What is the difference in the number of positive responders to SSRI's and placeb!
Question:
What is the difference in the number of positive responders to SSRI's and placebo?
In clinical trials what is on average the difference in the number of positive responders between SSRIs and placebo for the treatment of depression?
Please can you also refer to medical articles or websites if possible.
2 weeks ago
Thankyou thefreevariable it's a very interesting link.
2 weeks ago
Hi David D. thankyou for your interesting answer. Because of these differences in results, from none to large differences compared to placebo I do agree that doctors should discuss this with patients. The difference (whether subjective or measurable) between mild and severe depression should partly determine treatment measures.
Answers:
The answer to your question depends on what you mean by a couple of the words in it. What do you mean by "responder"? What do you mean by "depression"? Clinical trials vary in how they define those words.
Here is a good discussion of treatments from a website that's almost 10 years old:
http://www.mentalhealth.com/rx/p23-md01....
That NIMH study from 1989 and 1992 he refers to was an eye-opener for a lot of professionals. It showed lots of people doing well with mild depression, no matter how treated, including placebo. In severe depression, though, the placebo response wasn't the 30 - 50% that is often found. It was just 18%, while the response to the tricyclic antidepressant imipramine was 76%. It's not that antidepressants work better in sicker patients. It's that spontaneous improvement is less with very depressed people.
The biggest result of that study was that neither psychotherapy nor pharmacotherapy reached its full benefit in 16 weeks of treatment, so how long anyone was treated in a study is another variable besides the severity of depression.
"Depression" can mean anything from a little sadness to life-paralyzing lack of energy. There are lots of criteria and scales that try to quantify that in big groups, but for any particular individual it's very hard to say just how depressed he or she is with precision. That's why it makes much more sense to talk over what clinical trials mean to you with a mental health professional.