Putting the efficacy of psychiatric and general medicine medication into perspective: review of meta-analyses.
BACKGROUND
The efficacy of psychopharmacological treatments has been called into question. Psychiatrists are unfamiliar with the effectiveness of common medical drugs.


OBJECTIVE
To put the efficacy of psychiatric drugs into the perspective of that of major medical drugs.


METHODS
We searched Medline and the Cochrane Library for systematic reviews on the efficacy of drugs compared with placebo for common medical and psychiatric disorders, and systematically presented the effect sizes for primary efficacy outcomes.


RESULTS
We included 94 meta-analyses (48 drugs in 20 medical diseases, 16 drugs in 8 psychiatric disorders). There were some general medical drugs with clearly higher effect sizes than the psychotropic agents, but the psychiatric drugs were not generally less efficacious than other drugs.


CONCLUSIONS
Any comparison of different outcomes in different diseases can only serve the purpose of a qualitative perspective. The increment of improvement by drug over placebo must be viewed in the context of the disease's seriousness, suffering induced, natural course, duration, outcomes, adverse events and societal values.
Department of Psychiatry and Psychotherapy, Technische Universität München, Klinikum rechts der Isar, Ismaningerstr. 22, 81675 München, Germany. Stefan.Leucht@lrz.tum.de
Stefan
S
Leucht
Sandra
S
Hierl
Werner
W
Kissling
Markus
M
Dold
John M
JM
Davis
D015982:Bias; D016206:Databases, Bibliographic; D006801:Humans; D001523:Mental Disorders / Q000188:drug therapy; D015201:Meta-Analysis as Topic; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D004364:Pharmaceutical Preparations; D010919:Placebos; D011570:Psychiatry; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012196:Review Literature as Topic
D004364:Pharmaceutical Preparations; D010919:Placebos; D011619:Psychotropic Drugs