FacebookTwitterGoogle+RedditEmail

The Depressing Truth About Anti-Depressants

A paper published January 17 in a prestigious medical journal demonstrated in the starkest of terms how pharmaceutical companies tend to publish research that’s favorable to their products and leave unfavorable results tucked away in their files. It’s a problem that everyone outside the industry already recognizes, but the results of this most recent study should really set off alarms.

Led by Dr. Erick Turner of the Oregon Health and Science University in Portland and published in the New England Journal of Medicine [1], the study took the results of 74 Food and Drug Administration (FDA)-registered trials of antidepressant medications (trials done by the companies that developed the drugs) and compared them with the results that the drug companies published in peer-reviewed medical journals. The study involved 12 antidepressants approved between 1987 and 2004.

In seeking approval of new drugs, companies are required by law to register their clinical trials with the FDA before conducting them, and then report results to the agency when they’re done. Of those 74 trials, the survey found 38 that showed antidepressants to be effective, and all but one of those was duly published. But stunningly, out of 36 trials that showed the drugs to be of questionable or no benefit, the results from only 3 trials were published accurately. Of the rest, 22 were not published at all. All of the other 11 that were published concluded that the drugs did have a positive benefit, in direct contradiction of FDA’s conclusion.

So, in the authors’ words, “studies that the FDA judged as positive were approximately 12 times as likely to be published in a way that agreed with the FDA as were studies with nonpositive results.” And it wasn’t just a matter of holding back results. Trial-by-trial, the beneficial effects of antidepressants as published in medical journals were 18 percent bigger than those recorded in the official FDA data. The authors don’t speculate on how this effectiveness-inflation occurred, but combined with selective publication of positive results, it made antidepressants look a lot better than they really are.

Antidepressants are the most frequently prescribed class of drugs in the US, with about 60,000 prescriptions written every working hour. Encouraged by all those favorable journal papers, doctors tripled their prescription-writing for antidepressants between 1988 and 1998 [2], and prescriptions had shot up another 31 percent by 2005. The greatest increase has come among doctors who are not psychiatrists. The products have become a convenient way to deal with people who find themselves in rough situations. Soldiers in Afghanistan and Iraq are reportedly being given “bags of antidepressants” and upwards of one-third of nursing-home residents are taking antidepressants at any given time.

FDA registration is designed to curtail the kind of deceptive publication practices that can boost unnecessary prescribing, and their data for more recently developed drugs are available on the agency’s website. (But getting data for the eight older drugs examined by Turner and colleagues required use of the Freedom of Information Act). Most academics, journalists, and others looking to inform the public on a drug’s overall usefulness rely on studies published in medical journals as being the “gold standard” for reliability. So biased publishing, coming on top of heavy advertising [pdf], overtesting [3], and close interaction between sales reps and doctors, is a highly effective way to improve the market for a drug.

Turner’s study looked only for exaggeration of antidepressants’ benefits, not at their often terrible side effects. But selective publication can also keep the public in the dark about serious harm that drugs can do. Most infamously, Merck & Co. was accused of leaving out some negative results and spinning others from trials of the pain-reliever Vioxx, when a study of the drug’s association with an increased risk of heart attack was submitted to the New England Journal of Medicine. By the time Vioxx was withdrawn in 2004, FDA estimated that it had caused in the range of 25,000 to 50,000 fatal heart attacks.

Each year, the drug industry churns out enough product to fill more than 15 prescriptions per American, and that adds up to more than $200 billion in annual sales. An international survey of the medical literature showing that around 5 percent of hospital admissions result from avoidable adverse drug reactions [4]; that means about 2 million of the pharmaceutical industry’s customers end up needlessly hospitalized each year. Countless other people are suffering side effects without even taking the drugs; they are simply living too close to pharmaceutical factories in India and other countries that export to the US.

It’s a depressing situation, one that can be resolved only by taking drug testing out of the hands of the corporations themselves.

STAN COX is a plant breeder and writer in Salina, Kansas. His book Sick Planet: Corporate Food and Medicine will be published by Pluto Press in April. They can be reached at: t.stan@cox.net.

Notes

1. E.H. Turner et al., ‘Selective publication of antidepressant trials and its influence on apparent efficacy’, New England Journal of Medicine, 358: 252 (2008)

2. S.M. Foote and L. Etheredge, ‘Increasing use of new prescription drugs: a case study’, Health Affairs, Jul-Aug, 2000

3. D. Studdert et al., ‘Defensive medicine among high-risk specialist physicians in a volatile malpractice environment’, Journal of the American Medical Association 293: 2609 (2005) and D. Merenstein et al., ‘Use and costs of nonrecommended tests during routine preventive health exams’, American Journal of Preventive Medicine 30: 521 (2006).

4. H.J.M. Beijer and C.J. de Blaey, ‘Hospitalisations caused by adverse drug reactions (ADR): a meta-analysis of observational studies’, Pharmacy World and Science 24: 46 (2002)

 

 

 

 

More articles by:

Stan Cox (@CoxStan) is an editor at Green Social Thought, where this article first ran. He is author of Any Way You Slice It: The Past, Present, and Future of Rationing and, with Paul Cox, of How the World Breaks: Life in Catastrophe’s Path, From the Caribbean to Siberia

Weekend Edition
September 21, 2018
Friday - Sunday
Alexandra Isfahani-Hammond
Hurricane Florence and 9.7 Million Pigs
Andrew Levine
Israel’s Anti-Semitism Smear Campaign
Paul Street
Laquan McDonald is Being Tried for His Own Racist Murder
Brad Evans
What Does It Mean to Celebrate International Peace Day?
Nick Pemberton
With or Without Kavanaugh, The United States Is Anti-Choice
Jim Kavanagh
“Taxpayer Money” Threatens Medicare-for-All (And Every Other Social Program)
Jonathan Cook
Palestine: The Testbed for Trump’s Plan to Tear up the Rules-Based International Order
Jeffrey St. Clair
Roaming Charges: the Chickenhawks Have Finally Come Back Home to Roost!
David Rosen
As the Capitalist World Turns: From Empire to Imperialism to Globalization?
Jonah Raskin
Green Capitalism Rears Its Head at Global Climate Action Summit
James Munson
On Climate, the Centrists are the Deplorables
Robert Hunziker
Is Paris 2015 Already Underwater?
Arshad Khan
Will Their Ever be Justice for Rohingya Muslims?
Jill Richardson
Why Women Don’t Report Sexual Assault
Dave Clennon
A Victory for Historical Accuracy and the Peace Movement: Not One Emmy for Ken Burns and “The Vietnam War”
W. T. Whitney
US Harasses Cuba Amid Mysterious Circumstances
Nathan Kalman-Lamb
Things That Make Sports Fans Uncomfortable
George Capaccio
Iran: “Snapping Back” Sanctions and the Threat of War
Kenneth Surin
Brexit is Coming, But Which Will It Be?
Louis Proyect
Moore’s “Fahrenheit 11/9”: Entertaining Film, Crappy Politics
Ramzy Baroud
Why Israel Demolishes: Khan Al-Ahmar as Representation of Greater Genocide
Ben Dangl
The Zapatistas’ Dignified Rage: Revolutionary Theories and Anticapitalist Dreams of Subcommandante Marcos
Ron Jacobs
Faith, Madness, or Death
Bill Glahn
Crime Comes Knocking
Terry Heaton
Pat Robertson’s Hurricane “Miracle”
Dave Lindorff
In Montgomery County PA, It’s Often a Jury of White People
Louis Yako
From Citizens to Customers: the Corporate Customer Service Culture in America 
William Boardman
The Shame of Dianne Feinstein, the Courage of Christine Blasey Ford 
Ernie Niemi
Logging and Climate Change: Oregon is Appalachia and Timber is Our Coal
Jessicah Pierre
Nike Says “Believe in Something,” But Can It Sacrifice Something, Too?
Paul Fitzgerald - Elizabeth Gould
Weaponized Dreams? The Curious Case of Robert Moss
Olivia Alperstein
An Environmental 9/11: the EPA’s Gutting of Methane Regulations
Ted Rall
Why Christine Ford vs. Brett Kavanaugh is a Train Wreck You Can’t Look Away From
Lauren Regan
The Day the Valves Turned: Defending the Pipeline Protesters
Ralph Nader
Questions, Questions Where are the Answers?
Binoy Kampmark
Deplatforming Germaine Greer
Raouf Halaby
It Should Not Be A He Said She Said Verdict
Robert Koehler
The Accusation That Wouldn’t Go Away
Jim Hightower
Amazon is Making Workers Tweet About How Great It is to Work There
Robby Sherwin
Rabbi, Rabbi, Where For Art Thou Rabbi?
Vern Loomis
Has Something Evil This Way Come?
Steve Baggarly
Disarm Trident Walk Ends in Georgia
Graham Peebles
Priorities of the Time: Peace
Michael Doliner
The Department of Demonization
David Yearsley
Bollocks to Brexit: the Plumber Sings
FacebookTwitterGoogle+RedditEmail