Astral Codex Ten Podcast

SSC Journal Club Cipriani on Antidepressants


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The big news in psychiatry this month is Cipriani et al's Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. It purports to be the last word in the "do antidepressants work?" question, and a first (or at least early) word in the under-asked "which antidepressants are best?" question.

This study is very big, very sophisticated, and must have taken a very impressive amount of work. It meta-analyzes virtually every RCT of antidepressants ever done – 522 in all – then throws every statistical trick in the book at them to try to glob together into a coherent account of how antidepressants work. It includes Andrea Cipriani, one of the most famous research psychiatrists in the world – and John Ioannidis, one of the most famous statisticians. It's been covered in news sources around the world: my favorite headline is Newsweek's unsubtle Antidepressants Do Work And Many More People Should Take Them, but honorable mention to Reuters' Study Seeks To End Antidepressant Debate: The Drugs Do Work.

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Astral Codex Ten PodcastBy Jeremiah

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