Putting the efficacy of psychiatric and general medicine medication into perspective: review of meta-analyses
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Background: The efficacy of psychopharmacological treatments has been called into question. Psychiatrists are unfamiliar with the effectiveness of common medical drugs. Aims: To put the efficacy of psychiatric drugs into the perspective of that of major medical drugs. Method: 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.
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ADHD medications are as efficacious, or more efficacious, than many medications used for non-psychiatric disorders.
“These medications, which are as efficacious, or more efficacious, than many medications used for non-psychiatric disorders (Leucht et al., 2012)”
From The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder (2021) · cites this paper as Leucht et al., 2012
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The Lancet Commission on global mental health and sustainable development
Patel, V., Saxena, S., Lund, C., Thornicroft, G., Baingana, F., Bolton, P., Chisholm, D., Collins, P. Y., Cooper, J. L., Eaton, J., et al. (2018) · The Lancet · doi:10.1016/s0140-6736(18)31612-x · Cited by 3,692 · see citing works
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“These medications, which are as efficacious, or more efficacious, than many medications used for non-psychiatric disorders (Leucht et al., 2012), are classified as either stimulants (methylphenidate and amphetamine) or non-stimulants (atom-oxetine, extended release guanfacine, and extended release…”
Goodwin, G., Haddad, P. M., Ferrier, I. N., Aronson, J., Barnes, T., Cipriani, A., Coghill, D., Fazel, S., Geddes, J. R., Grunze, H., et al. (2016) · Journal of Psychopharmacology · doi:10.1177/0269881116636545 · Cited by 1,314 · see citing works
“Effect sizes in psychiatry, in common with the rest of medicine, are moderate (Leucht et al., 2012) but deliver worthwhile patient benefit.”
Time for united action on depression: a Lancet–World Psychiatric Association Commission
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Cleare, A., Pariante, C., Young, A., Anderson, I., Christmas, D., Cowen, P., Dickens, C., Ferrier, I., Geddes, J., Gilbody, S., et al. (2015) · Journal of Psychopharmacology · doi:10.1177/0269881115581093 · Cited by 759 · see citing works
“It is important to place the effect sizes of antidepressants into context as being similar to those seen for treatments used in medicine as a whole (Leucht et al., 2012).”
BackgroundBauer, M., Pfennig, A., Severus, E., Whybrow, P. C., Angst, J., Möller, H.-J., & Šon behalf of the Task Force on Unipolar Depressive Disorders (2013) · The World Journal of Biological Psychiatry · doi:10.3109/15622975.2013.804195 · Cited by 632 · see citing works
“Considering response, the placeboverum difference was estimated to be roughly between 10 and 20% (Storosum et al. 2001; Barbui et al. 2008; Melander et al. 2008; Leucht et al. 2012), corresponding to a Number Needed to Treat (NNT) of 5 – 7.”
MethodBarnes, T. R. E., Drake, R., Paton, C., Cooper, S. J., Deakin, J. F. W., Ferrier, I. N., Gregory, C. J., Haddad, P. M., Howes, O. D., Jones, I. R., et al. (2019) · Journal of Psychopharmacology · doi:10.1177/0269881119889296 · Cited by 607 · see citing works
“Analysing data from relevant studies, Leucht et al. (2012) found a statistically significant association between longer study duration and smaller relapse reduction by oral antipsychotic medication compared with placebo.”
BackgroundMethodInfluentialDeRubeis, R. J., Cohen, Z. D., Forand, N. R., Fournier, J. C., Gelfand, L. A., & Lorenzo-Luaces, L. (2014) · PLoS ONE · doi:10.1371/journal.pone.0083875 · Cited by 509 · see citing works
Antipsychotic medication in schizophrenia: a review
Lally, J., & MacCabe, J. H. (2015) · British Medical Bulletin · doi:10.1093/bmb/ldv017 · Cited by 515 · see citing works
“The effect size is comparable with that seen for many treatments for non-psychiatric disorders, such as hypertension, hypercholesterolaemia and type 2 diabetes.(9) This indicates that antipsychotic medications are not less effective when prescribed for their target conditions, than those used by other medical specialt…”
ResultLeichsenring, F., Steinert, C., Rabung, S., & Ioannidis, J. P. A. (2022) · World Psychiatry · doi:10.1002/wps.20941 · Cited by 485 · see citing works
Pharmacotherapy for post-traumatic stress disorder: Systematic review and meta-analysis
Hoskins, M., Pearce, J., Bethell, A., Dankova, L., Barbui, C., Tol, W. A., van Ommeren, M., de Jong, J., Seedat, S., Chen, H., et al. (2015) · British Journal of Psychiatry · doi:10.1192/bjp.bp.114.148551 · Cited by 418 · see citing works
Jakobsen, J. C., Katakam, K. K., Schou, A., Hellmuth, S. G., Stallknecht, S. E., Leth-Møller, K., Iversen, M., Banke, M. B., Petersen, I. J., Klingenberg, S. L., et al. (2017) · BMC Psychiatry · doi:10.1186/s12888-016-1173-2 · Cited by 366 · see citing works
“also suggested that a lack of difference between antidepressants and placebo is caused by an increasing ‘placebo’ effect (spontaneous recovery) [203].”
BackgroundInfluentialPharmacologic Treatment of Attention Deficit–Hyperactivity Disorder
Cortese, S. (2020) · New England Journal of Medicine · doi:10.1056/nejmra1917069 · Cited by 342 · see citing works
Antidepressant efficacy of agomelatine: meta-analysis of published and unpublished studies
Taylor, D. M., Sparshatt, A., Varma, S., & Olofinjana, O. (2014) · BMJ · doi:10.1136/bmj.g1888 · Cited by 336 · see citing works
Huhn, M., Tardy, M., Spineli, L. M., Kissling, W., Förstl, H., Pitschel-Walz, G., Leucht, C., Samara, M., Dold, M., Davis, J. M., et al. (2014) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2014.112 · Cited by 333 · see citing works
“We applied the following a priori–defined criteria to operationalize the selection: (1) all patients rather than special populations (eg, only first-episode patients); (2) classes of drugs rather than single drugs (eg, any antipsychotic rather than only haloperidol); (3) CBT and psychodynamic approaches (the former ar…”
MethodStein, D. J., Shoptaw, S. J., Vigo, D. V., Lund, C., Cuijpers, P., Bantjes, J., Sartorius, N., & Maj, M. (2022) · World Psychiatry · doi:10.1002/wps.20998 · Cited by 331 · see citing works
Post-traumatic stress disorder
Bisson, J. I., Cosgrove, S., Lewis, C., & Roberts, N. P. (2015) · BMJ · doi:10.1136/bmj.h6161 · Cited by 342 · see citing works
van den Brink, W., Aubin, H., Bladström, A., Torup, L., Gual, A., & Mann, K. (2013) · Alcohol and Alcoholism · doi:10.1093/alcalc/agt061 · Cited by 307 · see citing works
“These effect sizes are larger than those reported for heavy drinking outcomes in licensed medications for abstinence in alcohol dependence and within the range reported for approved medicinal products in other central nervous system indications (Leucht et al., 2012; Maisel et al., 2013).”
BackgroundEarly Intervention in Psychosis
McGorry, P. D. (2015) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000000284 · Cited by 286 · see citing works
“…reform (J Nerv Ment Dis 2015;203: 310–318) A lthough the efficacy of modern treatments in psychiatry is compa-rable with those in general medicine (Leucht et al., 2012), the reductions in mortality and morbidity seen in cancer and cardiovascular disease over recent decades have proven more…”
Treatment strategies for ADHD: an evidence-based guide to select optimal treatment
Caye, A., Swanson, J. M., Coghill, D., & Rohde, L. A. (2019) · Molecular Psychiatry · doi:10.1038/s41380-018-0116-3 · Cited by 303 · see citing works
Tahamtan, I., & Bornmann, L. (2019) · Scientometrics · doi:10.1007/s11192-019-03243-4 · Cited by 236 · see citing works
Mathie, R. T., Lloyd, S. M., Legg, L. A., Clausen, J., Moss, S., Davidson, J. R. T., & Ford, I. (2014) · Systematic Reviews · doi:10.1186/2046-4053-3-142 · Cited by 228 · see citing works
“Such ‘effect sizes’ seem comparable with, for example, sumatriptan for migraine, fluoxetine for major depressive disorder and cholinesterase inhibitors for dementia [18].”
BackgroundEvidence-based umbrella review of 162 peripheral biomarkers for major mental disorders
Carvalho, A. F., Solmi, M., Sanches, M., Machado, M. O., Stubbs, B., Ajnakina, O., Sherman, C., Sun, Y. R., Liu, C. S., Brunoni, A. R., et al. (2020) · Translational Psychiatry · doi:10.1038/s41398-020-0835-5 · Cited by 204 · see citing works
More treatment but no less depression: The treatment-prevalence paradox
Ormel, J., Hollon, S. D., Kessler, R. C., Cuijpers, P., & Monroe, S. M. (2022) · Clinical Psychology Review · doi:10.1016/j.cpr.2021.102111 · Cited by 213 · see citing works
Vagal nerve stimulation for treatment-resistant depression
Carreno, F. R., & Frazer, A. (2017) · Neurotherapeutics · doi:10.1007/s13311-017-0537-8 · Cited by 208 · see citing works
Dold, M., Aigner, M., Lanzenberger, R., & Kasper, S. (2013) · International Journal of Neuropsychopharmacology · doi:10.1017/s1461145712000740 · Cited by 211 · see citing works
Self-citationThe Long-Term Effects of Antipsychotic Medication on Clinical Course in Schizophrenia
GOFF, D. C., Falkai, P., Fleischhacker, W. W., Girgis, R. R., Kahn, R. S., Uchida, H., Zhao, J., & Lieberman, J. A. (2017) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2017.16091016 · Cited by 194 · see citing works
A Meta-Analysis of Placebo-Controlled Trials of Psychedelic-Assisted Therapy
Luoma, J. B., Chwyl, C., Bathje, G. J., Davis, A. K., & Lancelotta, R. (2020) · Journal of Psychoactive Drugs · doi:10.1080/02791072.2020.1769878 · Cited by 212 · see citing works
Cognitive behavioural therapy for psychosis prevention: a systematic review and meta-analysis
Hutton, P., & Taylor, P. J. (2014) · Psychological Medicine · doi:10.1017/s0033291713000354 · Cited by 184 · see citing works
“According to a recent comparison of psychiatric and general medical treatments, around 27 (25, 33) patients with heart disease need to take statins to prevent one major cardiac event, while around 16 (13, 25) need to take ACE-inhibitors for one to avoid death from chronic heart failure (Leucht et al., 2012).”
BackgroundStratified medicine for mental disorders
Schumann, G., Binder, E. B., Holte, A., de Kloet, E. R., Oedegaard, K. J., Robbins, T. W., Walker-Tilley, T. R., Bitter, I., Brown, V. J., Buitelaar, J., et al. (2014) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2013.09.010 · Cited by 186 · see citing works
“Medication related somatic disorders Psychotropic drugs have proven to compare favourably with medications used in other fields of medicine with regards to effective clinical disease control (Leucht et al., 2012).”
BackgroundMcIntyre, R., Harrison, J., Loft, H., Jacobson, W., & Olsen, C. (2016) · International Journal of Neuropsychopharmacology · doi:10.1093/ijnp/pyw055 · Cited by 185 · see citing works
“Moreover, the observed SES with vortioxetine are consistent with, and similar to, those reported for many drugs used in general medical and psychiatric practice (e.g. paroxetine, fluoxetine, and lithium; Leucht et al., 2012), and in disorders of cognition (e.”
ResultJonas, W. B., Crawford, C., Colloca, L., Kaptchuk, T. J., Moseley, B., Miller, F. G., Kriston, L., Linde, K., & Meissner, K. (2015) · BMJ Open · doi:10.1136/bmjopen-2015-009655 · Cited by 183 · see citing works
“98 Those studies, however, usually have much larger sample sizes, increasing con fi dence in their estimates.”
BackgroundPersonalized prediction of antidepressant v. placebo response: evidence from the EMBARC study
Webb, C. A., Trivedi, M. H., Cohen, Z. D., Dillon, D. G., Fournier, J. C. J., Goer, F., D, M. F. M., McGrath, P. J., Weissman, M. M., Parsey, R. V., et al. (2018) · Psychological Medicine · doi:10.1017/s0033291718001708 · Cited by 172 · see citing works
“…( d ∼ 0.30) (Kirsch et al ., 2008; Turner et al ., 2008; Fournier et al ., 2010; Khin et al ., 2011; Kirsch, 2015; Moncrieff and Kirsch, 2015; Cipriani et al ., 2018 ), and those observed between active treatments and controls from general medical contexts ( d ∼ 0.45) (Leucht et al ., 2012).”
BackgroundInfluentialMindfulness-based stress reduction for women diagnosed with breast cancer
Schell, L. K., Monsef, I., Wöckel, A., & Skoetz, N. (2019) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011518.pub2 · Cited by 168 · see citing works
Gut Microbiota in Anxiety and Depression: Unveiling the Relationships and Management Options
Kumar, A., Pramanik, J., Goyal, N., Chauhan, D., Sivamaruthi, B. S., Prajapati, B. G., & Chaiyasut, C. (2023) · Pharmaceuticals · doi:10.3390/ph16040565 · Cited by 164 · see citing works
“However, the effectiveness of currently available antidepressant medications used in clinics for symptom relief and prevention seems inconsistent [16].”
BackgroundCipriani, A., Williams, T., Nikolakopoulou, A., Salanti, G., Chaimani, A., Ipser, J., Cowen, P. J., Geddes, J. R., & Stein, D. J. (2017) · Psychological Medicine · doi:10.1017/s003329171700349x · Cited by 150 · see citing works
“Their point estimates of SMD were around 0.3, which is the same as antidepressants for depression, and indeed for many standard treatments in psychiatry and medicine (Leucht et al. 2012).”
BackgroundInfluentialEmergency Department Visits by Adults for Psychiatric Medication Adverse Events
Hampton, L. M., Daubresse, M., Chang, H., Alexander, G. C., & Budnitz, D. S. (2014) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2014.436 · Cited by 149 · see citing works
“We considered medications to be psychiatric (eTable 1 in the Supplement) if they met the following criteria: (1) they were classified as an antidepressant, antipsychotic, sedative and anxiolytic, stimulant, or other central nervous system medication in the modified Department of Veterans Affairs National Drug File use…”
Hoenders, R. H. J., Ghelman, R., Portella, C. F. S., Simmons, S., Locke, A., Cramer, H., Gallego-Pérez, D. F., & Jong, M. C. (2024) · Frontiers in Medicine · doi:10.3389/fmed.2024.1395698 · Cited by 165 · see citing works
“A lot of suffering has been prevented and many diseases cured (51, 52).”
BackgroundDold, M., Aigner, M., Lanzenberger, R., & Kasper, S. (2015) · International Journal of Neuropsychopharmacology · doi:10.1093/ijnp/pyv047 · Cited by 134 · see citing works
“49) that was determined in a review of 33 psychopharmacological medications across all psychiatric disorders (Leucht et al., 2012).”
BackgroundSelf-citationKane, J. M., Kishimoto, T., & Correll, C. U. (2013) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2013.01.012 · Cited by 131 · see citing works
“These effects are as dramatic as those of many other widely accepted treatments in general medicine [1].”
BackgroundMillan, M. J., Goodwin, G. M., Meyer-Lindenberg, A., & Ove Ögren, S. (2015) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2015.01.016 · Cited by 132 · see citing works
Recovery from chronic fatigue syndrome after treatments given in the PACE trial
White, P. D., Goldsmith, K., Johnson, A. L., Chalder, T., & Sharpe, M. (2013) · Psychological Medicine · doi:10.1017/s0033291713000020 · Cited by 124 · see citing works
“The NNT of 7 for recovery after both CBT and GET is within the range of the effects found for drug treatments in both general medical and psychiatric conditions (Leucht et al. 2012).”
BackgroundThe past, present and future of psychiatric diagnosis
FRANCES, A. J. (2013) · World Psychiatry · doi:10.1002/wps.20027 · Cited by 120 · see citing works
“A recent meta-analysis shows the results of psychiatric treatment to equal or surpass those of most medical specialties (13), but the treatments must be delivered to those who really need them, not squandered on those likely to do as well or better on their own.”
BackgroundEmotion regulation difficulties in traumatized youth: a meta-analysis and conceptual review
Villalta, L., Smith, P., Hickin, N., & Stringaris, A. (2018) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-018-1105-4 · Cited by 119 · see citing works
“in medicine effect sizes for death as an outcome as opposed to days off work) must also be taken into account [65].”
BackgroundOldham, C. M., & Ciraulo, D. A. (2014) · Chronobiology International · doi:10.3109/07420528.2013.833935 · Cited by 112 · see citing works
“These meta-analytic effect sizes are on the order of those found with antidepressant medications and, more compellingly, a range of currently available general psychiatric and general medicine prescription medications (Leucht et al., 2012).”
BackgroundHow effective are common medications: a perspective based on meta-analyses of major drugs
Leucht, S., Helfer, B., Gartlehner, G., & Davis, J. M. (2015) · BMC Medicine · doi:10.1186/s12916-015-0494-1 · Cited by 115 · see citing works
“There are many limitations in an overview of metaanalyses [4].”
BackgroundMethodSelf-citationPsychiatric diagnosis: impersonal, imperfect and important
Craddock, N. J., & Mynors‐Wallis, L. (2014) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.113.133090 · Cited by 113 · see citing works
Leucht, S., Priller, J., & Davis, J. M. (2024) · American Journal of Psychiatry · doi:10.1176/appi.ajp.20240738 · Cited by 117 · see citing works
Self-citationVeijola, J. M., Guo, J. Y., Moilanen, J. S., Jääskeläinen, E., Miettunen, J., Kyllönen, M., Haapea, M., Huhtaniska, S., Alaräisänen, A., Mäki, P. H., et al. (2014) · PLoS ONE · doi:10.1371/journal.pone.0101689 · Cited by 111 · see citing works
Zhu, F., Tu, H., & Chen, T. (2022) · Nutrients · doi:10.3390/nu14102081 · Cited by 119 · see citing works
“Although existing antidepressant drugs have some efficacy, they are very limited, and in clinical cases, they can only provide alleviation and prevention [35].”
BackgroundPollock, M., Fernandes, R. M., & Hartling, L. (2017) · BMC Medical Research Methodology · doi:10.1186/s12874-017-0325-5 · Cited by 107 · see citing works
Alcohol use disorders and ADHD.
Luderer, M., Ramos Quiroga, J. A., Faraone, S. V., Zhang-James, Y., & Reif, A. (2021) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2021.07.010 · Cited by 102 · see citing works
Does long term use of psychiatric drugs cause more harm than good?
Gøtzsche, P. C., Young, A. H., & Crace, J. (2015) · BMJ · doi:10.1136/bmj.h2435 · Cited by 103 · see citing works
Davidson, M., Saoud, J. B., Staner, C., Noël, N., Luthringer, E., Werner, S., Reilly, J. G., Schaffhauser, J.-Y., Rabinowitz, J., Weiser, M., et al. (2017) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2017.17010122 · Cited by 104 · see citing works
“Furthermore, the effect sizes for negative symptoms reported here are higher than those of currently marketed drugs indicated for schizophrenia and ofmany drugs utilized to treat chronic diseases in general medicine (35).”
Hieronymus, F., Nilsson, S., & Eriksson, E. (2016) · Translational Psychiatry · doi:10.1038/tp.2016.104 · Cited by 100 · see citing works
Clinically meaningful biomarkers for psychosis: A systematic and quantitative review
Prata, D. P., Mechelli, A., & Kapur, S. (2014) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2014.05.010 · Cited by 100 · see citing works
A Systematic Approach to Pharmacotherapy for Geriatric Major Depression
Mulsant, B. H., Blumberger, D. M., Ismail, Z., Rabheru, K., & Rapoport, M. J. (2014) · Clinics in Geriatric Medicine · doi:10.1016/j.cger.2014.05.002 · Cited by 100 · see citing works
“The limited empirical data on which strategy physicians use to match patients to antidepressants suggest that they consider 3 main factors: presence of specific target symptoms (particularly insomnia, anxiety, fatigue, or appetite changes); presence of comorbid conditions (particularly panic disorder, generalized anxi…”
InfluentialMann, K. F., Torup, L., Sørensen, P. S., Gual, A., Swift, R. M., Walker, B. M., & van den Brink, W. (2016) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2016.10.008 · Cited by 97 · see citing works
“However the effect sizes reported in the target population are well in the range for approved medicinal products in general medicine and psychiatry, including alcohol dependence (Leucht et al., 2012; Aubin et al., 2015).”
Hengartner, M. P., & Plöderl, M. (2018) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2018.00517 · Cited by 94 · see citing works
Nuijten, M., Blanken, P., van de Wetering, B., Nuijen, B., van den Brink, W., & Hendriks, V. M. (2016) · The Lancet · doi:10.1016/s0140-6736(16)00205-1 · Cited by 87 · see citing works
Bybjerg‐Grauholm, J., Pedersen, C. B., Bækvad‐Hansen, M., Pedersen, M. G., Adamsen, D., Hansen, C. S., Agerbo, E., Grove, J., Als, T. D., Schork, A. J., et al. (2020) · medRxiv · doi:10.1101/2020.11.30.20237768 · Cited by 79 · see citing works
Gosmann, N. P., Costa, M. D. A., Jaeger, M. D. B., Motta, L. S., Frozi, J., Spanemberg, L., Manfro, G. G., Cuijpers, P. J., Pine, D. S., & Salum, G. A. (2021) · PLoS Medicine · doi:10.1371/journal.pmed.1003664 · Cited by 87 · see citing works
“All included SSRIs and SNRIs showed greater reduction in overall psychopathology than placebo, with effect sizes comparable to those of other interventions in medicine [29].”
ResultTreatments for internet addiction, sex addiction and compulsive buying: A meta-analysis
Goslar, M., Leibetseder, M. M., Münch, H. M., Hofmann, S. G., & Laireiter, A. (2020) · Journal of Behavioral Addictions · doi:10.1556/2006.2020.00005 · Cited by 89 · see citing works
Solmi, M., Miola, A., Croatto, G., Pigato, G., Favaro, A., Fornaro, M., Berk, M., Smith, L., Quevedo, J., Maes, M. H. J., et al. (2020) · Brazilian Journal of Psychiatry · doi:10.1590/1516-4446-2020-0935 · Cited by 88 · see citing works
Methylphenidate for attention-deficit/hyperactivity disorder in adults: a narrative review
Jaeschke, R. R., Sujkowska, E., & Sowa-Kućma, M. (2021) · Psychopharmacology · doi:10.1007/s00213-021-05946-0 · Cited by 90 · see citing works
Citation Context Analysis as a Method for Conducting Rigorous and Impactful Literature Reviews
Anderson, M. H., & Lemken, R. K. (2020) · Organizational Research Methods · doi:10.1177/1094428120969905 · Cited by 83 · see citing works
Pharmacometabonomics and personalized medicine
Everett, J. R., Loo, R. L., & Pullen, F. S. (2013) · Annals of Clinical Biochemistry International Journal of Laboratory Medicine · doi:10.1177/0004563213497929 · Cited by 75 · see citing works
“The development of personalized healthcare is a necessary path for medicine to take, as it is increasingly clear that for many medicines, efficacy is only achieved in a subset of the patient population.(86) Equally, many otherwise efficacious medicines are withdrawn from the market because of safety concerns in a smal…”
BackgroundRecent advances in psychoradiology
Luo, L., You, W., DelBello, M. P., Gong, Q., & Li, F. Y. (2022) · Physics in Medicine and Biology · doi:10.1088/1361-6560/ac9d1e · Cited by 75 · see citing works
“Brain stimulation for precision treatment Evidence suggests that at present, existing pharmacological interventions for psychiatric disorders are often suboptimal (Leucht et al 2012).”
BackgroundQuintero, J., Gutiérrez-Casares, J. R., & Álamo, C. (2022) · Neurology and Therapy · doi:10.1007/s40120-022-00392-2 · Cited by 70 · see citing works
“Despite stimulant medications for ADHD being among the most effective drugs in psychiatry [36], there is a substantial placebo effect in subjects with ADHD [37], which could be explained by a synergy between placebo effects that influence the parent of the patient with ADHD and those acting on the clinician when inter…”
BackgroundDie Rolle von Placebo- und Nocebomechanismen bei depressiven Erkrankungen und ihrer Therapie
Rief, W. (2020) · Der Nervenarzt · doi:10.1007/s00115-020-00940-x · Cited by 2 · see citing works
Pharmacogenomics: A road ahead for precision medicine in psychiatry
Pardiñas, A. F., Owen, M. J., & Walters, J. (2021) · Neuron · doi:10.1016/j.neuron.2021.09.011 · Cited by 72 · see citing works
Sedgwick-Müller, J. A., Müller-Sedgwick, U., Adamou, M., Catani, M., Champ, R., Gudjónsson, G., Hank, D., Pitts, M., Young, S., & Asherson, P. (2022) · BMC Psychiatry · doi:10.1186/s12888-022-03898-z · Cited by 70 · see citing works
“Psychostimulant medications are among the most effective medications in use within adult mental health [89], and among the most efficacious of all common medical drugs [177].”
BackgroundUniversity students with attention deficit hyperactivity disorder (ADHD): a literature review
Sedgwick, J. (2017) · Irish Journal of Psychological Medicine · doi:10.1017/ipm.2017.20 · Cited by 76 · see citing works
“This is interesting in light of a study about the efficacy of psychiatric drugs in relation to common medical drugs, which found that ADHD medications are the most efficacious of all medical drugs (Leucht et al. 2012).”
BackgroundAre there meaningful biomarkers of treatment response for depression?
Breitenstein, B., Scheuer, S., & Holsboer, F. (2014) · Drug Discovery Today · doi:10.1016/j.drudis.2014.02.002 · Cited by 69 · see citing works
No role for initial severity on the efficacy of antidepressants: results of a multi-meta-analysis
Fountoulakis, K. Ν., Veroniki, A. A., Siamouli, M., & Möller, H. (2013) · Annals of General Psychiatry · doi:10.1186/1744-859x-12-26 · Cited by 66 · see citing works
“35 is a weak one and suggests that the treatment is not really working or it does not make any clinically relevant difference neglects the fact that such an effect size is the rule rather than the exception [54].”
Amitriptyline versus placebo for major depressive disorder
Leucht, C., Huhn, M., & Leucht, S. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd009138.pub2 · Cited by 60 · see citing works
Self-citationReplication and contradiction of highly cited research papers in psychiatry: 10-year follow-up
Tajika, A., Ogawa, Y., Takeshima, N., Hayasaka, Y., & Furukawa, T. A. (2015) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.113.143701 · Cited by 61 · see citing works
Sinclair, J., Chambers, S. E., Shiles, C. J., & Baldwin, D. S. (2016) · Drug Safety · doi:10.1007/s40264-016-0416-y · Cited by 62 · see citing works
“Pharmacotherapy is underused in its treatment despite evidence of moderate effect [152], similar to that in other conditions [155].”
Biagianti, B., Fisher, M., Neilands, T. B., Loewy, R. L., & Vinogradov, S. (2016) · Neuropsychology · doi:10.1037/neu0000311 · Cited by 60 · see citing works
Are antidepressants overprescribed? Yes
Spence, D. (2013) · BMJ · doi:10.1136/bmj.f191 · Cited by 58 · see citing works
Sayer, N. A., Noorbaloochi, S., Frazier, P. A., Pennebaker, J. W., Orazem, R. J., Schnurr, P. P., Murdoch, M., Carlson, K. F., Gravely, A. A., & Litz, B. T. (2015) · Journal of Traumatic Stress · doi:10.1002/jts.22047 · Cited by 58 · see citing works
Tiihonen, J., Tanskanen, A., Hoti, F., Vattulainen, P., Taipale, H., Mehtälä, J., & Lähteenvuo, M. (2017) · The Lancet Psychiatry · doi:10.1016/s2215-0366(17)30134-7 · Cited by 58 · see citing works
Leucht, S., Siafis, S., McGrath, J. J., McGorry, P. D., Howes, O. D., Tamminga, C. A., Carr, R., Bighelli, I., Schneider‐Thoma, J., Priller, J., et al. (2025) · Nature Reviews Disease Primers · doi:10.1038/s41572-025-00667-6 · Cited by 63 · see citing works
“The absolute difference compared with placebo (24% relapse versus 61% within 7–12 months) 255 is one of the largest in medicine 256 .”
Self-citationZink, M. (2014) · Advances in Medicine · doi:10.1155/2014/317980 · Cited by 55 · see citing works
A Neurodevelopment Approach for a Transitional Model of Early Onset Schizophrenia
Berardis, D. D., Filippis, S. D., Masi, G., Vicari, S., & Zuddas, A. (2021) · Brain Sciences · doi:10.3390/brainsci11020275 · Cited by 53 · see citing works
“The EPS are usually associated with high potency First Generation Antipsychotics (FGA) [119].”
BackgroundInfluentialEPA guidance on the role and responsibilities of psychiatrists
Bhugra, D., Ventriglio, A., Kuzman, M. R., Ikkos, G., Hermans, M., Falkai, P., Fiorillo, A., Musalek, M., Höschl, C., Dales, J., et al. (2015) · European Psychiatry · doi:10.1016/j.eurpsy.2015.02.002 · Cited by 52 · see citing works
“The role of the psychiatrist has also been described by the UEMS [26–28] in their Charter on Training of Medical Specialists in the European Union (requirements for the specialty of psychiatry).”
BackgroundInfluentialKaram, E. G., Karam, G. E., Farhat, C., Itani, L., Fayyad, J., Karam, A. N., Mneimneh, Z., Kessler, R., & Thornicroft, G. (2019) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796018000422 · Cited by 52 · see citing works
“Mental health treatment by specialists has progressed over the past decades with rigorous research studies designed to evaluate several aspects of the variety of treatments (mostly medical and psychological therapies including the use of modern technology) (Ginzburg et al., 2012; Leucht et al., 2012; Stott et al., 201…”
Backgroundde Vries, Y. A., de Jonge, P., van den Heuvel, E., Turner, E. H., & Roest, A. M. (2016) · British Journal of Psychiatry · doi:10.1192/bjp.bp.115.173450 · Cited by 50 · see citing works
Pharmacological Treatments for Disordered Gambling: A Meta-analysis
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- Authors
- Leucht, S., Hierl, S., Kissling, W., Dold, M., & Davis, J. M.
- Affiliations
- TUM Klinikum (DE)
- University of Illinois Chicago (US)
- Corresponding author
- Leucht, Stefan
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2012-02
- Volume
- 200
- Issue
- 2
- Pages
- 97-106
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2101652281
- Semantic Scholar
- 68218f1e65e6903db144e3aec0175e90671d7c26
- Cited by
- 451
- References
- 202
- Citations by year
- 2026: 22 · 2025: 30 · 2024: 31 · 2023: 21 · 2022: 28 · 2021: 33 · 2020: 38 · 2019: 40 · 2018: 28 · 2017: 30 · 2016: 23 · 2015: 41 · 2014: 39 · 2013: 28 · 2012: 16
- FWCI
- 10.93
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- mediaTUM – the media and publications repository of the Technical University Munich (Technical University Munich) (submittedVersion)
- Topics
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- psychotropic drugs, placebo response, effect size, adverse drug reactions
- MeSH terms
- Mental Disorders, Pharmaceutical Preparations, Humans, Placebos, Psychiatry, Psychotropic Drugs, Review Literature as Topic, Meta-Analysis as Topic, Bias, Databases, Bibliographic, Outcome Assessment, Health Care
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