Kirsch, Irving. "The Emperor's New Drugs: An Analysis of Antidepressant Medication Data Submitted to the U.S. Food and Drug Administration." Prevention & Treatment, Vol. 5, Article 23. 2002.
The present article reports analyses of a data set to which these objections do not apply, namely, the data submitted to the U.S. Food and Drug Administration (FDA) for approval of recent antidepressant medications. We analyzed the efficacy data submitted to the FDA for the six most widely prescribed antidepressants approved between 1987 and 1999 (RxList: The Internet Drug Index, 1999): fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), venlafaxine (Effexor), nefazodone (Serzone), and citalopram (Celexa). These represent all but one of the selective serotonin reuptake inhibitors (SSRI) approved during the study period. The FDA data set includes analyses of data from all patients who attended at least one evaluation visit, even if they subsequently dropped out of the trial prematurely. Results are reported from all well controlled efficacy trials of the use of these medications for the treatment of depression. FDA medical and statistical reviewers had access to the raw data and evaluated the trials independently. The findings of the primary medical and statistical reviewers were verified by at least one other reviewer, and the analysis was also assessed by an independent advisory panel. More important, the FDA data constitute the basis on which these medications were approved. Approval of these medications implies that these particular data are strong enough and reliable enough to warrant approval. To the extent that these data are flawed, the medications should not have been approved.
Oh, snap! And more:
Although mean differences were small, most of them favored the active drug, and overall, the difference was statistically significant. There were only 4 trials in which mean improvement scores in the placebo condition were equal to or higher than those in the drug condition, and in no case was placebo significantly more effective than active drug. This may indicate a small but significant drug effect. However, it is also possible that this difference between drug and placebo is an enhanced placebo effect due to the breaking of blind.Uh... man. It's so much easier to just trust the people who claim to have read all of this stuff and understood it, isn't it? Okay. I give up. I don't know what this stuff means. Too hard. I'll let it rest if there are no other directions to look than scholarly publications.