Recent Meta-Analyses of Antidepressant Medication Effectiveness

In 2018, The Lancet published the most ambitious and authoritative meta-analysis of antidepressant outcome studies to date: 522 trials of 21 different medications, with over 116,000 participants in all. This study was taken as a repudiation of past meta-analytic work that had cast doubt on whether these medications are substantially more effective than inert placebo.

The media response was immediate and overwhelming, proclaiming the debate settled, firmly establishing the overwhelming helpfulness of these medications and resulting in calls for their more widespread use. (This would be difficult to achieve, however, because current prescription rates in many countries exceed the estimated number of people to have depression in total.) The UK's Royal College of Psychiatrists declared that the study "puts to bed the controversy on anti-depressants."

But does it? The question is relevant, as millions of people are prescribed these medications every year. It would be wonderful to learn that the debate is over and that past critics have been over-ruled by this much more ambitious study. The challenge is that the 2018 study was presented primarily in the form of Odds Ratio data, which is widely misinterpreted by practitioners and the media. When we look at the actual effect size found in the study, and the actual proportion of people improving in medication versus placebo conditions, the picture becomes more nuanced - and what looked like a repudiation of previous findings seems instead to have been a replication of prior disappointing outcomes.

This is a filmed version of a presentation to the annual meeting of the Canadian Psychological Association in 2021.

I also provide continuing education online courses for professionals, as well as live and on-demand courses for the general public and organizations.

[ЛенираСимонияАлбукеркедеМоураК]

Thank you very much for this video! Very helpful information.

[marcjohnson]

This helped so much with my psych assignment thank you 😊

[heatherbaitz]

Thank-you for this clear and informative presentation!

[sociolocomtsac]

Thank you for this in-depth analysis. Seems like we need to understand the underlying mechanisms first to come up with a clearly efficacious AD.

[valeriejoylauria]

thank you very much for this video. I never knew this, as I'm sure many people don't . Unfortunately that gives is depressed people let's hope.

What are we to do?

[ashdot]

Anti-depressants just made my anhedonia deeper and really did nothing for my depression.

Good videos as always though