Bschor Tom, Kilarski Laura L
a Department of Psychiatry , Schlosspark-Hospital , Berlin , Germany.
b Department of Psychiatry and Psychotherapy , University Hospital, Technical University of Dresden , Dresden , Germany.
Expert Rev Neurother. 2016;16(4):367-74. doi: 10.1586/14737175.2016.1155985. Epub 2016 Mar 17.
Recently, the efficacy of antidepressants, a treatment used by 11% of US American adults, has been debated. Thousands of randomized controlled trials (RCTs) have been used to study antidepressants, with the majority demonstrating at least moderate superiority over placebo. In contrast, studies have found antidepressant effects to be unspecific and mainly resulting from placebo. The effects of antidepressants may also be overestimated due to selective publishing and selection of patients who have a high chance of response in RCTs. Studies have also shown the drugs do not reduce suicidal events when compared to placebo, and efficacy differences to placebo are often too small to prove clinical relevance. Here, we review the claims for and against antidepressant efficacy.
最近，抗抑郁药的疗效引发了争论，11%的美国成年人使用这种治疗方法。数千项随机对照试验（RCT）被用于研究抗抑郁药，大多数试验表明其至少比安慰剂有中度优势。相比之下，研究发现抗抑郁药的效果不具有特异性，主要是由安慰剂效应导致的。由于选择性发表以及在随机对照试验中选择有高反应几率的患者，抗抑郁药的效果可能也被高估了。研究还表明，与安慰剂相比，这些药物并不能减少自杀事件，而且与安慰剂的疗效差异往往太小，无法证明其临床相关性。在此，我们回顾了支持和反对抗抑郁药疗效的观点。
