The antidepressant drug paroxetine (Aropax, Paxil, Seroxat) has been found to be ineffective and riddled with disturbing side effects when used as a treatment for teens with depression, according to a reanalysis of an old drug trial led by researchers at the University of Adelaide.
Professor Jon Jureidini of the newly created Critical and Ethical Mental Health Research Group (CEMH) at the Robinson Research Institute, led a team of international researchers to re-examine the findings of the 1994-1998 drug trial known as “Study 329,” which evaluated the efficacy and safety of paroxetine compared with a placebo for adolescents diagnosed with major depression.
Study 329, which was funded by SmithKline Beecham (now GlaxoSmithKline), reported in 2001 that paroxetine, a selective serotonin reuptake inhibitor (SSRI), was effective and safe for depression in adolescents.
However, Jureidini’s reanalysis showed no advantages to taking paroxetine and discovered worrying side effects.
“Although concerns had already been raised about Study 329, and the way it was reported, the data was not previously made available so researchers and clinicians weren’t able to identify all of the errors in the published report,” says Jureidini.
“It wasn’t until the data was made available for re-examination that it became apparent that paroxetine was linked to serious adverse reactions, with 11 of the patients taking paroxetine engaging in suicidal or self-harming behaviours compared to only one person in the group of patients who took the placebo,” he says.
“Our study also revealed that paroxetine was no more effective at relieving the symptoms of depression than a placebo. This is highly concerning because prescribing this drug may have put young patients at unnecessary risk from a treatment that was supposed to help them,” he says.
Jureidini says it is important that research data and protocols are accessible so they can be reviewed and scrutinized.
“In 2013, an international researcher consortium called for undisclosed outcomes of trials to be published and for misleading publications to be corrected. This initiative was called restoring invisible and abandoned trials (RIAT),” says Jureidini.
“Study 329 was one of the trials identified as in need of restoration, and because the original funder was not interested in revisiting the trial, our research group took on the task.
“Our reanalysis of Study 329 came to very different conclusions to those in the original paper,” he says. “We also learnt a lot about incorrect reporting and the considerable fallout that can be associated with distorted data.”
“Regulatory research authorities should mandate that all data and protocols are accessible,” he says. “Although concerns about patient confidentiality and ‘commercial in confidence’ issues are important, the reanalysis of Study 329 illustrates the necessity of making primary trial data available to increase the rigor of evidence-based research,” he says.
CEMH is committed to undertaking and promoting critical and ethical appraisal of evidence, to help improve decision-making in mental health policy and practice.
Jureidini’s findings are published in the medical journal BMJ.
Source: University of Adelaide