What is the signal/noise ratio of antidepressant drug RCTs in children?
• Jeffrey Mann, Retired physician Salt Lake City, UT 84103 I think that a recommendation to use antidepressant drugs in children should be based on valid scientific evidence — RCTs that have a high signal/noise ratio [1]. Jureidini’s critical analysis of six RCTs of antidepressant drug use in children, who have major depression, suggests that those RCTs have significant noise and a small/unclear signal. One can therefore conclude, if Jureidini’s criticism is valid, that one cannot be confident in those RCTs’ results, because they have a low signal/noise ratio. Dr. Foreman states that the effect size and the discontinuation rates are similar to studies on adults with major depression and that “it would thus be equally true to claim that ‘trials of SSRIs in children show similar efficacy, side effect and dropout rates to those in adults’, a position far more supportive of their continued use than Juredini et al would have us take”. I cannot understand the logic of this statement. It wou
