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A new report in the New England Journal of Medicine found that studies of depression drugs were selectively published, so positive studies were promoted more frequently than the negative ones.
Per the study's authors, 'According to the published literature, it appeared that 94% of the trials conducted were positive. By contrast, the FDA analysis showed that 51% were positive.'
Not only does this report point to problems with the FDA drug approval process (as noted in the New York Times article), it also calls into question the increase in depression drug prescriptions that we've seen in recent years. In his book Surviving America's Depression Epidemic, author and clinical psychologist Bruce E. Levine, Ph.D. states:
'With the advent of Eli Lilly's serotonin-enhancer Prozac at the end of 1987, the general public and doctors began receiving a multi-billion dollar marketing blitz proclaiming that depression is caused by a deficiency of serotonin, and that this deficiency could be corrected by Prozac. Between 1987 and 1997, the percentage of Americans in outpatient treatment for depression more than tripled. Of those in treatment, the percentage prescribed medication almost doubled. In 1985 the total annual sales for all antidepressants in the U.S. was approximately $240 million, while today it is approximately $12 billion.'
While later studies were released casting doubt on the notion that depression is caused by serotonin deficiency, they were not widely publicized, according to Levine:
'The demise of the serotonin-deficiency theory of depression should not be considered news in 2007 because in 1998 The American Medical Association Essential Guide to Depression was already stating: ‘The link between low levels of serotonin and depressive illness is unclear, as some depressed people have too much serotonin.' That same year Elliot Valenstein, professor emeritus of psychology and neuroscience at the University of Michigan, in his book Blaming the Brain pointed out, ‘Furthermore, there is no convincing evidence that depressed people have a serotonin or norepinephrine deficiency.''
Yet since there was money to be made in pharmaceutical sales, depression drugs were still widely promoted to correct this deficiency. While the FDA approved these drugs, recent drug recalls and studies, cast a dubious light on this approval process. Levine notes:
In 2000 an article in USA Today, 'FDA Advisors Tied to Industry,' reported that in 55 percent of the FDA advisory meetings on drug approvals, half or more of the FDA advisers had financial connections to the interested drug company; and in 92 percent of these advisory meetings, at least one FDA adviser had a financial conflict of interest.
In his book, Levine proposes a more holistic approach to depression treatment that includes building morale, healing the source of depression and forming stronger bonds with family and community. To read more from Levine's book, see this Alternet article that ran late last year.