Efficacy of new generation antidepressants: differences seem illusory.

<h4>Background</h4>Recently, Cipriani and colleagues examined the relative efficacy of 12 new-generation antidepressants on major depression using network meta-analytic methods. They found that some of these medications outperformed others in patient response to treatment. However, sever...

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Autores principales:	A C Del Re, Glen I Spielmans, Christoph Flückiger, Bruce E Wampold
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/698116d3bdaf4fa4a6c8609ba3d3c652
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spelling	oai:doaj.org-article:698116d3bdaf4fa4a6c8609ba3d3c6522021-11-18T07:43:18ZEfficacy of new generation antidepressants: differences seem illusory.1932-620310.1371/journal.pone.0063509https://doaj.org/article/698116d3bdaf4fa4a6c8609ba3d3c6522014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23755107/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Recently, Cipriani and colleagues examined the relative efficacy of 12 new-generation antidepressants on major depression using network meta-analytic methods. They found that some of these medications outperformed others in patient response to treatment. However, several methodological criticisms have been raised about network meta-analysis and Cipriani's analysis in particular which creates the concern that the stated superiority of some antidepressants relative to others may be unwarranted.<h4>Materials and methods</h4>A Monte Carlo simulation was conducted which involved replicating Cipriani's network meta-analysis under the null hypothesis (i.e., no true differences between antidepressants). The following simulation strategy was implemented: (1) 1000 simulations were generated under the null hypothesis (i.e., under the assumption that there were no differences among the 12 antidepressants), (2) each of the 1000 simulations were network meta-analyzed, and (3) the total number of false positive results from the network meta-analyses were calculated.<h4>Findings</h4>Greater than 7 times out of 10, the network meta-analysis resulted in one or more comparisons that indicated the superiority of at least one antidepressant when no such true differences among them existed.<h4>Interpretation</h4>Based on our simulation study, the results indicated that under identical conditions to those of the 117 RCTs with 236 treatment arms contained in Cipriani et al.'s meta-analysis, one or more false claims about the relative efficacy of antidepressants will be made over 70% of the time. As others have shown as well, there is little evidence in these trials that any antidepressant is more effective than another. The tendency of network meta-analyses to generate false positive results should be considered when conducting multiple comparison analyses.A C Del ReGlen I SpielmansChristoph FlückigerBruce E WampoldPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 6, p e63509 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q A C Del Re Glen I Spielmans Christoph Flückiger Bruce E Wampold Efficacy of new generation antidepressants: differences seem illusory.
description	<h4>Background</h4>Recently, Cipriani and colleagues examined the relative efficacy of 12 new-generation antidepressants on major depression using network meta-analytic methods. They found that some of these medications outperformed others in patient response to treatment. However, several methodological criticisms have been raised about network meta-analysis and Cipriani's analysis in particular which creates the concern that the stated superiority of some antidepressants relative to others may be unwarranted.<h4>Materials and methods</h4>A Monte Carlo simulation was conducted which involved replicating Cipriani's network meta-analysis under the null hypothesis (i.e., no true differences between antidepressants). The following simulation strategy was implemented: (1) 1000 simulations were generated under the null hypothesis (i.e., under the assumption that there were no differences among the 12 antidepressants), (2) each of the 1000 simulations were network meta-analyzed, and (3) the total number of false positive results from the network meta-analyses were calculated.<h4>Findings</h4>Greater than 7 times out of 10, the network meta-analysis resulted in one or more comparisons that indicated the superiority of at least one antidepressant when no such true differences among them existed.<h4>Interpretation</h4>Based on our simulation study, the results indicated that under identical conditions to those of the 117 RCTs with 236 treatment arms contained in Cipriani et al.'s meta-analysis, one or more false claims about the relative efficacy of antidepressants will be made over 70% of the time. As others have shown as well, there is little evidence in these trials that any antidepressant is more effective than another. The tendency of network meta-analyses to generate false positive results should be considered when conducting multiple comparison analyses.
format	article
author	A C Del Re Glen I Spielmans Christoph Flückiger Bruce E Wampold
author_facet	A C Del Re Glen I Spielmans Christoph Flückiger Bruce E Wampold
author_sort	A C Del Re
title	Efficacy of new generation antidepressants: differences seem illusory.
title_short	Efficacy of new generation antidepressants: differences seem illusory.
title_full	Efficacy of new generation antidepressants: differences seem illusory.
title_fullStr	Efficacy of new generation antidepressants: differences seem illusory.
title_full_unstemmed	Efficacy of new generation antidepressants: differences seem illusory.
title_sort	efficacy of new generation antidepressants: differences seem illusory.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/698116d3bdaf4fa4a6c8609ba3d3c652
work_keys_str_mv	AT acdelre efficacyofnewgenerationantidepressantsdifferencesseemillusory AT glenispielmans efficacyofnewgenerationantidepressantsdifferencesseemillusory AT christophfluckiger efficacyofnewgenerationantidepressantsdifferencesseemillusory AT bruceewampold efficacyofnewgenerationantidepressantsdifferencesseemillusory
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Efficacy of new generation antidepressants: differences seem illusory.

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