harm patients. When prescribing a drug, doctors often don't know exactly how it will affect patients. Because the law allows pharmaceutical companies to publish only the positive results of tests conducted on medicines. The investigation of a British doctor.
Reboxetine is a drug that I also prescribed. With one of my patients the other medicines hadn't worked, so we wanted to try something new. Before writing the recipe, I had read the data from the clinical trials, and I saw that they were well structured and that the results were mostly positive. Reboxetine worked better than a placebo and was on par with other antidepressants it was compared to. The MHRA, the agency that regulates the distribution of medicines and health products in the United Kingdom, has approved it. Worldwide, millions of doses are prescribed each year. It had to be an effective and safe drug. I briefly discussed this with the patient and we agreed it was the right treatment to try, so I signed off on the prescription.
But we were wrong. In October 2010, a team of researchers finally managed to put together all the available data on reboxetine, taken both from published clinical trials and from those that never appeared in specialized journals. And the picture that emerged was terrifying. Seven trials had been conducted in which the drug was compared with a placebo. Only one, carried out on 2S4 patients, had given clearly positive results, and had been published in a scientific journal. But the other six trials, conducted on ten times as many patients, showed that reboxetine was no more effective than any sugar pill. None of those tests had been published and I had no idea they existed.
But it gets worse. Exactly the same picture emerged in trials comparing reboxetine with other drugs: Three small studies involving a total of 507 patients showed that the drugs all gave the same results, and they had all been published. But data from a study with 1.6S7 participants had been ignored: It showed that patients taking reboxetine were worse off than those using other drugs. On top of that, there were also side effects. From the studies that appeared in specialized journals it seemed that the drug worked, but when we looked at the unpublished ones we found that patients who were given reboxetine were more likely to experience side effects, stop taking it and abandon the trial precisely because of those effects.
I had done everything a doctor has to do. I had read the articles, I had critically evaluated them, I had discussed them with the patient and we had decided together on the basis of the evidence available to us. According to the published material, reboxetine was an effective and safe drug. In fact, it was no better than a placebo and did more harm than good. Basically, I had harmed my patient, simply because id
