Dogs bark, but the caravan goes on: A discussion on the meta-analysis of antidepressants by Andrea Cipriani et al.

Article type: Article Commentary

Authors: Makovec, Tomaž^a

Affiliations: [a] Medical Faculty, University of Ljubljana, Ljubljana, Slovenia E-mail: [email protected]

Correspondence: [*] E-mail: [email protected]

Abstract: BACKGROUND:In the case of depression (and other psychiatric disorders), a huge number of scientists have been trying for decades to establish and postulate the disease-based drug concept for antidepressants and these efforts have not born fruits. OBJECTIVE:To show that the discussions about statistical significance of the efficiency of the antidepressants over placebo are non-productive and irrelevant. METHOD:Researching the history of the onset of a chemical imbalance theory in the brain and the launch of antidepressants according to the drug-based disease model was the basis for doubting the appropriateness of using antidepressants in the treatment of depression. RESULTS:Antidepressants (AD), as their name suggests, are supposed to address a disease-specific model to reverse the neuropathological basis of depression. However, science has not constituted the theory, using various brain imagining techniques or measuring the concentration of serotonin in various body liquids, that depression is characterized by the lack of serotonin in synapses and then created a substance that would block the reuptake of this neurotransmitter or in some other ways elevate its content. CONCLUSION:Even the reductionistic phase of the AD story, the mechanism of action, failed to be consistent so it is unclear how the largest meta-analysis of about 21 antidepressants by Andrea Cipriani et al. appeared in The Lancet.

Keywords: Antidepressants, risk-benefit ratio, meta-analysis

DOI: 10.3233/JRS-190049

Journal: International Journal of Risk & Safety in Medicine, vol. 31, no. 3, pp. 149-155, 2020