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Authors' response

Published online by Cambridge University Press:  02 January 2018

Philip J. Cowen
Affiliation:
University of Oxford
Daniel Whiting
Affiliation:
University of Oxford, email: phil.cowen@psych.ox.ac.uk
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Abstract

Type
Columns
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © Royal College of Psychiatrists, 2014

By taking part of a single sentence out of context, Sumeet Gupta misrepresents our article. We wrote: ‘Controlled studies have suggested favourable efficacy and tolerability profiles; however, agomelatine is not without its controversies, with recent meta-analyses showing only marginal advantages over placebo’ (our italics). We also stated that, ‘although narrative reviews of the efficacy of agomelatine emphasise its superior efficacy relative to placebo and certain other antidepressants such as sertraline and fluoxetine, formal meta-analyses have found these effects to be less convincing and of uncertain clinical significance’ (the meta-analysis by Koesters et al Reference Koesters, Guaiana, Cipriani, Becker and Barbui1 had not been published when we submitted our article, so we relied on that of Singh et al Reference Singh, Singh and Kar2 which reaches similar conclusions). Merely reading the abstract is enough to encounter the phrase: ‘Current meta-analyses show marginal clinical benefits of agomelatine relative to placebo’. Overall, our conclusion is similar to that of Koesters et al Reference Koesters, Guaiana, Cipriani, Becker and Barbui1 : ‘The present systematic review found that acute treatment with agomelatine is associated with a difference of 1.5 points on the HRSD. This difference was statistically significant, although the clinical relevance of this small effect is questionable’.

Drug companies are often accused, with justification, of making exaggerated and misleading claims. Their critics should avoid emulating them.

Footnotes

Declaration of interest: P.J.C. has been a paid member of advisory boards for Eli Lilly, Lundbeck and Servier.

References

1 Koesters, M, Guaiana, G, Cipriani, A, Becker, T, Barbui, C. Agomelatine efficacy and acceptability revisited: systematic review and meta-analysis of published and unpublished randomised trials. Br J Psychiatry 2013; 203: 179–87.Google Scholar
2 Singh, SP, Singh, V, Kar, N. Efficacy of agomelatine in major depressive disorder: meta-analysis and appraisal. Int J Neuropsychopharmacology 2012; 15: 417–28.Google Scholar
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