Common Statistical Method Conflates Withdrawal with Relapse

Researchers argue that common study methods for psychiatric drugs may inadvertently minimize withdrawal effects and inflate drug efficacy.

This article by Peter Simons has been published by Mad in America. It begins:

“Survival analysis is a statistical technique often used to test whether psychiatric drugs prevent relapse. But, in a new article in BMJ Evidence-Based Medicine, researchers write that it is inappropriate to use it for that purpose.

The researchers were Joanna Moncrieff at University College London, Janus Christian Jakobsen at the University of Southern Denmark, and Max Bachmann at the University of East Anglia.

They note that while this method may be appropriate for some situations when it comes to psychiatric drug studies, it is prone to conflating withdrawal with relapse and can lead to misleading conclusions. Thus, they suggest it should be avoided for these studies. The researchers write:

‘We suggest that survival analysis should not be routinely employed in trials of interventions aimed at relapse prevention in long-term psychiatric conditions.’

In survival analysis, researchers generally compare one, or both, of the following: whether there are more relapses off the drug and whether those relapses happen sooner.

The first question is a vital one: do people taking the psychiatric drug being studied suffer fewer relapses? But the problem is that discontinuing the drug leads to withdrawal effects, which are often counted as relapse, especially in drug trials. So, because of withdrawal, people who discontinue the drug appear to relapse more—even though it is actually drug withdrawal …”

You can read more from here.

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