Publication bias contributes to misperception by doctors that antidepressants are safer, more effective than they really are, new study suggests.
Psychiatric journals are less likely to publish studies that find antidepressants increase the risk of suicide than studies that suggest they do not, a new study reports. The publication bias contributes to a misperception by doctors that antidepressants are safer and more effective in preventing suicide than they really are, the study suggests.
Researchers at universities in Austria and Switzerland noted that the prevailing view in psychiatry is that antidepressants are effective in preventing suicide, despite studies showing no clear preventive benefit or even an increased risk of suicide from antidepressants.
To account for this misperception, researchers analyzed which of the studies reporting associations between antidepressant use and the risk of suicidal behavior were published in the journals intended for psychiatrists. Of the 27 studies available for analysis, not one study indicated a reduced risk of suicide from taking antidepressants, though the drugs may be prescribed for that purpose.
What the researchers found is that studies reporting unfavorable results (an increased risk of suicide) were less likely to be published in psychiatric journals than studies suggesting favorable results (no increased risk). They also found that lead authors with financial conflicts of interest from their ties to pharmaceutical companies published more favorable studies, and their studies were more likely to be published in psychiatric journals, than lead authors without ties to drug companies.
“This study provides evidence that research producing inconvenient results that challenge common clinical practice and discourse receive less scientific attention within academic psychiatry,” concluded lead author Martin Plöderl, PhD, a clinical psychologist at Paracelsus Medical University in Salzburg, Austria. The study was published in the Journal of Clinical Epidemiology, not a psychiatric journal.
The researchers included a recommendation that because fewer studies reporting unfavorable results from taking psychiatric drugs are published in psychiatric journals, doctors should look elsewhere to be fully informed about the drugs.
“Psychiatrists should be encouraged to inform themselves about potential harms of psychiatric drugs based on scientific sources outside of their field for a more balanced appraisal of the evidence,” the researchers advised.
They also warned that the increased risk of suicide from antidepressants “potentially poses a serious public health issue, given the widespread prescription of these drugs and the unsubstantiated claims [of no increased risk] within academic psychiatry.”
Antidepressant use has risen significantly over the past 15 years, and so have suicides and senseless acts of violence like mass shootings. In 2020, some 45 million Americans, or roughly one in seven, were taking antidepressants, up from 34 million in 2006. This 32% increase in users parallels the 35% increase in suicides in the U.S. over the same period. During this time, many school shootings and other acts of senseless violence were also committed by individuals taking antidepressants or in withdrawal from them. Psychiatrist Peter Breggin, M.D., describes antidepressants as neurotoxic because they harm and disrupt the functions of the brain, causing abnormal thinking and behaviors that include anxiety, irritability, hostility, aggressiveness, loss of judgment, impulsivity, and mania, which can lead to violence and suicide.
More fundamentally, a landmark 2022 study questioned the prescribing of antidepressants at all, after finding the common reason for taking them – to correct a chemical imbalance in the brain – had no scientific basis. The study investigated whether evidence supported the theory that a low level of the brain chemical serotonin causes depression.
“The serotonin theory of depression has been one of the most influential and extensively researched biological theories of the origins of depression,” the researchers wrote. “Our study shows that this view is not supported by scientific evidence. It also calls into question the basis for the use of antidepressants.”
The Citizens Commission on Human Rights (CCHR) continues to raise public awareness of the risks of serious side effects and withdrawal symptoms from antidepressants and other psychiatric drugs, so that consumers and their physicians can make fully informed decisions about starting or stopping the drugs.
WARNING: Anyone wishing to discontinue or change the dose of an antidepressant or other psychiatric drug is cautioned to do so only under the supervision of a physician because of potentially dangerous withdrawal symptoms.
CCHR also recommends a complete physical examination with lab tests, nutritional and allergy screenings, and a review of all current medications to identify any physical causes of depression or other unwanted mental and behavioral symptoms, which might otherwise be misdiagnosed and incorrectly treated as a psychiatric disorder.