The efficacy of psychiatric drugs
By Liz Lockhart
Many debates have raged over whether the drugs used to treat mental health disorders are effective. Somebelieve that they offer great benefit whilst others think they are a waste of time and money. Concerns have also been expressed over commercial conflict of interest along with unclear mechanism of drug action and their side-effects.
A new press release from the Royal College of Psychiatrists offers interesting facts and figures on this subject which suggest that psychiatric drugs are ‘as effective as other drugs’.
The majority of us commonly accept the place of pharmacology in the treatment of physical illness and ailments, whether this be a cold remedy, pain relief or antibiotics, I am sure that nearly all of us will have used these drugs in the past. If we were to undergo an operation, the use of medication would not be disputed. However, when it comes to mental illness we may be a lot more sceptical, however, if we are to accept the findings of the study cited by the Royal College of Psychiatrists (RCPsych) we must accept that psychiatric drugs have an equal place alongside other drugs in the treatment of ill health.
The research was conducted by Technische Universitat Munich in Germany. Researchers examined 33 meta-analyses of 16 different drugs used to treat psychiatric disorders. These disorders include schizophrenia, bipolar disorder major depressive disorder, obsessive compulsive disorder, Alzheimer’s disorder and attention deficit hyperactivity disorder.
The researchers also examined 94 meta-analyses of 48 drugs used to treat medical diseases which include cardiovascular disease, hypertension, rheumatoid arthritis chronic asthma, type 2 diabetes and hepatitis C.
RCPsych explains that a meta-analysis is a ‘trial of trials’ where all properly conducted clinical trials of a particular treatment are studied to calculate the true benefits of that intervention.
Led by Professor Stefan Leucht, the research team compared the effect sizes of the different drugs and the results show that for psychiatric drugs the overall effect sizes were found to be in the same range as the general medicine drugs.
Antidepressants used to prevent patients having a relapse of major depressive disorder (maintenance treatment) had an effect size of 0.64. Antipsychotics used to prevent relapse in schizophrenia had an effect size of 0.92. An effect size of 0.2 is considered significant but low, and an effect size of 0.8 or above is considered high. Overall, taking all diseases into account, the mean effect sizes were only of medium size for both psychiatric and general medicine drugs.
‘We believe our study puts the effectiveness of psychiatric drugs and general medical drugs into perspective. There is a deep mistrust of psychiatry, fostered by reports suggesting that the efficacy of psychiatric drugs is very small. Psychiatrists, patients, carers and the media are often unsettled by these findings, and some may think that psychiatric medication is not worth the bother,’ said Professor Leucht.
‘There are reasons why people should be critical about psychiatric drug treatment, such as a lack of diagnostic tests, commercial conflict of interest, unclear mechanism of drug action and side-effects. But our study shows that the psychiatric drugs were not generally inferior to those used in other medical specialties, and the effectiveness of psychiatric drugs is supported by randomised controlled trials, Leucht concluded.
This study is published British Journal of Psychiatry 2012.
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