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Healthy Skepticism Library item: 15310

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Journal Article

Leo J, Lacasse JR.
Clinical Trials of Therapy versus Medication: Even in a Tie, Medication wins
BMJ 2009 Mar 5; Rapid response
http://www.bmj.com/cgi/eletters/338/feb05_1/b463#211098


Abstract:

Central to the idea of evidence-based medicine is that the choices made by patients and doctors to use a certain treatment should at least in part be based on scientific studies published in peer reviewed academic journals. For a patient diagnosed with a mental disorder, the choice often comes down to whether to use behavioral therapy, psychotropic medications, or a combination of the two. We think the following story will shed some light on how conflicts of interest can complicate the decision making process.

Earlier this year, The Journal of the American Medical Association (JAMA) published a study examining the efficacy of both Lexapro, an SSRI, and problem-solving therapy in undepressed, recovering stroke patients.1 The study found that recovering stroke patients treated with either therapy or medication were less likely to be subsequently diagnosed with depression. After one year, 22% of the placebo group developed depression, while only 9% of the Lexapro group and 12% of the therapy group did. Following the study’s publication there were numerous articles in the mainstream media extolling the benefits of the SSRIs. For instance, in USA Today, the lead author of the study stated: “I hope I don’t have a stroke, but if I do, I would certainly want to be on an antidepressant.“2 …

 

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What these howls of outrage and hurt amount to is that the medical profession is distressed to find its high opinion of itself not shared by writers of [prescription] drug advertising. It would be a great step forward if doctors stopped bemoaning this attack on their professional maturity and began recognizing how thoroughly justified it is.
- Pierre R. Garai (advertising executive) 1963