Journalists on Prozac

Recent headlines announcing the results of a US study of clinically depressed adolescents were unequivocal: “Talk and pills best for depression in kids” (CNN.com); “Prescribed drugs with therapy aid teen depression” (Wall Street Journal); “Combination aids depressed youths” (New York Times); and “Prozac plus talk is best for teen depression” (Washington Post).

The headlines were matched by the exuberant claim of the study researchers who said that 71% of teenagers treated with a combination of fluoxetine (Prozac) and cognitive behaviour therapy improved—compared with only 35% of teens treated with placebo alone. That claim, published last month (JAMA 2004;292: 807-20), was based on data from the Treatment for Adolescents with Depression Study (TADS), a nationwide, 13-site study of 439 depressed adolescents.

But several points that might concern both laypeople and scientists went unreported by the New York Times, Washington Post, Wall Street Journal, US News & World Report, the Associated Press, National Public Radio's (NPR) Science Friday, and CNN.

Not one of these media giants reported that two of the study's four treatment arms were unblinded—and that it was in one of these unblinded arms that the purported benefit of fluoxetine was described. Lead author Dr John March of Duke University, North Carolina, declared fluoxetine plus talk therapy “the big winner” in an interview with wire service HealthDay reporter Serena Gordon—a phrase he …