RateRx is a study that surveyed thousands of US doctors about the clinical utility of medications for specified conditions. Doctors are not permitted to see other doctors' ratings and comments until they've submitted their own, although I'm not sure how they could stop me from viewing ratings as a patient, and then signing on as a doctor and submitting my own ratings. Doctors can also comment on other doctors' comments. The study is ongoing, and contributing doctors can also add ratings for new medications not already on the list.
The way you look up ratings is alphabetically, by condition:
Then you click on the number of treatments or the condition, and you'll get a dropdown list of individual drugs, with ratings and a link to reviews:
The drugs are listed from highest to lowest rated. So it turns out, Prozac is the most highly rated antidepressant, with 4.0 out of 5 stars. The lowest rated is Liothyronine or T3, with 2.2 stars.
Prozac seems to be the only SSRI on the list, which also includes, in descending number of stars:
Effexor 3.9
Wellbutrin 3.9
Remeron 3.3
Imipramine 3.0
Desipramine 3.0
Nortriptyline 3.0
Tranylcypromine 2.9
Isocarboxazid 2.8
Phenelzine 2.8
Protriptyline 2.8
Trazadone 2.7
Trimipramine 2.6
Amoxapine 2.5
Maprotiline 2.5
Chlordiazepoxide 2.2
& Amitriptyline
Liothyronine 2.2
One nice feature is that when you click on the reviews, you can see each doctor who submitted a rating, and link to his or her profile. Not everyone comments. For instance, in the case of Prozac, there were three comments up at the top, and none below. These are the comments, and all three commenters are psychiatrists:
Actually, I counted, and 23 of the 47 raters of Prozac are psychiatrists. A bunch of the others are neurologists. Then there are a few family medicine docs, as well as some internists. A couple of OB/Gyns, a pediatrician, a couple nephrologists, 1 pharmacologist, 3 clinical psychologists, and 1 labeled, "American Board of Phlebology". Personally, I'm not comfortable having people who can't prescribe or don't see patients comment on how patients respond to medications.
The drug that was most frequently rated, 103 to be exact, was desipramine. The comments were mainly about side effects. One comment I thought was useful was, "If the side effects can be tolerated, it can work. Usually, the prescribed dose is too low."
Most of the comments about Phenelzine were about dietary concerns, with some good general descriptions:
Phenelzine or Nardil is an antidepressant in the group called MAO Inhibitors. These older medications have the highest response rate, which is about 80%. They also require dietary restrictions to prevent a high blood pressire reaction to foods containing tyramine (cheese, processed meat, red wine, soy and some others). Other side effects: insomnia, dizziness.
and
Useful for atypical depression. People with atypical depression tend to feel better during enjoyable activities, have increased appetite and sleep a couple hours more each day than when not depressed, have a feeling that their arms & legs are heavy, & have an ongoing fear of rejection. Problem with this med: dangerous interactions with MULTIPLE other meds and SEVERAL foods.
So here's my assessment:
It's not a bad idea to have a large survey of doctor ratings and comments. The comments are probably more useful than the ratings, and can be very informative for patients.
It would be helpful to have more statistics listed, like how many of the raters of cardiac medications are cardiologists. I mean, it's not like I know nothing about cardiology, but I wouldn't presume to comment on how well those meds work in the clinical setting, because that's not what I do. By the way, the American Board of Phlebologist also put in his two cents about Amlodipine/HCTZ/Valsartan. I suspect he pops up in most ratings, and gets his name out there that way.
The main drawback is that the setup can be misleading. It seems like a gross oversight to have ratings for lots of MAOI's and Tricyclics, but only one SSRI. I think that would confuse a patient who is looking for advice about commonly prescribed antidepressants. I don't know if RateRx just expects doctors to add the most commonly prescribed meds, but it seems to me the people running the survey should encourage ratings of those drugs. It's not like it's hard to get prescribing information. Drug companies certainly know which meds are most popular.
So check out RateRx, and let me know what you think.
