Publication

Antidepressiva: al decennia voor­geschreven én toch nog steeds bekritiseerd; een perspectief op oorzaken en oplossingen

Ormel, J., Ruhé, H. G., Bockting, C. L. H., Nolen, W., Schene, A. H., Spijker, J., Ten Doesschate, M., Cramer, A. O. J., Verhaak, P. & Spinhoven, P., 2020, In : Tijdschrift voor Psychiatrie. 62, 3, p. 213-222 10 p.

Research output: Contribution to journalArticleAcademicpeer-review

APA

Ormel, J., Ruhé, H. G., Bockting, C. L. H., Nolen, W., Schene, A. H., Spijker, J., Ten Doesschate, M., Cramer, A. O. J., Verhaak, P., & Spinhoven, P. (2020). Antidepressiva: al decennia voor­geschreven én toch nog steeds bekritiseerd; een perspectief op oorzaken en oplossingen. Tijdschrift voor Psychiatrie, 62(3), 213-222. https://www.tijdschriftvoorpsychiatrie.nl/issues/550/articles/12140

Author

Ormel, J ; Ruhé, H G ; Bockting, C L H ; Nolen, W ; Schene, A H ; Spijker, J ; Ten Doesschate, M ; Cramer, A O J ; Verhaak, P ; Spinhoven, P. / Antidepressiva : al decennia voor­geschreven én toch nog steeds bekritiseerd; een perspectief op oorzaken en oplossingen. In: Tijdschrift voor Psychiatrie. 2020 ; Vol. 62, No. 3. pp. 213-222.

Harvard

Ormel, J, Ruhé, HG, Bockting, CLH, Nolen, W, Schene, AH, Spijker, J, Ten Doesschate, M, Cramer, AOJ, Verhaak, P & Spinhoven, P 2020, 'Antidepressiva: al decennia voor­geschreven én toch nog steeds bekritiseerd; een perspectief op oorzaken en oplossingen', Tijdschrift voor Psychiatrie, vol. 62, no. 3, pp. 213-222. <https://www.tijdschriftvoorpsychiatrie.nl/issues/550/articles/12140>

Standard

Antidepressiva : al decennia voor­geschreven én toch nog steeds bekritiseerd; een perspectief op oorzaken en oplossingen. / Ormel, J; Ruhé, H G; Bockting, C L H; Nolen, W; Schene, A H; Spijker, J; Ten Doesschate, M; Cramer, A O J; Verhaak, P; Spinhoven, P.

In: Tijdschrift voor Psychiatrie, Vol. 62, No. 3, 2020, p. 213-222.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

Ormel J, Ruhé HG, Bockting CLH, Nolen W, Schene AH, Spijker J et al. Antidepressiva: al decennia voor­geschreven én toch nog steeds bekritiseerd; een perspectief op oorzaken en oplossingen. Tijdschrift voor Psychiatrie. 2020;62(3):213-222.


BibTeX

@article{c4c7065361534d7e9d9a8f31d6fb16fb,
title = "Antidepressiva: al decennia voor­geschreven {\'e}n toch nog steeds bekritiseerd; een perspectief op oorzaken en oplossingen",
abstract = "BACKGROUND: From around 1980, antidepressants (ad) have increasingly been prescribed, for longer periods of time, especially selective serotonin reuptake inhibitors (ssris). Paradoxically, their effectiveness is still doubted, especially outside the psychiatric profession. AIM: To explain increase and offer a perspective on causes and solutions, and to indicate how to reach consensus. METHOD: Position paper with critical analysis and synthesis of relevant literature. RESULTS: The rise in AD prescriptions results from: 1. increased safety and ease of prescribing, 2. increased presentation and recognition of depression in primary care, 3. extension of indication criteria, 4. effective marketing strategies, and 5. effectiveness in acute phase (aad) and of relapse/recurrence prevention in continuation/maintenance phases (coad).Critics point to: 1. low added value of aad relative to placebo, 2. many drop-outs and non-responders, 3. relapse/recurrence prevention with coad works only for responders to aad, 4. relapse/recurrence after AD discontinuation often involves withdrawal symptoms, and 5. publication bias, selective reporting, selective patient selection, and suboptimal blinding, resulting in overestimated effectiveness and underestimated disadvantages.Factors that keep fueling the controversy are: 1. critics stress the net effectiveness of AD whereas proponents point at gross effectiveness which includes spontaneous recovery and placebo effect; 2. persistence of distrust in industry-funded rcts; 3. ideological positions, reinforced by conflicts of interest and selective citations; 4. lack of rcts with relevant long-term outcome measurements. CONCLUSION: Although consensus is difficult to achieve given the ideological component, there are options. Three factors are critically important: confer to establish which data convince the opposition, response prediction (what works for whom), and rcts with long-term functional outcomes.",
author = "J Ormel and Ruh{\'e}, {H G} and Bockting, {C L H} and W Nolen and Schene, {A H} and J Spijker and {Ten Doesschate}, M and Cramer, {A O J} and P Verhaak and P Spinhoven",
year = "2020",
language = "Dutch",
volume = "62",
pages = "213--222",
journal = "Tijdschrift voor Psychiatrie",
issn = "0303-7339",
publisher = "Uitgeverij Boom-SUN",
number = "3",

}

RIS

TY - JOUR

T1 - Antidepressiva

T2 - al decennia voor­geschreven én toch nog steeds bekritiseerd; een perspectief op oorzaken en oplossingen

AU - Ormel, J

AU - Ruhé, H G

AU - Bockting, C L H

AU - Nolen, W

AU - Schene, A H

AU - Spijker, J

AU - Ten Doesschate, M

AU - Cramer, A O J

AU - Verhaak, P

AU - Spinhoven, P

PY - 2020

Y1 - 2020

N2 - BACKGROUND: From around 1980, antidepressants (ad) have increasingly been prescribed, for longer periods of time, especially selective serotonin reuptake inhibitors (ssris). Paradoxically, their effectiveness is still doubted, especially outside the psychiatric profession. AIM: To explain increase and offer a perspective on causes and solutions, and to indicate how to reach consensus. METHOD: Position paper with critical analysis and synthesis of relevant literature. RESULTS: The rise in AD prescriptions results from: 1. increased safety and ease of prescribing, 2. increased presentation and recognition of depression in primary care, 3. extension of indication criteria, 4. effective marketing strategies, and 5. effectiveness in acute phase (aad) and of relapse/recurrence prevention in continuation/maintenance phases (coad).Critics point to: 1. low added value of aad relative to placebo, 2. many drop-outs and non-responders, 3. relapse/recurrence prevention with coad works only for responders to aad, 4. relapse/recurrence after AD discontinuation often involves withdrawal symptoms, and 5. publication bias, selective reporting, selective patient selection, and suboptimal blinding, resulting in overestimated effectiveness and underestimated disadvantages.Factors that keep fueling the controversy are: 1. critics stress the net effectiveness of AD whereas proponents point at gross effectiveness which includes spontaneous recovery and placebo effect; 2. persistence of distrust in industry-funded rcts; 3. ideological positions, reinforced by conflicts of interest and selective citations; 4. lack of rcts with relevant long-term outcome measurements. CONCLUSION: Although consensus is difficult to achieve given the ideological component, there are options. Three factors are critically important: confer to establish which data convince the opposition, response prediction (what works for whom), and rcts with long-term functional outcomes.

AB - BACKGROUND: From around 1980, antidepressants (ad) have increasingly been prescribed, for longer periods of time, especially selective serotonin reuptake inhibitors (ssris). Paradoxically, their effectiveness is still doubted, especially outside the psychiatric profession. AIM: To explain increase and offer a perspective on causes and solutions, and to indicate how to reach consensus. METHOD: Position paper with critical analysis and synthesis of relevant literature. RESULTS: The rise in AD prescriptions results from: 1. increased safety and ease of prescribing, 2. increased presentation and recognition of depression in primary care, 3. extension of indication criteria, 4. effective marketing strategies, and 5. effectiveness in acute phase (aad) and of relapse/recurrence prevention in continuation/maintenance phases (coad).Critics point to: 1. low added value of aad relative to placebo, 2. many drop-outs and non-responders, 3. relapse/recurrence prevention with coad works only for responders to aad, 4. relapse/recurrence after AD discontinuation often involves withdrawal symptoms, and 5. publication bias, selective reporting, selective patient selection, and suboptimal blinding, resulting in overestimated effectiveness and underestimated disadvantages.Factors that keep fueling the controversy are: 1. critics stress the net effectiveness of AD whereas proponents point at gross effectiveness which includes spontaneous recovery and placebo effect; 2. persistence of distrust in industry-funded rcts; 3. ideological positions, reinforced by conflicts of interest and selective citations; 4. lack of rcts with relevant long-term outcome measurements. CONCLUSION: Although consensus is difficult to achieve given the ideological component, there are options. Three factors are critically important: confer to establish which data convince the opposition, response prediction (what works for whom), and rcts with long-term functional outcomes.

M3 - Article

C2 - 32207131

VL - 62

SP - 213

EP - 222

JO - Tijdschrift voor Psychiatrie

JF - Tijdschrift voor Psychiatrie

SN - 0303-7339

IS - 3

ER -

ID: 128749034