Reposted by Martin PlöderlSolomon Kurz @solomonkurz.bsky.social · 13hTIL about zombie trials. What a time to be alive 262
Martin Plöderl @ploederl.bsky.social · 15hMy new blog featured by @mad-in-america.bsky.social about what we can (need) to learn from fluoxetine trials for pediatric depression in order to judge other antidepressants commonly used for children and adolescents. A more elaborated version is on my website: ploederlm.github.io/blogs/fluoxe...madinamerica.comFrom Efficacy to Non-Efficacy: Lessons from Pediatric Fluoxetine TrialsModern studies find that fluoxetine has lost its efficacy for children and can now be considered clinically equivalent to placebo. 073
Reposted by Martin PlöderlIan Hussey @ianhussey.mmmdata.io · 28/09/2026Germany has cancelled funding for the German Cochrane Foundation. Bad news all around. Cochrane’s benefit to cost ratio is huge. @cochrane.org www.sueddeutsche.de/politik/wark...sueddeutsche.deBund streicht renommierter Cochrane-Stiftung die FörderungDie Cochrane-Stiftung, die seit Jahren die Nutzen medizinischer Therapien untersucht, soll künftig nicht mehr staatlich gefördert werden. 32813
Martin Plöderl @ploederl.bsky.social · 28/09/2026The corresponding author responded, but issues could not be resolved, IMO. Letter is now "under review" since about 3 months. 000
Reposted by Martin PlöderlIan Hussey @ianhussey.mmmdata.io · 25/09/2026"Systematic reviews are only as credible as the studies they include" INSPECT-SR was published yesterday, giving concrete guidance on how to exclude untrustworthy studies. Cochrane's statement: www.cochrane.org/about-us/new... Article: www.cochrane.org/about-us/new... Guidance: inspect-sr.comcochrane.orgNew tool helps researchers spot problematic trials before they distort evidence | Cochrane 26031
Martin Plöderl @ploederl.bsky.social · 23/09/2026Important study on antidepressant withdrawal issues, which are IMO still not adequately considered in research and clinical practice. "Our results thus indicate that affective symptoms that emerge acutely during antidepressant tapering are largely due to withdrawal and not relapse."karger.comAcute Affective Symptoms during Antidepressant Tapering Indicate Withdrawal Reactions Rather than Relapse: Results from a Prospective Longitudinal Cohort StudyAbstract. Introduction: It remains contested if rapid onset of affective symptoms during antidepressant tapering reflects pharmacological withdrawal effects or relapse of an underlying mental disorder... 072
Martin Plöderl @ploederl.bsky.social · 22/09/2026Ouch! "Individualized aiTBS did not outperform sham in treatment-resistant depression" "Neither fMRI-connectivity nor EEG-frequency targeting improved outcomes over sham" www.sciencedirect.com/science/arti...sciencedirect.com 012
Martin Plöderl @ploederl.bsky.social · 21/09/2026The weirdest invitation I ever received: "Dear Dr. Martin Plöderl Your publication on “Suicide of a Tenor Amidst the Stage Setting of the Werther Opera's Death Scene ” reflects strong relevance to the themes of our upcoming scientific meeting. We are organizing an international conference..." 120
Martin Plöderl @ploederl.bsky.social · 20/09/2026Just came across this meta-analysis on antidepressants to treat anxiety in elderly people. Have a look at the forest plot. Yes, the effects of some SSRI trials are implausibly large. Study: doi.org/10.1016/s221... Here an overview of the errors I detected: pubpeer.com/publications... 2112
Reposted by Martin PlöderlRobert Reich @rbreich.bsky.social · 20/09/2026Taxing the rich is absolutely essential to saving our economy and our democracy. Don't believe me? Look at this chart.youtube.comThe Hidden Danger of America's Wealth GapTaxing the rich is absolutely essential to saving our economy and our democracy.Don't believe me? Look at this chart. 25678862900
Reposted by Martin PlöderlRuben C. Arslan @ruben.the100.ci · 18/09/2026This is very misleading. The effect size for treatment of .30 is a Cohen's d from RCTs, i.e. causal. The effect size for alliance is a Pearson's r of .30 (more like .6 expressed as d) and massively subject to confounding and reverse causation. So, this is not at all comparing like with like. 1104
Martin Plöderl @ploederl.bsky.social · 18/09/2026The role of therapeutic alliance in prescribing: "A meta-analysis of eight pharmacotherapy studies found the alliance to have an overall effect size of 0.30 across a range of psychiatric disorders, rivaling the effect sizes of many psychiatric medications"psychiatryonline.orgThe Pharmacotherapeutic Alliance: An Evidence-Based Intervention for Enhancing Psychiatric Outcomes | American Journal of PsychiatryPsychiatryOnline.org is the platform for all American Psychiatric Association Publishing journals, DSM, and bestselling textbooks, as well as APA Practice Guidelines, and continuing medical education. 122
Reposted by Martin PlöderlAmazzoneFuriosa 🦋 @amazzonefuriosa.bsky.social · 16/09/2026This rapid response is interesting: "Rather than focusing solely on how to restore supplies should the shortage prompt a broader question: why do so many healthcare professionals prescribe venlafaxine?" www.bmj.com/content/394/...bmj.comVenlafaxine shortage: commonly used antidepressant out of stock in UK until NovemberA commonly used antidepressant is likely to be unavailable in the UK until later this year. The Department of Health and Social Care has issued a tier 2 medium impact alert warning of supply shortage... 231
Martin Plöderl @ploederl.bsky.social · 16/09/2026Within 1 week, I received three notifications of online shops or nonprofit organizations that user accounts were hacked. In one instance, this potentially affected credit card details. Increase of AI-assisted hacking? 011
Martin Plöderl @ploederl.bsky.social · 16/09/2026The average patient does not exist. I agree. Therefore, we cannot use average efficacy estimates from RCTs. Here it gets tricky, because this argument can be used to dismiss the poor average efficacy. Even more so no "super-responder" have been found yet. www.sciencedirect.com/science/arti...doi.orgRedirecting 221
Martin Plöderl @ploederl.bsky.social · 15/09/2026www.psychiatrist.com/jcp/suicidal...psychiatrist.comSuicidality Emerging From Rapid Venlafaxine Discontinuation: A Challenge–Dechallenge–Rechallenge Case ReportThis case report presents a patient with no history of suicidal crisis who experienced 2 suicidal crises within 6 months, each directly following rapid discontinuation of venlafaxine. 123
Martin Plöderl @ploederl.bsky.social · 15/09/2026This is risky! Venlafaxine can cause severe withdrawal symptoms. In our case report, a patient developed suicidality after stopping venlafaxine because it was not available anymore ->bmj.comVenlafaxine shortage: commonly used antidepressant out of stock in UK until NovemberA commonly used antidepressant is likely to be unavailable in the UK until later this year. The Department of Health and Social Care has issued a tier 2 medium impact alert warning of supply shortage... 021
Martin Plöderl @ploederl.bsky.social · 15/09/2026Aus der Geschichte der Psychiatrie in Salzburg: ein Priester will seinen Job zurück, den er in der NS-Zeit verlor, mit folgendem (zeitlosen) Argument 020
Reposted by Martin PlöderlHealth Nerd @gidmk.bsky.social · 15/09/2026New piece on a great project from @matthewbjane.bsky.social looking at problematic research. Also, extremely worrisome issues in studies of exercise for depression. gidmk.substack.com/p/how-do-we-...gidmk.substack.comHow Do We Deal With Seriously Problematic Research?A new solution to a very serious issue 12910
Reposted by Martin PlöderlMad in America @mad-in-america.bsky.social · 14/09/2026Pharmaceutical Industry Corruption Is Structural, Systemic, and Profitable, New Review Finds By Richard Sears Legal scholar Marc Rodwin: Ending industry misconduct requires complete structural separation between drug money and medical decision-makers. buff.ly/mdp4Zybmadinamerica.comPharmaceutical Industry Corruption Is Structural, Systemic, and Profitable, New Review FindsA new empirical review published in the Journal of Law, Medicine & Ethics reports that pharmaceutical industry corruption is a structural, Legal scholar Marc A. Rodwin argues that ending widespread… 043
Reposted by Martin PlöderlMatthew B. Jané @matthewbjane.bsky.social · 13/09/2026I’ve been quiet on social media lately, but today I’m launching Audit Clinical Evidence (ACE), an initiative I’ve been developing over the past year. Take a look: AuditClinicalEvidence.orgauditclinicalevidence.orgACEIndependent audits of published clinical research for statistical errors, data inconsistencies, and research integrity violations. 89132
Reposted by Martin PlöderlHerr Varius @flrfnk.de · 29/04/2025Irgendwie auch nach fast 50 Jahren aktuell: Als Loriot politisch wurde: »Da gibt’s keinen linken und rechten Weg, es gibt einen richtigen Weg.« 3nach9 (1979) 07230
Reposted by Martin PlöderlWalter Keim @wkeim.bsky.social · 12/09/2026A Call for a Paradigm Shift in Schizophrenia Treatment: Reassessing Long-Term Antipsychotic Use and the Evidence for Psychosocial Interventions Long term antipsychotic treatment shows diminishing benefits, weak evidence for first episode psychosis www.madinamerica.com/2026/09/a-ca...madinamerica.comA Call for a Paradigm Shift in Schizophrenia Treatment: Reassessing Long-Term Antipsychotic Use and the Evidence for Psychosocial InterventionsThe evidence challenges the assumption that lifelong antipsychotic treatment is necessary for most individuals with schizophrenia. 023
Martin Plöderl @ploederl.bsky.social · 12/09/20261. Bergström's new book arrived. He is an expert and pioneer in the "Open Dialogue" approach. Will post some quotes during reading. 370
Martin Plöderl @ploederl.bsky.social · 12/09/2026Ever wondered why leading figures in academic medicine have such an impressive publication output? Ghostwriting! "However, a count of changes from the outline to the final draft shows that frontstage author contributions were minimal..."journals.sagepub.comSage Journals: Discover world-class researchSubscription and open access journals from Sage, the world's leading independent academic publisher. 062
Martin Plöderl @ploederl.bsky.social · 12/09/2026This ketamine study on bipolar depression reported substantial effects. Interestingly, the primary outcome was changed from 2w to 4w after start of recruitment, and one secondary outcome (MADRS suic item) was withdrawn. Unfortunately, no access to PDF jamanetwork.com/journals/jam...jamanetwork.comSerial Ketamine Infusions for Treatment-Resistant Bipolar DepressionThe Ket-BD randomized clinical trial evaluates the efficacy, safety, and tolerability of adjunctive intravenous ketamine compared with midazolam for treatment-resistant bipolar I or II depression. 275
Reposted by Martin Plöderlwomensartbluesky.bsky.social @womensartbluesky.bsky.social · 12/09/2026Cate Blanchett on a bike, 2004 by US photographer Annie Leibovitz #WomensArt #Saturday 61780202
Martin Plöderl @ploederl.bsky.social · 11/09/2026Friends from the US tell me that lithium became a popular nutritional supplement, based on the belief that it is neuroprotective and life-extending. However, it is not known what a "normal" level of lithium should be, and the literature is far from being conclusive (free access on Researchgate).link.springer.comManifestations of Lithium Deficiency in the Human Body: What is Known to Date (A Narrative Review) - Biological Trace Element ResearchLithium is a pharmacological agent with a well-established role in psychopharmacology. Interest in its “trace” doses as a potential nutrient has increased in the context of geochemical variability of ... 020
Reposted by Martin PlöderlJulia M. Rohrer @dingdingpeng.the100.ci · 11/09/2026"Remember that each patient a psychiatrist treats is effectively a single-subject prospective, open-label observational trial where the control group is the memory of every other similar patient who the psychiatrist has seen." 2384
Martin Plöderl @ploederl.bsky.social · 11/09/2026"But in my practice I see that these meds are working!" This is a good piece about the problems underlying such (common) beliefs in our field. Applies not just to psychiatrists of course (as the author points out at the end).polypharmacy.substack.comPsychiatrists as superstitious pigeonsComing to terms with small effects and large variation in treating common disorders 0237
Martin Plöderl @ploederl.bsky.social · 11/09/2026It was nice to have been invited to the 3rd Datathon of @sharectd.bsky.social in Göttingen. Again, three teams worked with Jannsen's IPD data on esketamine. Interesting results which hopefully will be published soon. 030
Reposted by Martin PlöderlThorsten Padberg @padbergthorsten.bsky.social · 10/09/2026Mit meinen großartigen Kolleg*innen sind wir die aktuell wirklich schwierigen Fragen der Psychotherapie angegangen. Es ist ein spannendes Buch geworden (erscheint Anfang 2027). 171
Reposted by Martin PlöderlThorsten Padberg @padbergthorsten.bsky.social · 10/09/2026Nothing new under the sun: "Inter−rater reliability among medical doctors was modest, indicating that diagnostic agreement between two doctors occurred in roughly 55% of cases." 1/4 www.frontiersin.org/journals/psy...frontiersin.orgFrontiers | Reliability of psychiatric diagnoses in the 21st centuryBackgroundReliable diagnosis is a cornerstone of medical practice, yet concerns about diagnostic reliability have long haunted psychiatry. In the 1970s, the ... 242
Reposted by Martin PlöderlJoar Øveraas Halvorsen @joarhalvorsen.bsky.social · 10/09/2026«Randomization and other forms of experimental control do not detach research from real-world contexts but, rather, reduce systematic error and uncertainty to better isolate causal effects.» 🎯 www.jclinepi.com/article/S089...jclinepi.comRandomized, controlled, and realThe growing use of the term “real-world evidence” (RWE) has introduced a classification of clinical research based on its perceived proximity to routine practice rather than its methodological charact... 074
Reposted by Martin PlöderlEdzard Ernst @edzard.bsky.social · 08/09/2026Medical terms about to be re-named by Trump edzardernst.com/2026/09/medi...edzardernst.comMedical terms about to be re-named by TrumpYou might have noticed: whenever Trump wants to detract the public from something embarrassing or criminal, he makes headlines by re-naming something. That seems to work quite well: for a day or two, the world is outraged by his moronic action. Yet, the public focus on the embarrassment or crime quickly returns, and Trump has 052
Reposted by Martin PlöderlEiko Fried @eikofried.bsky.social · 06/09/2026Elections in Sachsen Anhalt: rightwing extremist party AfD terrifyingly close to absolute majority, because parties <5% don't make it into parliament in Germany. If BSW were to drop to 4.9%, AfD has ~49.77% at the moment, I believe. 3102
Reposted by Martin PlöderlWolfgang Hagen @docjosiahboone.wien.rocks.ap.brid.gy · 06/09/2026Wiener Beitrag zur #Odyssee. > Penelope, angfressen Dialektgedicht von Elfriede Gerstl (1932 - 2009) #WienLiebe #odyssey 413048
Reposted by Martin PlöderlSimon Kuestenmacher @simongerman600.bsky.social · 06/09/2026Bonnet height in cars increasing is bad for pedestrians in case of accidents. This is a case of weighing consumer preferences (people like driving in big cars) and public health concerns (more dangerous for pedestrians) against each other. Interesting to see what society as a whole find acceptable. 48829
Martin Plöderl @ploederl.bsky.social · 03/09/20261. Rant: with the help of BMC Journals, the literature is flooded with potentially fraudulent ketamine/esketamine studies. I just came across this one. SMD = 3.8 on day 7, when administered during anesthesia. Absurd!link.springer.comEfficacy and safety evaluation of intravenous esketamine in alleviating perioperative depressive symptoms in Parkinson’s disease: a randomized controlled trial - BMC AnesthesiologyObjective Depressive symptoms frequently afflict individuals with Parkinson’s disease (PD). The current study was consequently conducted to determine the efficacy of low-dose intravenous esketamine in... 2166
Martin Plöderl @ploederl.bsky.social · 03/09/20261. No associations between BNDF and response to ketamine in this RCT. This contrasts the common assumption that ketamine works by increasing neuroplasticity. Authors argue that therapeutic levels have not been achieved and refer to a meta-analysis where there WAS an assoc bw BNDF and response -> BUTsciencedirect.comSerum brain-derived neurotrophic factor following oral esketamine in treatment-resistant depression: Results from a randomized placebo-controlled trialKetamine and its enantiomer esketamine are efficacious in 30–35% of the patients with treatment-resistant depression (TRD). Increased serum brain-deri… 141
Reposted by Martin PlöderlJoe Simmons @joesimmons.bsky.social · 02/09/2026Evidence of fraud in Study 1 of Ariely and Wertenbroch. We weren't necessarily expecting to interrogate this study, since the recent replication failure focused only on Study 2. But we stumbled on some evidence, which then led us to find an older version of the paper... 082
Reposted by Martin PlöderlBrent Toderian @brenttoderian.bsky.social · 01/09/2026“When mayors in other cities ask me how #Copenhagen afforded to invest in its cycling networks, I ask them how on earth they have been able to afford highway projects. We invested in bike lanes because that was the cheapest option.” What the world can learn from Copenhagen’s cycling revolution.theprogressplaybook.comCopenhagen Cycling Revolution: Lessons for CitiesClose to two-thirds of the city’s residents commute by bike to school or work every day. 16801293
Reposted by Martin PlöderlAndrew Heiss @andrew.heiss.phd · 31/08/2026Data Colada strikes again with incredible data forensics work 0224
Martin Plöderl @ploederl.bsky.social · 31/08/2026Escitalopram was not superior to placebo in people w anxiety issues. Effect size not reported but is d = -0.1 (-0.7 to 0.5). Results are at odds w common assumptions how meds work. Most studies about escitalopram and anxiety were old industry trials. Study shows we need independent replications!sciencedirect.comBrain activation and connectivity after 2–3 weeks of escitalopram administration in anxiety disorders: A randomised trialDespite the extensive use of selective serotonin reuptake inhibitors (SSRIs) for anxiety treatment worldwide, their neural mechanism of action remains… 042
Martin Plöderl @ploederl.bsky.social · 30/08/2026Antidepressant use in Germany and Austria, based on the OECD database and, for previous years in Austria, on a publication by Kapusta et al. Germany has a new record in 2024, while in Austria, rates are plateauing since a few years 031
Martin Plöderl @ploederl.bsky.social · 30/08/2026Antidepressant prescription rates in the US up to 2024, based on the Medical Expenditure Panel Survey. Even more prescriptions than in 2023 in all age groups. 240
Reposted by Martin PlöderlProf. James Davies @drjamesdaviesbskys.bsky.social · 13/08/2026My new paper on the three foundational pillars of psychotherapy, and how to organise clinical training around them. www.tandfonline.com/doi/full/10....tandfonline.comThe Three Pillars Model of psychotherapy: A new integrative framework to guide early-career clinical supervision and practiceIntegrative psychotherapy is now the most common form of psychotherapeutic practice. Yet, research shows that early-career therapists often struggle to integrate diverse theoretical models in ways ... 064
Reposted by Martin PlöderlMad in America @mad-in-america.bsky.social · 29/08/2026When Medical Science Refuses to Correct Itself By Ed Pigott, PhD & Jay Amsterdam Two decades of notification that NEJM’s STAR*D publications contain demonstrably false claims should expose the journal to legal consequences for knowingly allowing these claims to remain uncorrected. buff.ly/pC1a0Ktmadinamerica.comWhen Medical Science Refuses to Correct ItselfScience is supposed to be self-correcting. But what happens when the journals entrusted to uphold this principle become its gatekeepers? 052