Polar opposite headlines on antidepressant effectiveness stories

A study published in JAMA this week drew markedly different news coverage. The LA Times headline read: “Study finds medication of little help to patients with mild, moderate depression.”

But the HealthDay wire service, whose story appeared on the websites of BusinessWeek, MSN, Yahoo News, and ABCNews.com among others, had a glaringly different headline and framing perspective that read: “Severely depressed gain most from antidepressants.”

The HealthDay story went on to state:

But the findings are not actually that surprising, said one expert, and don’t necessarily mean that people with mild-to-moderate depression should not try antidepressants.

“I’m not sure this is a finding that’s counter to giving medication to people with mild-to-moderate depression,” said Dr. Gregory Asnis, director of the anxiety and depression program at Montefiore Medical Center in New York City.

Why they conducted this interview but didn’t quote any of the study authors is odd.

The Times reported:

Hundreds of studies have attested to the benefits of antidepressants over placebos, (senior author Robert J. DeRubeis) said. But many studies involve only participants with severe depression. Confusion arises, he said, “because there is a tendency to generalize the findings to mean that all depressed people benefit from medications.”

That seems to be an important point.

Meantime, USA Today reported other important perspectives from the author and from another source:

“The health establishment needs to take stock and ask about costs and benefits” of antidepressants, DeRubeis says. Meanwhile, he says, his study “should give one pause” about prescribing antidepressants to mildly, moderately or even severely depressed patients. Instead, he says, doctors might want to consider non-drug options, such as exercise or psychotherapy.

Such findings “demonstrate a failure in the system: These drugs were not thoroughly tested in mild to moderate depression prior to their approval,” says Thomas Moore, a senior scientist at the Institute for Safe Medication Practices in Horsham, Pa., and co-author of the 2008 paper. “Any new antidepressants should be.”

So which is it?

• The study should give pause about prescribing antidepressants? or

• This is no reason to avoid meds?

Looks like it depends on which story you read.

(Addendum: Just moments after I posted this, I saw that MedPageToday.com posted its story on this study. It offers a very reasonable and wide-ranging look at the study, the questions it raises, and the possible limitations of the research.)