On 2015 Oct 28, Peter Gøtzsche commented:

The authors write that "approximately 50-60% of patients are thought to improve clinically as a consequence of antidepressant treatment." This is not correct. About 50% of the patients get better on an antidepressant and 40% on placebo, ie. only a 10% difference, and according to the patients’ own judgments, the drugs don’t work (1,2). Furthermore, these trials were not effectively blinded, and if atropine is put in the placebo to blind the trials better, even the psychiatrists cannot find any effect (3).

The authors write that, "Currently there is no evidence to suggest that ECT causes any kind of brain damage, although temporary cognitive impairment is frequently reported" and that "ECT seems to be a safe procedure". This is not the case. ECT is highly controversial (4), patients report permanent memory problems (5), and there seems to be a death rate of about 1 per 1000 (6).

Only one RCT met the inclusion criteria and that trial was a post-hoc analysis of data in elderly people who participated in the Nottingham trial. It would be of interest to readers to know what the Nottingham trial showed.

1 Laughren TP. Overview for December 13 Meeting of Psychopharmacologic Drugs Advisory Committee (PDAC). 2006 Nov 16. Available online at: www.fda.gov/ohrms/dockets/ac/06/briefi ng/2006-4272b1-01-FDA.pdf (accessed 22 October 2012).

2 Gøtzsche PC. Deadly psychiatry and organised denial. Copenhagen: People’s Press; 2015.

3 Moncrieff J, Wessely S, Hardy R. Active placebos versus antidepressants for depression. Cochrane Database Systematic Reviews 2004;1:CD003012.

4 Carney S, Geddes J. Electroconvulsive therapy. BMJ 2003;326:1343-4.

5 Rose D, Wykes T, Leese M, Bindman J, Fleischmann P. Patients perspectives on electroconvulsive therapy: systematic review. BMJ 2003;326:1363-5.

6 Read J, Bentall R. The effectiveness of electroconvulsive therapy: a literature review. Epidemiol Psichiatr Soc 2010 Oct-Dec;19:333-47.

On 2015 Oct 28, Peter Gøtzsche commented:

The authors write that "approximately 50-60% of patients are thought to improve clinically as a consequence of antidepressant treatment." This is not correct. About 50% of the patients get better on an antidepressant and 40% on placebo, ie. only a 10% difference, and according to the patients’ own judgments, the drugs don’t work (1,2). Furthermore, these trials were not effectively blinded, and if atropine is put in the placebo to blind the trials better, even the psychiatrists cannot find any effect (3).

The authors write that, "Currently there is no evidence to suggest that ECT causes any kind of brain damage, although temporary cognitive impairment is frequently reported" and that "ECT seems to be a safe procedure". This is not the case. ECT is highly controversial (4), patients report permanent memory problems (5), and there seems to be a death rate of about 1 per 1000 (6).

Only one RCT met the inclusion criteria and that trial was a post-hoc analysis of data in elderly people who participated in the Nottingham trial. It would be of interest to readers to know what the Nottingham trial showed.

1 Laughren TP. Overview for December 13 Meeting of Psychopharmacologic Drugs Advisory Committee (PDAC). 2006 Nov 16. Available online at: www.fda.gov/ohrms/dockets/ac/06/briefi ng/2006-4272b1-01-FDA.pdf (accessed 22 October 2012).

2 Gøtzsche PC. Deadly psychiatry and organised denial. Copenhagen: People’s Press; 2015.

3 Moncrieff J, Wessely S, Hardy R. Active placebos versus antidepressants for depression. Cochrane Database Systematic Reviews 2004;1:CD003012.

4 Carney S, Geddes J. Electroconvulsive therapy. BMJ 2003;326:1343-4.

5 Rose D, Wykes T, Leese M, Bindman J, Fleischmann P. Patients perspectives on electroconvulsive therapy: systematic review. BMJ 2003;326:1363-5.

6 Read J, Bentall R. The effectiveness of electroconvulsive therapy: a literature review. Epidemiol Psichiatr Soc 2010 Oct-Dec;19:333-47.