“Reassuring results”

This “systematic umbrella review” by Dragioti et al was published in The Journal of the American Medical Association [JAMA]on the 2 October 2019.

The President of the Royal College of Psychiatrists, Professor Wendy Burn, stated that this review provided “reassuring results” and went on to say that “this paper finds that antidepressants are generally safe, and indicates that they protect from suicide in adults.”

The summary of the paper, as given by the authors, is as follows:

A few thoughts:

Whilst this “umbrella review” found little convincing evidence of harm, this does not imply that they found convincing evidence that antidepressants are safe. Furthermore this review did NOT include common adverse effects such as sexual dysfunction and did not include antidepressant dependence and withdrawal. Other adverse effects that were not addressed in this review include metabolic dysfunction (including weight gain), cardiovascular disease, and dementia.

The President of the Royal College of Psychiatrists states that this review “indicates that antidepressants protect from suicide in adults”. However I cannot find the evidence in this review that convinces me that such a conclusion can be made.

I look forward to academics more able than I am, looking more closely at this review, and responding to the broad message given out: that we can be “reassured” on the safety of antidepressants.

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