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Publication bias and 'spin' raise questions about drugs for anxiety disorders
A new analysis raises serious questions about the increasingly common use of second-generation antidepressant drugs to treat anxiety disorders.
It concludes that studies supporting the value of these medications for that purpose have been distorted by publication bias, outcome reporting bias and "spin." Even though they may still play a role in treating these disorders, the effectiveness of the drugs has been overestimated.
Publication bias was one of the most serious problems. Bias in "outcome reporting" was also observed, in which the positive
outcomes from drug use were emphasized over those found to be negative. And simple spin was also reported.
"These findings mirror what we found previously with the same drugs when used to treat major depression, and with antipsychotics," said Erick Turner, M.D., associate professor of psychiatry in the OHSU School of Medicine, and the study's senior author. "When their studies don't turn out well, you usually won't know it from the peer-reviewed literature."
This points to a flaw in the way doctors learn about the drugs they prescribe, the researchers said.
"There is strong evidence that significant results from randomized controlled trials are more likely to be published than nonsignificant results," the researchers wrote in their study.
Antidepressants are now widely prescribed for conditions other than depression, the study noted. They are being used for generalized anxiety disorder, panic disorder, social anxiety, post-traumatic stress disorder and other uses.
Oregon State University, Oregon Health & Science University, and the University of Groningen in The Netherlands. JAMA Psychiatry
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