Skip to main content Accessibility help
×
Home

Initial depression severity and response to antidepressants v. placebo: patient-level data analysis from 34 randomised controlled trials

  • Jonathan Rabinowitz (a1), Nomi Werbeloff (a1), Francine S. Mandel (a2), François Menard (a3), Lauren Marangell (a4) and Shitij Kapur (a5)...

Summary

Several often-cited meta-analyses have reported that the efficacy of antidepressant medications depends on the severity of depression. They found that drug–placebo differences increased as a function of initial severity, which was attributed to decreased responsiveness to placebo among patients with severe depression rather than to increased responsiveness to medication. We retested this using patient-level data and also undertaking a meta-analysis of trial-level data from 34 randomised placebo controlled trials (n = 10 737) from the NEWMEDS registry. Although our trial-level data support prevous findings, patient-level data did not show any significant effect of initial depression severity on drug v. placebo difference.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Initial depression severity and response to antidepressants v. placebo: patient-level data analysis from 34 randomised controlled trials
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Initial depression severity and response to antidepressants v. placebo: patient-level data analysis from 34 randomised controlled trials
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Initial depression severity and response to antidepressants v. placebo: patient-level data analysis from 34 randomised controlled trials
      Available formats
      ×

Copyright

Corresponding author

Jonathan Rabinowitz, Bar Ilan University, Ramat Gan, Israel 52900. Email: Jonathan.Rabinowitz@biu.ac.il

Footnotes

Hide All

Declaration of interest

J.R. has received research support, and/or consultancy fees and/or travel support from Amgen, Janssen, JNJ, Eli Lilly, Pfizer, BiolineRx, F. Hoffmann-La Roche, Piere-Fabre, Kamada, Spatz Medical, Ethypharm and Avraham Pharmaceuticals and is on the scientific advisory board of MedAvante. F.M. is an employee of H. Lundbeck A/S. F.M. is an employee of Pfizer. L.M. was an employee of Eli Lilly and Company when this work was done. S.K. has received grant support from GSK and has served as a consultant and/or speaker for AstraZeneca, BiolineRx, BMS-Otsuka, Eli Lilly, Janssen (J&J), Lundbeck, Neuro-Search, Pfizer, F. Hoffmann-La Roche, Servier and Solvay Wyeth.

Footnotes

References

Hide All
1 Jarrett, C. The 10 most controversial psychology studies ever published. Res Dig: British Psychological Society 2014; 19 September (http://digest.bps.org.uk/2014/09/the-10-most-controversial-psychology.html).
2 Kirsch, I, Deacon, BJ, Huedo-Medina, TB, Scoboria, A, Moore, TJ, Johnson, BT. Initial severity and antidepressant benefits: a meta-analysis of data submitted to the Food and Drug Administration. PLoS Med 2008; 5: e45.
3 Fountoulakis, KN, Veroniki, AA, Siamouli, M, Moller, HJ. No role for initial severity on the efficacy of antidepressants: results of a multi-meta-analysis. Ann Gen Psychiatry 2013; 12: 26.
4 Khan, A, Leventhal, RM, Khan, SR, Brown, WA. Severity of depression and response to antidepressants and placebo: an analysis of the Food and Drug Administration database. J Clin Psychopharmacol 2002; 22: 40–5
5 Fournier, JC, DeRubeis, RJ, Hollon, SD, Dimidjian, S, Amsterdam, JD, Shelton, RC, et al. Antidepressant drug effects and depression severity: a patient-level meta-analysis. JAMA 2010; 303: 4753.
6 Institute of Medicine. Models of data sharing: THE NEWMEDS CONSORTIUM. Sharing Clinical Research Data: Workshop Summary: 3738. The National Academies Press, 2013 (http://www.nap.edu/read/18267/chapter/5#39).
7 Hamilton, M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1960; 23: 5662.
8 Montgomery, SA, Åsberg, M. A new depression scale designed to be sensitive to change. Br J Psychiatry 1979; 134: 382–9.
Type Description Title
PDF
Supplementary materials

Rabinowitz et al. supplementary material
Supplementary Material

 PDF (1.3 MB)
1.3 MB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Initial depression severity and response to antidepressants v. placebo: patient-level data analysis from 34 randomised controlled trials

  • Jonathan Rabinowitz (a1), Nomi Werbeloff (a1), Francine S. Mandel (a2), François Menard (a3), Lauren Marangell (a4) and Shitij Kapur (a5)...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *