It almost seems to be an everyday issue, but more and more we see how drug trials that don’t show benefits are being either ignored, hidden or modified by the pharmaceutical industry. In a review of the studies on 12 antidepressant drugs, researchers led by Erick H. Turner found that 31% of the studies on these drugs went unpublished and the majority were negative or were conveyed to have a positive outcome which was contrary to the data. The paper was published in the New England Journal of Medicine, in their January 17, 2008 issue. What was truly remarkable was how much the perceived benefits of the drugs were changed because of the lack of publication of all of the data. According to the authors, if you looked at the published research, the antidepressant drugs had positive outcomes 94% of the time. If you include the unpublished research that number drops to a mere 51%. This is a huge difference and should make everyone think twice before agreeing to be put on the medications or at least safer, alternatives should be investigated first.
According to the papers conclusion, “We cannot determine whether the bias observed resulted from a failure to submit manuscripts on the part of authors and sponsors, from decisions by journal editors and reviewers not to publish, or both. Selective reporting of clinical trial results may have adverse consequences for researchers, study participants, health care professionals, and patients.” In my opinion, it is the sponsors who are probably most likely to apply pressure to stop publication. This would mean that the pharmaceutical industry is to blame. We need to take research on drug efficacy out of their hands and into the hands of real researchers without the onus of pressure and conflict of interest.
Why is this so damaging? When you do a search on meta-analysis of antidepressant drugs, you find a number that show how beneficial the drugs are, like the one by Drs. Dubika, Hadley and Roberts entitled, “Suicidal behaviour in youths with depression treated with new-generation antidepressants” published in the British Journal of Psychiatry in 2006. Would that study’s conclusion, which is that “Antidepressants may cause a small short-term risk of self-harm or suicidal events in children and adolescents with major depressive disorder” have changed to a large short-term risk or a small long-term risk or maybe worst case scenario, a large long-term risk? Chances are, based on the Turner paper that the answer is yes, the results would have changed but by how much, we cannot tell.
What we can say is that there is a major problem that needs a solution and it has to come sooner than later. How many of us are on medications that may not be helping us or maybe damaging our health and that of our loved ones?
So what do we do about it? Determine biochemical imbalances and toxicity influences on behavior as well as inflammatory processes that have been shown to cause depression in people for decades. The research exists but it is being downplayed by greedy pharmaceutical giants whose obvious intention is to make money at all costs and deflect criticism and downgrade safe alternatives.
Tomorrow, I will discuss a few tests I think are extremely helpful in working with mild to moderate depression in both adults and children.