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Mark Zimmerman, M.D., en klinisk forsker ved Rhode Island Hospital, og hanss team analyserede det som er brugt i antidepressions effektivitets Studier (AET) og fandt ud af inklusion/exklusions kriteriet for AETs er blevet indsnævret så meget i de seneste fem år at de fleste patienter er exkluderet. Undersøgelsen er idag offenliggjort i Mayo Clinic Proceedings.

"Inklusion/exklusions kriteriet er blevet iindsnævret over de sidste fem år og det foreslår derfor at AETs kunne være endog mindre generaliseret end de var tidligere," sagde Zimmerman, direktør for outpatient psykiatri og det delvise hospitalsprogram ved Rhode Island Hospital og direktør for Rhode Islands Methods til forbedrinng af Diagnose Vurdering og Ydelser projektet [Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) ] en undersøgelse som integrerer forskernes vurderingsredskaber og procedurer med hospitalsforbundet outpatient prakses.


Kommentar: Det fremgår af resten af artiklen som er på engelsk at medicinalindustrien har indsnævret antidepressionsundersøgelserne, således at de fleste folk som er depressive bliver exkluderet. På den måde er det en nem måde for medicinalindustien at komme frem og sige at deres nye piller virker mod depression. Med andre ord ren fusk og bedrag uden nogen somhelst omsorg for patienterne. Det drejer sig om at sælge den sidste gift og få børsnoteringerne op deres aktier.

Se også: Medicinalmafiaen's syge metode


"More than a decade ago, our clinical research group raised concerns about the generalizability of AETs and suggested that the majority of patients seen in routine clinical practice would not qualify for an AET," Zimmerman added. "These results were replicated multiple times. We therefore wondered if drug companies changed how they recruited patients into studies. In fact, they have, but in an unexpected way. The more recent AETs are even less generalizable than the prior studies, which themselves excluded most depressed patients from drug company-sponsored treatment studies."

Zimmerman examined 170 placebo-controlled AETs published during the past 20 years, 56 of which were published during the past five years. The more recent studies were significantly more likely to: 1)exclude patients with comorbid Axis I disorders and personality disorders; 2)exclude patients because the episode duration was too long or too short; and 3)exclude patients who met diagnostic criteria for major depression but did not score high enough on a rating scale.

"For severely ill patients, such as those who express suicidal thoughts, it makes ethical sense to exclude them from a study where they may receive placebos," said Zimmerman. "However, excluding patients with co-morbid psychiatric disorders has become more frequent, and patients with any comorbid Axis I disorder are twice as likely to be excluded in recent studies. This is important because the majority of depressed patients have another psychiatric diagnosis. The exclusion of depressed patients who score too low on rating scales is the most concerning. This would exclude approximately half of the patients seen in clinical practice. In addition, studies have shown that antidepressants do not work as well for less severely depressed patients. Thus, drug companies seem to be stacking the deck to demonstrate that their products work, even though they might work only for a narrow segment of depressed patients."