A blogger discussing it here(Improbable Research);
A cheerfully depressing investigation: “Which Placebo to Cure Depression?”
The abstract here; You do expect your doctor to have read all the associated research?
http://www.biomedcentral.com/1741-7015/11/230
1 INSERM U669, Maison de Solenn, 97 Boulevard de Port Royal, 75679 Paris Cedex 14, France
2 Université de Rennes 1, EA-4712 Behavior and Basal Ganglia Unit, Rennes, France
3 Centre Hospitalier Guillaume Régnier, Service Hospitalo-Universitaire de Psychiatrie, Rennes, France
4 Department of Forensic Medicine and Pathology, University Hospital R. Poincaré (AP-HP, UVSQ), Garches, France
5 Laboratory of Medical Ethics, University of Paris 5, 45 St Pères Street, 75006 Paris, France
6 Centre d’Investigation Clinique CIC-P INSERM 0203, Hôpital de Pontchaillou, Centre Hospitalier Universitaire de Rennes et Université de Rennes 1, Rennes, France
7 Laboratoire de Pharmacologie Expérimentale et Clinique, Faculté de Médecine, CS34317, 2 Avenue du Pr Léon Bernard, 35043 Rennes, France
8 Université Paris-Sud and Université Paris Descartes, UMR-S0669, Paris, France
9 AP-HP, Hôpital Paul Brousse, Département de santé publique, Villejuif, France
2 Université de Rennes 1, EA-4712 Behavior and Basal Ganglia Unit, Rennes, France
3 Centre Hospitalier Guillaume Régnier, Service Hospitalo-Universitaire de Psychiatrie, Rennes, France
4 Department of Forensic Medicine and Pathology, University Hospital R. Poincaré (AP-HP, UVSQ), Garches, France
5 Laboratory of Medical Ethics, University of Paris 5, 45 St Pères Street, 75006 Paris, France
6 Centre d’Investigation Clinique CIC-P INSERM 0203, Hôpital de Pontchaillou, Centre Hospitalier Universitaire de Rennes et Université de Rennes 1, Rennes, France
7 Laboratoire de Pharmacologie Expérimentale et Clinique, Faculté de Médecine, CS34317, 2 Avenue du Pr Léon Bernard, 35043 Rennes, France
8 Université Paris-Sud and Université Paris Descartes, UMR-S0669, Paris, France
9 AP-HP, Hôpital Paul Brousse, Département de santé publique, Villejuif, France
BMC Medicine 2013, 11:230
doi:10.1186/1741-7015-11-230
The electronic version of this article is the complete one and can be found online at: http://www.biomedcentral.com/1741-7015/11/230
The electronic version of this article is the complete one and can be found online at: http://www.biomedcentral.com/1741-7015/11/230
| Received: | 7 February 2013 |
| Accepted: | 4 October 2013 |
| Published: | 25 October 2013 |
© 2013 Naudet et al.; licensee BioMed Central Ltd.
This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background
Antidepressants are often considered to be mere placebos despite the fact that meta-analyses
are able to rank them. It follows that it should also be possible to rank different
placebos, which are all made of sucrose. To explore this issue, which is rather more
epistemological than clinical, we designed an unusual meta-analysis to investigate
whether the effects of placebo in one situation are different from the effects of
placebo in another situation.
Methods
Published and unpublished studies were searched for by three reviewers on Medline,
the Cochrane Library, Embase, clinicaltrials.gov, Current Controlled Trial, in bibliographies,
and by mailing key organizations. The following studies in first-line treatment for
major depressive disorder were considered to construct an “evidence network”: 1) randomized
controlled trials (RCTs) versus placebo on fluoxetine, venlafaxine and 2) fluoxetine
versus venlafaxine head-to-head RCTs.
Two network meta-analyses were run to indirectly compare response and remission rates
among three different placebos: 1) fluoxetine placebo, 2) venlafaxine placebo, and
3) venlafaxine/fluoxetine placebo (that is, placebo compared to both venlafaxine and
fluoxetine). Publication biases were assessed using funnel plots and statistically
tested.
Results
The three placebos were not significantly different in terms of response or remission.
The antidepressant agents were significantly more efficacious than the placebos, and
venlafaxine was more efficacious than fluoxetine. The funnel plots, however, showed
a major publication bias.
Conclusion
The presence of significant levels of publication bias indicates that we cannot even be certain of the conclusion that sucrose equals sucrose in trials of major depressive disorder.
A
cheerfully depressing investigation: “Which Placebo to Cure
Depression?” - See more at:
http://www.improbable.com/2013/12/08/a-cheerfully-depressing-investigation-which-placebo-to-cure-depression/#sthash.lZb70p6B.dpuf
A
cheerfully depressing investigation: “Which Placebo to Cure
Depression?” - See more at:
http://www.improbable.com/2013/12/08/a-cheerfully-depressing-investigation-which-placebo-to-cure-depression/#sthash.lZb70p6B.dpuf
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