杏吧原创

POPULAR antidepressants such as Prozac and Zoloft are being dished out to people with a much wider range of problems than the patients the drugs were originally tested on.

A team at Rhode Island Hospital looked at the criteria used to select subjects for clinical trials of antidepressants reported between 1994 and 1998. They then applied the same criteria to over 300 psychiatric outpatients at the hospital. Only about 15 per cent of them would have been eligible for the antidepressant trials, they found, yet 94 per cent were prescribed the drugs within three months.

The outpatients had all been diagnosed with 鈥渦nipolar鈥� depression, the condition for which all the drugs in the trials had been approved. But about 40 per cent would have been excluded from the trials simply because their depression wasn鈥檛 severe enough. Many others would have been ruled out because they suffered from other conditions as well, such as anxiety, suicidal feelings, alcoholism, bulimia, bipolar disorder and psychosis.

鈥淚t鈥檚 akin to testing an antibiotic for some infectious disease and only including individuals with a temperatures above 103 degrees,鈥� says the study coordinator Mark Zimmerman. He says the findings show the need for regulatory agencies such as the FDA to demand wider testing.

For other psychiatrists the results aren鈥檛 a surprise. 鈥淚 think everybody who does both trials and clinical practice knows the practice patients don鈥檛 go into the trials,鈥� says Stephen Stahl of the Neuroscience Education Institute in California. He also questions some of the results.

But the study is the first to document this trend, says Stahl. The numbers are shocking and, he says, raise a major question: 鈥淲hy are we studying patients who are different from the ones we treat?鈥�