The Healthy Solution

Unfavourable drug studies don't make it to print. That is the verdict of a team of US researchers who have been looking at what gets published in medical journals and literature and what doesn't.

They found that nearly a third of antidepressant drug studies have never published. Nearly all of these show that the drug being tested did not work. The research team from the Oregon Health and Science University led by Erick Turner also found that in some of the studies that had published, unfavourable results had been recast to make the medicine appear more effective.

The idea that unfavourable test results get put to one side - sometimes call the 'file drawer effect' - has been around for years.

The Turner team was able to test it because the USA's Food and Drug Administration keeps a registry in which companies must log details of their drug tests before experiments begin. The team followed all the antidepressant drugs trials between 1987 and 2004.

• 74 studies of 12 different antidepressants were started.
• 38 produced positive results for the drug. All but one of these was published.
• 36 studies produced, according to the FDA, negative or questionable results. Only 3 were published while another 11 were turned around and written as if the drug had worked.

This is clearly bad news for patients. 'Selective publication can lead doctors to make inappropriate prescribing decisions that may not be in the best interest of their patients and, thus, the public health,' wrote Turner in the New England Journal of Medicine.

Who is to blame? Turner's team are not sure. Although the authors and drug company sponsors may not have submitted the unfavourable results for publication, medical journals and their editors may also have played a role by deciding they would rather publish favourable results - which are more likely to attract interest attention and headlines.

'There's an expectation that if you get a positive result, that's what you're supposed to do, and if you get a negative result you have failed,' Turner told Reuters. 'The first impulse is to say, "I was wrong. Maybe I should move on to something more interesting" so the results may never get written up.'