am therefore unable to judge how accurately the coverage has been.

I would however wish to quote the following from Dr Ben Goldacre from his Bad Science blog which I read regularly:-

"It seems to me that the media walk around with big sticky labels marked “good” and “bad”. This meta-analysis is a fascinating bit of work, and it tells a damning story about the pharmaceutical industry’s burying data, but it has also been ridiculously misreported, in the first day of its life.

1. It was not a study of SSRI antidepressant drugs: neither nefazodone nor venlafaxine are SSRI drugs.

2. It did not look at all the trials ever done on these drugs: it looked only at the trials done before the drugs were licensed (none of them more than six weeks long), and specifically excluded all the trials done after they were licensed. It is common for quacks and journalists to think that the moment of licensing is some kind of definitive “it works” stamp of approval. It’s not, it’s just the beginning of the story of a drugs’ evidence, usually.

3. It did not show that these drugs have no benefit over placebo: it showed that they do have a statistically significant (”measurable”) benefit over placebo, but for mild and moderate depression that benefit was not big enough for most people to consider it clinically significant, ie there was an improvement, but not enough points improvement on a depression rating scale for anyone to get too excited over it.

4. I could go on.

And remember kids, placeboes are amazingly powerful."


No competing interests declared.